Permit CITY OF TIGARD PLUMBING PERMIT
• COMMUNITY DEVELOPMENT Permit#: PLM2014-00012
Date Issued: 01/16/2014
TIGARD 13125 SW Hall Blvd..Tigard OR 97223 503.718.2439 parcel: 1S126BC01506
Jurisdiction: TIGARD
Site address: 9020 SW WASHINGTON SQUARE RD 250
Project: LoanStar Home Lending Subdivision:CONDO,THE SUPPLEMENTAL PLAT Lot: 25-4
Project Description: Add'.(1)sink.(1)dishwasher. (1)hub drain.(1)primer,(1)expansion tank&(1)water heater
Contractor: GRIDLINE PLUMBING Owner: WISCO REAL ESTATE EQUITY FUND I
4343 SE 37TH 1501 SW TAYLOR ST STE 100
PORTLAND, OR 97202 PORTLAND, OR 97205
PHONE 503-771-8790 PHONE.
FAX
FEES
Quantity Description Date Amount
1 ea Dishwasher 01/15/2014 $25 02
Specifics: 1 ea Expansion Tank 01/15/2014 $12 51
1 ea Floor Drain/Floor Sink/Hub 01/15/2014 $25.02
Type of Use: COM 1 ea Primer 01/15/2014 $12 51
Class of Work: ALT 1 ea Sink 01/15/2014 $25.02
Type of Const: 1 ea Water Healer 01/15/2014 $37.52
Occupancy Grp: 1 12%State Surcharge- 01/15/2014 $16.51
Stories: Plumbing
Total 5154
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code. State of OR Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of
issuance. or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility • a ion . Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or di •ct questions to OUN • calling 503.232.1987 or 1.800.332.2344. C�
Is ed By: /� `/ Permittee Signatu
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application
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Building Fixtures
ivED I ttk: t;rrICE USE 0N1.I
City of Tigard nau s 1 lififiltiffll=I . .f --eve J
NI13125 SW Hall Blvd.,Tigard,0 1 5 2Q14 Plan Review
■ Phone: 503.718.2439 Fax: 503.598 may_ Other Permit No.:liz p.Cj f y-oar
Inspection Line: 503.639.4175
1IGARD Date R 9 B y cur r 0 Ste Page 2 for
Internet: www.tigard-or.gov O [,BARD Notified/Method: Supplemental Information
TYPE OF (4 tSlCW1 FEE* SCHEDULE
3 El New construction Demolition For special information use checklist
Description Qty. I Ea. I Total
n/alterationheplacement ❑Other: New 1-2-family dwellings(includes 10011.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
I-and 2-family dwelling C.ommercia1/industrial SFR(2)bath 437.78 "b
SFR(3)bads 500.32
❑
PD Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler( sq.ft) Page 2
X.
4 JOB SITE INFORMATION AND LOCATI N Site utilities: I
1
of � C ,/^ ,+� J sq, , 7p Catch basin or area drain 18.76
Job site address: ! c/ !,/ /V /�
�' ) Drywell,leach line,or trench drain 18.76
ity/State/ZIP: I , 01-, Q/c 9 4,
/ Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.:�50 I Project name: 5 Y/ Manufactured home utilities 50.03
Cross street/directions to job site: `! Manholes 18.76
1 /(1/�- s 9 / Rain drain connector 18.76
ry Y r �c�� / Sanitary sewer(no.linear IL: Page 2
// Storm sewer(no.linear fl.: ) Page 2
Water service(no.linear fl.: ) Page 2 47::-/'
Subdivision: Lot no.: Fixture or item:
.i Tax map/parcel no.: Baekflow preventer 31 7
DESCRIPTION OF WORK Backwater valve 1151
4,, Clothes washer 25.02
- 4/ ` /� - c Dishwasher
,,e7 25.0215.0,2
�l - )
/'� �f� � D xp/� /-/„.)-4/1/ 'liking fountain 25.02
f - r I yvi€1.--- / f/ /f/' ctors/sump 25.02
. ❑ PROPERTY OVY I ❑ TENANT
`Expansion tank X/ 12.51 / .,/
Name: Fixture/sewer cap 25.02
Floor drain/floor silt/hub --$7 25.02 ,0,:72-
Address:
Garbage disposal 25.02
tiCity/State/ZIP: Hose bib 25.02
, Phone:( ) Fax:( ) Ice maker 12.51
❑ APPuciIJrr ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name:
Medical gas(value:S ) Page 2
Primer 12.51 , "7
Contact name:
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory X. / 25.02 ��
-'''N- City/State/ZIP: Solar units(potable water) I 62.54
62 Phone:( ) I Fax::( ) Tub/shower/shower pan l 12.51
JJJ iril: Urinal 25.02
Water closet 25.02
CONTRACTOR )/ 5�--
j J Water heater 37.52
i
ess name: -sue/ p7r , � ////ryL h//? CT Water piping/DWV 56.29
ess: ¢3 / Q�,� ' Other: 25.02
State/ZIP: /ia , g i- �02_ Subtotal /37,4P
e: ) - , J Fax:( y7/_ Q3 Minimum permit fee: $72.50 �-•
"a- CCB Lic.: D , Plumbing Lic.no. / [J�fi Plan review (25%of permit fee) �r' r
` �/ _ / State surcharge(12%of permit fee) ge.5
`.) Authorized signature:,/. -._ / TOTAL PERMIT FEE
Print name: ,�j / Date: / / This permit application expires if a permit is not obtained within 180 days
�/( � �C��t I ! / ) after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
t:\Building%PermiuwuNU-PermitApp.doc 10ro1ro9 440-4616T(to102/COM1WEB)
Plumbing Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qtr. Fee(ea) Total Square Footage: Permit Fee:
Footing drain-Ia 100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3.600 $169.69
3,601 to 7,200 5233.20
Sewer-1st 100' 62.54
7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-Ist 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52 Valuation: Permit Fee:
Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 55,011.00 to 510,000.00 $72.50 for the first 55,000.00 and 51.52 for
Other Inspections or Fees -1 `` Fee(a} Total each additional$100.00 or fraction thereof,to
l and including$10,000.00.
Inspection of existing plumbing or for 510,001.00 to 525,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no fee Is specifically indicated 90.00/1rr each additional$100.00 or fraction thereof,to
(minimum charge-1/2 hour) and including$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr _ _ and including$50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
(minimum charge-1/2 hour) _ each additional$100.00 or fraction thereof.
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*. Plan Review for Plumbing Installations
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work performed: Capped Added Relocate ❑ Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
-Jacuzzi/Whirlpool engineer.
El Car Wash: -Each Stall New exterior plumbing site utilities for any complex structure
-Drive Stall as defined in OAR918-780-0040.
Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher: -Commercial 111 Any multipurpose fire sprinkler system.
-Domestic ❑ Any complex structure as defined in OAR918-750-1040.
Drinking Fountain Submit 2 sets of plans with any of the above.
Eye Wash p Y
Floor Drain/sink: -2"
3" t Isometric or Riser Diagram
"4" ❑ Isometric or riser diagram is required for new buildings
-Car Wash Drain that meet the qualifications above.
Garbage -Domestic non-food
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
Ice Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -Lav/Bar non-food related
-Bradley
-Cont/Serv/Util food related
- via *Note: If the fixture work under this permit results in an
Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and
Washer-Clothes fees assessed for the sewer increase must be paid before the
Water Extractor
WaterCloser-Toilet plumbing permit can be issued.
-Urinal
Other Fixtures:
1:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9020 SW WASHINGTON SQUARE RD 250,
TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
2014-02-20 00:00:00
PLM2014-00012
PASS - No C of O
Nice job
Violation Summary:
Inspector Contractor