Permit 4 CITY OF TIGARD • PLUMBING PERMIT
•
COMMUNITY DEVELOPMENT Ra Permit#: PLM2014-00110
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 �� Date Issued: 04/14/2014
Parcel: 1S136AD04001
Jurisdiction: Tigard
Site address: 11539 SW PACIFIC HWY
Project: Burger King Subdivision: VILLA RIDGE Lot: 7
Project Description: Replace 40'of 3"waste pipe.4/24/14 r-.rinted •ermit to add additional waster line re.lacement,re•lacement of
(6)floor drains and(7)hub drains. Repair of primer lines not required to be permitted per building official.
Contractor: COMMERCIAL PLUMBING SERVICE Owner: PACIFIC TERRACE COMMERCIAL LLC
21185 NW EVERGREEN PKWY SUITE 105 BY SMITH, EDITA M
HILLSBORO, OR 97124 833 NW 170TH DR
BEAVERTON, OR 97006
PHONE: 503-439-9999 PHONE:
FAX: 503-439-1999
FEES
Quantity Description Date Amount
13 ea Floor Drain/Floor Sink/Hub 04/24/2014 $325.26
Specifics: 1 ea Water Piping/DWV 04/24/2014 $56.29
1 12%State Surcharge- 04/24/2014 $45.79
Type of Use: SF Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $427.34
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 Noti '• ion Cen - . Those r es are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direc •uestions to OUNC b ng 5 3.232.1987 or 1.800.332.2344.
c \ i
Issu By:
z' Permittee Signature: I \ .� ��;`�• _t11,��mi.
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
Building Fixtures RECEIVED I OR OFFICF. USE ONLYCity of Tigard Received a d, y ' f Permit No.: j T
711 • 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: 1 ' /�CJ
■ 4 2014 Plan Review Other Permit No.:
Phone: 503.718.2439 Fax: 503.598.19 R 2 Date/By:
Inspection Line: 503.639.4175 Date Read B rnr s:
I I c It I Internet: www.ti ardor. ov CITY OF 1 f GARS Ready/By:
S See Page 2 Information
g g Notified/Method: Supplemental
TYPE OF WO WIQINGMINION FEE* SCHEDULE
❑New construction El Demolition For special information use checklist.
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ 1-and 2-family dwelling El Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building El Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 11 5 3 J 6.4_0 p,4_, x
C. /a,y Catch basin or area drain 18.76
City/State/ZIP: t" Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name: Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Q- /� Clothes washer 25.02
�^� � � `�^�• 1�-� ��-�i Dishwasher 25.02
Cv, o ,q�, Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name: Fixture/sewer cap 7-1496_Fl>, 25.02
Floor drain/floor sink/hub /3 25.02
Address: Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name:
Medi 1 g alue:$ ) Page 2
Pri 12.51
Contact name: Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
CONTRALTO Water closet 25.02
Water heater 37.52
Business name: �Gq?�t ryl,, ` �6 � � �rt�l Water piping/DWV 56.29
Address: M+. ea+y�•�C." 5 e"r"--$ T-01-T C.1, Other: 25.02
City/State/ZIP: Subtotal
Phone:( ) Fax:( ) Minimum permit fee: $72.50
CCB Lic.: Plumbing Lic.no.: Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: _ _ j TOTAL PERMIT FEE
Print name: 1/ T�'n Q i L e�� Date: (� Z Li 1�,( This permit application expires if a permit is not obtained within 180 days
/` ( after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Pennits\PLMU-PennitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee:
Footing drain-1S`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 $233.20
Sewer-1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 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 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
p and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr 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
Baptistry/Font ❑ Any new commercial building with water service 2"and
greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
-Jacuzzi/Whirlpool engineer.
El CCar Wash: Each Stall New exterior plumbing site utilities for any complex structure
Drive tall
_ as defined in OAR918-780-0040.
Cuspidor/Water Aspirator 1:1 Medical gas and vacuum systems for health care facilities.
Dishwasher Commercial El Any multipurpose fire sprinkler system.
Domestic ❑ Any complex structure as defined in OAR918-780-0040.
Drinking Fountain
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink: -2"
3" Isometric or Riser Diagram
4 ❑ Isometric or riser diagram is required for new buildings
-Car Wash Drain
Garbage Domestic non-food that meet the qualifications above.
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
-Com/Serv/Util food related
-Service *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
WaterCloset-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2014-00110
T t G A R O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/14/2014
Parcel: 1 S136AD04001
Jurisdiction: Tigard
Site address: 11539 SW PACIFIC HWY
Project: Burger King Subdivision: VILLA RIDGE Lot: 7
Project Description: Replace 40'of 3"waste pipe.
Contractor: COMMERCIAL PLUMBING SERVICE Owner: PACIFIC TERRACE COMMERCIAL LLC
21185 NW EVERGREEN PKWY SUITE 105 BY SMITH, EDITA M
HILLSBORO, OR 97124 833 NW 170TH DR
BEAVERTON, OR 97006
PHONE: 503-439-9999 PHONE:
FAX: 503-439-1999
FEES
Quantity Description Date Amount
1 ea Water Piping/DWV 04/14/2014 $56.29
Specifics: 1 12%State Surcharge- 04/14/2014 $8.70
Plumbing
Type of Use: SF 16 ea Minimum Fee Adjustment- 04/14/2014 $16.21
Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, . • ork is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utili 1otification ter. Those rules are set forth in OAR 952-001-0010 through OAR 952 1-0090. You may obtain a copy of the rules
or.erect questions to 0 •C • .If•g 503.232.1987 or 1.800.332.2344.
Issued By: / Permittee Signature: x '
��1✓� �� G ' Imo/
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion • the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Applicatio
Site Utilities RECEIVED FOR OFFICE USE ONLY
City of Tigard Received Permit No
MI
• 13125 SW Hall Blvd.,Tigard,t1e1°';2�3 4 20 4 Date/By: N /e/( f Li49c i t� //0
tT Plan Review Other Permit No.:
Phone: 503.718.2439 Fax: 1 8. 960
Date/By:
T IGARD Inspection Line: 503.639.4175_CITY OF TIGARD Ready/By: Page Date Read B Jur�s 0 See Pa e 2 for
Internet: www.tigard-or.go 1►[[� Notified/Method: Supplemental Information
TYP$uI' Ili DIVISION FEE* SCHEDULE
❑New construction 0 Demolition For special information use checklist
Description I Qty. I Ea. I Total
12 dition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ 1-and 2-family dwelling Emmercial/industrial SFR(2)bath 437.78
❑Accessory building SFR(3)bath 500.32
❑ Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION D LOCATION Site utilities:
Job site address: + Catch basin or area drain 18.76
``�� (�Pic ��� Drywell,leach line,or trench drain 18.76
City/State/ZIP: 1 1 Cyp,2___CN-, 012..._ c;\1 a.,,�
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name: c1)112c, i6,41C Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76 ci
Sanitary sewer(no.linear ft. ribr Page 2 65t-
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
� / \ Clothes washer 25.02
E � 461 °P -_3tl L) , �t�1:5 Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib • 25.02
Phone:( ) Fax:( ) Ice maker 12.51
airrPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name: �M>I�Q�;Ifa(, 1►1�►1��r S /IG�S
Medical gas(value:$ ) Page 2
Contact name: A •Q - C7 p62.'Z� Primer 12.51
Roof drain(commercial) 12.51
Address: 02_1 (,J Erigka , Sink/basin/lavatory 25.02
City/State 41-1_,44/ZI41-1_,44 20,26 DE_ ',1 I `-i Solar units(potable water) 62.54
Phone:450) 9•--di'I't f Fax: :64. ) /r l-. rift I Tub/shower/shower pan 12.51
E-mail: Q(_ -- ,Q,/iieS, 3 s a Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name:COM/ CiA.C- .2.Ctnn%AIG SEQV/Ge..S Waterheater/DWV / 56.29 'j 4 Address: p2,�/& a d0,4(. •/7i•e Other: 25.02
City/State/ZIP: /445 62 t'.2, Subtotal •-�'�
Phone:603) l_1/11 Fax:A3 ) 13q./1 i 1 Minimum permit fee: $72.50 Zz,So
Plan review (25%of permit fee)
CCB Lic.: * ,. (o Q/,S Plumbing Lic.no.: State surcharge(12%of permit fee) qq� •
Authorized s ? /ure: TOTAL PERMIT FEE g i•0"'
I
Print name: I Date:41 /41 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I\Building\Permits\PLMU-Permit App...- 0/01/P• 440-46I6T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee:
Footing drain-1 100' 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 $233.20
Sewer- 1st 100' 62.54 415`1 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52
Storm&Rain Drain-1st 100' 62.54 Valuation: Permit Fee:
$1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Other ec
Ins tions or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
Inspections and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr 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*.
Quantity by Fixture Type Plan Review for Plumbing Installations
Fixture Type for Replace/
Work Performed: Capped Added Relocate Plan review is required for any of the following.
Baptistry/Font Please check all that apply.
Bath -Tub/Shower ❑ Any new commercial building with water service 2"and
-Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic El Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
-3"
Isometric or Riser Diagram
Car Wash Drain
Garbage Domestic-non-food ❑ Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter
Washer-Clothes *Note: If the fixture work under this permit results in an
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
WaterCloset-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
http://www.tigard-or.gov/c ity_hal 1/departments/cd/docs/PLM U-Perm itAp2 doc
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
11539 SW PACIFIC HWY, TIGARD, OR, 97223
Commercial - Plumbing
305 Plumbing underslab
2014-04-16 00:00:00
PLM2014-00110
FAIL
NOTE This is a under slab inspection/consultation for re-plumbing the greasey waste
lines, thru-out.
1. Provide fixture count for additional fixtures to be added to existing permit.
2. Provide drawing of proposed plumbing layout for changes to greasey waste plumbing
showing: type of fixtures, size of venting/drainage piping, and length of runs. Submit to
G. Heimos at City of Tigard Plumbing Department, 13125 SW Hall Blvd. Ph
503-367-7118 mobile
dispatch@cps-services.biz
Violation Summary:
Inspector Contractor