Permit CITY OF TIGARD PLUMBING PERMIT
111 COMMUNITY DEVELOPMENT Permit#: PLM2014-00184
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/05/2014
Parcel: 2S112DA00300
Jurisdiction: Tigard
Site address: 15230 SW SEQUOIA PKWY 120
Project: Big Town Hero Subdivision: PACIFIC CORPORATE CENTER Lot: PTS 6-7
Project Description: Relocating(1)2"floor drain,(1)ice machine,(1)utility sink,and installing(1)backflow preventer.
Contractor: CLASSIC PLUMBING LLC Owner: PACIFIC REALTY ASSOCIATES
521 S BALINE ST ATTN: N PIVEN
NEWBERG,OR 97132 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-554-1605 PHONE:
FAX: 503-538-8570
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 06/05/2014 $31.27
Specifics: 1 ea Floor Drain/Floor Sink/Hub 06/05/2014 $25.02
1 ea Ice Maker 06/05/2014 $12.51
Type of Use: COM 1 ea Sink 06/05/2014 $25.02
Class of Work: ALT 1 12%State Surcharge- 06/05/2014 $11.26
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $105.08
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 Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 . :' .2344.
Issued By: Perm =- -•• ature:
drkip
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 FOR OFFICE 1 .E: ONI.I
City of Tigard %\ Received
74 ll :ti Date/By: to J /`1 on- Permit No.: /)�V� l.�jil_ LA::t._s• 13125 SW Hall Blvd.,Tigard,OR 97223 Y OfIJ y
i Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 �1 011t Date/By: Other Permit No.: 0040070)if-w) 3
Inspection Line: 503.639.4175 t--
Date Ready/By: Juris: ® See Page'2for
TI G A K D Internet: www.tigard-or.gov -, Notified/Method: Supplemental Information
TYPE OF W I ,,,a (Sr`td'1 0.c)„1\' _ FEE* SCHEDULE
❑New construction ❑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 ®Commercial/industrial SFR(2)bath 437.78
12 Accessory building SFR(3)bath 500.32
g ❑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:15230 Sequoia Pkwy Catch basin or area drain 18.76
City/State/ZIP:Portland OR 97224 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: 120 I Project name:Big Town Hero 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 1 31.27 31.27
DESCRIPTION OF WORK Backwater valve 0 12.51
Clothes washer 25.02
Dishwasher 25.02
Re locate hand sink Drinking fountain 25.02
Relocate drain and floor sink for soda fountian and ice machine Ejectors/sump 25.02
❑ PROPERTY OWNER I ® TENANT Expansion tank 12.51
Name:JDH Inc Fixture/sewer cap 25.02
Floor drain/floor sink/hub xI 25.02 --5004- h
Address:15230 Sequoia Pkwy Garbage disposal 25.02
City/State/ZIP:Portland,OR 97224 Hose bib 25.02
Phone:(503)891-9109 Fax:(503)691-9953 Ice maker 1 12.51 12.51
® APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name:Big Town Hero-Sequoia Medical gas(value:$ ) Page 2
Contact name:Jon Hoevet Primer 12.51
Roof drain(commercial) 12.51
Address:23%Fernwood Circle Sink/basin/lavatory 1 25.02 As'-(:61
City/State/ZIP:Lake Oswego,OR 97034 Solar units(potable water) 62.54
Phone:(503)891-9109 Fax::(503)691-9953 Tub/shower/shower pan 12.51
E-mail:jonhoevet @comcast.net Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name:Classic Plumbing LLC Water Pip Pf 1 in DWV 56.29
Address:521 S.Blaine Street Other: 25.02
City/State/ZIP:Newberg,OR 97132-3307 Subtotal eta .g--
Phone:(503-)554-1605 Fax:(503)538-8570 Minimum permit fee: $72.50
CCB Lic.:193736 Plumbing Lic.no.:PB1016 Plan review (25%of permit fee)
State surcharge(12%of permit fee) // t 16
Authorized signature: TOTAL PERMIT FEE ii 105,,V 1
Print name: /ice zl L b Q 1 I Date:6/3/14 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-PermitApp.doe 10/01/09 440-4616T(l 0/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Pagel - 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 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
Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
Other Inspections or Fees 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/ Plan review is any required for of the following.Performed: Capped Added Relocate q y ow g
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 mm ❑ 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 ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040.
,ye Wash - -
Floor Drain/sink -2" _ 1 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 1
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station _
Shower -Gang
-Stall
Sink/Lav -Non-food related 1
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-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/city_hal l/departments/cd/docs/PLMF-PermitApp2doc
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
15230 SW SEQUOIA PKWY 120, TIGARD, OR,
97224
Commercial - Plumbing
399 Plumbing final
FAIL
PLM2014-00184
George Heimos
1. Provide RP backflow test results. 603.3.3
All else ok
Lb 1844. Classicplg@hotmail.com
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
15230 SW SEQUOIA PKWY 120, TIGARD, OR,
97224
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2014-00184
George Heimos
Soda fountain. 1/2" watts model 009QT, serial no. 14157300
Violation Summary:
Inspector Contractor