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Permit CITY OF TIGARD PLUMBING PERMIT 14 44 ■ COMMUNITY DEVELOPMENT Permit#: PLM2014-00155 Tigard OR 97223 503.718.2439 13125 SW Hall Blvd.,Ti Date Issued: 06/02/2014 t� TtAR)� g Parcel: 1 S133AD02200 Jurisdiction: Tigard Site address: 10730 SW 130TH AVE Project: Westgate Baptist Church Subdivision: CHAPARRAL Lot: 1 Project Description: ADD(1)drinking fountain,(2)2"floor drains,(1)break room sink,(4)lays,(1)service sink,(2)urinals.(4)water closets and(1)eye wash for 2nd story TI to complete classrooms,youth room,office and(2)restrooms. Permit for rough-in only for drains/water for science lab-all fixtures will be set under a separate permit. Contractor: SHARPE PLUMBING Owner: WESTGATE BAPTIST CHURCH PO BOX 23984 12930 SW SCHOLLS FERRY RD TIGARD, OR 97281 TIGARD, OR 97223 PHONE: 503-524-3500 HONE: 503-459-1485 FAX: 503-400-6714 FEES Quantity Description Date Amount 1 ea Drinking Fountain 06/02/2014 $25.02 Specifics: 2 ea Floor Drain/Floor Sink/Hub 06/02/2014 $50.04 2 ea Sink 06/02/2014 $50.04 Type of Use: 4 ea Lavatories 06/02/2014 $100.08 Class of Work: 2 ea Urinal 06/02/2014 $50.04 Type of Const: 4 ea Water Closet 06/02/2014 $100.08 Occupancy Grp: 1 Misc Other Fee 06/02/2014 $1.00 Stories: 1 12%State Surcharge- 06/02/2014 $45.16 Plumbing Total $421.46 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 or 1.800.332.2344. • Issued By: / Perm ittee Signature: )gt P14 12‘ 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. W. Plumbing Permit Application RECEIVE. Building Fixtures FOR OFFICE USE ONLY City of Tigard Received / h' g MAY 1 2014 Date/By: s/iz /y emit NoA-,y.2oiy D o ism III =• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598.196^ l DateBy: Other Permit N6 /Q�jy ow9/6 T 1 G A K D Inspection Line: 503.639.4175 , ITY OF TIGAR I Date Ready/By Juris 65 See Page 2 for Internet s S s.tigard-or.gov . Notified/Method Supplemental Information TYPE OF WORK FEE* SCHEDULE New construction ❑ Demolition For special information use checklist. Description I Qty. I Ea. I Total % ❑Addition/alteration/replacement ❑Other: New I-2-family dwellings(includes 100 ft.for each utility connection) 4 CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 El 1-and 2-family dwelling ommercial/industrial SFR(2)bath 437.78 El Accessory building Multi-family SFR(3)bath 500.32 ❑Multi-famil Each additional bath/kitchen 25.02 ❑ Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: d 1 �h Catch basin or area drain 18.76 Job site address: J sw /0 City/State/ZIP: �' J LZ3 Drywell,leach line,or trench drain 18.76 l /�) 0 97 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: Project name: �15,5 Tra_A-r-E Manufactured home utilities 50.03 Cross street/directions to job site: SG(40(.(s 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 Clothes washer 25.02 ZND STv+Z,/ 'TT / IQ cs 1' ,oamS C.C ASS(20awrNS Dishwasher 25.02 dF .tC,ES ) CSC C LU tMMMCG SCt rive.e LA Q Drinking fountain / 25.02 ES I FIT , YI N)� pp,l,Et- 1 ht WA-LL 5.Ejectors/sump 25.02 PROPERTY OWNER 0 TENANT Expansion tank 12.51 Name: / ��r�A,� !1 Are r,' Fixture/sewer cap 25.02 U `S r Cti v1cµ (Floor drain loor sink/hub 2 25.02 Address: /Z9 30 St,J $C:I1OU.S F.,YZ2y rN T,azbage disposal 25.02 City/State/ZIP:-r I6_ptezi,, oa E qr 7?2 3 Hose bib 25.02 Phone:(503) S 2 yySnir Fax:( ) Ice maker 12.51 APPLICANT CONTACT PERSON Interceptor/grease trap 25.02 Medical gas(value:$ ) Page 2 Business name: 8 u n2v`► r;gr/U S i7C tridok) a-r rC Primer 12.51 Contact name: R�� "hU flD U oof drain(commercial) 12.51 Address: ///6S- S-&.1 L YIUN S `SS nk/basin/lavato C�� 25.02 ry�y) se-/244 6 City/State/ZIP: `‘ma p 626.- Solar units(potable water) 62.54 Phone:(Sc 3) 5 7 Z 7 39 z Fax::( ) Tub/shower/shower pan 12.51 6 p 4 6- A 6 Urinal 25.02 E-mail: Cti VI-roe. God Water closet y 25.02 CONTRACTOR Water heater 37.52 Business name: Sharpe. 91 wnbt(1�j Water piping/DWV 56.29 Address: PO Go* 239 $Li J Other: dye 1,44-1.4 I 25.02 City/State/ZIP: -T\ p ard , OR t g l 2 g I Subtotal /Phone:(.S03) L9 - I Li$S Fax:(50 3) Li,k0 _(pi 1, t/1/i Minimum permit fee: $72.50 CCB Lic.: 1 2 g 9 g 'yp/�s Plumbing Lic.no.: SIC 3 J P y/1 Plan review (25%of permit fee) a6 r3J� u St ate surcharge(12%of permit fee) Authorized signature: / TOTAL PERMIT FEE 702/ 76-. Print name: 14E-vim r 5 H(+2 P c Date: o.c f D 81/N 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:1Building\Permits\PLMU-PermitApp.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-I" 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 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 Replied Plan review is required for of the following. Work Performed: Capped Added Relocate q any 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 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 ❑ Any multipurpose fire sprinkler system. Drinking Fountain 1 ✓ ❑ Any complex structure as defined in OAR918-780-0040. Eye Wash 1 Floor Drain/sink -2" ,t. ✓ Submit 2 sets of plans with any of the above. -3,, -4" Car Wash Drain Isometric or Riser Diagram 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 lee 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 ANnf OD I / Swimming Pool Filter *Note: If the fixture work under this ermit results in an Washer-Clothes p 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 1 V plumbing permit can be issued. Other Fixtures: C:\Users\BDutton.WBCINTRA\Downloads\PLMF-PermitApp(5).doc 2 N ___. . Accumulative Sewer Tally Tenant Name:Westgate Baptist Church SWR# 2014-00046 r i i.�� Site Address: 10730 SW 130th Ave PLM# 2014-00155 Parcel#: 1S133AD02200 Fixture Value Previous Previous Credits Capped Fixture Fixture New New # value count capped#s value count added# added value total#s total values Baptisery/Font 4 0 0 0 0 0 Bath: -Tub/Shower 4 0 0 0 0 0 -Jacuzzi/Whirlpool 4 0 0 0 0 0 Car Wash: -Each Stall 6 0 0 0 0 0 -Drive through 16 0 0 0 0 0 Cuspidor/Water Aspirator 1 0 0 0 0 0 Dishwasher. -Commercial. 4 0 0 0 0 0 -Domestic 2 0 0 0 0 0 Drinking Fountain 1 0 0 1 1 1 1 Eye Wash 1 0 0 1 1 1 1 Floor Drain/Sink: -2 inch 2 0 0 2 4 2 4 -3 inch 5 0 0 0 0 0 -4 inch 6 0 0 0 0 0 -Car Wash 6 0 0 0 0 0 Garbage Disposal: -Domestic(to 3/4 HP) 16 0 0 0 0 0 -Commercial(to 5 HP) 32 0 0 0 0 0 -Industrial(over 5 HP) 42 0 0 0 0 0 Ice Machine/Refrigerator Drain 1 0 0 0 0 0 Living Unit 16 0 0 0 0 0 Oil Sep(Gas Station) 6 0 0 0 0 0 Rec.Vehicle Dump station 16 0 0 0 0 0 Shower: -Gang(per head) 1 0 0 0 0 0 -Stall 2 0 0 0 0 0 Sink -Lav/l3ar-Non-Food Related 2 0 0 6 12 6 12 -Bradley 5 0 0 0 0 0 -Com/Serv/Util-Food Related 3 0 0 0 0 0 Swimming Pool Filter 1 0 0 0 0 0 Washer-Clothes 6 0 0 0 0 0 Water Extractor 6 0 0 0 0 0 Water Closet-Toilet 6 0 0 4 24 4 24 Urinal 6 0 0 2 12 2 12 Previous EDU Count 0 0 Capped EDU Credit 0 TOTALS 0 0 0 0 16 4 16 54 Current Fixture Value 54 divided by 16= 3.375 Current EDU 1 EDU= S4,800.00 Previous Fixture Value 0 divided by 16= 0.000 Previous EDU Change 54 divided by 16= 3.375 over (under) $ 16,224.00 Enter EDU Change Here 3.380 Notes: Authorized Name/Signature: Dianna I lowse Date: 5/12/2014 Building Division Note: The property owner shall retain the ORIGINAL sewer tally record. If credits exist,this document will serve as a voucher which must be submitted to the City of Tigard Building Division to redeem credits towards future system development charges. I:\Building\Sewer Tally\SewerTallySheet_4800._070113.xlsx 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 10730 SW 130TH AVE, TIGARD, OR, 97223 Commercial - Plumbing 399 Plumbing ﬁnal PASS - No C of O PLM2014-00155 George Heimos ALL FIXTURES noted on inspection dated 12/16/14 installed and pass ﬁnal inspection NOTE: ROUGH installation of ﬁve acid waste sinks roughed in with trap arm San tee stalled for sinks dated 06/10/14, no drainage cap offs required on drainage piping. No water piping for acid waste sinks completed at this time. 1. New Permit required for completion of acid waste sinks. Violation Summary: Inspector Contractor