Permit (2) CITY OF TIGARD PLUMBING PERMIT
IIII * COMMUNITY DEVELOPMENT Permit#: PLM2014-00266
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/12/2014
T t�'''�R O 9 Parcel: 25101 DB00103
Jurisdiction: Tigard
Site address: 7360 SW HUNZIKER RD 101
Project: MSP Accounting Subdivision:CONDO SUPPLEMENTAL PLAT NO.4: Lot: 22830-2
Project Description: Install new breakroom sink
Contractor: WESTERN PLUMBING Owner: HILLTOP BUSINESS CENTER LLC
9460 SW TIGARD AVE SUITE 101 HUNZIKER LLC
TIGARD,OR 97223 9430 NW KAISER RD
PORTLAND,OR 97231
PHONE: 503-639-5296 PHONE:
FAX: 503-684-9015
FEES
Quantity Description Date Amount
1 ea Sink 08/12/2014 $25.02
Specifics: 1 12%State Surcharge- 08/12/2014 $8.70
Plumbing
Type of Use COM 47 ea Minimum Fee Adjustment- 08/12/2014 $47.48
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, 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 questi•, • OUNC by calling 503.232.1987 or 1.800.332.2344.
•
Issued :y: /dif / Permittee Signatu-t: _�
%
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.
08/08/2014 13:10 5036849015 WESTERN PLUMBING INC PAGE 01/03
Plumbing Permit Applic
Building Fixtures CF1VFE 1(w it II, I I \I (1,,{ ,
City of Tigard °��r may: 4� it 14 Permit No.
IAI
13125 SW Hall Blvd.,Tigard,OR 910,16 11 2 Q'!` p�lyao r�-oaoa(Pt�o
Ill Phone: 503.718.2439 Fax 503.598.1960 Plan ' Permit
s i Inspection Line: 503.639.4175 CITY OF(IGAHU I7a<e RUBY.(/ 71 o. ` e
Internet: www.tigard-or.gov Notiffed/Merhod:0 N
-,'aVr�l�a�slyb''1' , „:is i .:"..,_. . _a .•L ,. -- -. .J.
a,`� ;
igfR at .)*.1:,l i, a .r; : ' -•'.',•. .6c• ∎...•
❑New construction ❑Demolition, .. -' "�,/r�� .Fors.-cia! ,»rwtiontee
14. checklist
Descn.;on E:i Total
Jf Additton/alteration/repleeement ❑Other: r New 1-2-family dwells (includes 100 ft.for each utility connection) ^
i '411--,',',12:-.."..t`:- r, i:3r;; -. ri- SFR(t)bath 11111. 312.70
❑ 1-and 2--family dwelling M.1 Commercial/industrial SFR(2)bath 437.78
❑Accessory building ['Multi-family
SFR(3)bath 500.32
❑Master builder Each additional bath/kitchen 25.02
d -' rt ! z Fire sprinkler( sq.ft.) Page 2 -C
t Site utilities: 1
Job site address: i , r1 j Y Catch basin or area drain 18.76
0 T 11 A j Drywall,leach line,or trench drain 18.76
City/State/ZIP; -7 1crsi)�;,,t a (� '�
�� n Footing drain(no"linear ft.: ) Page 2 J
Suite/bldg.apt.no.: Project name: Manufactured home utilities 50.03 V3
Cross street/direetions to job site; r-r.Sw A e cu,, /,, a. 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: Lot no.:
Fixture or Item:
Tax rasp/parcel no.: ) /C(1) 6 0/X0,G,: Backflow preventcr 31.27
-..iii 'n �' a." 1Y Olra5 Backwater 5 valve 12.51•
v:• t.r r19ir''''. �',,, .:.; . .i.f,,: . .±,.:: ' C washer
25,02
(,, / Dishwasher 25.02 ME
S� Rap U,►�( Lr ,SI l'i,• Drinking fountain 25,02 MI
Ejectors/sump 25.02
n 7 . 0
2.0/..?ti'�b;:a k ,w•,.. ,.. a . ..,.,.... 7 .,. "'' Expansion tank
Name: Fixture/sewer cap 25.02
- Floor drain/floor sinic/hub 25.02
Address: _
Garbage disposal _ 25.02
City/State/ZIP: _ ~ifose bib 25,02
Phon{e� (f ) Fax ( ) ~Ice maker !
K■,!..1141,441,°fit;, 1. ... ', Intt rceptOf/grease trap 2$.02
Business name: Medical gas(value,$ ) Page 2
Contact name: Primer 12.51
Roof drain(commercial) _ 12.51
Address: Sink/basin/lavatory j 25.02 ,p2
City/State/ZIP: Solar units(potable water) 62.54
---_,
Phone:( ) Fax::( ) Tub/shower/shower pen 12.51
E-mail: Urinal 25.02-
i' f• }. „ ' - .. Water closet 25.02
ti, - i Water
' heater _ 37.52
Business name:Western Plumbing,Inc. Water piping/DWV 56.29
Address:9460 SW Tigard Street,Suite 101 Other: 25.02
City/State/ZIP:Tigard,OR 9722.3 Subtotal ),O'D -
Phone:(503)639-5296 Fax:(503)684-9015 Minimum permit fee; S72.50
Plan review (25%of permit fee)
CCB Lic.:2439 Plumbing Lie.no.:3429PB State surcharge(I2%of permit fee) ^��,
Authorized signature: �/r ,/1 .i„ '-J Tv
,�/ .L���(,l TOTAL PERMIT FEE ,� )
Print name: an bate: / �`tl This permit application expires if a permit Is not obtained within 180 days
otter it Yea been accepted as complete.
"Pee methodology an by Tri-County Building Industry Service Aoard.
t\Buddb,Qtrermite\PLMU-ramliADp.doc 10/01/09 440-4616T(Io/o2/cOMATB)
08/08/2014 13:10 5036849015 WESTERN PLUMBING INC PAGE 02/03
Plumbina_Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Su. ression S stems:
Footing drain-le 100' 50.03 0 to 2 000 $121,90 v is
Footing drain-each additional 100' 37.52 M 3 001 16
to 7,200 $233.20
Sewer-1st 100' Ellin 7 01 and ..-4 „er 5327,54
Sewer-each additional 100' MI 37.52
Water Service- 10 6234 � Medical Gas S stems:
Water Service-eacac each additional 100' .., .. ;
Storm&Rain Drain-1st 100' SZIIIIMEM 51.00 to$5.000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 II= 55,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1,52 for
17- .' °. each additional$100,00 or fraction thereof,to
.14.17,,7:;',?.;: w '”: and including$1 0,000.00.
Inspection of existing plumbing or for $10,001.00 to 525,000,00 5148.50 for the first$10,000.00 and 51,54 for
which no fee is specifically indicated ■ 90,00/hr each additional$100.00 or fraction thereof,to
minimum char: -.1/2 hour)
and includi L$25 000.00.
Inspections outside of normal business 11.11 90.00/hr $25,001.00 to$50,000.00 $379.50 fm the first$25,000.00 and$1.45 fbr
hours minimum : -2 hours each additional$100.00 or fraction thereof,to
Reinspection Fees _ 90.00/hr MI and including$50,000.00.
Additional plan review for revisions IIII 90,00/hr •$50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
minimum -1/2 hour each additional$100.00 or fraction thereof
Subtotal: _�_
r..._
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures
e could result in increased sewer fees*.
4 r `41,"•7 rr ' "141`,,T4'.-, ; ' " c r',"1 r . 7 t '
1,s;-17,,,,,,v.,,
lif ""' t ��„.u7 Plan review is required for any of the following.
'� �. ..-�..• «� i;,. y� ,ron.lia S .,rn�rwe'.�• ,s a, :;v_.;. Please check all that a l
Baptistry/Font pP y
Bath -Tub/Shower ❑ Any new commercial building with waterr service 2"and
-Jacuzzi/whirlpool
greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thtu ❑ 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.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
•3"
-4" ;
Car Wash Drain :',-.`,011.:-..
Garbage Domestio-non-food � ■ isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the .ualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refiig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav •Non-tbod related i
-Bradley
•Commercial-food related
-Service
wasmh�mmc� Filter *Note: If the fixture work under this permit results in an
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_hall/departments/cd/docs/PLMF-PermitApp2doe