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Permit CITY OF TIGARD • I PLUMBING PERMIT r r q COMMUNITY DEVELOPMENT ©AMIE Permit#: PLM2014-00360 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/03/2014 Parcel: 1 S 135BD00300 Jurisdiction: TIGARD Site address: 9735 SW SHADY LN 307 Project: Dr.Weinberg Subdivision: ASHBROOK FARM Lot: 5 Project Description: Interior plumbing:Relocating(3)existing sinks and(1)water heater.11/5/14,addinq(1)sink&(1)hub drain (existing,being relocated/. Contractor: CASCADE PLUMBING CO Owner: MCFADDEN,ARTHUR L 2416 N HAYDEN ISLAND DR BY SKLARZ, ERIC PORTLAND, OR 97217 621 SW MORRISON ST, STE 800 PORTLAND, OR 97205 PHONE: 503-289-7095 PHONE: FAX: 503-283-9514 FEES Quantity Description Date Amount 1 ea Floor Drain/Floor Sink/Hub 11/18/2014 $25.02 Specifics: 4 ea Sink 11/18/2014 $100.08 1 ea Water Heater 11/03/2014 $37.52 Type of Use: COM 1 12%State Surcharge- 11/18/2014 $19.51 Class of Work: ALT Plumbing Type of Const: Occupancy Grp: Stories: Total $182.13 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 Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules o erect questions to 6 NC • calling 503.232.1987 or 1.800.332.2344. Issued By: y: / f Permittee Si.Sig ature: col 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. riumpllIpert ppTitt A licat' • 'Building Fixtures FOR OFFICE. USE ONLY .... City of Tigard FiEcw FD Received IluctI3v. r/0/4 :142 1"nil N'''' tif,e/ -^003&10 Ns Li t2S SW I lull IiIvd„Tiprd.0 III Plan Revie% : PhOne: 503.7114,2.134 I'm' 503 598ttitt 4 2014 Olher Permit No.. Diltc/By. TIGARD ,InNpuCtion Line 50.639.4 I 75 Onic Rendv/bv. Juni 0 See Pip 2 for interviet: WWW.t igard-or.gov ir, ikftramiliiriecume.h-od. sup,il.,,,,,,,,,,r.r...„„ ...._ TYPE OF Olt ' I INV • FEE SCHEDULE ,,... U Ne■%construction Aim) For.vpr-cial inforntrue,n use thralls,. - - ,Description 1 gly. 1 Ca. 1 Total El A dd ill on/alterat Main:pi acen tem 0 Other: New I.2-family dwellings(includes 100 11 for each ant itv connection) - ---- CATECORV OF CONSTRUCTION SFR(1)bath 312 70 . -- ..... -.. . - •• 0 I-and 2-tamily dwelling 0 Commercial/industrial SFR(2)bath 437.7/1 " _ , - _ SFR(1)bath 500.32 0 Accessor2:building 0 Multi-family . --- -•• - Each additional bath/kitchen 25 02 0 Master builder 0 Other: — 1-'in:sprinkler( sq.ft.) Page 2 JOB,SITE INFORMATION AND LOCATION Site utilities; .. . . ._ ....., Joh site address.9735 SW SHADY LANE Catch bas —in or area drain III .- Dry well,leach line.or trench drain 18.76 City/Statc/ZIP:TIGARD,OR — Footing drain(no,linear R.: ) Pas 2 Suite/bldg./apt, to 307 Project name:DR WEINBERG Manufactured home or nines 50,03 -- Cross street/directions to job site: Manholes I 8.76 -- - - •••• Rain drain connector 18.76 ... •-- Sanitary sewer(no.linear IL: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 . water service(no,linear 0.: ) Page 2 lot no.: Fixture or,iteni: 1 Subdivision: ... - . Backnow prevciiter 31.27 Tax map/parcel no.: DESCRIPTION OF' WORK Backwater valve 12.51 ' A -•- Clothes washer 25.02 _a 4 1 1VreS *6 Q4& -/rw÷pA nu_i- . Dishwasher 25.02 P' - 4- 004:iD _ r --a ^IP Drinking fountain 25.02 ._ r• beau - , sliferpcs s.w1-1—L -1 , , 4((21;A Ejectors/sump _ 25.02 -- . .... 0 PROPERTY'OWNER . ' '0 TENANT Expansion tank 12.51 ' — - Fixiure/sewer cap 25 02 Name: 1:1001 drain/Iloor sii6.....ht;) 1 25.02 r;)5z Address: - '- Wilms disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker . 12.51 0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 - . .. - . g u Mcdical as(vale;$ ) Page 2 Business name:CASCADE PLUMBINC comPANY Primer 12,51 Contact name:CRYSTAL JONES Roof drain(commercial) 3251 Addn.:ss:2416 N HAYDEN ISLAND DRIVE, Sink/basin/lavatory I 25.02 City/State/ZIP:PORTLAND,OR 97217 - &Ant units(potable water) 62.54 Phone:(503)289-7095 Fax::(503)283-9514 'rub/shower/shower pan 12.51 ..,. . . -.. - - ...... .. -.-. .._ 5 1:-niail.CASCADEPLUM(ii)YAIR)O.COM _ Urinal 2 02 Water closet 25.02 _ CONTRACMR WNW heater 37.32 Business name:CASCADE PIA;IMBING COMPANY Water piping/DWV 56.29 -- Address:2416 N HAYDEN ISLAM)DRIVE Oilier: 25.07 City/State/ZIP:PORTLAND,OR 97217 Subtotul 4.0)--- _ . : Phone:( Minimum permit 6.7.4: S72.50 503)289-7095 ras;(503)2834514 Plan review (25'4 ofpermi(lee) (VII lie.: 120893 Plumbing Lie,no.:34-412PR ... - - _ ,., Stine surcharge(12%of permit lee) jaz I AillItorizeci t:ignaturc: -r7.12 TOTAL PERMIT I-EL__ Iblarj--- - le Print name:CiasTAI.JONE tuf I Date: '11.4.4 4 ILI This iscrnth liplike atm expires if a permit is ma obtained within M do)s c ii niter It has been accepted N4(Om*lc elt• ' - 'Fee methodohvy set It)Tri-County Building Industry Service Board') 1%14.•1/W•0•‘4.1..4,1r1.1.11.'-rermilApp.doe 10/01100 440-4f.I fin I iyuir ommut 1 Z 000/T000Z DIslIaKfIld aaVDSVO fTSOCHCOS XVd Kd OS:S tiOZ/170/TT Plumbing Permit Applicat' - City of Tigard .Pfigc 2 - Supplemental InformattOn Fee Schedule: Residential Fire Suppression Systems: Site Utilities ttty. Fee(ea) Total Square Footage: Permit Fee: Fowling drain- 1" 100' . 50.03 " 0 to 2.000 5121.90 looting drain•cu,h addatinnal 100' 37 62 -- 2.001 to 3,600 $1 t').■9 — i 3.601 to 7.200 __ 5233.20 Sewer• f st 100 ••-••• 42.54 7,201 and greater - 5327.54 - J Sewer-each additional 1(10*- 37,52 - Water Service-1st 100' 62.54 w rvi Medical Gas Systems:^ C Ce•each additional 100' 37,52 Storm&Ruin Drain-I st 100' Valuation: Permit Fee: 62.54 $1.00 to 55.0X10.00 Minimum tee$72.50 Storm&Ram Drain•each additional 100' :37.52 55,001.0010 510.000.00 572.50 liar the first 55.000.00 and 51.52 for ' Other inspections or Fees Qty. Fee(ca) Total each additional 7100,00 or fraction thereof.to and including.510.000.00. Inspection of existing plumbing or liar $10,001.00 to$25.000.00 $14X M)for the lion$10,000.00 and$1 54 li,r „which no Ice is specifically indicated 90 0)0/hr each additional$100.00 or fraction thereof to (minimum charge-.1/2 hour) and including 525,000,110. Inspections outside of normal business 90.00/hr 525.001.00 to$50,000.00 $379.50 for the Irst$25,000,00 and$1•16 Or boon(minimum charge-2 hours) each additional 5100.00 or fraction thereof to Rcanspcction Fees 90.00/hr and including 550.000.00. Additional plan review for revisions 90.00/hr 560.001.00 gird up S742.00 fiat the first S50,000,00 and S1.2U for - (minimum charge-1/2 hour) each additional$100.00 or fraciian thereof Subtotal: Commercial Fixture Work Arc 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*. Quanti by Fixture Type Plan Review for Plumbing Installations WorkPerformed:r for Replace/ Plan review is required for any of the following, Work Pcf Capped Added Rdoatrc U F• Ba tistry/F'oni Please check all that apply. Bath -Tub/Shower ❑ Any new commercial building with water service 2"and ,faeuezi/Whirlpool greater.except systems designed and stamped by licensed Car Wash -Each Stall engineer. -Dove'fbru ❑ New exterior plumbing site utilities for any complex structure c'uya,dor/Water Aspirator -- OS defined in(AR?18-780-0040, Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care litcilities. -Domestic —1 ❑ Any multipurpose tire sprinkler system. Drinking Fountain ❑ Any complex%tructure its defined in OAR91R-780-0040. Live Wash Floor Drain/sink -2- i Submit 2 sets of plane with any of the above. •4.. - Car Wash Drain , Isometric or Riser Diagram Garbage -Domestic-nun-Rand U lsometrlC or riser diagram is required for new buildings Disposal -Domestic-food related �� that meet the qualifications above. -Commercial-food related •Industrial-food related lee MachJRclril,Drains Oil Separator(Gas Station) Comments regarding fixture work: Ito:.Vehicle Dump Station Shower -Gang -I — - -Stall Sink/I-av -Non-loud related � - •I)nadlc, -Commcrcia1.fl nd related • -Service SwimmingPool Filter Washer-Clothes *Note: If the fixture work under this permit results in an outer F.rtractur increase of sewer EDUs,a sewer permit will be issued and water Cornet-Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. y Oster fixtures. C:\Users\Owncr\Downloads\PLMF-PermitApp(5).doc• 2 2000/Z000l DtslIENTId 3QVDSYD i'T26C9ZCOS %V3 Kd OS:S PTOZ/fro/TT � r •t CITY OF TIGARD PLUMBING PERMIT 11 COMMUNITY DEVELOPMENT Permit#: PLM2014-00360 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/03/2014 T[Ca t\R L1 g Parcel: 1S135BD00300 Jurisdiction: TIGARD Site address: 9735 SW SHADY LN 307 Project: Dr.Weinberg Subdivision: ASHBROOK FARM Lot: 5 Project Description: Interior plumbing:Relocating(3)existing sinks and(1)water heater. 11/5/14,adding(1)sink&(1)hub drain (existing,being relocated). 12/11/14:Reprinted permit to include(1)dishwasher and medical gas with a valuation of$2,500. Contractor: CASCADE PLUMBING CO Owner: MCFADDEN,ARTHUR L 2416 N HAYDEN ISLAND DR BY SKLARZ, ERIC PORTLAND, OR 97217 621 SW MORRISON ST, STE 800 PORTLAND, OR 97205 PHONE: 503-289-7095 PHONE: FAX: 503-283-9514 FEES Quantity Description Date Amount 1 ea Dishwasher 12/11/2014 $25.02 Specifics: 1 ea Floor Drain/Floor Sink/Hub 11/18/2014 $25.02 1 ea Medical Gas 12/11/2014 $72.50 Type of Use: COM 4 ea Sink 11/18/2014 $100.08 Class of Work: ALT 1 ea Water Heater 11/03/2014 $37.52 Type of Const: 1 12%State Surcharge- 11/18/2014 $31.22 Occupancy Grp: Plumbing Stories: 24 Plan Review-Plumbing 12/11/2014 $24.38 Total $315.74 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: • Permittee Signature: 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 Ftllz t)LII(,. I SI. OM l City of Tigard r Received `, g `�� Date'By: Permit No.:/tin�fnl(f�y)3/ II • 13125 SW Hall Blvd.,Tigard,OR %i� V I�LIr lof(J IR'J Plan Review• Phone: 503.718.2439 Fax: 503.5''. ..1 \� Other Permit No.: Date/By: Inspection Line: 503.639.4175 �O Date Ready B Jnris: H See Page 2 for TIGARD Internet: v,wv.tigard-or.gov C�� ,'+', y y i tA�i'4`;J Notifled'Method: Supplemental Information TYPE OF WORK [[[V��� 1V FEE* SCHEDULE It❑ New construction ❑ D011 '`t`_���3 For special information use checklist t`, �V Descri.tion a Ea. Total ® Addition/alteration/replacement ❑ v New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 El I-and 2-family dwelling ® Commercial/industrial SFR(2)bath 437.78 building SFR(3)bath 500.32 ❑ Accesso ry 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:9735 SW Shady Lane Catch basin or area drain 18.76 City/State/ZIP:Tigard,OR Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: 36 1 I Project name:Weinberg 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 Relocate&replace 2 existing sinks Clothes washer 25.02 �d Ota� <x;s�(,v .N, Dishwasher „7 25.02 d2s.t 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 ® APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name:Cascade Plumbing Co Medical gas(value:S 2500) L7.----1 Page 2 72.50 Primer 12.51 Contact name:Crystal Jones Roof drain(commercial) 12.51 Address:2416 N.Hayden Island Drive Sink/basin/lavatory City/State/ZIP:Portland,OR 97217 Solar units(potable water) 62.54 Phone:(503)289*-7095 Fax: :(503)283-9514 Tub/shower/shower pan 12.51 E-mail:cascadeplum@yahoo.com Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 37.52 Business name:Cascade Plumbing Co Water piping/DWV 56.29 Address:2416 N.Hayden Island Drive Other: 25.02 City/State/ZIP:Portland,OR 97217 Subtotal 1 7t5 Phone:(503)289-7095 Fax:(5503)283-9514 Minimum permit fee: $72.50 Plan review (25%of permit fee) i(,3/ CCB Lic.: 120893 Plumbing Lic.no.:34-412PB State surcharge(12%of permit fee) t t I 7!_ Authorized signature: L.4.4 �/ i//,►L. T 133(.t TOTAL PERMIT FEE Print name:Crystal Jones 1 Date:12/09/2014 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. 1:,.BuildngTamits•.PLMU-PamitApp.doc 10'0109 44046161(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 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 S 100 to 55,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional I O0 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 Future Type for Replace/ Plan review is required for any of the following. Work Performed: Capped Added Relocate Please check all that apply. y Baptistry, 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 0 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" Isometric or Riser Diagram Car Wash Drain ❑ Isometric or riser diagram is required for new buildings-Domestic-non-food 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 *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: C:\Users\Owner\Downloads\PLMF-PermitApp.doc 2 IICITY OF TIGARD PLUMBING PERMIT s • COMMUNITY DEVELOPMENT Permit#: PLM2014-00360 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/03/2014 Parcel: 1 S 135BD00300 Jurisdiction: TIGARD Site address: 9735 SW SHADY LN 307 Project: Dr.Weinberg Subdivision: ASHBROOK FARM Lot: 5 Project Description: Interior plumbing:Relocating(3)existing sinks and(1)water heater. Contractor: CASCADE PLUMBING CO Owner: MCFADDEN,ARTHUR L 2416 N HAYDEN ISLAND DR BY SKLARZ, ERIC PORTLAND,OR 97217 621 SW MORRISON ST,STE 800 PORTLAND, OR 97205 PHONE: 503-289-7095 PHONE: FAX: 503-283-9514 FEES Quantity Description Date Amount 3 ea Sink 11/03/2014 $75.06 Specifics: 1 12%State Surcharge- 11/03/2014 $13.51 Plumbing Type of Use: COM 1 ea Water Heater 11/03/2014 $37.52 Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $126.09 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: - Permittee Signature: 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. Plumbin Permit A licat' Building Fixtures ) I tiFD 1.0R OFI I(TL t SE ONI.1 lt.viv l I City f Tigard n (� PermitNo.: tY � I)uterl4y %V � 1/ �jT- pc/'io?�JN-t.�.3(p�Q + 13125 SW Hull Hlvd„'I'iEurd,OR 972.2;1j'� Plan Review Phone: 503.718,2439 Fax: 503.598,1960 Other Perini'Ni,.. p /'7-Q0.13`I I Aua:ll ly: �1' T I G A R D Inspection Line: 503.639.4)75 CITY( I E(iARU i},,te Ren<lynly: ru<. Id See 2 for v CITY t 1 lJ1 tLlf 11l '/ Information Internet: wvvw u� dr,r n 1:., 11i�t���iQl� hat � Notified/Method. Supple+nend ❑Demolition❑New construction -•. Fur special information use checklist Ikscnption 1 l?tv. I Ea. 1 Total ®Addition/ultvnuion/rcpluct.-tncnl 0 Other: New I-2-family dwellings(includes 100 tt,for each utility connection) CATEGORY OF CONSTRUCTION • SFR(I)bath 312,70 ❑ I-and 2-family dwelling CR Commercial/industrial SFR(2)hulk 437,78 SFR(3)bath 500.32 ❑Accessory building ❑Multi-family ------- - _ Hoch additional hath/kitchcn 25,02 ❑Master builder ❑Other: Fire sprinkler( ,iq.ft.) Page 2 Job site addrvs:9735SW SIWDY LANE Site utilities: NE �' Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/StatcIL1P:TIGARD,OR Fooling drain(no,linear Ili, ) Page age 2 Suite/bldg./apt.no.: 307 J I-Project name:DR WE Manufactured Mafactured 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 Sturm sewer(no.linear ft.: ) Page 2 Water service(no.linear It Page 2 - - • Subdivision: Lot no.: Fixture or item: T;cx m;rplparc:cl nu.: Hackllow preventer 31.27 Dt SCRWP'rION OP WORK Duckwuter valve 12.51 RELOCATE 3 EX51''ING SINKS& 1 WATER HEATER Clothes washer 25.02 ---... ............._..,, ...- _..._---- -- I)ishwasher 25.02 Drinking fountain 25.02 -_ Ejectors/sump 25,02 CANT C7;'l'ia>t'£iZx'Yat C7.'r Hxpnnsum tank 12.51 Name: - Fixture/sewer cap 25.02 Floor drain/floor sink/huh 25.02 Address: t iarbuge disposal 25.02 City/State/7IP: I lose bib 25.021 Phone:( ) Fax: Ice maker 12.51 Q APPLICANT' Q'COKTJACT PERSON Interceptor/yremte trop 25.02 Business name:CASCADE PLUMBING COMPANY Medical gas(value:5 ) Page 2 _,..,..__ Primer 12.51 Contact name:CRYSTAL JONES ,_•-•,-„_.__ _-___ Roof drain(commercial) 12.51 Address:2416 N HAYDEN ISLAND DRIVE - - 3 25.02 75.06 City/Statc/LIP:PORTLAND,OR 97217 Solar unit.:(potable water) - 62.54 Phone:(5113)289-7095 Fax::(503)283-9514 Tub/shower/shower pan 12,51 Urinal 25.02 E-mail:C:ASCADEPLUMCaaYAHOO,COM , . • Water closet 25.02 . _._ ... CONTRACTgR. . Water heater I 37.52 37,52 Business name:CASCADE PLUMBING COMPANY -- ' r__._.... _._ Water pipmg/DWV 54.29 Addres-x:2416 N HAYDEN ISLAND DRIVE Other: 25.02 City/State/Z11':PORTLAND,OR 97217 Subtotal 1 12.58 Phone:(503)289-7095 Fax:(503)283-9514 W Minimum perntit fee: S72.50 CCB Lie.: 120893 Plumbing Lic.no.:34-412PB _. Plan review (25"%�of permit fee) _ - 1--- - State surcharge(12%of permit fee) 13.51 f Authorized signature: TOl'AE.PERMIT FEE f. 12,6.09 - _ -� This permit application estirrs if•permit is not obtained within tan day. Print name:CRYSTAI-,JONE - Date: 10/3I/2014 1 after it ha%been accepted as complete, "Fee methodology set by Tri-Curtuty Ruilding Industry Service Lkuud lArtuiWlty rermu rtml.kr*mnAppOw i run t,m 4404eieTlu0/0:/COM/WCD) Z000/T00021 °NIS:KR'ld 3av'DSv3 tTS6CSZCOS XVd KVI70:TT 1'TOZ/TC/OT Plumbing Permit Application - City of Tigard Page 2 - Supplemental information Fee Schedule: Residential Fire Sup ression Systems: Site Utilities Q• Fee(ea). -Total Square'Footaget Perrnit-Fee: Footing drain-I"100' 50,03 0 to 2.000 5121.90 Footing drum-each additional 100' 37.52 2,001 l0 3,600 SI69.69 — •_• 3,601 to 7,200 S233.20 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 L_ Rain r & ain Ihuin-lit 100' 62,54 Valli atiou ''Permit Fee: $1.00 to$5,000.00 Minimum fee 572.5(1 Stour,&Rain train-each additional 100' 37,52 $5,001.00 in$10,000.00 $72,50 for the tint$5,000,011 and$1,52 for (qty. 1 to(ea) Topes each additional 5100.00 or fraction thereof.to Other Inspections or Fees and including 510.000,(. Inspection of existing plumbing or for 510,001.00 to 525.000.00 $148.50 for the first S10,000,00 and 51.54 for which no fee is specifically indicated 90.00/hr each additional$11(1.00 or fraction thereon',to (minimum churgc—1/2 hour) and including 525,000.00. Inspections outside of normal business 90.00/hr 525,001.00 to$50,000.00 $379.50 Ibr the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to Reinspection fits 90.00/hr and including 550.000,00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742,00 for the first$50,000.00 and$1,211 for (minimum charge—1/2 hour) each additional SI00.00 Of fraction thereof. Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? !ryes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Quantitp by Fixture"type • Plan Review'for Plumbing Fixture Type for • Replace/ Plan review is required for any of the following. Work Perforated: Capped Added Rdaate Baptistry/Hont Please check all that apply. Bath Tub/Shower ❑ Any new commercial building with water service 2"and — -Jacur�i/whirtpool greater,except systems designed and stamped by licensed Car Wash Hach Sutll engineer, -Drive Thru ❑ New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918-780-0040. l)ishwacher -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. I've Wash Floor Drain/sink -2" -_ Submit 2 sets of plans with any of the above. -3" ISometf pie:or Riticr Diagram t'ur Wush Drain Garbage Domestic non-food ❑ Isometric or riser diagram is required fur new buildings Disposal -Domestic—food related that meet the qualifications above. -Commercial—food related -Industrial-food related Ice Mueh,/Refrig.Drains Oil Separator Leas Station) Comments regarding fixture work: Rec.Vehicle Dump Station __ "OTHER FIXTURE" iS A WATER HEATER Shower -Gang -Stall Sink/Lay -Non-rood related 3 -Hnudicy -Commercial-kW 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 lees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures, C::1 uscrsl Owncr\Downioads\PI,MF-PermitApp(5).doc 2 2000/Z0000 ONIEINI 'Id 3CIVDSVD fTS6C8ZC0S YVd PIVb0:TT UIOZ/TC/OT RECEIVED CASCADE PLUMBING CO. COMMERCIAL*RESIDENTIAL*INDUSTRIAL C 2 2 2014 WWW_CASCADEPLUMBINGCOMPANYCOM CITY OF TIGARD 2416 N. HAYDEN ISLAND DRIVE PORTLAND, OR 97217 503-289-7095 BUILDING DIVISION 503-283-9514 FAX CCB: 120896 EMAIL CASCADEPLUWIYAHQO.COM At the address of 9735 S.W. Shady Lane Suite#307 Cascade plumbing did the remodel of of Dr. Wienberg Which included the relocation of several sinks&the addition of Vacuum &Air to (2) new chairs location. We made connection to the existing vac&air systems at a point of connection under the existing west chair. We installed a full port ball valve in the existing 1 1/4" pvc.Vac&the 1/2" copper air line. We extended the air&vac to the (2) new chair locations at which point we pressure tested the air&vacuum tested the pvc.Vacuum in the ceiling downstairs. We tested it from Tuesday the 25th of November thru the 26th. 19" of mercury on the vacuum & 150 psi on the air. After which time we relieved test installed the shutoffs on the air @ the 2 chairs&female adapters on the vac. All ball valves are open &operating with the existing system. Shane Farley Cascade Plumbing 503 289-7095 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 9735 SW SHADY LN 307, TIGARD, OR, 97223 Commercial - Plumbing 399 Plumbing final FAIL PLM2014-00360 George Heimos NOTE: med gas vacuum and air extended to existing dental chairs. Contractor to provide verification letter for testing to NFPA 99 code, call for inspection when completed. 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 9735 SW SHADY LN 307, TIGARD, OR, 97223 Commercial - Plumbing 399 Plumbing final PASS - No C of O December 23, 2014 at 9:12:53 AM PLM2014-00360 George Heimos Note: documentation received from Cascade Plumbing Co. regarding med gas vacuum and air alteration and testing received on 12/22/14 and meets the intent of the 2014 NFPA 99 code. 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 9735 SW SHADY LN 307, TIGARD, OR, 97223 Commercial - Plumbing 399 Plumbing final FAIL PLM2014-00360 George Heimos 1. Westside Endodontics 308: hard cap 2nd drain stub out on sterilization sink. 101.4.1.1.3 2. Corrections from inspection dated 11/19/14 not completed. 3. Recall inspection when corrections have been completed. Re-inspection required. 103.5.6.1 4. Re-inspection fee will be assessed if previous correction(s) are not approved on next inspection 103.5.6 5. Did not inspect any plumbing in 308, work not completed. 103.5.6 6. Add dishwasher to TI spc. 308 to existing permit. 103.4.1 NOTE: inspected plumbing in TI space 398 and everything looks good except above corrections for plumbing only, not med gas. General contractor: pam@roberttoddconstruction.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 9735 SW SHADY LN 307, TIGARD, OR, 97223 Commercial - Plumbing 399 Plumbing final FAIL PLM2014-00360 George Heimos 1. Corrections from 11/19/14 not completed, recall inspection when completed, no inspection. 2. Add to new permit 1-se dishwasher. Violation Summary: Inspector Contractor