Permit Iq CITY OF TIGARD PLUMBING PERMIT
I I COMMUNITY DEVELOPMENT Permit#: PLM2014-00259
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/22/2015
Parcel: 2S112CB00900
Jurisdiction: Tigard
Site address: 15000 SW HALL BLVD
Project: Bonaventure of Tigard Subdivision: WILSON ACRES Lot: 8
Project Description: Interior plumbing for a new 3-story senior living facility.
Contractor: JET INDUSTRIES INC Owner: MWSH TIGARD LLC
1935 SILVERTON RD NE 3425 BOONE RD SE
SALEM, OR 97303 SALEM, OR 97317
PHONE: 503-363-2334 PHONE: 503-566-5715
FAX: 503-363-2622
FEES
Quantity Description Date Amount
4 ea Rain Drain Connector 01/22/2015 $75.04
Specifics: 4 ea Backflow Preventer 01/22/2015 $125.08
54 ea Clothes Washer 01/22/2015 $1,351.08
Type of Use: COM 71 ea Dishwasher 01/22/2015 $1,776.42
Class of Work: NEW 1 ea Drinking Fountain 01/22/2015 $25.02
Type of Const: 2 ea Ejectors/Sump 01/22/2015 $50.04
Occupancy Grp: 1 ea Expansion Tank 01/22/2015 $12.51
Stories: 46 ea Floor Drain/Floor Sink/Hub 01/22/2015 $1,150.92
70 ea Garbage Disposal 01/22/2015 $1,751.40
22 ea Hose Bib 01/22/2015 $550.44
2 ea Ice Maker 01/22/2015 $25.02
27 ea Primer 01/22/2015 $337.77
4 ea Roof Drain(Commercial) 01/22/2015 $50.04
161 ea Sink 01/22/2015 $4,028.22
190 ea Lavatories 01/22/2015 $4,753.80
190 ea Tub/Shower/Shower Pan 01/22/2015 $2,376.90
Total $33,420.36
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 ions o NC by calling 503.232.1987 or 1.800.332.2344.
Issu d By: Permittee Signature: ?^ l}
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.
. (2).,4_,0 pl---oFkr/ kb a cit I/417-r--
.i Plumbing Permit Application 1
Building Fixtures IN�� FOR OFFICE USE ONLY
City of Tigard Received
114 `� g Date/By: f t'( /y T Permit No.: /044,/Zi',/-o ?.r
• 13125 SW Hall Blvd.,Tigard,OR 97223 '10161 Plan Review / A v'�� D�
Phone: 503.718.2439 Fax: 503.598.03 4 Date/By:/..�7.-/S '�3 Other Permit No.: & - k_t'Z'
Inspection Line: 503.639.4175 FF�� r� /
I I t. \I:1) 1`��V Date Ready/By: Juris: 65 See Page 2 for �'
Internet: www.tigard-or.gov (� Tl Notified/Method:
V� f , Supplemental Information
TYPE OF WOIll,�`wt�QI���S� FEE* SCHEDULE
®New construction €molliittiion For special information use checklist.
Description I Qty. ] 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: 15000 SW Hall Blvd Catch basin or area drain 18.76
~
City/State/ZIP:Tigard,Oregon,97224 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name:Bonaventur of Tigard Manufactured home utilities 50.03
Cross street/directions to job site:SW Ross St. Manholes 18.76
1-5 exit 291,West on Carman Dr.South on SW Upper Boones Ferry Rd.Right on Rain drain connector V 18.76
Durham Rs..64 mi.Right on SW Hall Blvd,.43 mi.to SW Ross,on NE corner. 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.: 15000 Fixture or item:
Tax map/parcel no.:24112c800900 Backflow preventer -I),v 3 31.27 93.81 J
DESCRIPTION OF WORK Backwater valve 1 12.51
Clothes washer ✓ �t{ / 41 25.02 1025.82 /
new plumbing for a 3 story senior living facility Dishwasher / ( .. xr - 80 25.02 2001.60
Drinking fountain t/ b'f I 25.02 25.02
Ejectors/sump OX 2 25.02 50.04 ✓
® PROPERTY OWNER I ❑ TENANT Expansion tank Q't 1 12.51 12.51 ,✓
Name:Bonaventure Senior Housing Fixture/sewer cap 25.02
Address:3425 Boone Rd.SE Floor drain/floor sink/hub (lie 43 25.02 1075.06 6/.
Garbage disposal 7 a Y 7 1 25.02 25.02 ✓
City/State/ZIP:Salem,Oregon,97317 Hose bib ✓ �py 11 25.02 275.22 :V
Phone:(503)361-7153 Fax:(503)588-3531 Ice maker / 1 12.51 12.51 ✓
® APPLICANT ® CONTACT PERSON Interceptor/grease trap o I/ 2 25.02 50.04 ✓
Business name: Bonaventur Senior Housing Medical gas(value:$ ) Page 2 !
Primer � x 10 12.51 ✓
Contact name:Jim Clarkson Roof drain(commercial) rc 4 12.51 50.04 ,/
Address:4325 Boone Rd.SE
Sin asin/lav tory /V 34 25.02 -$556-8-4
City/State/ZIP:Salem,Oregon,97317 it o '��� ).(-4;-
Solar units(potable water) 62.54
Phone:(503)373-3165 Fax: :(503)588-3531 Tub/shower/shower pan V 17 12.51 •itt0 b-1
E-mail:jlarkson@IiveBSL.com Urinal d St/ 2 25.02 50.04 r/
Water closet fitte✓ 18 25.02
CONTRACTOR /
--I-Tr Water heater (7 A✓ 4 37.52 150.08
Business name:tbd T / Lt4a7 i i f Cj
Water piping/DWV irk .1 56.29 ,4 -29--✓
Address: PO �9( 7 2_ Other: `fits flTfr /fE7j K 25.02 5
�_ gag.4
City/State/ZIP: l.PZe h-/ 0 2 9`7 I /-t sr- Subtotal (%,54).4 7
Phone:(503) ?j'" a`3f Fax:(503) Minimum permit fee: $72.50 ---
CCB Lic.: ?j9951 //5- Plumbing Lic.no.: pl/-/t,X Plan review (25%of pennit fee) $l t V TY•4'
State surcharge(12%of permit fee) 7'i/+[3
Authorized signature: 7//(! TOTAL PERMIT FE
Print name: i Lt -2..,,,i Date: tit/4 y This permit application expires if a permit is not obtained within 1 0 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:Building Permit 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-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 $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 Replace/ Plan review is required for any of the following.
Work Performed: Capped Added Relocate 9 Y g•
Baptistry/Font Please check all that apply.
Bath Tub/Shower El 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 ❑ 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,, WOW
4„ aIy/r Isometric or Riser Diagram
Car Wash Drain
g
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 111/
-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 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 plumbing permit can be issued.
Other Fixtures:
M:\Drafting\Projects\1403 Tigard\AHJ\City\MEP permit submittals\TigarQPLMF-PermitApp-COMPLETED.doc
Location:
Record Type:
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Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
15000 SW HALL BLVD, TIGARD, OR, 97224
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2014-00259
Chip Barnett
Violation Summary:
Inspector Contractor