Permit p CITY OF TIGARD PLUMBING PERMIT
r . COMMUNITY DEVELOPMENT Permit#: PLM2015-00034
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/02/2015
Parcel: 2S102AA03901
Jurisdiction: Tigard
Site address: 8905 SW COMMERCIAL ST
Project: The Crane Mat Company Subdivision: TIGARD HIGHWAY TRACTS Lot: 23
Project Description: Cap line with(2)sinks,replace(1)tub/shower with ADA shower stall,(1)sink and(1)water heater.
Contractor: COLUMBIA CONSTRUCTION INC Owner: PENNY CONNOR INVESTMENTS LLC
28170 BOBERG RD 8905 SW COMMERCIAL#A
WILSONVILLE, OR 97070 TIGARD,OR 97223
PHONE: 503-427-0304 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Fixture/Sewer Cap 02/02/2015 $25.02
Specifics: 1 ea Sink 02/02/2015 $25.02
1 ea Tub/Shower/Shower Pan 02/02/2015 $12.51
Type of Use: COM 1 ea Water Heater 02/02/2015 $37.52
Class of Work: ALT 1 12%State Surcharge- 02/02/2015 $12.01
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $112.08
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 N9iitieatt0T1- -_'ter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or ct questions to OU C b ailing 503.232.1987 or 1.800.332.2344.
Issued By: /N / / / Permittee Signature: r I p
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 RECEIVED FOR OFFICE USE ONLY
Received
City of Tigard [[QQ - � � ((/'ll Permit No.: _1
13125 SW Hall Blvd.,Tigard,OR 9F2�3' 2 2015 Date/By: /`� ( /�Y'r/ r ;LC/ -e)CO3
Plan Review Q
• Phone: 503.718.2439 Fax: 5 9 Date/By: Other Permit No.: b1 ti pgoi f-6109.0`,!/
Inspection Line: 503.639.4175 k OF TIGARD Date Ready/By: Juris ® See Page 2 for r
I WARD Internet: www.tigard-or.govBUILDING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑New construction ❑Demolition For special information use checklist
Description Qty. Ea. 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 lk Commercial/industrial SFR(2)bath 437.78
building SFR(3)bath 500.32
❑Accessory 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: y c 0 S S W CO tK f f'C�" Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:
rT9 f O' Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name: ne Ciitive lid Co. 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: ��77 I Lot no.: Fixture or item:
Tax map/parcel no.: 25/ ..3 ,9i 4 0 3 96/ Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Dvr„0 Q 4uN
i,ddr►tj ;iiew2r Dishwasher 25.02
/
Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name: Fixture/sewer cap i 25.02 4.,^6" py
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
Medical gas(value:$ ) Page 2
Business name: _
Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory I 25.02 a 6-.452-
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan f 12.51 /;-5/
E-mail: Urinal 25.02
CONTRACTOR Water closet 25.02
I Water heater ( 37.52 37.57-
Business name: CL V bi
+r a�-�0 k. ��s Water i m
WV 56.29
Address: 2817 d S w Q
heal a -7
pr Other: 25.02
City/State/ZIP: (4)l6Svw,vr/jt / OR "4 L 070 Subtotal /4)6.0)
Phone: ( Minimum permit fee: $72.50 -
(�� ) �Z 7 o�D y Fax' ) Plan review (25%of permit fee) --
CCB Lic.: i tiCKQ' /� 'Plumbing Lic.no.: Fog,j(�� State surcharge(12%of permit fee) /a,Q
Authorized signature: Q/f/uf j?�'�,ii/ TOTAL PERMIT FEE /42..44
Print name: ��l�ff-t�k Pia C ��wwuuvv Date: /2/ /�� This permit application expires if a permit is not obtained within 180 days
/"ia ` after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:\Building\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-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*. Plan Review for Plumbing Installations
Quanti by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate
❑ Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower I
engineer.
Jacuzzi/Whirlpool
Car Wash: -Each Stall ❑ New exterior plumbing site utilities for any complex structure
-Drive Stall as defined in OAR918-780-0040.
Cuspidor/Water Aspirator - ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial El Any multipurpose fire sprinkler system.
Domestic ❑ Any complex structure as defined in OAR918-780-0040.
Drinking Fountain
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink: -2"
3" Isometric or Riser Diagram
4" • ❑ Isometric or riser diagram is required for new buildings
-Car Wash Drain
Garbage Domestic non-food that meet the qualifications above.
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
Ice Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -LavBar non-food related 2 _ II/
-Bradley
-Com/Serv/Util food related •
-Service *Note: If the fixture work under this permit results in an
Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and
Washer-Clothes
Water Extractor fees assessed for the sewer increase must be paid before the
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
Accumulative Sewer Tally
le► Tenant Name: The Crane Mat Co SWR# N/A
TIGARD Site Address: 8905 SW Commercial St 131,M# 2015-00034
Parcel #: 2S102AA03901
Fixture \aloe 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 0 0 0
Eye Wash 1 0 0 0 0 0
Floor Drain/Sink: -2 inch 2 0 0 0 0 0
-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/Bar-Non-Food Related 2 0 2 4 0 -2 -4
-Bradley 5 0 0 0 0 0
-Com/Sery/Util-Food Related 3 0 0 0 0 0
Swimming Pool Filter I 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 0 0 0
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Crc.Iii 0
TOTALS 0 0 2 4 0 _ 0 -2 -4
Current Fixture Value -4 divided by 16= -0.250 Current ED1 1 EDU= $4,900.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change -4 divided by 16= -0.250 over (under) $ (1,225.00)
Enter EDU Change Here -0.250
Notes: Capping(1)trunk line with(2)sinks on it.
Authorized Name/Signature: Debbie Adamski Date: 2/2/2015
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_4900._070114.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
8905 SW COMMERCIAL ST, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2015-00034
George Heimos
1. Provide hot water. R306.4
2. Recall inspection, all else ok
Violation Summary:
Inspector Contractor