Permit p CITY OF TIGARD PLUMBING PERMIT
sr . • COMMUNITY DEVELOPMENT Permit#: PLM2015-00046
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/17/2015
Parcel: 2S113AB00101
Jurisdiction: Tigard
Site address: 16101 SW 72ND AVE 200
Project: Perlo Construction Subdivision: ROSEWOOD ACRE TRACTS Lot: D
Project Description: Installation of water supply line for ice maker in refrigerator.
Contractor: POWER PLUMBING CO Owner: PACIFIC REALTY ASSOCIATES LP
PO BOX 19418 ATTN: N PIVEN
PORTLAND,OR 97280 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-244-1900 PHONE:
FAX: 503-244-8825
FEES
Quantity Description Date Amount
1 ea Ice Maker 02/17/2015 $12.51
Specifics: 1 12%State Surcharge- 02/17/2015 $8.70
Plumbing
Type of Use COM 60 ea Minimum Fee Adjustment- 02/17/2015 $59.99
Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issu By: Permittee Slynatu e:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
FEB-16-2015 15:33 From: To:5035981960 Page:1/2
RECEIVE!)
Plumbing Permit Application
Building Fixtures FEB 1 7 2015 FOR OFFICE USE ONL%
City of Tigard ne erey 1 /7 /5 "4„.../) Puma Nc ;-)1,-,9yey 5'cleiCi e&,
• 13125 SW Hall Blvd..Tiiarli (GARD Plan REVIEW /
Phone: 503.7582439 Fax: 1 Pow . Other Permu No.; gLe /5 -aroo
Inspection Line: 503.639.41x1 y,SJOJ Date Ready/By: "ddi LI See Page 2 for
71G,1KI) Internet www.tigard-or.gov Nonfted/Method Supplemental Information
�+tx-'• .,,��:�^w wti"�,,.{�„y45 ,d •. 7{ t �r'� 'iF^"7 p i 77_vtr� .:F '•r q
t±5. .z ' dell '''. •I e't: d 1 y !a b�*17 P.4➢� Cw_ =_t "E" ..i x"141 Ye u�rwf7a104 ��$ `k ti t-"
❑Demolition
For special information use checklist
New construction _ Descri ttion • . Ea. Total
' ,Addtuon/allmation/replacement []Other New I-2 4amil'dwethnis(includes 100 ft.for each utility connection)
{ .t" c: .unit a,?,iiz` o-I ,� r :;.ytr;, SFR(1)bath■�w ra1- w
`,fit r SFR(2)bath
El 1-and 2-family dwelling — j Cotttmerctal/industrial 437.78
_ SFR(3)bath ■ 50032
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑Muster builder ❑ Other: Fire sprinkler( sq.ft.) Page 2
?�-w=`-aeZt^L J r o i e'-e g " � Site utilities:
� '. n lkY. yiii t�, sr
z~A_ chit,
n Catch basin or area drain EMI
Job site address: r 1�J Drywcll•leach line.or trench drain 18.76
City/State/ZIP: t 0✓".d_411 1) 1- ell ,21.1
Footing drain(no.linear tt: ) Page 2
SuitelbldgJapt.no.: .- ZQ) Project name' a,110 04- +IL Manufactured home utilities 50.03
Cross street/directions to job site Manholes 18.76
Rain drain connector 18,76
—" Sanitary sewer(no.linear ft.:, ) Pagc 2
-
Storm sewer(no,linear ft.: ) Page 2
Water service(no.linear ft.:_ ) Pagc 2
Subdivision: I Lot no.: Fixture or item:
Back-flow preventer 31.27
Tax map/parcel no.;
Backwater valve 12.51 NMI
p ar ;w ' r°'?t i.;a` 411-.at�t-iu C
--: i2_,-r, .,.a 2�._ a .
Clothes washer 25-02
a jr; i Dishwasher 25,02 II
Dunking fountain II 25.02
/ Ejectors/sump 25.02
�. ter�•, _: ttcc * zt ,�''f Expansion tank 12-51
Fixture/sewer cap 25.02 Mil
Name: Floor drain/floor sink/hub 25.02
Address: Garbage disposal 25.02
City/State/ZIP: 1-lose bib 25.02
Phone. ) Fax:( ) Ice maker I IIMMI 12 .S
,� f$31"1!450,:.v , lnterce tor/ case trap 25.02
;;.,sere iV . a G'"; t,.-—,(inC, F-,< . P b7
µ'�'� " ` / f Medical gas(value:$„r) Page 2
Business ttaine: Po / i /1 a' 4 L il
Primer 12.51
Contact name: LIO !, 7/(J/ ' Roof drain(commercial) _®�
Address: 4/ /e Sink/basin/lavatory Ell 25-02
City/State/ZIP: ifi afaiffial AM %72 Solar units(potable wilier) 62.54
Phone:(SZI3) pt./I.(__7"Q t1 Fax::(51)3) .w'/-0 f as- Tub/shower/shower pan 11111 1.2.51
Urinal 25.02
�E-mail: { se 1 V c _ 1(3 W #/U4*7 b/ 4r ti . Water closet 25.02
4 Kr a^ sf. ��fftti s :alit•tlbsr a)'
,a'rn3 :w,ww N,±2a �,zPlii. ..,.. .r' 16ii `. - Water heater ■ 37.52
Business name: ' _ ` Water piping/DWV 56-29
•Address. (Q / / 0 //-! : --1illi Other: 25.02
, ` '7 L Subtotal 12 .S I
City/StatelZll': ' Minimurn permit fee: 572-50 72.sb
Phone:( ) ,2t{t-/-1906 Fax'(Sp3) al-N-8815
3 Plan review (25%of permit fee) l
CCB Lie.: 5-i Lic.no.:Z�j 7 g y`/ • State surcharge(12%of permit fee) Y...10
.1O
Authorized signature: TOTAL PERMIT FEE < I I.
�.1)
—
�� DatC: /� This permit application expires if■permit is dot obtained within 180 days
Print name: / / 6 ' I after it h■s Iwo steepled ss complete-
*Fed methodology set by Tri-County Building Industry Service Board f
iiBuiWing\pnrmoaLMU-PrrmtApa.des to/oe/U9 4�0-�616T(lanVCDMIWfB)
FEB-16-2015 15:33 From: To:5035981960 Page:2/2
Plumhinss Permit Application - City of Tigard
Page 2 - Suppiement ai Information
Fee Schedule: Residential Fire Sn• •ression Systems:
r,oy r'F17 1 , ar J'ff. p,. vas.'.a .-.,,y,..1-- ra s+4.-.1 M�t s.',g*,y'. Ij...,..r trw�, 'n:
it .. is )l vL-`.' . _;., o i z.e'ff'' ,;,. 1
-,t f ��� �fd ii.u,3r�r�.asX�1�����.+iMmir. ' '�.'. ii4• „r�"fr4'f'p..... ?�i.. EYI,sL��la,..:.Li .:.Fen....,:i# iyr' "I is•,,.
_ ael� .,..,+ba: .,t v.st�N .��-rrr� :
Footing drain-1 100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2 001 to 3 600 5169.69
3,601 to 7,200 5233.20
Sewer-1st 100' 62.54 7,201 and rester 5327.54
Sewer-each additional 100' 37.52
-Water Service-1st 100' , 62.54 Medical Gas Systems:
Water Service•each additional 100 37.52 ',;; r- ,r i, ,y 7,, g:v• 9^ 1- ; ti E .. ,' ',1
Storm&Rain Drain•1st 100' G2„54 "'"ai,;; . .:1' :. -. . ,..ra. ` 4.1 3,4A.--ate ",'„its
$1.00 to$5,000.00 Minimum tee S72.50
Storm&Rain Drain-each additional 100' 37.52 $5,00 1.00 to$10,000.00 $72.50 for the first 55,000.00 and S1.52 for
u' a�,:�'�;ls.1 , .sT'''.' n. �;•. + .;a,I;;l• each additional$100.00 or fraction thereof.to
i„c 1 .a;�y,�J,i;7 M;";.' ;A. ��." r tt3:, +'sw end including 510.000.00-
lnspection of existing plumhing or for 510.001.00 to$25,000.00 S148.50 for the first 510,000.00 and 51.54 for
which no fee is specifically indicated 90,00/hr each additional$100.00 or fraction thereof,to
(minimum charge-112 hour) and including 525,00(1.00,
lnspe tions°onside of normal business 90.00/hr 525.001.00 to$50,000.00 $379.50 for the first$25,000.00 and 51.45 for
hours minimum • -2 hours) each additional 5100.00 or fraction thereof to
keinspection Fccs 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 550,000.00 and$1.20 for
(minimum charge-1/2 hour) each additional 510(1.00 or fraction thereof
•
Subtotal: I 1
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*.
C; - it r :-., 1 t k uanhl ixture ri, ,��psr •�+�.� :a t a r t a a r J . ^f� rv.`sr :F:
,!_-., x1'1 t .1r n, '-..:=.14,-,-."- 1.ti °• •f. •Cep1iee '•1�-,^7'2 jr�, - $a.,94 ,u aaiai,. .,a41OOite Plan review is required for any of the following.
'u"= t- " Ap !• Please check all that apply.
Pp Y•
" ❑ Any new commercial building with water service 2'and
Bath -Tub/Rower
greater,except systems designed and stamped by licensed
r
engineer.-Each Stall Car Wash -Drive ❑ New exterior plumbing site utilities for any complex structure
as defined in 784-0040.
Dishwasher 0 Medical gas and nd vacuum systems for health care facilities.
-Domestic ❑ Any multipurpose fire sprinkler system.
Dunkin, ❑ Any complex structure as defined in OAR918-7X0-0041,Fountain
E Wash Eill
Floor Drain/sink Submit 2 sets of plans with any of the above.
. .�v n L.l -N f.., ,•:''r.n '"t+- a -S'..N q t E -4••Car Wash Drain ■ Isometric or riser diagram is required for new buildings
Garbage -Domestic-non-food
Disposal s, that meet the qualifications above.
-i-ndustrial-food related
Oil,' .orator Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station I
Shower Clang .1 0 , I h r - a , G. _
-Stall
SinklLav -Non-food related
-Bradley
I
-Commercial-food related
-Service
Swimming Pool Filter "Note: If the fixture work under this permit results in an
Washer r Extractor increase of sewer:EDUs,a sewer permit will be issued and
Water F�uttraaax I
Water Closet-Toilet 1 fees assessed for the sewer increase must be paid before the
Urinal `i f i plumbing permit call be issued-
Other Fixtures'
-- --htipJ/www_tigard-or.gov/city_hall dePartntents/ed/docs/PLMFF-FemiitApl2doc
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
16101 SW 72ND AVE 200, TIGARD, OR, 97224
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2015-00046
George Heimos
Violation Summary:
Inspector Contractor