Permit CITY OF TIGARD PLUMBING PERMIT
11111
' COMMUNITY DEVELOPMENT Permit#: PLM2015-00076
I Date Issued: 03/16/2015
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.243• I
I
TINSIBM Parcel: 2S102AA03301
Jurisdiction: Tigard
Site address: 12345 SW HALL BLVD 1
Project: Tigard Terrace Apartments Subdivision: TIGARD HIGHWAY TRACTS Lot: 24
Project Description: Extending storm sewer 25 ft.to street.5/12/15: Reprinted permit to include(1)catch basin.
Contractor: OVERLOOK CONSTRUCTION LLC Owner: KC TIGARD TERRACE LLC
PO BOX 83145 11030 NW 2ND CT
PORTLAND,OR 97283 PORTLAND, OR 97231
PHONE: 503-577-5071 PHONE:
FAX: 503-283-9870
FEES
Quantity Description Date Amount
1 ea Catch Basin or Area Drain 05/12/2015 $18.76
Specifics: 100 If Storm Sewer 03/16/2015 $62.54
1 12%State Surcharge- 05/12/2015 $9.76
Type of Use: MF Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $91 06
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 . 44.
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 ����{��� D(►,� mutt t: + ,) ()\1 1
City of Tigard Received 3
'I 13125 SW flail E31vd.,'figard,t)K 97223 ry ii Darduy: j�i jrf� PAN°.."1/11C20/C-'-'044/' '7C�
8 Phone: 503.718.2439 Fax: 50.3 598.1 L0 i Ilan Review
t?rte Hy: Other Permit No..
Inspection line. 5(13.639.4175 Dine Ready/By: _ __
11 G A R f) Jun,. FA `Ref Page 2 for
Internet. ww•w.tigard-or.gov CI� c)F T}(,z,ARd Notilied/Method: ;yi�, Supplemental Information
TYPE OF w LDtNG O1\1151°N
FEE* SCt1EDU1 E
For srxclal in armalwn use checklist
❑New construction ❑Demolition - I
Description I-Qty. Ea. Total
AdditionIalteralion/rephau.ment ❑Other: .- New I-2-family dwellings(includes 100 It.for each utility+comieclion)
CATEGORY OF CONSTRUCTlO1 ti 4 a SFR(1)bath 312.7()
�'�'
❑ 1-and 2-1'wnily dwelling ❑Comma SFR(2)bath 437,78
_... �... ___ _ SFR(3)bath 500.32
i
❑Accessory building vtulti-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: 4,13 j S 5 Lv 1-0 i( 8&.d (.latch basin or area drain 18.76 __-
Cily/Statc/l.IP: j Drywcll,leach line.or trench drain 18.76
tCl j.�@ ci , O 7 o2 3 3 Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name:
al t�{t✓r P yY7a f� �r"{�tnufactured home utilities 50.03
Cross streetidirecdions to job site: ,,iM)/( J Manholes 18.76
Rain drain connector 18.76
-..�•._ .._ Sanitary sewer(no.linear ft.. ) Page 2
Storm sewer(no.linear fl,) ` i Page 2 (e;
Water service(no.linear II.: ) Page 2
Subdivision:ivision: Lot no.: Fixture or item:
Tax map/parcel no.: I3acktlow preventer 31.27
Backwater valve 12.51
DESCRIPTION OF WORK __.._ �_._......_..._.._...__,.__-
Z_..d( Q4x) i Clothes washer 25.02
)rd....___.__5Y I?ishwashcr 25.02
'51/4 I r etet/ L() G4 i_ r�1• X7 Drinking fountain 25.02 _
Ejectors/sump 25.02
❑ PROPERTY OWNER 1 ❑ TENANT Expansion tank 12.51
Name: _ / Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: (C ,.:r..- „,„:_x,,....._ / Ati.
�7 __._. ._...._._....._........._-_ _ Garbage disposal 25.02
City/State/ZIP: P",.• k - ("� . Ilnse bib 25.02
Phone:(SZA)6-7-is... cu?r Fax:9> )2 ir. -9 a-70 Ice maker 12.51
•
❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25,02
Business name (S� r- /d ! LL C... Medical gas(valor $ ) Page 2
/���_/�� Primer 12 51
Contact name: f k„-(r V_ _J� Root'drain(commercial) 12.51
Address: P C �-'()K �- ( r'S P� {�i<t'G'l 2(3 Sinkibasinilavatory 25.02
City/Stale/ZIP: Solar units(potable water) 62.54
Phone:6b?,) S7 7-5-0-7 I Fax::(b3 H)c-I?y'.j rAo Tub/shower/shower pan
12.51
E-mail: Urinal 25.02
8�JE CONTRACTOR _j t 1TZ tti Water heater 25.02
Z Water heater 37 52
Business name: l!@G �-tF L QYLS Water pr P i g/
DL V 56.29
Address. pi,, �7
c3/,./S--- Other: 25.02
City/State/ZIP: fait () C k Subtotal (ice _511
_ Minimum permit fee: $72.50
Phone:(cz„... s.-77....'SZJ7( Fax:( .A )?,..,7i `-cI'.?4 P` --),/-7Z)
CCI3 Lie.: �' G1 CV, /4 Plumbing Lie.no.: Plan review (25%of permit fee)
ii J _. ._.__.____... ......�_ State surcharge(12%of permit fee) -1 a
Authorized signature: �Y'r ! - TOTAL.PERMIT FEE r 5 via
Print name J Tate -j This permit application aspires if a permit is not obtained within ISO days
n)
(� C� C kc �-f ..-Si after it has been accepted as complete_
"Fee methodology so by'In-County Building Industry Service Board
I\Ha,MingiPmndr'PI SI:.PeremApp dos I u'OI.115 4441-46 l 0010.1,2X omilisEtt)
u CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2015-00076
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/16/2015
Parcel: 2S102AA03301
Jurisdiction: Tigard
Site address: 12345 SW HALL BLVD 1
Project: Tigard Terrace Apartments Subdivision: TIGARD HIGHWAY TRACTS Lot: 24
Project Description: Extending storm sewer 25 ft.to street.
Contractor: OVERLOOK CONSTRUCTION LLC Owner: KC TIGARD TERRACE LLC
PO BOX 83145 11030 NW 2ND CT
PORTLAND, OR 97283 PORTLAND, OR 97231
PHONE: 503-577-5071 PHONE:
FAX: 503-283-9870
FEES
Quantity Description Date Amount
If Storm and Rain Drain 03/16/2015 $62.54
Specifics: 1 12%State Surcharge- 03/16/2015 $8.70
Plumbing
Type of Use: MF 10 ea Minimum Fee Adjustment- 03/16/2015 $9.96
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.
Issued By: / Permittee Signature: a 1-/
!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.
Plumbing Permit Application
Building Fixtures FOR OFFICE USE ONLI
RECEIVED Received !"
City of Tigard Date/13 : 3 / 5`07-7- Permit No.: o/. ( ) 7a/
q 13125 SW Hall Blvd.,Tigard,OR 97223 6 Plan Review 1
Phone: 503.718.2439 Fax: 503.598.18 1 V 215 Date/13y: Other Permit No.:
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: orris lid See Page 2 for
Internet: www.tigard-or.gov CITY OF T�GARD Notified/Method: -� Supplemental Information
TYPE OF W LDING DIVIS{ON FEE* SCHEDULE
❑New construction ❑Demolition For special information use checklist
Description I Qty. 1 Ea. I Total
Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility comection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building fulti-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: 62.35/. 5 IA/ N,j1( t'lX Catch basin or area drain 18.76
City/State/ZIP: �t' � 3� Drywell,leach line,or trench drain 18.76
1;1/glad Q� 702 Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name: %1(9l 1 P.�� ufactured home utilities 50.03
Cross street/directions to job site: K"/( Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear f r 1 Page 2 6,2_F-ti
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
� mo`^ ?‘0e_ Clothes washer 25.02
Z X( 7Q i l �11 1� 5 12�,1�
r
_Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name: (.(,C Fixture/sewer cap 25.02
�O l- CIX lc4� Floor drain/floor sink/hub 25.02
Address: Garbage disposal 25.02
City/State/ZIP: PO C 2 t2$3 Hose bib 25.02
Phone:6-02))5-2-2, SU?I Fax:t?) ka$3-9 -70 Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
I S - t / J,.,,9 f, ^S, L Medical gas(value:$ ) Page 2
Business name: t� t'[CJLCX f�/`1
Primer 12.51
Contact name: k_ Roof drain(commercial) 12.51
Address: p O Ka)( 03/ct`S PQ21t44.d 972(3 Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
(6.-CG s-?3_�� r 6'b )02 3-957a Tub/shower/shower pan 12.51 r
Phone: / i Fax: .3 P
E-mail: Urinal 25.02
Water closet 25.02
3 OE CONTRACTOR 5-4.K... CC 1t- 1 g2_4/,i
Water heater 37.52
Business name: 0 v QcC Crnvi- u� water P�P� �1 in WV 56.29
Address: f o (7dA. G3I /S Other: _ 25.02
City/State/ZIP: P it F/D U R_ �j 7 )� Subtotal 5�
Phone:(cc/.p s77-5J-7I Fax:($7ii3 )a8'3 -q(g''7U Minimum permit fee: $72.50 7d_97)
CCB Lic.: ,�( Plan review (25%of permit fee)
J 'U U 0 /(p Plumbing Lic.no.:
State surcharge(12%of permit fee) 7 0
Authorized signature: TOTAL PERMIT FEE 1,-6 vii
Print name: l 'NI Date: f a-is -/7 This permit application expires if a permit is not obtained within 180 days
�(}Y�1� t after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I l Building\PermitalPLMU-PermitApp.doc 10/01/09 440-4616T(IO/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-la 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 (. ,541 $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 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*. Plan Review for Plumbing Installations
Quantity 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
Baptistry/Font ❑ Any new commercial building with water service 2"and
Bath: Tub/Shower greater,except systems designed and stamped by licensed
engineer.
-Jacuzzi/Whirlpool
Car -Each Stall ❑ New exterior plumbing site utilities for any complex structure
Drive tall as defined in OAR918-780-0040.
Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher. -Commercial ❑ 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"
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 MachiRefrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -Lav/Bar non-food related
-Bradley
-Com/Serv/Util food related
-Service *Note: If the fixture work under this permit results in an
Swimming Pool Filer increase of sewer EDUs,a sewer permit will be issued and
Washer-Clothes fees assessed for the sewer increase must be paid before the
•Water Extractor plumbing Water Closet-Toilet P g P ermit can be issued.
Urinal
Other Fixtures:
IABuilding\Permits\PLMF PermitApp.doc 08/04/2011 2
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
12345 SW HALL BLVD 1, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2015-00076
George Heimos
Violation Summary:
Inspector Contractor