Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2015-00099
TI t.A 1 D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/31/2015
Parcel: 25101 BCO2800
Jurisdiction: Tigard
Site address: 8250 SW HUNZIKER RD
Project: Centrex Subdivision: 1990-082 PARTITION PLAT Lot: 1
Project Description: Interior plumbing:Adding(1)domestic dishwasher,(3)sinks,(1)water closet;replacing(1)sink,and(1)water
closet;and capping(1)shower stall.
Contractor: WESTERN PLUMBING Owner: SEVERSON, JAMES A&ROBIN 0
9460 SW TIGARD AVE SUITE 101 29404 SW HEATER RD
TIGARD, OR 97223 SHERWOOD, OR 97140
PHONE: 503-639-5296 PHONE:
FAX: 503-684-9015
FEES
Quantity Description Date Amount
1 ea Dishwasher 03/31/2015 $25.02
Specifics: 1 ea Fixture/Sewer Cap 03/31/2015 $25.02
3 ea Sink 03/31/2015 $75.06
Type of Use: COM 2 ea Water Closet 03/31/2015 $50.04
Class of Work: ALT 1 12%State Surcharge- 03/31/2015 $21.02
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $196.16
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 location - -r. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You m- obtain co. of the rules
or ect questions to OUN • .- mg .x.232.1987 or 1.800.332.2344.
Is ued By: // / Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspecti date.
This permit card shall be kept in a conspicuous place on the job site until ompletion of the project.
Approved plans are required on the job site at the time of each inspection.
03/29/2015 09:10 50368849990(1155�jj WESTERN PLUMBING INC PAGE 01/02
Plumbing Permit Appli c' ' ` EP )f , . - -
_ ii f) ...r. �/ ._.15--Building Fixtures MAR 3 0 2015 F(.rn on:u•t. t `1 1 1,1 1 _
City of Tigard Recetrad 3 �'
may. i1 PCxmie No.. ay2o/S , .- -
]3125 SW Half Blvd.,Tigagl,OR 97 I
ii Phone: 503.7182439 Fax 503.59*, I .JAfU Other Permit Pto,•'A /Ad
•r I 1 , Inspection Line: 503 639*PILDING D!VIS101 ' Auto Ready/By:
rii.ilpprilimm- '3-
Internet www Tigard-or gw
» ,, T
❑New construction ' 0 Demolition For Special beformatilolt ase checkGu
Description l Qty. 1 Ea. 1 Total
b'l Addition/alteration/replacement ❑Other: New 1-2-faintly dweltt.:s includes 100 ft.for each utility connection)
)
`.> x `. SFR(i bath 312.70
❑ I-and 2-family dwelling Yii Commercial/industrial SFR(2)bath
[]Accessory building 0 Multi-family SFR(3)bath 500.32
- Each additional bath/kitchen 25.02
❑Master builder ❑Otha
Fire sprinkler( .sq.R) Page 2
zaiiT, °�k7 ;. 4
Site utilities:
QW211 re:1!it,ii ,-, r .r . ._ .. .,-. '. .. .,•Job site address; Q' > 1 y N -t 12 r �� �S Catch basin or area drain 18.76 mi
Drywall,leach line,or trench drain 18.76
City/State/ZIP:"T1( , ( C i'�C) _
Suite/bldg./apt.no.:°�""', „'Project name: Footing drain(no.linear ft.: ) Page 2
. i. cicw24.r s 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
r-- "- Stour#sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.. ) Page 2 r
i Subdivision: Lot no.: Fixture or item: 1
Tax map/parcel no.: Baokflow preventer 31.27 i
"'"' "' C'''-• 7,i 1 .''' Backwater valve�',,, ,,1Sy,i1. .. r : ..-. ...
Clothes washer 25.02
111. . ,o al.. i►a .11. 1,►►,. Dishwasher i 25.02 _A a
Drinking fountain 25.02
Ejectors/sump 111111 25.02
.,r 7 . . . , Expansion tank _� I`I`\\``
Name:
µ V��
Name:
Fixture/sewer cap a, 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
iff• ;4f r^ , • Interceptor/grease trap NM 25.02
Business name: gas(value:$ ) Page 2
Primer 12.51
Contact name:
Roof drain(cotnmcrcial) 12.51_1
Address: _ Sink/basin/lavaw
ry N1\ Ili 25.02 l`J,116
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
r Water closet lti
PIE 25.02
l1 o r7... - . r t,,.". .. • '.r,:,. Water beater 37.52
Business name:Western Plumbing,Inc. Water i in WV ■ 56.29
Address:9460 SW Tigard Street,Suite 101 Other: 25.02
City/State/ZIP:Tigard,OR 97223 Subtotal 15.-,'t,1,
Phone:(503)639-5296 Fax:(503)684-9015 Minimum permit fee $72.50
Plan review (25%of permit fee) _
CC8 Lie.:2439 Plumbing Lic.no.:3429PB State surcharge(12%of permit fee) 1X11,(;
Authorized signature: ' .Ab11 1 TOTAL PERMIT FEE ;,CA 4tr� •�
Print name: �_ VV IC‘ , l Date:` �f I permit application expires if*permit is not obtained within 180 days
"1 J after It has been accepted to complete,
'Fee methodology set by Ili-County Building Industry Service Boaard.
t.\auilding\Parnits\PLMV-hnnitApp.doe 10/01/D9 aeq.AnsaT(10/02/COM/WEB)
03/29/2015 09:10 5036849015 WESTERN PLUMBING INC PAGE 02/02
Plumbing Permit Application - City of Tigard
Page 2-Supplemental Information
Fee Schedule: Residential Fire Sur 4 ression S stems:
7'-- -
Footing drain 1'100' 50.03 ME 0 to 2,000 $121.90
Footing drain-each additional 100' _ 37.52 2,001 to 3,600 5169.69
to
Sewer- Ist 100' 62.54 3,601 7,200 $233.20
i 7,201 and greater $327.54
Sewer-each additional 100' MilitallIMI
water Service-1st 100' 62.54 Mil
Water Service-each additional 100' _�� Medical Gas S stems:
Storm&Rain Drain-1st 100' 62.54
=�� $1.00 to$5,000.00 Minimum fee$72.50
Storm&Ram Drain each additional 100' $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
e a c h f,to
1.024.;„.....-- - and includin_$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 5100.00 or fraction thereof,to
minimum char_ -1/2 hour and including$25,000.00.
Inspections outside of normal business 1111 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours minimum char,..e-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees NM 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$50,000.04 and$1.20 for
(minimum ch :e-1/2 hour 1 each additional$100.00 or fraction thereof.
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately re• •rt fixtures could result in increased sewer fees*.
R
-.-',,i1,.�4 r.:; 1 -4_71 1i�f''f R,, � ,1{r�*t �'l;tat" 'w .. F .x ���,1�.�
uB ,r,'.4I t,l k{i•s r., s' 1 4 rFx- ,.,s �"��7� g' i. ,.
.4.i.a.1.-. ...t..,.A..,..ec,I,ti� ,,,,,,a.;r;11 a..., i::,.. '.R"�,.,, .,,fpN rM.yw.u',ta Plan review is required for any of the following.
Please check all that apply.
Rath Tub/Shower ❑ Any new commercial building with water service 2"and
,iacuzzi/Whiripoot 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 1 / ❑ My multipurpose fire sprinkler system.
Drinking Fountain ❑ My 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,'
Car Wash Drain -
Garbage -Domcstio-non food • Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the •ualifications 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/Lay -Non-food related 1 -
-Bradley• -
•
-Commercial-food related .
-Service -
Swimming Pool Filter v
Washer-Clothes — *Note: If the fixture work under this permit results In an
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
water Closet•Toilet l _1 fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
http://www,ti gard-or.gov/eity_hal Udepartments/ed/docs/PLMF-PemtitAped oc
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8250 SW HUNZIKER RD, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2015-00099
Inspection Type: Inspector:
399 Plumbing final George Heimos
Result:
FA I L
Comments:
1 . Complete breakroom sink" all else ok
2. Recall inspection
Violation Summary:
Inspector Contractor