Permit CITY OF TIGARD PLUMBING PERMIT
111111 = COMMUNITY DEVELOPMENT Permit#: PLM2015-00141
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/06/2015
Parcel: 1 S136DB02601
Jurisdiction: Tigard
Site address: 11606 SW PACIFIC HWY 250
Project: Dead God's Tattoo Subdivision: 2000-025 PARTITION PLAT Lot: 2
Project Description: Interior plumbing:Adding(1)expansion tank,(2)sinks,and(1)water heater.
Contractor: WESTERN PLUMBING Owner: HWY 99 LLC
9460 SW TIGARD AVE SUITE 101 11606 SW PACIFIC HWY, STE 200
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503-639-5296 PHONE:
FAX: 503-684-9015
FEES
Quantity Description Date Amount
1 ea Expansion Tank 05/06/2015 $12.51
Specifics: 2 ea Sink 05/06/2015 $50.04
1 ea Water Heater 05/06/2015 $37.52
Type of Use: COM 1 12%State Surcharge- 05/06/2015 $15.01
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $115.08
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility No ation Cen- Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or dire questions to OUNC • 503.232.1987 or 1.800.332.2344.
,
Iss ed By: 4�, 1 ' Permittee ignature: /1
Call 503.639.4175 by 7:00 a.m.for the next ova' •• : inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
05/05/2015 03:25 5036849015 WESTERN PLUMBING INC PAGE 01/02
PlumbinPermit Appliestsi • ,36 , &c 1
Building Fixtures R 01-'11('E (•,,•: (_.;
City of Tigard atefg : -_ /1/)'l�pi 5-_00
A ���Y/ 6 2 015 DatdBy: _ 6 I s Permit No.:
13]25 SW!tall Blvd.,Tigard,0I�97E23 Plan Review
Phone: 503.718.2439 Fax: 503.59$,!960 Dewy, Other Permit No.S Lt/g 20 f 5-- is a g.
Inspection Line' 503.639.417# 1 ill( . I l'I(TARt /By. ei Seep 3 for
Internet www ttgard-or gov Date R cut
If�rR �t y r �1 111 A Notified/Method pptemeatai Information
pp Vii, s ' .'L i` 11 ; �a,a1? [ !�
r_ �164:V ',Vi'-:5+a t*I .{ '.!4 ,. . ,.- :; ', ,:.f,..IIT'4,I.1��:ifn.i y N,. ±i t f a ". l ' -
Newconstruction ❑Demolition ._' Fee special ilefonrefpq use checklist
111..Add=ucm/elteration/eeplaeement ❑Off; Description a4. Ea. Total
1
'w' diyv t I/. t 1,_ New 1-2-family dwell: (includes 100 ft for each utility connection)
• '#,t�' -tir` - SFR(1)bath 1111111 312.70
❑ 1-and 2-family dwelling ,r'/Commercial/Mdustrial SFR(2)bath ME 437.78
IN
❑Accessory building 0 Multi-family SFR(3) ' 500,32
❑Master builder Each additional bath/kitchen 25.02
❑Other -_--,
P5 =1 1 r Fire sprinkler( sq.ft.) Page 2
,r) Wlh s r
dw"C.. �hr I � 1a:q,cr`i , ,r. - _...r ,,,..„..,....„.:,:;',..:',.,,...::„4:::;,-.:::‘,,,,-,P.',. sit.utilities:
Job site address: ' ,' C_ r . 'S. Catch basin or area drain
Crty/State2lP: /gyp ���'}' ]� Drywell,leach line.or trench drain 18-76
.111 L'1L :x Footing drain(no.linear 11.:_) MEI
Suite/bldgJapt no.: 4 Project name:I.,s i, d' '. •.t;tti. 1 Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector
Sanitary sewer(no.linear ft: Page 2
-° Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: Backftow premier E1111116111.1111111
, .`u 74,hL.II Il w
, ., 1, Wr,I $adnvaur valve
12.51
- Clothes washer
25.02
Dishwasher 25.02
a ♦a r, ..1,a . fountain
,rn su• Drinking fount � 25 Oz
Ejectors/ rmp 25.02
W:r 9r,. ;,�,t-,,. ,‘..,...•••,',.•, l, r, 1.,.' ' Expansion tank 12.51 �'Jl
Name: Fixture/sewer cap 25.02
Address:
- Floor drain/floor sink/hub 25.02
Garbage disposal 25.02 1
City/State/ZIP: Hose bib r 25,02 -
Phonµe�:( ) Fax ( ) Ice maker
w p/�pQ 12.51
„. �C`+ , 3" Interceptor/b'ease trap 25.02
Business tutttre: Medical gas(value:S ) 111 Page 2
Contact name: Primer 12.51
Roof drain(commercial) 12.51
Address:
Sink/basin/lavatory 25.02 .(4,
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan iit,if.... 12.51
E-mail: iU� .t r �) ,lute- Urinal 25.02
9-"Y. '.7,1" 1 ,,, i -" , +c.l • ,:7•f"} , t ,- Water closet ��.�' 25.02 l`~-'�•
,; 6e :,.a .. _ :' Water hoping 37.52 Mil
Business name:Western Plumbing,Inc. Water piping/DWV 56.29
Address:9460 SW Tigard Street,Seine 101 Other: 25.02
City/State/ZIP:Tigard,OR 97223 Subtotal ��1�,�^�
Phone:(503)639-5296 Fax:(503)684-9015 • Minimum permit fee: 572.50
Plan review (25%of permit fcc)
CCB Lie.:2439 Plumbing Lic.no.:3429PB Pi
Authorized signature: , State surcharge(12%of permit fee) ', i l''
_ .� T, J 40(.1.1.1 TOTAL PERMIT FE ' . {},IC'
Print name: .. tS 110 }�,�a Date: cjite. ,s Title permit application expires if s permit Y not obtained wttbia 180 days Crg
after it has been accepted as compete. 1194.
*Fee methodology set by Ili-County Building Industry Service Board.
1.V8uildrn5\Pervn.to\PLMU-Pe'itApp.doc 10/01/09 4{0-46{6T(10/02JCOM/WEa)
05/05/2015 03:25 5036849015 WESTERN PLUMBING INC PAGE 02/02
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee'Schedule: Residential Fire Su t ,ression S stems:
�ei+1 77 t F�.5f,t�'i�t715. t "}0,4 r i ,7771,,!t a t . IfLLti' 1 rr ,1;re v , ;x>w+'.'�,77L', .5'5s"'"'�W,17, r•:rM .:7I1Vi i rF 7
.}„PA. 4-. , rn. .,r+ .:, ,kt5:i-...u„pn Sin. ,:. 4. t:A1,:.4.4 ,7 ..ay Ii S1, � r ,;( ��' '''.
�N�4reore�' � "^:trV .a .'.�.�t�.lii7iF� �.:�Pi,..m..1.�r.�.'r.:aen •,'
Footing drain-1"100' 50,03 UM 0 to 2,000 _ $121 90
Footing drain-each additional 100' 37.52 (2.001 to 3,600 $169.69
Sewer-1st 100' 62.54 3,601 a greater $327.54
7-201 and gater $327.54
Sewer-each additional 100' IiiiiIIIIIIII
Water Service-I st 100' 62,54 Medical Gas S stems:
water Service-each additional 100' 37.52
Stonn&Rain Drain-1st 100' r 62.54 } ;2,;is „ - ,;
Storm&Ram in Dra -each additional 100 37 52 ME $1.00 to$5,00000 Minimum fee$72 50
$5,001.00 to$10,000.00 S72.50 for the first S5,000 00 and SI 52 for
57.7 w To.J ,. .a 7 a T a s r � iE s '''...,1 r each additional 100.
OO or
fraction thereof,to=.04,4 ,0:... r a,xataa ,...F,;:,,�,,,,.tao.wit ,,,.;,.T: s , 4a4!Atoi.,timidiAi:I and including$1 0,000.00.ins action 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 char a 1/2 hour) and including 525,000.00.
inspections outside of normal business El 90.00/hr al $25,001 00 to 550,000.00 5379.50 for the first$25,000.00 and$1,45 for
hours minimum clt: •e-2 hours
hours
Fees each additional 5100.00 or fraction thereof,to
90.o0fir and includin:$50,000.00.
Additional plan review for revisions 1111 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
minimum chaise-1/2 hour) each additional$100.00 or fraction thereof I
Subtotal: In
Commercial Fixture Work:
Arc you capping,adding or replacing fixtures? If"yes',
please indicate work performed by fixture. Failure to
accurately re.•t rt fixtures could result in increased sewer fees*.
L{Yi.�f r ', ,.t..�p •q.� 1 a �t.,U.�:�41:I A E�' • TLL!. .. s ;��"�^o�r.�g .7 - (,� `r4.^F^k+' viggt
_ -1; 11nt A. ,l.. M,.ore r a::.i� *,'--5 roe :t1,.,-,,a.-,r-x..ia'..:o-.Mrrt5
S }Jgl>t,t 1Rf i! i�rssc�it' �t 1: �M:a. .i ! r i�� u- t ,_t� ."�' v
>yjr,11114#,W.4,,-', Fao-e.�`r?,N,444, 11 l.1-. Plan review is required for any of the following.
Baptistry/Font I Please check all that apply.
Bath Tub/Shower ❑ Any new commercial building with water service 2"and
Jacuzziremir of greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thnt ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in 0AR918-780-0040.
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 l sets of plans with any of the above.
-3"
4.. s ql ia', t�iz •r ua:1"r r s-q"'t r,r 1""+,,ur�-d-:•mr, t _
Car Wash Drain ..5.. :. M.t: ;.
Garbage Domestic-non-food i ❑ Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above. 1
-
-Commercial-food related _
-industrial-food related _
Ice Mach./Rcfrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Roc. Vehicle Dump Station
Shower -Gang
-Stall
Sink/Li,v -Non-food related
-Bradley
-Commercial-food related '
-Service _
Swimming Fool Filter
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 - -. fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures: 'L�FCy +
http:i/www.tigard-or.eov/city_hall/departments/cd/docs/PLMF-PermitAppdoc
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
11509 SW PACIFIC HWY, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
FAIL
PLM2015-00141
George Heimos
1. Provide a minimum of 6" above top of water heater for vacuum breaker. 608.7/Table
6-2
2. Recall inspection, all else ok
Violation Summary:
Inspector Contractor
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
11509 SW PACIFIC HWY, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2015-00141
George Heimos
Violation Summary:
Inspector Contractor