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Permit CITY OF TIGARD PLUMBING PERMIT I/ . COMMUNITY DEVELOPMENT Permit#: PLM2015-00159 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/19/2015 Parcel: 1 S135BA00102 Jurisdiction: Tigard Site address: 10206 SW WASHINGTON SQUARE RD Project: Ulta Subdivision: OAKBURG Lot: 9 Project Description: Relocate and replace existing plumbing fixtures for TI. No sewer permit required as no new fixtures will be added. Contractor: QUALITY WEST PLUMBING LLC Owner: PPR SQUARE TOO LLC 2304 NW SHADDEN DR PO BOX 847 MCMINNVILLE, OR 97128 CARLSBAD, CA 92018 PHONE: 503-927-0299 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Clothes Washer 05/19/2015 $25.02 Specifics: 1 ea Drinking Fountain 05/19/2015 $25.02 4 ea Floor Drain/Floor Sink/Hub 05/19/2015 $100.08 Type of Use: 6 ea Sink 05/19/2015 $150.12 Class of Work: 2 ea Lavatories 05/19/2015 $50.04 Type of Conet: 2 ea Water Closet 05/19/2015 $50.04 Occupancy Grp: 1 ea Water Heater 05/19/2015 $37.52 Stories: 1 12%State Surcharge- 05/19/2015 $52.54 Plumbing Total $490.38 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: / 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 Applic n Building Fixtures t"t ,.ti �' ,i ' lOR UI'l•ICE L'SI. (NE) City of Tigard �' j‘k �dB'y, �',� s ,1�. rcnHit N�, 14 ■ 11125 SW Hall Blvd.,Tigard,(1t3 3 2 n.. ��r /.�9 Plion : 503.71 R 2439 Fax; 5()3.59R,19 flan kcvilw n,te/ny. Other Permit N o7D4 E0060 -I 1`_n k l hasprctiup 503.639.4171 9 i �' t 5 K i • rile Ready/fly; 1 See Pagel for Internet .tigurd-ar.gov l 1 r(.;: Notined/Mrthud; w. su td.Lomita'Intormadon I # '1�'�i alq .,l...'.' .t o F# + FEE ,.a?•.., p ❑Ncw construction ❑Demolition For special information use checklist i 1)escrit5tin .l City. I F . Total ®Add ition/alteration/replacement ❑Other: New I-2-family dwellings(includes 100 R,for etch utility connection) GATEE-.ORY,OF CONSTRpGTIOty ?: ° ,;; ,, ,,i,` SFR(1)lath 312.70 ❑ 1-and 2-family dwelling ®Commercial/industrial SIR(2)bath 437.7R SFR(3)bath 50032 ❑ Accessory building ❑Multi-family Each additional bath/kitchen 25.02 . ❑Master builder ❑Other: Fire sprinkler t sq.Il.) Page 2 3OB SITE INFORMATION;ANA-LOCATION Site utilities: Job site address:10206 SW WASHINGTON SQ RD Catch basin or err drain I g,76 Diywell,leach line,or trench drain 1/4,76 City/State/ZIP:TICARI)•OR Footing druin(no.linear ft.: ) Page 2 Suite/bldgJapL no.:10531 Project name:ULTA Manufactured home utilities 50.03 Cmv.strcet/directinns to yoh site: Manholes 1X,76 Rain drain connector I x.76 Sanitary sewer(no.linear II.:_) Pure 2 Storm sewer(no.linear ft..:_) Page 2 Water service(no.linear ti.:i) i Page 2 Subdivision: Lot no.: Fixture or Item• Tax asap/parcel no.: liackSow prevents 31.27 '' DESCRIPTION''Or,WORK, Backwater valve 12.51 Clothes washer 1 25.02 25.02 RrOI.00ATI &RIX:ONF1Cl1Rl?PI,UM RING ROUGH IN AND INSTALL Dishwasher 25,02 NEW I•'IX'I'URES Drinking fountain 1 25.02 25.02 E.-jet-tors/sump 061" 25,02 f `` G © :MOPElt *OWf1Lit y ❑ 1'E TAIY7` ;„iy„, Fxpunstun tank l 12 1 Name' Fixture/sewer cap r 111,71M1111 25'02 bri . o Flour drain/flour sink/hub 25,02 25.02 Address: Garbage disposal 25.02 City/State/ZIP: 1 Home bib 25.02 ' Phone:( ) I Fax:( ) Ice make' 12.51 .AF ANh" r'-4 I41 i ii$4,,,i,, a,,CONTA T iiiiiiO ;l' Interceptor/grease trap 25.02 Businc s name: Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: Roof drain(commercial) 5 . 12.51 Address: ry // ' 25.02 200.16 ✓z Sink/busira/luvu N• � City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) I Fax::( ) Tub/shower/shower pun 1 12,51 l.-mail: 1 Urinal 25.02 N{ j C ti 2 25,02 50.04 „ ..,;; ,,',. :: t CONT Oli;; s iy i} ;11t h wale closet • Water heater 1 37„52 37.52 Business namc:Cascade Plumbing Co Let 7 A•/E7" "(...4‘iyag4.1 Water piping/DWV 56.29 Address:15765 SW 74m Ave#110-A Other: 25.02 City/StradZIP:Tigard,OR 97224 Subtotal 937, te Phone:(503)289-7095 Fax:(503)283-9514 Minimum permit tee: 572.50 CCB Lic.:204392 Plumbing Lic.no.:PBI528 Plan review (25%of pernit fee) -- -- - Statc surcharge(12%of permit fee) $o;.SV Authorized signature: jf '1'OTAI.PERMIT FEE yQe,3a Print name:Crystal Jonti:cascadcplum@yahoo.com I Date: Th k permit appucadon expires H a penult Is oot obtairee with io IMO asye offer It Ass been accepted m complete. *Fee mpah,r4,lnlp0.et by Tri-runty Building industry service Board. rnM,4t,ng\Po shine MU-PemitApp.doc 10 0I/5. 440M616T(10/02/COM/WI H) 2000/T000�j I ONIWiITid HGVDSVO 17T56£8Z£OS %Vd lid ZT:9 STOZ/£T/SO Plumbing Permit Application - City of Tigard Page 2-Supplemental Information Fcc Schedule:s Residential Suppression ems Site Utilbt�e ' � ��a1i t( . iu,iT OLA 'aeotesP elnit eq f°. Footing drain-1"100' 1 50.03 0 to 2,000 S121.9_0 Footing drain-each additional 100' - 37.52 _2.001 to 3,600 $169.69 3,601 to 7,200 $233,20 Sews-lst 100' 1 62,54 7.201Imdgrenta , $327.54 Sewer-each additional 1010' 37,52 Water Service•1a 100'I 02.54 Medical Gas Systems- Water Service-each additional 100' 37.52 i Storm&Rain Drain-1st 100' 62.54 Valuation. 'P , erin tt Fees' ". . $1.00 to 55.000.00 Minimum fee S72.50 Storm&Rain Drain•each additional 100' 37.52 $5,001,00 to 510.000.00 $72.50 for the first 55.0 x1.00 and 51,52 for Other Inspections nr Fees Qty, Fet("°� , '"�'oa' _and additional S 100,00 tar fraction thereof.to each A( Itl including$10.000,00. Inspection of existing phimbing or ter 510,001.00 to$25,(100.00 $145.50 for the first S10.000.00 and$1.54 for which no fee is specifically indicated ')0.00/hr each additional 510(1.110 or fraction there, of;to (minimum charge 1/2 Maur) and including 525.000.00. Inspections outside of normal business 90,0 /hr 525.001.00 to$50,000.00 S379,50 for the first 525,000.00 and$1,45 for hours(minimum charge-I 2 Hours) each additional$100,00 or fitacliun thereof,to Reinspeciion Fees 90.00/hr _ and including,$50,000.00, Additional plan review for revisions c1,00/hr ' 550,001.00 and up $742.00 for the first$50,000.00 and S1.20 for (minimum charge-1/2 hour) each additional S 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*. xturoTvpe Plan rest'Clipped Flan Ratvte w ffo nPA,lr the rabil�gl.TnstsllatiAas' .; WuLire; r1 r for rucd• n Quantity b Aided Relocate 9u y e tbllowing. Baptistry/font I Please check all that apply. Rath -Tub/Shower ❑ Any new commercial building with water service 2"and -Ju b/Showhirllmot p-citer.except systems designed and stamped by licensed Czar Wash -Each Stall engineer. .nriveiiki ❑ New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirated as dcltticd In OAR918-780-0040. Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities. -Domestic ❑ Any multipurpose fire sprinkler system, Drinking Fountain 1 I ❑ Any complex structure as defined in OAR918-780-004(1, L Flt err Jittk -7,' 4 Submit Z sets of plans with any of the above. -31" I. - . -4 - U l.�.., Isolothuettic Gr'fiiser TIA*Ca>11<7 ':Ili I '''' I Car wash,Drain isometric or riser diagram is r uired for new buildings Garbage -Domestic-non-food m $ Disposal -Domestic loot related that meet the qualifications above. - Commercial»food related -Industrial-food related Ice Maeh.JRefrig.Drains I _ Oil Separator(Gus Station) _ Comments regarding fixture work: Roe.Vehicle Dump Station , Shower -Gang -Stall Sink/Iav -Non-food related 8 -Bradley {Commercial foes)related -Service Swimming Pool Nitta - washer-(1 hes -1 *Note: If the fixture work under this permit results in an Water Extractor increase of sewer F,I)s,a sewer permit will be issued and water Closet-Toilet 2 fees assessed for the sewer increase must be paid before the Urinal 1 plumbing permit can be issued. Other Fixtures: I _ C:1Uscrs\Owncrll)csktopl \permit applications\City of tigard oregnn,doc 2 Z000/Z000Z 9NIWind 3QV3SVD tI26CBZC0s XVd Aid ZT:9 STOZ/CT/S0 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 10206 SW WASHINGTON SQUARE RD, TIGARD, OR, 97223 Commercial - Plumbing 399 Plumbing ﬁnal PASS - No C of O PLM2015-00159 George Heimos Violation Summary: Inspector Contractor