Permit INy n
OF TIGARD PLUMBING PERMIT
' ' COMMUNITY DEVELOPMENT Permit#: PLM2015-00290
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/08/2015
Parcel: 2S 101 DA00104
Jurisdiction: TIGARD
Site address: 13333 SW 68TH PKWY, STE#210
Project: NW Capital Management Subdivision: VARNS ACRES Lot: 9
Project Description: Plumbing for new breakroom and bathroom. (1)dishwasher,(1)expansion tank,(2)2"floor drains,(1)ice maker,
(1)primer,(2)lays,(1)shower stall,(1)water closet&(1)water heater.
Contractor: RUSSELL&SONS PLUMBING INC Owner: TRIANGLE POINTE TWO LLC
PO BOX 192 901 NE GLISAN ST, STE 100
BATTLE GROUND,WA 98604 PORTLAND, OR 97232
PHONE: 360-949-7697 PHONE:
FAX: 360-953-8976
FEES
Quantity Description Date Amount
1 ea Dishwasher 09/04/2015 $25.02
Specifics: 2 ea Floor Drain/Floor Sink/Hub 09/04/2015 $50.04
1 ea Ice Maker 09/04/2015 $12.51
Type of Use: COM 1 ea Primer 09/04/2015 $12.51
Class of Work: ALT 2 ea Lavatories 09/04/2015 $50.04
Type of Const: 1 ea Tub/Shower/Shower Pan 09/04/2015 $12.51
Occupancy Grp: 1 ea Water Closet 09/04/2015 $25.02
Stories: 1 ea Water Heater 09/04/2015 $37.52
1 12%State Surcharge- 09/04/2015 $27.02
Plumbing
1 ea Expansion Tank 09/04/2015 $12.51
0 12%State Surcharge- 09/04/2015 $1.50
Plumbing
•
Total $266.20
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 Signatur
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.
RUG-31-2015(MON) 16: 10 RUSSELL & SONS PLUMBING (FRX)3602633378 P. 001/003
Plumbing Permit Application
Building Fixtures RECEIVED FOR orrice 1.sr, ONLY
City of Tigard Received `� I t / / �}C�a
t3' � Permitxo.; )
• 13125 SW Hall Hlvd.,Tigard,OR 9, j 31 2015 Date/By: • I / I5 �/Q
' Phone: 503.718.2439 Fax 503.598.1960 Date/Br.Plan "y Other Permit No, e 5--meta
T i C A P.n Inspection Line 503.639.4175 CITY OF TI G AR D Date Ready/By: 9e ��f )orb: G5 See Page 2 for
Internet: www.tigard-or.gov* : a _, r..I /.Q,;t": ■ Notified/Method:/ Supilcmcntalinformation
sn .-I.arms _
a-..., ... ^.n is a Ikl�, a , a , :. ,.�..,�,. ,�sr.
..ro• r��. :,�J... �' ,L r'.-��T.. 4„"�4#^rr s�_i'��e - �c �- glIMEW s--.:-Artiga.1:a .t4.ettYlli7WFa>•a}rl�io-hi��,y,n
❑New cunslrur lion ❑Demolition For special lxforrrtadon use checklist
Description I O y. [ lea. Total
❑Addition/alteration/r>placement 1:31 Other:T.I. New 1-2-family dwellings(includes 100 R.for each utility connection)
#il ;: a.. t rlasi.■ �_. '°-` t SFR(1)bath 312.70�;;_ RXt O . ,�-�.:. , , �1�.1tIt11rIP .:
I-and 2-family dwelling SFR(2)bath 437.78
❑ Y g 1 L ED Commercial/industrial
❑Accessory building 0
Each additional batlr/kitchen 25.02
❑Master builder ❑Other:
Hrre spunkier�sq.ft) Purge 2
t ir t W ,I, r ,,. � 11:,'..,,."• _ . _
,t gl,/B,:$4,1r iiii!FQR 7iii* �'IOI14, i�r;:' w.i , Site utilities:
Job site address:13333 SW 68r"Parkway Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76 \J
Gily/SWtd7TP:Tigard,OR 97223 Footing drain(no.linear It:__-_) _ Page 2 -�
Suite/bldg./apt-no.:pia a)0 1 Project name:NW Captittd.Management TT Manufactured home utilities 50.03 f\
Cross atreeUdirectiuns to job site:Old Farmers Insurance Building I � uy
Manholes 18.76
"���� (� j• Rain drain connector 18.76
�r �3 lye Sanitary sewer(no,linear ft: Page 2
A ,/ ... - Storm scwer(no.linear It: ) rage 2
/ Water service(no,linear ft.:_1 Page 2
Subdivision:n/a Lot no.:n/a Fixture or Item:
Tax map/parcel no.:a/a ! 4 5161/ 7DA Q LS/OC fiuckflow pm-venter 31.27
r;- r t _ - „. y _ Backwater valve 2,51
"" "" G�• ' Clothes washer 25.02
Plumbing as required for new break room and bathroom Dishwasher I 25.02 25.02
Drinking fountain 25.02
J
Ejectors/sump 25.02
[Idijgl .1 F16r,'ta A ;l .; Expansion tank 1 , 1151 12.51
- Fixture/sewer cap 25.02
Name:
Floor drain/floor sink/huh 2 • 25,02 50.04
Address: . _Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 1 , 12.51 12,51
r .fi-c,y ..-.�.a...�
iT1.' �il�44{.t . V'r'If� - y ,�;1IF Interceptor/grease trap 25.
I 02
Business name:Russell&Sons Plumbing Inc r Medical gas(value:S ) Page 2
Primer 1 12.51 12.51
Contact name:Mark Muonlo
Roof drain(commercial) 12.51
-Address:9000 NE 901"Street Sink/basin/lavatory 2 25.02 50,04
City/State/ZIP:Vancouver,WA 98662 Solar tin`•otable water) 62,54
Phone:(360)949.7697 1 Fax::(360)953.8976 Tu.Mr' uwrr pan 1 12.51 12.51
E-mail:markttt rsplumbing,nct Urinal 25,02
t"I'�fl#g 'µ',,,ho, , osr ..,. Water closet I 25.02
c, "1 ctR 1't=ro wr *.t .h zs oz
ss F1 , „ V. ..a.Y.. *" r" Water eater 1 . 37.52 37,52
Business name:Russell&Sons Plumbing Inc Water piping/DWV 7 56,29 -5eiar
Address:9000 NE 90th Street Other: 1 25.02 IS
City/StatrJZTP:Vancouver,WA 98662 Subtotal iiD3s94 ,231'
Phone:(360)949.7697 Fax:(360)953.8976 Minimum permit fee: $72.50
CCB Lie.:148999 Plumbing Lie.no.:37-511PB Plan review (25%of permit fee) �,�15'Sfi-q 59
State surcharge(12%of permit fcc) X528 2w6i'
Authorized signature: ���j�J^ TOTAL PERMIT FEE 9!12.35- P
Print name:Mark Muonlo L.rLiG_ Date:8.31.15 This permit applkatton expires if a permit is not obtained within ISO days *).1176.
after it has been accepted as complete.
*Fee urcthodology mt by 1 ri-Caiunty Building Industry Service Board,
I fl.ildmg,Pennitsu•LMIJ.PennitApp.doc tonatra■a 44O-4616T(t0/02/COM/0.TD)
RUG-31-2015(MON) 16: 10 RUSSELL & SONS PLUMBING (FRX)3602633378 P. 002/003
Plumbing Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Su. r ression S stems:
:';Si Y7titihe :a . .5, i:" , I ; tet"�? vrimi ,. am,,. . i
-r....
Footing drain-1"100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2x001 to 3,60(1 5169.69
3,601 to 7,200 5233.20
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 S stems:
' Wuter Service-each additional 100' 37.52
Willa-60W iFl H i t37 . ' i
Storm ct Rain Drain-1st 100' 62.54 ' "" "�§ '' .
Si.00 to S5.000.00 Minimum fee$72.50
Storm&Raul Drain-each additional 100' 37.52 55,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
0 a W w �a �Tn , inch additional$100.00 or fraction thereof,to
i " �11« :}'' :
and includin!$10 000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 514R.$0 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 includin_$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 fur 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 includin:$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$120 for
(minimum charge-1/2 hour) each additional$100.00 or fraction(hereof
Subtotal:
Commercial Fixture Work:
Arc 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`.
4 � ,A1 F : t;t,�brc. a Plan l"atRet�co �ult"b>liana{�o"'�"ns
ure fhr�� ' Rcpt any of the following.
M orLi'erfiirruedaxwss,:- Please check all that apply.
13aptistrylFont
Bath fub/Shower ❑ Any new commercial building with water service 2"and
-7actsezi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -F;ach Stall engineer.
-Drive Thru ❑ Ncw exterior plumbing site utilities for any complex structure
(:uspidor/Water Aspirator ' as defined in OAR918-780-0040.
Dishwasher -Commercial 1 ❑ Medical gas and vacuum systems for health care facilities.
-Domestic I ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" 2 Submit 2 sets of plans with any of the above.
-3"
Car Wash Drain C] Isometric or riser diagram is required for new buildings-t)omestic-non-food
Disposal -Doincstio-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Muchlkefrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
'Rec.Vehicle Dump Station Add new break&restroom plumbing
Shower -Gang No demolition of existing fixtures
-Stall 1
Sink/Lav -Non-food related 2
-Bradley
-Commercial-food related
-Service
Swimming Paul Filter If the fixture work under this permit results in an
Washer-Clothes
Water Extractor increase of sewer FDUs,a sewer permit will he issued and
Waterfloset-Toilet I fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
R:\Shared Documcnts\3 Current lobs13 Commercial\N W Capital Managelent TT 8.28.15\04 Pcrmilting1PLMVff-PcrmitApp.doc
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
13333 SW 68TH PKWY STE 210, TIGARD, OR,
97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
November 9, 2015 at 11:04:19
AM
PLM2015-00290
Don Sylvester
Violation Summary:
Inspector Contractor