Permit CITY OF TIGARD PLUMBING PERMIT
it COMMUNITY DEVELOPMENT Permit#: PLM2015-00341
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/07/2015
Parcel: 251018801400
Jurisdiction: Tigard
Site address: 12078 SW GARDEN PL
Project: Park 217-Bldg 5 Subdivision: CROW PARK 217 Lot: 2
Project Description: Relocate plumbing fixtures: (1)2"floor drain,(2)non-food related sinks,(1)water heater&(1)water closet.
Contractor: CASCADE PLUMBING CO Owner: ICON OWNER POOL 1 WEST LLC
2416 N HAYDEN ISLAND DR BY RYAN
PORTLAND, OR 97217 PO BOX 460169
HOUSTON,TX 77056
PHONE: 503-289-7095 PHONE:
FAX: 503-283-9514
FEES
Quantity Description Date Amount
1 ea Floor Drain/Floor Sink/Hub 10/07/2015 $25.02
Specifics: 1 ea Sink 10/07/2015 $25.02
1 ea Lavatories 10/07/2015 $25.02
Type of Use: COM 1 ea Water Closet 10/07/2015 $25.02
Class of Work: ALT 1 ea Water Heater 10/07/2015 $37.52
Type of Const: 1 12%State Surcharge- 10/07/2015 $16.51
Occupancy Grp: Plumbing
Stories:
Total $154.11
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: i
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 ApplicatitEC
'EIVEP
00 Building Fixtures FOR OFFICE. I SE: ()'LA
City of Tigard OCT 7 2015 Received i.„ Adfr
Date By, /0/7/25- 417,-vr. Permit No/OZ/-4:2045...._00.39/
II " 13125 SW Hall Blvd.,Tigard,OR 97223
Plan Review
a Phone: 503.718.2439 Fax: 503.11TV oF"'GARD , DateiBy: Other Penett Teleczois-6'0.26?
Inspection Line: 503.639.4175 ‘-'
TIGARD f Date Ready,By: Anil: 1 63 See Page 2 for
Internet www,tig.ard-c,r.gov IUILDING sioN
vi
DI ,,_„, 1 NotifiediMethed. Supplemental Info rnuttio n
, , ,,
T1 PE OF WORK ''-' ,..,.
" Ft E'' SCHEDUI.E.
._.,
0 New construction 0 Demolition For yecial information use checklist.
Deseriphon j Qty. I Ea. I Total
0 Add itikm/al i era tionfreplacement , 0 Other: . New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
437.
( 78
0 1-and 2-famil dwelling ' 111 C ornmerciza old us.trial SFR 2)bath
i
SFR(3)bath 1 500.32
0 Accessory building 0 Multi-family
r--, Each additional bathlitchen 25,02
0 Mactor builder . Lj Other:
i
lire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Catch basin or area drain 18.76
Job site adds ess: 12078 SW Garden Place
Drvwell,leach line,or trench drain 1 18.76 •
City/State/ZIP:Tigard,OR
Footing drain(no.linear ft.: ) Page 2 I
Suitelbldgiapt.no.: I Project name:park 217 /3 z.b G ..5- Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76 I
Sanitary sewer(no,linear ft.: ) , Page 2 •
-
Storm sewer(no.linear ft.: ) Paae 2
Water service(no,linear ft.: ) 1 Page 2
Subdivision:
Lot no.: I Fixture or item:
T Backflow preventer 1 31.27
ax map no.:
DESCRIPTIO Backwater valve 12.51
N OF VvORK
Clothes washer 25.02
relocate rough in and install fixtures
Dishwasher 25.0'
Drinking fountain . 25.02
Ejectors/sump 25.02
LTI PROPERTY OWNER 0 TENANT Expansion tank 12.51
,.._,..
Fixturelsewer cap 11 Alati.17--C . 25.02
. Name:
Floor drain/floor sink,thub Ore 1 25.02 25.02 4/
Address:
Garbage disposal . 25.02 :
City/State/ZIP:
Hose bib j 25.02 .
Phone:( 1 I Fax: ,
.
• ice maker 12.51 i
, I_
7 APP.! 1C ANT t 0 CO NT ACT PERSON Interceptorio-ease trap 25.02 I
Medical gas(value:S ) Page 2
Business name.
Primer 1 12.51
Contact name: .
Roof drain commercial) 12,51
Address:
Sin `basin(ris'ivattn......D 2 25.02 50.04 ..-'"
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) i Fax*-( ) , Tub/shower/shower pan 12.51
Fax:'
E-mail: Urinal 25.02
Water closet 1 25.02 75.02
OP-- CON FRAcToR
Water heater 1 37.52 37.52 1.---
Business name:Cascade Plumbing Co Water pipingDW V 56.29
Address:15765 SW 74th Ave#110-A
i I Other: 1 25.02
........
City/State/ZIP:Tigard,OR 97224
Subtotal 137.60
" 1
Phone:(503)289-7095 Fak:(503)283-9514
I-- Minimum permit fee: 572.50
CCB Lie.:204392 Plumbing Lie.no.:P131528 I Plan review (25%of permit fee)
1 .
i State surcharge(12%of permit fee)
Authorized signature: 4' 411 ,- ... .... TOTAL PERMIT FEE 137
411L.:•‘.410.4 ' - 4' Amiliatakt..
, Print name:Crystal Jones I
I Date:10/5/2015 This permit application expires if a permit is not obtained within days
e 5 after it has been accepted as complete.
*Fee methodology set by Tri-Comny Building Industry Service Board. ,
/SZ(. ii
t'BuilaingTerinuis PLNIU-PennitApp arc 1 oia 1'05 440-46.1.61,,10,02 COM WEB1
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-1"100' 50.03 0 to 2,000 S 121.90
Footing drain-each additional 100' 37.52 2,001 to 3.600 5169.69
3,601 to 7,200 S233.20
Sewer-1st 100' 62.54 7,201 and greater S327.54
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
S1.00 to 55,000.00 Minimum fee S72.50
Storm&Rain Drain-each additional 100' 37.52 S5,001.00 to S10,000.00 S72.50 for the first S5,000.00 and S1.52 for
Other Inspections or Fees Qty. Fee(ea) Total each additional S 100.00 or fraction thereof,to
and including S 10,000.00.
Inspection of existing plumbing or for S 10,001.00 to S25,000.00 S 148.50 for the rust S 10,000.00 and S I.54 for
which no fee is specifically indicated 90.00/hr each additional S 100.00 or fraction thereof,to
(minimum charge-1/2 hour) and including 525,000.00.
Inspections outside of normal business 90.00/hr S25,001.00 to S50,000.00 S379.50 for the first S25,000.00 and S 1.45 for
hours(minimum charge-2 hours) each additional S 100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including S50,000.00.
Additional plan review for revisions 90.00/hr 550,001.00 and up S742.00 for the first S50,000.00 and S1.20 for
(minimum charge-1/2 hour) each additional S100.00 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*.
Quantity by Fixture Type Plan Review for Plumbing Installations
Fixture Type for Replace/
Work Performed: Capped Added Relocate Plan review is required for any of the following.
Baptistry/Font Please check all that apply.
Bath Tub/Shower ❑ Any new commercial building with water service 2"and
Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Tluu ❑ 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 ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" 1 Submit 2 sets of plans with any of the above.
-3..
_4..
Car Wash Drain Isometric or Riser Diagram
Garbage Domestic-non-food ❑ Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications 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/Lav -Non-food related 2
-Bradley
-Commercial-food related
-Service
Swimming Pool 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 1 fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
C:\Users\Cascade Main\Desktop\permit applications\tigard permit.doc 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
12078 SW GARDEN PL, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
November 5, 2015 at 9:14:53
AM
PLM2015-00341
Don Sylvester
Violation Summary:
Inspector Contractor