Permit CITY OF TIGARD PLUMBING PERMIT
• COMMUNITY DEVELOPMENT Permittt PLM2015 00349
',1' Date Issued: 10/14/2015
TIGARD 13125 SW Hall Blvd ,Tigard OR 97223 503 718 2439
Parcel: 151 34BC00100
Jurisdiction: Tigard
Site address: 12100 SW SCHOLLS FERRY RD
Project: 7-11 Subdivision: GREENWOOD TERRACE CONDO Lot: 17
Project Description: Install new water heater,remove and replace some existing piping for access.
Contractor: S&S SEARS INC Owner: ATLAS GREENWAY LLC
PO BOX 446 333 NW NINTH AVE, STE 1009
GLADSTONE, OR 97027 PORTLAND,OR 97209
PHONE 503-650-8200 PHONE
FAX 5023-650-8203
FEES
Quantity Description Date Amount
ea Water Heater 10/14/2015 $37 52
Specifics: 1 12%State Surcharge- 10/14/2015 $8 70
Plumbing
Type of Use COM 35 ea Minimum Fee Adjustment- 10/14/2015 $34 98
Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $81 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
Utili otification -• er. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090 You may obtain opy of the rules
direct questions to OU ■ by • -: 503 232 1987 or 1 800 332 2344
Issued By: 01 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 Application
Building Fixtures It FOR OFFICE USE ONLY
City of Tigard Received /0 /V i6 /l l Permit No
-
q 13125 SW Hall Blvd,Tigard,OR 97223 Date/By ! �y�J�
4 2015 Dee Review
' Phone: 503.718.2439 Fax: 503.580-P64 Other Permit No
Date/By
T 1 G A R D Inspection Line: 503 639 4175 Date Ready/By turns El See Page 2 for
Internet* www.tigat'd-or'.gov rI.ft OF 'HARD Notified/Method• Supplemental Information
TYPE O gg 's ' ' FEE* SCHEDULE
U t• ;���dG 4tion '9PY�l' For special information use checklist.
❑ New construction ■ uemohtton
Description I Qty. I Ea I Total
1 dition/alteration/replacement ❑Other: New I-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
❑ I-and 2-family dwelling Commercial/industrial SFR(2)bath 437 78
SFR(3)bath 500.32
❑Accessory building ❑ Multi-family
Each additional bath/kitchen 25 02
❑ Master builder ❑Other:
Fire sprinkler( sy ft) Page 2
JOB SITE INFORMATION ANDD�LOC TION Site utilities:
Job site address: t 7,1 bO C) IA) 5��'�_" �I Catch basin or area drain 18.76
if 7 Drywell,leach line,or trench drain 18 76
City/State/ZIP: Footing drain(no linear ft:_) Page 2
Suite/bldg./apt.no.: Project name: 7—/l 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
Storm sewer(no.linear ft.•_) Page 2
Watei service(no lineal ft. _) Page 2
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater vale 12 51
��41jClothes washer 25 02
-Al l h(�+ l.x77J.�-�✓ Dishwasher 25.02
,./..,( ; ,+5 4��tie 444,tk /� :iP-'� Drinking fountain 25 02
re-, et- �cAo 4,,,,_'R I _5 r7, Ejectors/sump 25 02
❑ PROPERTY OWNER ❑ TENANT Expansion tank 12 51
Name: Fixture/sewer cap 25 02
—
Floor dram/toor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25 02
Phone:( ) Fax:( ) Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25 02
Business name:
Medical gas(value $ ) Page 2
Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax: :( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
CONTRACTOR Water closet 25.02 �y
Water heater i 37.52 7 Y
Business name: ' ✓
iii_ J i 14 Water piping/DWV 56.29
Address: I O ,jOx- /y47 6 Other. 25.02
City/State/ZIP: VA /�4Q3.� _ _ a _ G1 02,2 Subtotal
Phone:(5--6_;)(2SL?3 b�,e V IFa—x:(503)00"gzi23 Minimum permit fee: $72.50 7,1.so
CCB L1c.: Plumbing Lic.no.: Plan review (25%of permit fee)5
frmpv. a State surcharge(12%of per it fee) g.'0
Authorized signature: / — TOTAL PERMIT FEE /.09•U
Print name: 5 A-e .y��/� Date:/61---/ 6 ! This permit application expires if a permit is not obtained within IRO days
t� LLL ✓✓✓III after it has been accepted as complete.
*Fee methodology set byTn-County Building Industry Service Board
I\I3ui1d nu\Pennas\PLMU-PeunitApp doe 10(01(09 440-46161(10(02/COM/WEB)
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- I' 100' 50 03 0 to 2,000 $121.90
Footing drain-each additional 100 37.52 2,001 to 3,600 $169-69
3,601 to 7,200 $233.20
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 Systems:
Water Service-each additional 100' 37.52
Storm&Rain Drain- I s[ 100' 62.54 Valuation: Permit Fee:
$1 00 to$5,000.00 Minimum fee$72.50 .
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1 52 for
Other Inspections or Fees , Qty. Fee(ea) Total each additional$100 00 or fraction thereof,to
and including$10,000.00
Inspection of existing pluibing 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 charge—1/2 hour) - and including$25,000.00.
Inspections outside of normal business 90 00/hr $25.001 00 to$50,000.00 5379 50 for 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 including$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$1.20 for
(minimum charge 1/2 hour) each additional$100.00 or traction 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*. , Plan Review for Plumbing Installations
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for - Replace/. Please check all that apply.
Work Performed: Capped • . Added Relocate
Baptistry/Font ❑ Any new commercial building with water service 2"and
greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
-Jacuzzi/Whirlpool engineer.
Car Wash Each Stall ❑ New exterior plumbing site utilities for any complex structure
Drive tall as defined in OAR918-780-0040.
Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher: -Commercial _ ❑ Any multipurpose fire sprinkler system.
Domestic ❑ Any complex structure as defined in OAR9I 8-780-0040.
Drinking Fountain
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink -2•-
3 ' . Isometric or Riser Diagram
4 ' ❑ Isometric or riser diagram is required for new buildings
-Car Wash Drain
Garbage Domestic non-food that meet the qualifications above.
Disposal. -Domestic food related
-Commercial food related
-Industrial food related .
Ice Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station) . • .
Rec.Vehicle Dump Station .. .
Shower: -Gang .
-Stall . ' • .
Sink -Lav/Bar non-food related
-Bradley .
-Com/Sery/Util food related ,
-Service *Note: If the fixture work under this permit results in an
Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and
Washer-Clothes
Water Extractor must paid assessed for the sewer increase mt be aid before the
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF_PernitApp.doc 08/04/2011 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
12100 SW SCHOLLS FERRY RD, TIGARD, OR,
97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
October 26, 2015 at 9:54:19
AM
PLM2015-00349
Don Sylvester
1. Corrections are complete- plumb. Final ok.
Violation Summary:
Inspector Contractor