Permit (28) III4
CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2016-00068
T fiARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/09/2016
Parcel: 1 S126DB02800
Jurisdiction: Tigard
Site address: 9370 SW GREENBURG RD 601
Project: The Commons Subdivision: 1991-018 PARTITION PLAT Lot: 1
Project Description: Interior plumbing:Relocating(1)sink and(1)water closet.
Contractor: CASCADE PLUMBING CO Owner: FRANKLIN COMMONS ASSOCIATES, LLC
15765 SW 74TH AVE#110-A BY NORRIS&STEVENS
TIGARD, OR 97224 621 SW MORRISON STE 800
PORTLAND, OR 97205
PHONE: 971-312-1174 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Sink 02/09/2016 $25.02
Specifics: 1 ea Water Closet 02/09/2016 $25.02
1 12%State Surcharge- 02/09/2016 $8.70
Type of Use: COM Plumbing
Class of Work: ALT 22 ea Minimum Fee Adjustment- 02/09/2016 $22.46
Type of Const: Plumbing
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
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
Issued By: Permittee Signature: 0.5?
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.
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City of Tigard R '" 2016 Received n 1 Permit No.
13125 SW Hall Blvd.,Tigard,OR 9722 Date.By: J 1�p //?°AP-0-n a
`` ���11 i Plan Review ( �•'
Phone: 503.718.2439 Fax: 503.59LIV
?if g Attu Date By: Other Permit No. (/1R�V14a_...oc et,3
Inspection Line: 503.639.4175 BUILDING'
TIL D N rr.I 4-I;1�ryll
l I C 1 R D Internet: www.ti and-or. ov Io ) I� q F r l 91 Date ReadyBy: lurir Supplemental
See age 2 for
g g Notified Method: '�' Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑New construction 0 Demolition For special information use checklist.
Description I Qty. I Ea. 1 Total
® Addition/alteration/replacement 0 Other: New I-2-family dwellings(includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
0 I-and 2-family dwelling I ®Commercial/industrial SFR(2)bath 437.78
buildingSFR(3)bath 500.32
❑Accessory 0 Multi-family
Each additional bath%kitchen 25.02
0 Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:9370 SW Greenburg rd Catch basin or arca drain 18.76
Drywell,leach line.or trench drain 18.76
City/State/ZIP:Tigard,OR
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.:601 I Project name:Commons 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
Water service(no.linear ft.:_) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Relocate existing fixtures Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER l 0 TENANT Expansion tank 12.51
Name: Fixture:sewer cap 25.02
Floor drain/floor sink;huh 25.02
Address:
Garbage disposal 25.02
I
City/State/ZIP: Hose bib ( 25.02
Phone:( ) Fax:( ) Ice maker 12 51
0 APPLICANT 0 CONTACT PERSON Interceptor'grease trap I 25.02
Business name: Medical gas(value:S ) Page 2
Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address:
Sink'basinlavatory I 25.02 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) , Fax: :( ) Tub/shower shower pan I 12.51
E-mail Urinal 25.02
Water closet 1 25.02 25.02
CONTRACTOR
Water heater I 37.52
Business name:Cascade Plumbing Co
Water piping DWV 56.29
Address: 15765 SW 74t''Ave#110-A Other: I 25.02
City/State/ZIP:Tigard,OR 97224 Subtotal 50.1)4
Phone:(503)289-7095 Fax:(503)283-9514 Minimum permit fee: 572.50 72.50
Plan review (25%ofpenult fee)
CCB Lie.:204392 Plumbing Lie.no.:PB1528
State surcharge(12%of permit fee) 8.70
Authorized signature: ()pia n qt,_,..____ TOTAL PERMIT FEE 81.20
Print name:Crystal Jones l SC Date:02/08/2016 This permit application expires if a permit is not obtained within 180 days
after It has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1 Budding Pennus PLbtU-1'erm0App doc 10 01 09 -1-10-0,161.110 02 COM WEBI
Plumbing Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Total,
Site Utilities Qty'. Fee(ea) Square'Footage: Permit Fee:
Footing drain-14 100' 50.03 0 to 2,000 S121.90
Footing drain-each additional 100' 37.52 2,001 to 3.600 S 169.69
Sewer-1st 100' 62.54 3,601 to 7,200 5233.20
7,201 and greater 5327,54
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 $1.00 to 55,000.00 Minimum fee S72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to S10,000.00 S72.50 for the first S5,000.00 and SI.52 for
Fee .,T
each additional$100.00 or fraction thereof,to
Other Inspections or Fees Qty. (ea) otal
and including S10,000.00.
Inspection of existing plumbing or for S10,001.00 to S25,000.00 S 148.50 for the first S 10,000.00 and S 1.54 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 550,000.00 S379.50 for the first S25,000.00 and S1.45 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 5742.00 for the first$50,000.00 and S 1.20 for
(minimum charge-1/2 hour) each additional$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*.
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/FontPlease check all that apply.
Bath -Tub/Shower 0 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 Thru 0 New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial 0 Medical gas and vacuum systems for health care facilities.
-Domestic 0 Any multipurpose fire sprinkler system.
Drinking Fountain 0 Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
Car Wash DrainIsometric or Riser Diagram <,
Garbage Domestic-non-food
0 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
-Bradley
• -Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet I fees assessed for the sewer increase must be paid before the
_Urinal plumbing permit can be issued.
Other Fixtures:
C:\Users\Cascade Main\Desktoplpermit 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
9370 SW GREENBURG RD 601, TIGARD, OR,
97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2016-00068
Don Sylvester
Violation Summary:
Inspector Contractor