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Permit
CITY OF TIGARD PLUMBING PERMIT r. COMMUNITY DEVELOPMENT Permit#: PLM2016-00428 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/10/2016 Parcel: 2S102AD02200 Jurisdiction: Tigard Site address: 8900 SW BURNHAM ST Project: Burnham Business Park Subdivision: None Lot: None Project Description: Trench 30'of sanitary sewer line.Line is being trenched between mailboxes and property line located in front of the southern most building. Contractor: APOLLO DRAIN&ROOTER SERVICE Owner: BURNHAM BUSINESS&STORAGE LLC 2208 NW BIRDSDALE#8 9500 SW BARBUR BLVD STE 300 GRESHAM, OR 97030 PORTLAND, OR 97219 PHONE: 503-239-8801 PHONE: FAX: 503-669-9568 FEES Quantity Description Date Amount 30 If Sanitary Sewer 08/10/2016 $62.54 Specifics: 1 12%State Surcharge- 08/10/2016 $8.70 Plumbing Type of Use: COM 10 ea Minimum Fee Adjustment- 08/10/2016 $9.96 Class of Work: ALT Plumbing 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 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 quest' • t•OUNC by calling 503.232.1987 or 1.800.332.2344. Issued y: I / • ' 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. Aug. 9. 2016 12: 53PM No. 2753 P. 1 Plumbing Permit Applica Site Utilities ',t ,.>Pai .�"� FOR OFFICE USL ONL1 City of Tigard 12eeeived 1114 13125 SW Hall Blvd.,Tigard,OR 9, �fi9 Dmemy, o lo I Peimir No.: AL� `�_rya"g p � I'L �/ 9016 Plan Review Phone: 503.718.2439 Pax: 503.59 . 0 Date/B : Other Permit No.: TIC;AR n Inspection Line: 501639.4175 4,vri, „ rf �g bate Ready/9y: kris: 0 See Page 2 for Internet: www ttgard-orgov ,� f Ai.a Po, i@ Noiified/Meihod: Supplemental Information � 117 I}._ � I ..- ----.-^ . I [ TM'{r1_C;�ID,tLIIiC. D New construction ❑Demolition FOr sa/el it prmario,r rise checklist, Description Qty. Ea. Total Addition/alteration/replacement ❑Other: New I-2-family dwellings(includes 100 R.for each utility eonncctian) r�;/.{IIr tlt?n,„ (flit (ig)ri ;1..1;';t'Iflld)r'I SFR(1)bath 312.70 ❑ 1-and 2-family dwelling :I9 onunerctaiJindusrrial SFR(2)bath 437.78 AccessorySFR(3)bath 500.32 © building ❑Multi-family Each additional bath/lcitchen 25.02 ❑Master builder ❑Other --- m Fire sprinkler p sq.ft.) Page 2 rI0 } 'Il NT'r it 4OJ;5)1,(III iii 1-_91 II O ;0.r, r)'r1. ... ...... ... � - Site ntliltle$; Job site address: Ogee) 5�,&) 6,rr- ham, 5+ Catch basin or arca drain 18.76 __ City/State/ZIP: T ar-ri OR R12.23 (2 2 3 F owing drainleacLinc,linear trench drain Pageg2 `� ) 4' //�� �� n Footing (no. ft.: ) 2 Suite/bldg,/apt"no.: Project name:? ,,kKe►-►M-1 o• P,_ 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 Water service(no.linear ft.: ) Page 2 Subdivision: I Lot no.; Fixture or Item: Tax map/parcel no.: Backflow preventer 31.27 ' Backtivater valve 12.51 z, C -,-- - trM : ^+t-ra '"t;l,t - ;' �.t 0 . N7."'' '-.. r,r _ .;ate=�. Clothes washer 25.02 Trench ?) ,' ,.rt i 4-a h e� _ P �-y Dishwasher�rem' �' Drinking fountain4,f Ejectors/sump 25.02 '' 4141r.'"741'1:1"5-U1'67222. 1".'" i' tP} ,--1 741 `., -.? tri hx i 's7 ." 7 ` ... ,. StiNl 'tli]'i I� +m "3 c ' , 222.1 t�a' - ' - 4-'' 2 Expansionreewers 12.51 Name: Fixture/sewer cap 25.02 Address: Floor drain/floor sink/hub 25.02 _ Garbage disposal 25,02 City/Slate/ZIP: Hose bib 25.02 Phone:( ) Fax ( ) ' Ice maker 12.51 . `4 10SFAI y .7s!,;' e� a oWu 4;'4, k '1 ,, Interceptor/grease trap 25.02 Business name: A'�L�i l o brain i Rocs f •,r 6V� Medical gas(value:S ) Page 2 ti<arri. O,i /c 1 Primer Contact name: i`l 12.51 r7 O� Roof drain(commercial) 12.51 Address: 2 n Q h dcUey At , (St 9 Sink/basin/lavatory _ 25.02 City/State/ZIP: are V �j G Solar units(potable ly-C. � _ L 70 go water) 62.54 Phone:( ) (7C _ }620 Fax::( ) 0629-9 sea Tub/shower/shower pan 12.51 ill, Urinal �" 1 25.02 E-mail: L why e,✓3.� ° 'k' s'w iVC ft:7 `.,ra s- r'-'.t ;'17-1`. F'X7.,-7 1„- Water closet 25.02 ,�......`.- w.t e��FP t 4t gf� .n' 'S ' y ,�' � h19V 0 ' ;'' 'i '- i Vii.:;"r ro°-2!c• f� e� Water heater 37.52 Business name: rT Q i �n f)rain 4, / 1-14_4--(V•e J Water piping/DWV 56.29 Address: Q 1n E7 5.d Ca ' Oilier: 25.02 City/State/ZIP: ( /i..,�o n� y y X11 9 711 AveHL Subtotal I Phone:( _ 13 t _/Fax:(/- 3) 041_61 SOW Minimum permit fee: S72.50 7a.5� CCB Lie.: 14 C4 `('j Plumbing Lie.no.: 2[2.-53`4' .,2,2,, Plan review (25%of permit fee) - -- 1 b r State surcharge(12%of permit fee) 3,74-.) Authorized signature: 0�,a0 ,- �e4 ate_-- TOTAL PERMIT FEE. Print name: 014.. .... Date:Sr q F 6, 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. Ianuilding1permirsUPLMU,permiutpp.doo 10/01/09 440.4616T(IO/0O/COMNVEM) Aug. 9. 2016 12: 53PM No. 2753 P. 2 Plumbing Permit Application - City of Tigard Page 2 -Supplemental Information Fee Schedule: Residential Fire Sur i ression S stems: •,n}!; ll!%,iotili i "if- .7:1 J4,3feta][7:7::!;ia 0: ioliti-Lir: I r(T.ffit 12;1.:; l r'111iiglI 1;1 it, ., Footing drain-1"100' 50.03 0 to 2.000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 Sewer-Ist 100' 3,601 to 7,200 $233.20 ■' 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 . Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 S5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for 7} o -; 1f f tr}i 11 Ti : tach additional$100.00 or fraction thcrcoo to dJli,ii lLltyir i. table;_i_ Inti= .....1_._ " IL and including$10,000.00. Inspection of existing plumbing 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 $379.50 for the first$25,000.00 and 51.45 for hours minimum char•c-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/Ix - $50,001.00 and up $742.00 for the first$50,000.00 and 51.20 for (minimum eherre-112 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*. }�A p < j-='71'n r ,..r--:-..5-r--) .•t. Quanfityy Ii'blxfitre a �;, a Y4,,N 014 1 t 11 t`4_71± `i 1 s)'}I 1 1 Il 1 �'l I i '�T,0-i'NT l-•:40, 7. ;, Ca�pac� •.-51;2.046-7,1 - t AKe P �t�l'�&+' �P���� -' � '.,01.064::. � Plan review is required for any of the following. Ji istr yr ortnecd __ lease check all that apply. Baptistry/Font Bath -Tub/Shower CI 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 ❑ 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 CI multipurpose fire sprinkler system. ^-, Drinking Fountain ❑ 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. -3" - ; � R i 4 '�a � . lx � •• te ^" .a ; Car Wash Drain ❑ Isometric or riser diagram is required for new buildings Garbage -Domestic-non-food 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 -StallIIII "- Sink/Lay -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 fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: http://www.tigard-or.gov/document centerBuilding/PLMUJermitApp.dc