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Permit (62) CITY OF TIGARD PLUMBING PERMIT II COMMUNITY DEVELOPMENT Permit#: PLM2016-00447 T(GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/18/2016 Parcel: 1S1260000300 Jurisdiction: Tigard Site address: 9312 SW WASHINGTON SQUARE RD W01 Project: Kay Jewelers Subdivision: None Lot: None Project Description: Add ADA restroom:(1)lay,(1)water closet&(1)water heater. Contractor: R A WARNER PLUMBING Owner: PPR WASHINGTON SQUARE LLC PO BOX 820785 PO BOX 847 VANCOUVER,WA 98682 CARLSBAD, CA 92018 PHONE: 360-772-2490 PHONE: FAX: 360-263-5354 FEES Quantity Description Date Amount 1 ea Lavatories 08/17/2016 $25.02 Specifics: 1 ea Water Closet 08/17/2016 $25.02 1 ea Water Heater 08/17/2016 $37.52 Type of Use: COM 1 12%State Surcharge- 08/17/2016 $10.51 Class of Work: ALT Plumbing Type of Const: Occupancy Grp: Stories: Total $98.07 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: 1111111hs • OW/ 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. Plu=g Permit Ap>plic_a_ tin_n Building Fixtures City of Tigard RECEIVEDFOR OFFICE 1S O1L1 • 13125 SW Hall Blvd.,Tigard,OR 97 Received �i� _ Phone: 503.718.2439 Fax: 503.5gn 4 1 7 2016 Date/By: 1f Permit No.: Inspection Line: 503.639.4175 3. j Plan Review ey -QQ�y7 7 1 G A R D p CITY Date/By: Other Permit No.: Internet: www.tigard-or.gov �� ��� 114 Date Ready/By: Notified/Method: / -10007t�t TYPE !w !Pi lI/ 1 ► See Pagel for O Supplemental Information ❑New construction • E'_SCDIIL 0 Demolition For special information use checklist Total :ddition/alteration/replacementDescription A 0 Other: Qty. CATEGORY OF New 1-2-family dwellings(includes 100 ft.for each utility • CONETTRECTION ' SFR(1)bath ❑ 1-and 2-family dwelling P r 312.70 - ►_ Commercial/industrial SFR(2)bath _® ❑Accessory building -I 0 Multi-family SFR(3)bath 111111 500.32 - ❑Master builder Each additional bath/kitchen _ 0 Other: 25.02 -` ` JOE SITE INFORMATION AND LOCATION` Fire sprinkler sq.ft.) Page 2 MI Job site address: /' --_-�=• •• j Z L Cj �� Catch basin or area drain City/State/ZIP: t ,A�J 18.76 - r. Drywell,leach line,or trench drain 18.76 - Footing drain(no.linear ft.: Suite/bldg./apt.no.: _) 11111Project name: l��„ Jr� { Cross street/directions to job site: Page 2 - Manufactured home utilities 50.03 - Manholes _ 18.76 Rain drain connector 1111111 - 11111111111111..1111111111111111....... Sanitary sewer(no.linear ft.: ) Page18.76 2 Storm (no.linear ft.: Subdivision: _) _ Page 2 - Water service(no.linear ft.:_) - Tax map/parcel no.: Lot no.: Fixture or item: / ` /�630` ` A,0 Backflow preventer 111111' DESCRIp IQ1 p V►! 31.27 - 4N4 12.51111111111111 ,s E v�" • _/eClothes washer Dishwasher 1111111125.02 11111111 f 25.02 - Drinking fountain _ 25.02 &° - a pit©PRIy`j' Ejectors/sump 25.02 - iroiks'I Expansion tank _ 12.51 Fixture/sewer cap 111111Address: Floor drain/floor sink/hub 25.02 111111111City/State/ZIP: 25.02 - Garbage disposal 111111Phone:( ) 25.02 Mil Hose bib _ 25.02 - MEI ❑ APPLICANT 12.51 44 CONTACT.PERSON Interceptor/grease trap _ EMIMIIIIIIIINIE 25.02 - Medical gas(value:$ ) _ Contact name: 1101111111111111111111111 Page 2 11111111111IIIIII Address: 12.51 M. Roof drain(commercial) 1111111 111111111112.51 • Sinlc/basin/lavatory / 25.02 - Phone:( ) Solar units(potable water) MI6254 1111111111 Tub/shower/shower pan Inn12.51 111111111 11111125.0202 - CONTRACTOR Water closet Business name: 4 r 25.02 n Address: ��e �} 5:7,,t Water piping/DW 37.52 cJ ZfJ V 1111111156.29 City/State/ZIP: Co Other: _ 02MIN �4 arG o z total - Phone: L (�C� ) '7?2 - „„1...‹.(qc� subtotal [SIM Minimum permit fee: $72.50 MI Plumbing Lic.no.: I? 7-c-2./ t�v?CCIMMERIMmENE Plan review (25%of permit fee) v Authorized signature: State surcharge(12%of permit fee) rwrimargazi TOTAL PERMIT FEE MEM Date: g /.. .4.„ This permit application expires if a permit is not obtained within 180 days after it has been accepted *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/o2/cow a) JAM- Jam- -1<Z Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Residential Fire Su r r ression S stems: Fee Schedule: Fee(ea) Total S I wire Foota�.e: Permit Fees Qty. $121.90 Site Utilities - 50.03 _ oto 2,000 $169.69 Footing drain 15'100' imm®_ 2,001 to 3,600 $233.20 3,601 to 7,200 Sewer-drain each additional 100' am 62.54 7,201 and a eater Sewer-eachst 100' _®_ Water Sewer- rviadditional100'100' 111111 62.54 _ Medical Gas S stems: Water Service 1st _®_ Valuation: Perlmit Fee , Worm ServiceRin-each1st additional0' 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain 1st 100' 111111_® $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for Storm&Rain Drain-each additional 100' each additional$100.00 or fraction thereof,to �, Fee(ea) Total and includin_$10,000.00. Other Ins r ections or Fees $10,001.00 to$25,000.00 and incl for the first$10,000.00 and$1.54 for In whichno fee is existingsps plumbing a for each additional$100.00 or fraction thereof,to of90.00/hr ■ and includin:$25,000.00. (minimumii no is to—1//2 lly indicated ■ Inspections n chte outside of hour) 90.00/hr $25,001.00 to$50,000.00 $379.50 for the fust$25,000.00 and$1.45 for hours(min umchar:e normal business each additional$100.00 or fraction thereof,to _ and includin:$50,000.00. hours(minimum 2 hours 90.00/hr 1111111 Reinspection Fees $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for 90.00/hr - each additional$100.00 or fraction thereof. Additional plan review for revisions _ (minimum char:e 1/2 hour) Subtotal: __ Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", performed by fixture. Failure to please indicate work Plan#eVieW,fOr Plulmbin. Iitsta_ ., a Ons e Plan review is required for any of the following. accurately report fixtures could result in uincbreFa.��u�sewer fees*. Work Replace!' Please check all that apply. Fixture Type for Capped Added Relocate 0 Any new commercial building with water service 2"and Performed: --- greater,except systems designed and stamped by licensed Ba h: /Font --- engineer. Bath: -Tub/Shower —= 0 New exterior plumbing site utilities for any complex structure JacuShow irLool as defined in OAR918 780-0040. Car Wash: -Each Stall —=— 0 Medical gas and vacuum systems for health care facilities. -Drive or =-- 0 Any multipurpose fire sprinkler system. Diss ashen: Aspsuitor -- 0 Any complex structure as defined in OAR918-780 0040. Dishwasher: -Commercial =-- Domestic —== Submit 2 sets of plans with any of the above. Drinkin:Fountain Floor Drain/sink: -2" _—= Isometric Riser Di 'r aM -3" --- ❑ Isometric or riser diagram is required for new buildings a === that meet the qualifications above. -Car Wash Drain Garbage -Domestic non-food --- Disposal: -Domestic food related —_ -Commercial food related -- .11.111111 -Industrial food related 111.1111.1.1111.1.11 == Comments regarding fixture work: Ice Mach./Refri:.Drains --- Oil S ,arator(Gas Station) --- Rec.Vehicle Dum s Station --- Shower: -Gang 111.11111.1111.111111111-Stall Sink: -Lav/Bar non-food related ==- 11111111 -Bradley - -Cervica /Util food related ==— *Note: If the fixture work under tthiispermitt be issued and service --- increase of sewer EDUs,a sewer p Swiinmin:Pool Filter 11...111...111.1.1 fees assessed for the sewer increase must be paid before the Washer-Clothes 11111111111111111111111111111 plumbing permit can be issued. Water Extractor — Water Closet-Toilet — Other Fixtures: —_— I:\Building\Permits\PLMF PermitApp.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 9312 SW WASHINGTON SQUARE RD W01, TIGARD, OR, 97223 Commercial - Plumbing 399 Plumbing final PASS - No C of O PLM2016-00447 Don Sylvester Violation Summary: Inspector Contractor