Permit (10) CITY OF TIGARD PLUMBING PERMIT
' 1e '' COMMUNITY DEVELOPMENT
Permit#: PLM2016-00485
Tf(3ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/21/2016
Parcel: 2S112DD01600
Jurisdiction: Tigard
Site address: 15575 SW SEQUOIA PKWY 130
Project: BFit Subdivision: PACIFIC CORPORATE CENTER Lot: 4
Project Description: Interior plumbing for TI:Capping(1)drinking fountain,(4)lavatories,(5)water closets,and(1)urinal;Adding(1)
drinking fountain,(9)shower stalls,(10)lavatories,(9)water closets,and(1)urinal.
Contractor: COLUMBIA MECHANICAL INC Owner: PACIFIC REALTY ASSOCIATES
PO BOX 2164 ATTN: N PIVEN
WOODLAND,WA 98674 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 360-225-1600 PHONE:
FAX: 360-225-8755
FEES
Quantity Description Date Amount
1 ea Drinking Fountain 09/21/2016 $25.02
Specifics: 11 ea Fixture/Sewer Cap 09/21/2016 $275.22
10 ea Sink 09/21/2016 $250.20
Type of Use: COM g ea Tub/Shower/Shower Pan 09/21/2016 $112.59
Class of Work: ALT
Type ea Urinal 09/21/2016 $25.02
of Const:
g ea Water Closet 09/21/2016 $225.18
Occupancy Grp:
Stories: 1 12%State Surcharge- 09/21/2016 $109.59
Plumbing
Total $1,022.82
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•
: mittee Signature: _ P"
(47.
-./Lf.•01-,'"4"--- —
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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Plumbing Permit ApplicationsAN-is,).- V
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City of Tigard s11,.�-Q1 eetved
13125 SW}tall Blvd„Tigard,OR 97223 *� i,.0._ (3 I 1 Permit No.: P f� �}�,pp// c 1
Phone: .503.718.2439 Fax: 503.598.1960 � �''��� '''.:41
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'.t t Other Permit No.
TIGARD Inspection Line: 503.639.4175 �,, "
Internetwww tigard or.gov D Date Ready/By Iwis" H See page 2 for
Notified/Method: G Supplemental Information
TYPE OF WOR T
FEE* SCHEDULE
0 New construction ❑Demolition For special information use checklist
❑Addition/alteration/replacement Description Qty. 1 Ea. ( Total
Other' New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
0 1-and 2-family dwelling 1,t Commercial/industrial SFR(2)bath 437.78
0 Accessory building ❑Multi-family SFR(3)bath 500.32
0 Master builder Each additional bath/kitchen 25.02
❑Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:15575 SW Sequoia Parkway Catch basin or area drain 18.76
Drywell,leach line,or trench drain 1%.76
City/State/ZIP:Tigard,Oregon 97224
Suite/bldg./apt.no.:130 Project name:BFit Footing drain(no.linear ft.: ) Page 2
Manufactured home utilities 50.03
Cross street/directions to job site:Sequoia+Rewood
Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft_: ) Page 2
Subdivision:Pacific Corporate Center Water service(no.linear ft.: ) __ Page 2
Lot no.:4 Fixture or item:
Tax map/parcel no.:2S1120D01600 Backflow preventer 31.27
1).ESCRIP'TION OF WORK. Backwater valve 12.51
Health Club Clothes washer 25.02
Dishwasher 25.02
Drinking fountain i 25.02
Ejectors/sump 25.02
IDPROPERTY OWNER ►li TENANT Expansion tank 12.51
Name:BFit Fixture/sewer cap l' 25.02 `>
Address: 1265 Laurel'free Lane,Suite 200 Floor drain/floor sink/hub 25.02
Cit)1StateJZ1 P:Carlsbad,CA 92011 Garbage disposal 25.02
Bose bib 2502
Phone:(760)285-7926 Fax:(435)656-8433
Ice maker 12.51
C APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:Cumming Construction,Inc. Medical gas(value:$ ) Page 2
Contact name:Grant Cumming Primer 12.51
Address:1483 East 3850 South Roof drain(commercial) 12.51
Sink/basin/lavatory' 25.02
City/State/ZIP:Saint George,Utah 84790 25-.i."Lc,
Solar units(potable water) 62.54
Phone:(435)656-8433 _� I Fax::(435)656-8447 Tub/shower/shower pan '� 12.51
-1
l�2
E-mail:geumming�lvcummingconstruction.com Urinal 25 02
CONTRACTOR, Water closet e 25.02
Water heater
Business name:Columbia Mechanical 37.52
Water piping/DWV 56.29
Address:PO Box 2164
Other 25.02
City/State/ZIP:Woodland,WA 98674
Subtotal �(/3 4
Phone:(360)518-4248 Fax:(435)656-8447 Minimum permit fee: $72.50
CCB Lie.:151122 Plumbing Lie,no.:37-451P13 - Plan review (25%of permit fee)
Authorized signature: State surcharge(12%of permit fee) %rqt',5(-
' ��' �%'" TOTAL PERMIT FEE W,il
I Print name:sent Belika
This
Date:9/21/16 s 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.
Iiiuilding1Pertnits.PL.Mtl-PennitApp-doe 10/01/09
440.406'C(7 0102;COMIW En)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
• Fee Schedule: Residential Fire Suppression S stems:
1 w
Footing drain- 100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
7,201
Sewer-1st 100' 62.54 7,201 and greater $327.54
$327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas S stems:
Water Service-each additional 100' 37.52
Storm&Rain Drain-1st 100' 62.54 ' 1 � ��' '
$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
7 , , F =€ each additional$100.00 or fraction thereof,to
I 9,E ' �... ,, 4 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 char a-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$1.45 for
hours minimum ch. e-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 ch. a-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 ; � ; e�m{ i 1 � ._.a is i�?E i a€ 14. k�
WitrifiVigiMO'e Plan review is required for any of the following.
Yx1414t4Please check all that apply.
I!vo� oied+r, >_� ,N ,.. . _ >. s_< ❑ Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
-Jacuzzi/Whirlpool New r.
Car Wash: Stall ❑ New exterior plumbing site utilities for any complex structure
-EachTani as defined in OAR918-780-0040.
Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial
0 Any multipurpose fire sprinkler system.
Domestic 0 Any complex structure as defined in OAR918-780-0040.
Drinking Fountain '
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink: -2" . .
-4" 0 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 q
Sink: -Lav/Bar non-food related kt ;V
-Bradley
-Com/Serv/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 fees assessed for the sewer increase must be paid before the
Water Extractor
Water Closet-Toilet 5 plumbing permit can be issued.
'�'
Urinal
Other Fixtures:
I:\Building\Permits\PLMF PetmitApp.doc 08/04/2011 2