Permit (178) 1,14 , CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2016-00547
T[ . R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/21/2016
Parcel: 2S110DCO2200
Jurisdiction: Tigard
Site address: 15660 SW PACIFIC HWY A-4
Project: Tea Massage Subdivision: 1997-016 PARTITION PLAT Lot: 2
Project Description: Add(1)clothes washer,(1)laundry sink,(1)shower&(1)water heater.
Contractor: VENNE PLUMBING LLC Owner: ROIC OREGON LLC
15145 SW DIVISION ST ATTN: SCHOEBEL, RICHARD
SHERWOOD, OR 97140 8905 TOWN CENTRE DR, STE 108
SAN DIEGO, CA 92122
PHONE: 503-624-9309 PHONE:
FAX: 503-684-0940
FEES
Quantity Description Date Amount
1 ea Clothes Washer 11/21/2016 $25.02
Specifics: 1 ea Sink 11/21/2016 $25.02
1 ea Tub/Shower/Shower Pan 11/21/2016 $12.51
Type of Use: COM 1 ea Water Heater 11/21/2016 $37.52
Class of Work: ALT 1 12%State Surcharge- 11/21/2016 $12.01
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $112.08
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 B
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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.
2016-10-31 11 :29 VENNEPLUMBING 5036840940 >> 5035981960 p 1/2
Plumbing Permit Applic: = II, (E,1101..41 • 1
BuiIding Fixtures - - a- . c•,
City of Tigard L�� L ar iYyr1 /11111111)11)1•1111111.111r1111111111,1111
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1114 !t C 016 Ili/Reyvicw Permit No.
_- )3125 SW Hall Bivd.,Tigard,OR 971iZ2� � ,� IL �`O/��� 7
Phone: 5(13,718,2439 Fax: 503.598,1960 pee, Other Permit No.:5-10,e.aOjlo Gv 36,4/
i u.1. Inspection Line: 503639.411 %.,/ r
Internet: www.tigard•or.guv L A . a- j Date tteacty/lly: lurk S See Page 2 for
�jj�T Notified/method:
TYPE )�. %I y`g"k� Supplemental Information
VI-a�i O FEE° SCHEDULE
❑New construction 0 Demolition For,,speciarigfornuuionuse check(LcL
....,.........,..„. .,.-._..,.._..._ Des( P:,..,..
i4 Addition/alteration/replacement ❑Other• ,.,:1..•,.(. t ncl ec _...t ea�utlIi.,L.o.. e i n.
' New t-2-family dwcllin�tt(inc.ludex 10(1 R.fix tach utili connection)
CATEGORY OF CONSTRUCTION SFR(I)bath312.70
❑1-and 2-familydwelling "SFR(2)bath --_.._.__
®CornmercialCnduslrial 437.78
El Acceswry building SER(,3)bath 50 .32
_ _ �]Multi family
Master builder - Each additional bath/kitchen 25.02
Other:
------.-------,_•_..._ Fire sprinkler( sq R) Page 2
JOB SITE INFORMATION AND LOCATION
Site utilities:
Job site address:t,5b60 ew pacific hwy Gatch basin or area drain 18.76
i
City/State/ZIP: tigard rywell,leach line,or trench drain 18.76
Suite/bldg./apt.no.:a4 Pagett Warne: ~ 1;\ r✓ C Footing Ear ,.linear _)
k ting d 'n(ni ft.: age
50.03
-- T . .... .. .........I....,,...:•.,._...,..:.‘. .:.,.,....... Manufactured home utilities P
Cross ti,. ,.,. ... .N„...,..._
strext/drrcchons to job site: J r ,� Manholes 18.76
',+‘ LP' 11' Rain drain connector
/� Sanitary sewer(no.linear ti.:
; , g- 1 ,j Storm sewer(no,linear ft-;,_-) Page 2
'S4jkl ) Water service(no.linear R.:
Subdivision: . Lot no.; -•) Page i
Fixture or Item:
Tax map/parcel no.: a S//DDG o aaDO Backflow preventer 31.27
DESCRIPTION OF WORK '^- _Backwater valve 12.51
(_i (' -. / / Clothes washer 25.02 _5 -
r
�,�c r �_, , Li,,.1( 4<. ti �1_a TO.c' _,.. l ..._ ,,......--,...T.
-
�� + 3 I-l�- --- - .... .,. Dishwasher. , ,.... .. .,... ._.,.. 25.02 T ---.-T-
L\� -`1 S(;L. 1� 1 }t,7 i �,-V� :�)i l )'-- Drinking fountain 25.02
------ Ejectors/sump 25.(12
CI PROPERTY OWNER 0 TENAN -� Expansion tank
12.51
Fixture/sewer cap
25.02
Name:
Floor draiWtloor sink/hub
Address: 25.02
Garbage disposal 25.02
City/State/ZIP:
-_._................._.. _-_-_._..�..-_
Hose bib 25.02
Phone:,( ) Fax;
) tee maker
� APPLICANT . ......-, __.,.._.. 12,51
0 CONTACT PERtiON I terceptor/grruse trap 25.02
Business name;venue plumbing T-- Mediad gas,(value:$^_ _) Page 2
Contact name:ryan venue Primer rrimer r __ _- 12.51
.0 e -
--- --
_... _. ....._ -,..:.................__,....._.,, _.- . Roof drain(commercial) 12.51
Address:15145 SW Division
_.. _,...,. �...-..., ,n,..,,..,. _.,� ._ ..._,.,,.._......
___... Sink/basin/lavatory _._25.02 ��
City/State/ZIP:Sherwood,or 97140
Solar units(potable water) 62.54
Phone:(S0.3)624-9309 Fax;;( ) Tub/shower/shower pert / 12.51 I r
(-mail;ryan@ venneplumbing.com Ilrinal 25.02
CONTRACTOR Water closet 25.02
...- ...._. -.-_..,._-...--
nn Water heater / 37.52 )5 l
Business name: fir.) iJ t. `C.u t-i 6/ it.)d, Water
pipin./DW_.w,_,...._._�
-�...._.,....................................-�__.-,,.._........ Water piping/DWV 56.29
(Toter 25.02
City/StatcCLIP: - Subtotal /l 2(7 j 1
^-- Minimum permit fee: x72.50
Phone:( ) Fax:( )
CCB Lie.:192494 Plumbing Lic.no.:pb956 Plan review (25%of permit fee)surcharge J State (12%of permit fee)_121-._
Authonzed signal c: __.�_ ..__._�_. ...._...-..-... _-..
TOTAL PERMIT FEE
E.Print name: .` I ' Date: 't'ht Permit avid Us*expires if art is not obtained within 1 days
_ • L,• \�.1`•' 1r L-1`�Cr 1 L �✓ After it has been e(((gged as complete
"I'ee methodology set by Tri-County Building Industry Service Board.
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2016-10-31 11 :30 VENNEPLUMBING 5036840940 >> 5035981960 P 2/2
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-1"100' 50.03 0 to 2,000 $121.90
Footing drain-tach additional 100' 37.52 2,001 to 3,600 $169.69 _
-Sewer-Ism iUO'- _ 62,54 3601 to 7,200 $23320 _..._._....,....,,...._.
7.201 and greater $327,54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gras Systems:
Water Service-each additional 100' 37.52
Storm&Ruin Drain-1st 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 fix
Other Inspections or Fees Qty. Fee(ea) Total
eacheach additional$100.00 or fraction thereof,to
S 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$1.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Reinspectiom 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 bow)
each edditiottal$100.00 or fraction thereof.
Subtotal: ,_.,... ....-..� .......,,_._., ea -ditinal$100.0....rfration,
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 Relocate Plan review is required for anyof the following.
Work Performed: Capped Added Please check all that
13aplistry/Pomo apply.
Bath Tub/Shower ❑ Any new commercial building with water service 2"and
Jacorti/Whirlpool 1.. __. greater,except systems designed and stamped by licensed
car
Wash -1 ach Stall
engineer.
-Drive'Oyu 0 New exterior plumbing site utilities for any complex Stricture
Cut idor/Waler As irator as defined in 0AR918-780-0040.
Dishwasher -Commercial 0 Medical gas and vacuum systems for health care facilities.
-Domestic 0 Any multipurpose fire sprinkler system.
Drinking t"'ountain T 0 Any complex structure as defined in OAR918-780-0040.
Eye Wtth
Flour Drain/sink -2" Submit 2 sets of plans with any of the above.
•3"
4,. Isometric or Riser Diagram
Car Wash Drain
Garbage Domestic-non-food U Isometric or riser diagram is required for new buildings
Disposal -Domtcstie Total related that meet the qualifications above.
-Commercial.food related
-Industrial-food related - -
ice Mach./Rctiig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -(fang
-Stall I
Sink/Lav -Non-ford related r
-Bradley
-('nmmcrcial•food related
-Service
Swimming Pool Filter
Washer-Clothes i *Note: If the fixture work under this permit results in an
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:
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