Permit (11) CITY OF TIGARD PLUMBING PERMIT
1111
it Permit#: PLM2017-00090
COMMUNITY DEVELOPMENT
Date Issued: 03/16/2017
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2516/20/ 0200
Jurisdiction: Tigard
Site address: 7900 SW HUNZIKER RD
Project: Grow Construction Subdivision: None Lot: None
Project Description: Backflow preventer.
Contractor: COMMERCIAL PLUMBING SERVICE Owner: WALL STREET INDUSTRIAL LLC
21185 NW EVERGREEN PKWY SUITE 105 7900 SW HUNZIKER RD
HILLSBORO, OR 97124 TIGARD, OR 97223
PHONE:
PHONE: 503-439-9999
FAX: 503-439-1999
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 03/16/2017 $31.27
Specifics: 1 12%State Surcharge- 03/16/2017 $8.70
Plumbing
Type of Use: COM 41 ea Minimum Fee Adjustment- 03/16/2017 $41.23
yp Plumbing
Class of Work: OTR
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: `z / Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application ..
;- 4
Building Fixtures FOR OFFICE USE ONLY
- City of Tigard Received
Date/By: � //'7 ""
Date/By: Permit N2004-7.,7e/7Q
06916?
114
q 13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review3Other Permit No.:
Inspection Line: 503.639.4175 Date Read Juris: H See Page 2 for
TIGARD Ready/By:
www.tigard-or.gov Notified/Method: Supplemental Information
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❑New construction ['Demolition -
Demolition _ For special information use checklist
Description I Qty. I Ea. I Total
®Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
' ;44 444'444744 ' '�G p 1 ".! / / // SFR(1)bath 312.70
r 4r// ' ,2 441,4'42,444"4;4'44.. %/ r
❑ 1-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
%W ri r''. /,i �.ci$ ktl 9+i1 9t /s.il!!j .^.ili ) / E'''-' j %' .:
Site utilities:
Job site address:7900 SW Hunziker Road Catch basin or area drain 18.76
City/State/ZIP:Tigard,Oregon,97223 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name:Grow Construction Manufactured home utilities 50.03
Cross street/directions to job site:SW Wall Street 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 1 31.27 31.27
"" /,74 1fIi t% %r ',V4',44/
yJ % /' i Backwater valve
e 12.51
" c%r,%ii' "" ' ( i ; '4'2' . ` ` ,.., /,!/ Clothes waser
25.02
insatall 8"dcda valve located in existing vault at address. Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
,: r/i: , veio'''i:A 41 441,1",144;f';44',•44t'. r rr { c4;‘,,,-Ki;;; 'i4-";"441441
Expansion tank 12.51
Name:Grow Construction Oregon Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:7900 SW Hunziker st
Garbage disposal 25.02
City/State/ZIP:Tigard,Oregon,97223 Hose bib 25.02
Phone:(503)278-5332 Fax: _)__- Ice maker
12.51
'• 44 ' -4r% :,, r §~ ' t Interceptor/grease trap 25.02
4 , < • '� o, <d / , : , . ..Li, 44ir •
Business name:Commercial Plumbing Services Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Brian Hills
Roof drain(commercial) 12.51
Address:21185 NW Evergreen Parkway Suite 105 Sink/basin/lavatory 25.02
City/State/ZIP:Hillsboro,Oregon,97124 Solar units(potable water) 62.54
Phone:(503)439-9999 Fax::(503)439-1999 Tub/shower/shower pan 12.51
E-mail:dispatch@cps-services.biz Urinal 25.02
Water closet 25.02
,,.44444 '72 /i:., Water heater 37.52
Business name:Commercial Plumbing Serivce Water piping/DWV 56.29
Address:21185 NW Evergreen Parkway Suite 105 Other: 25.02
City/State/ZIP:Hillsboro,Oregon,97124 Subtotal 31.27
Phone:(503)439-9999 Fax:(503)439-1999 Minimum permit fee: $72.50 72.50
Plan review (25%of permit fee)
CCB Lic.:126015 Plumbing Lic.no.:37-421PB
State surcharge(12%of permit fee) 81.20
Authorized signature: �� � TOTAL PERMIT FEE 81.20
rmer Date. Z/ This permit application expires if a permit is not obtained within 180 days
Print name:Heather F
3 1// 1 after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits'PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Su. s ression Systems:
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
3,601 to 7,200 $233.20
Sewer-1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54
Water Service-each additional 100' 37.52 Medical Gas Systems:
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 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
each additional$100.00 or fraction thereof,to
° t 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 char: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 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�r��eessult in increased sewer fees".
nom//�f% 1 e ,
r1 , PIP4Plan review is required for any of the following.
�,.�5�- ! ,. .��.�,..e ,,...� ,•�i/�iii A�ii-. �..,,
Baptistry/Font Please check all that apply.
Bath -Tub/Shower ❑ 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 CIMedical gas and vacuum systems for health care facilities.
Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain
CI 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"
Car Wash Drain
Garbage -Domestic-non-food ❑ 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 fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
C:\Users\Dispatch2\permit\TIGARD PLUMBING PERMIT.doc 2