Permit (83) CITY OF TIGARD PLUMBING PERMIT
G
�! - COMMUNITY DEVELOPMENT 11 Permit#: PLM2017-00117
T[G; eL 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 I Date Issued: 04/05/2017
firma' Parcel: 2S 102AB04500
Jurisdiction: Tigard
Site address: 12436 SW MAIN ST
Project: Beach Hut Subdivision: None Lot: None
Project Description: Adding(1)dishwasher,(4)2"floor drains,(1)grease trap,(1)primer,(1)ice machine drain,(1)lay,(2)sinks,(1)
water closet&(1)water heater. Replace/relocate(1)lay,(4)sinks&(1)water closet. 5/4/2017:REPRINTED
permit to include 10 ft.of sanitary sewer.
Contractor: NADEANS CUSTOM PLUMBING Owner: CACH, CHRISTOPHER J
19376 LELAND RD 14420 SW 114TH AVE
OREGON CITY, OR 97045 TIGARD, OR 97224
PHONE: 503-869-0416 PHONE:
FAX: 503-650-6078
FEES
Quantity Description Date Amount
1 ea Dishwasher 04/05/2017 $25.02
Specifics: 5 ea Floor Drain/Floor Sink/Hub 04/05/2017 $125.10
1 ea Ice Maker 04/05/2017 $12.51
Type of Use: COM 1 ea Interceptor/Grease Trap 04/05/2017 $25.02
Class of Work: ALT
1 ea Primer 04/05/2017
Type of Const: $12.51
6 ea Sink 04/05/2017 $150.12
Occupancy Grp: 2 ea Lavatories 04/05/2017
Stories: $50.04
2 ea Water Closet 04/05/2017 $50.04
1 ea Water Heater 04/05/2017 $37.52
1 12%State Surcharge- 04/05/2017 $58.55
Plumbing
10 If Sanitary Sewer 05/04/2017 $62.54
0 12%State Surcharge- 05/04/2017 $7.50
Plumbing
Total $616.47
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:
l %
�r
�.
/401.1
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 .
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application
Building Fixtures 14; : 1" t ; . 1,.
City of Tigard Received
Date/B y 7 (...------
Permit No.: jrr( /
13125 SW Hall Blvd.,Tigard,OR 97223 y a-O t?-oC /
I Phone: 503.718.2439 Fax: 503.598.1. 80 ' Plan Review
4 t '/ Date/By: Other Permit No.:5,44.p:47-a"/140
Inspection Line: 503.639.4175 Date Ready/By: /
T[G A K n `F
Internet: www.tigard-or.gov Faris: l21 See Page 2 for
y e: Notified/Method: Supplemental Information
TYPE QF; lff.liYr
tiliiVe;rinfr r t„ ',`- FEE* SCHEDULE
For special information use checklist
❑New construction 0 Demolition
DescriptionI Qty. Ea. Total
Addition/alteration/replacement ❑Other ) New 1-2-famil dwellin s includes 100 ft.for each utility connection)
CATEGORY QF CONS 2UCTIQ t '' a " SFR(1)bath 312.70
❑ 1-and 2-family dwelling ETCommer+al/I t SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
"JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: /?_ vg G S i (A jla y i Catch basin or area drain 18.76 Qi
City/State/ZIP: i/�c i, r Cf Oie 4/12'z 3 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Page 2
i'
Suite/bldg./apt.no.: " Project name: e-'47 4.-6 Ho 7 Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
I
Rain drain connector q 18.76
Sanitary sewer(no.linear ft.: 1 U) i Page 2 9..,..s-ii
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.: 2 Cj/ 1, -6/5 O c/S-d67 Backflow preventer 31.27
DEg °9. F 'W(14-0C;,4- ;; .flat Backwater valve 12.51
�r�r; ' 25.02
__�- �/ �� � ��' Clothes washer
,4.,,a____,^ G,I3^ i S - Dishwasher 02,
C2e25.02 5.
401- i 64) of a-4A,,fe°f--ia ,L j-tom Drinkin
V g fountain 25.02
Ejectors/sump 25.02
�
TROP/R.
o H i,"; + ] TENANT` Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Address: Floor drain/floor sink/hub S' 25.02 Z
i
City/State/ZIP:
Garbage disposal 25.02
Phone: Hose bib 25.02
( ) Fax:( ) Ice maker / 12.51 i2.3/
'j iP ` '
APPLICANT {] CONTACT"°,'E12SON Interceptor/grease trap / 25.02 2 S Gz
Business name: S'w,'�, L LG Medical gas(value:$ ) Page 2
Contact name: (,t r 15-
Primer12.51 J,'tr S"�
Roof drain(commercial) 12.51
Address: r'(, .fok �Z
Sink/basin/lavatory 8 25.02 200 16
City/State/ZIP: 70 r 7//a C/2 ,- Z- 7/ Solar units(potable water) 62.54
Phone:(3-0;3') S-,8' 2(7 7 3 Fax::( ) Tub/shower/shower pan 12.51
E-mail: C- (7,-.; 1,,i GLI e/., c Urinal 25.02
�/� r c: <-
Water closet ^
CQI�1T RA+ Yt L_ 25.02 .�.G
''''- Water heater / 37.52 3 .SZ
Business name: �Q.���1 Cos Okn P�0I�>n�
Address: 6 J heater
56.29
9 3 9. L CJ-1 g ^7 l Other: 25.02
City/State/ZIP: Or c JQ R C l ly O t L / '04/5 Subtotal 43-7n
Phone:�o3) 0 6c3 0Li/d11 Fax:(505 ) (,, C1,--b Q-7Q Minimum permit fee: $72.50
CCB Lic.: t '93 61. )llolf9 ( Plumbing Lic.no.: 279DDPlan review (25%of permit fee)
ALL?
I .�if`I7State surcharge(12%of permit fee) 5S,J6
TOTAL PERMIT FEE 5446.s �iAuthorized signature:
Print name: I.C.AA 01/16 Date:3,- {,9�(� This permit application expires if a permit is not obtained within 180 days
d 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 4404616T(10/02/COM/WEB) ,S 41
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
'Site Utilities Qtr• Fee(Ca) Total" Square Footage: Permit Fee:
Footing drain-I'100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
Sewer-1st 100' 62.543,601 to 7,200 $233.20
t 6 � 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 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 for
Other IniiRreCtlons or Fees :-oty :'F ( 'Total " each additional$100.00 or fraction thereof,to
Inspection of existing plumbing or for and including$10,000.00.
which no fee is specifically indicated 90.00/hr $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
(minimum charge 1/2 hour) each additional$100.00 or fraction thereof,to
Inspections outside of normal business 90.00/} and including$25,000.00.
hours(minimum charge-2 hours) $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
Reinspection Fees 90.00/hr each additional$100.00 or fraction thereof,to
and including$50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the fust$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 result in increased sewer fees*. -
Plan Review for Pl> tlg Insilatio>ds ,
Quantity by Fixture Tree Plan review is required for any of the following.
Fixture Type for Rowe Please check all that apply.
I Work Performed: ,- Capped Added Relocate
Baptistry/Font 0 Any new commercial building with water service 2"and
Bath: -Tub/Shower greater,except systems designed and stamped by licensed
-Jacuzzi/Whirlpool engineer.
Car Wash: -Each Stall 0 New exterior plumbing site utilities for any complex structure
-Drive Thru 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"
3" X 1 y. Isometric or Riser Diagram
-4 ❑ Isometric or riser diagramrequiredbuildings
-Car Wash Drain is for new buildin s
Garbage -Domestic non-food that meet the qualifications above.
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
Ice Mach./Refrig.Drains 1 Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -Lav/Bar non-food related /- / -
-Bradley
-Com/Sery/Util food related a g
-Service *Note: If the fixture work under this permit results in an
Swimming Pool Filter
I Washer-Clothes increase of sewer EDUs,a sewer permit will be issued and
Water Extractor fees assessed for the sewer increase must be paid before the
Water Closet-Toilet /_ / plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Pennits\PLMF_PermitApp.doc 08/04/2011 2
CITY OF TIGARD PLUMBING PERMIT
ill1;' COMMUNITY DEVELOPMENT Permit#: PLM2017-00117
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/05/2017
[ �#.RL7 9 Parcel: 2S102AB04500
Jurisdiction: Tigard
Site address: 12436 SW MAIN ST
Project: Beach Hut Subdivision: None Lot: None
Project Description: Adding(1)dishwasher,(4)2"floor drains,(1)grease trap,(1)primer,(1)ice machine drain,(1)lay,(2)sinks,(1)
water closet&(1)water heater. Replace/relocate(1)lay,(4)sinks&(1)water closet.
Contractor: NADEANS CUSTOM PLUMBING Owner: CACH, CHRISTOPHER J
19376 LELAND RD 14420 SW 114TH AVE
OREGON CITY, OR 97045 TIGARD, OR 97224
PHONE: 503-869-0416 PHONE:
FAX: 503-650-6078
FEES
Quantity Description Date Amount
1 ea Dishwasher 04/05/2017 $25.02
Specifics: 5 ea Floor Drain/Floor Sink/Hub 04/05/2017 $125.10
1 ea Ice Maker 04/05/2017 $12.51
Type of Use: COM ea Interceptor/Grease Trap 04/05/2017 $25.02
Class of Work: ALT 1 ea Primer 04/05/2017 $12.51
Type of Const: 6 ea Sink 04/05/2017 $150.12
Occupancy Grp: 2 ea Lavatories 04/05/2017 $50.04
Stories: 2 ea Water Closet 04/05/2017 $50.04
1 ea Water Heater 04/05/2017 $37.52
1 12%State Surcharge- 04/05/2017 $58.55
Plumbing
Total $546.43
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:
/
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
Building Fixtures 7 ,,, i
City of Tigard • Received
y: 't r32...40)DaPermit No.: LHa.OI 7'OQ Il7
IN . U 13125 SW Hall Blvd.,Tigard,OR 97223 Plan y: y /�
an Review Other Permit No.: O I/O
Phone: 503.718.2439 Fax: 503.598.1960 4 E , Date/By: 2 a l ��l`w
Inspection Line: 503.639.4175
TIGARD Date Read/By Awls ® See Page
2 for
Internet: www.tigard-or.gov
Notified/Method: Supplemental Information
TYPE OF elfniNeFir,, ,I n FEE* SCHEDULE /-
El New construction 0 Demolition For special information use checklist f
Description Qty. I Ea. I Total F
ET Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) "u
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ 1-and 2-family dwelling ErCommercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building 0 Multi-family 'J
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 O
kl ,
JOB SITE INFORMATION AND LOCATION Site utilities:
� Catch basin or area drain 18.76 li
Job site address: 17 t/. G S V Alt� s� /
Drywell,leach line,or trench drain 18.76
City/State/ZIP: i, (� /'-'2-.7-...3. 0�
6Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name: : f'Cl C;( �14 I 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: Lot no.: Fixture or item:
Tax map/parcel no.: a S/ O �}O . '` h Q 115- 0
l5- 0 Backflow preventer 31.27
nEs '�F WORK
v ,S.:-.!i', Backwater valve 12.51
'�'"�_ Clothes washer 25.02
eh,/r"b/47r Dishwasher25.02 .G'
Drinking fountain 25.02
Ejectors/sump 25.02
❑4PROPERT O . -+ J ❑ TENANT Expansion tank 12.51
ititName: Fixture/sewer cap 25.02
Floor drain/floor sink/hub S 25.02 /25. /
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker / 12.51 /2 5/
,APPLICANT 0 CONTACT PERSON Interceptor/grease trap / 25.02 2,57c-7 Business name: ' LI / L L�, Medical gas(value:$ ) Page 2
w� c
Primer / 12.51 /2 .57
Contact name:
r S Roof drain(commercial) 12.51
Address: y� / 2 /�
tf .SOS 1 ��� Sink/basin/lavatory �j 25.02 �/V.
City/State/ZIP: /•'',:"y-.f/et, � ,/l
Qf'� � `�. Solar units(potable water) 62.54
Phone:(5.7.') S S 2 0 7 Fax::( ) Tub/shower/shower pan 12.51
E-mail: 6/`/`, 5 La _s 1,,,,,t,, e 1/e c_-f r, ,c: c' 17:,4,,. Urinal n 25.02
Water closet
L. 25.02 . ,C t
CONTRACTOR
Water heater / 37.52 3:,z.-7
Business name: N A 1�(1,1 C.e O p phi m�;1� Water piping/DWV 56.29
Address: 19376 L t,l C/t kJ Other: 25.02
City/State/ZIP: Or c Jo� c;1,../ we_ 7-0115 Subtotal Lf(7
/ / Minimum permit fee: $72.50
Phone:(4:203) i 61 (Ai�b Fax:(SGS ) `J�g Plan review (25%of permit fee)
CCB Lic.: t '93 7 t.7. I ltoto Plumbing Lic.no.: p'J 279
/I State surcharge(12%of permit fee) 5),
Authorized si ature: 71/l
TOTAL PERMIT FEE y Lf 5Z/6.4
Print name: 7O-R L Date:3 This permit application expires if a permit is not obtained within 180 days
mC.A i� "�J o 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 Suppression Systems:
Site Utilities Qry Fee(ea) Total Square Footage: Permit Fee:
Footing drain-1 s`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 Medical Gas Systems:
Water Service-each additional 100' 37.52
Storm&Rain 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 for
»
Other Inspections or Fees each additional$100.00 or fraction thereof,to
!Qty•' ;F < � To
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
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 result in increased sewer fees*. Plan Review for Plumbing Installations
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate
Baptistry/Font
0 Any new commercial building with water service 2"and
Bath: Tub/Shower greater,except systems designed and stamped by licensed
-Jacuzzi/Whirlpool engineer.
Car Wash: Each Stall
0 New exterior plumbing site utilities for any complex structure
Drive tall 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" .
3" �4 Isometric or Riser Diagram
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 / -
Sink: -Lav/Bar non-food related /-
-Bradley
-Com/Serv/Util food related a /1
-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 beaid before the
Water Extractor p
Water Closet-Toilet /_ / plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12436 SW MAIN ST, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2017-00117
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
1 . Note: caulk around base of mop sink.
2. Adjust grade on indirect waste pipe for dishwasher. ( back graded ) provide 1 " air gap
at floor sink.
3. Approved with correction.
Violation Summary:
Inspector Contractor