Permit (133) . CITY OF TIGARD PLUMBING PERMIT
III A
COMMUNITY DEVELOPMENT
Permit#: PLM2017-00103
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/19/2017
T f f3;�R tD Parcel: 2S114AA00100
Jurisdiction: Tigard
Site address: 9000 SW DURHAM RD
Project: Caring Closet Subdivision: None Lot: None
Project Description: Add 150'of sanitary sewer line,200'of water service,(1)clothes washer, (1)lay, (1)water closet.&(1)water
heater.
Contractor: VENNE PLUMBING LLC Owner: TIGARD-TUALATIN SCHOOL DISTRICT
15145 SW DIVISION ST 6960 SW SANDBURG ST
SHERWOOD, OR 97140 TIGARD, OR 97223
PHONE: 503-624-9309 PHONE.
FAX: 503-684-0940
FEES
Quantity Description Date Amount
150 If Sanitary Sewer 04/18/2017 $100.06
Specifics: 200 If Water Service 04/18/2017 $100.06
1 ea Clothes Washer 04/18/2017 $25.02
Type of Use: COM 1 ea Lavatories 04/18/2017 $25.02
Class of Work: ALT 1 ea Water Closet 04/18/2017 $25.02
Type of Const: 1 ea Water Heater 04/18/2017 $37.52
Occupancy Grp: 1 12%State Surcharge- 04/18/2017 $37.52
Stories: Plumbing
Total $350.22
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 dire ..estions toe NC by calling 503.232.1987 or 1.800.332.2344.
rTh
I-sued By: Permittee Si. ature: )
Call 503.639.4175 by 7:00 a.m,for the next available i. .ection 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 FOR OFFICE LSE 011.1'
City of Tigard - t Received - 1517 /7 (.--- r.P) Permit No.: ,LN?'.nI 7-OO /4)3
13125 SW Hall Blvd.,Tigard,OR 123
= Phone: 503.718.2439 Fax: 503 598,1,960 c _ Date/By:
ReviewPlan
Date/By: Other Permit No.:
�OO17- �I4
3
TIGARD Inspection Line: 503.639.4175 �.,/i:? ,w c0i% Date Read/BY Juris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method:
Supplemental Information
TIFF 104 t�,' 1 i P 1) FEE* SCHEDULE
i�itl' F":f't t3rta ,,. ., 61
/ill 'ew construction 0 Demolition For special information use checklist C
Description Qty. Ea. I Total
`,1 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 Q
❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 .1
SFR(3)bath 500.32 I
❑Accessory building ❑Multi-family 1
Each additional bath/kitchen 25.02 Q
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
VI
/� A,„6„4„,,....._ Catch basin or area drain 18.76
Job site address: `��too, 4_1) '41.
DryCity/State/ZIP: / ` 64,4 lJ�= Q,Z Z 3 Footing
1,leach line,or trench drain 18.76
/ ` < Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name: ear t✓y e''s"'/- Manufactured home utilities 50.03
Cross street/directions to job site: 0Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:1403 Page 2 /MO
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.:Soe) Page 2 /eVt 00
Subdivision: / Lot no.: Fixture or item:
Tax map/parcel no.: of 5 I l'7 4/t}('ele,0 Backflow preventer 31.27
- Backwater valve 12.51
DESCRIPTION OF WORK ;g
/ �' �` Clothes washer 1 25.02 ���
Ai>I> 'tol(A--T ) S,nl4 lc9A76'1- i 'kT1.9%- ejto Fe..-i c-vesk Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNERS t' 0 TENANT Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
APPLICANT ' 0 CONTACT PERSON Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name: Pt1 t Z,LC
Primer 12.51
Contact name: %/A^J Vs c fy,►u cl
Roof drain(commercial) 12.51
Address: l 57 ii- ‘'/Ai DvJtr a av, s I. Sink/basin/lavatory i 25.02 d. ",",o 0-
City/State/ZIP: tr u- meaty d 44i '1 pia Solar units(potable water) 62.54
Phone:(cl ) (Iy vi R..0,vl Fax::( ) Tub/shower/shower pan 12.51
E-mailf.y Urinal 25.02
�� Water closet i 25.02 lQ`,�'-•Or
CO CTb :`' '.. Water heater 1 37.52 37 62-
Business name: \),Q.,,H.{ -Pt w^NIS 1 riD to t-t...,C...-. Water piping/DW V 56.29
Address: I S/,-(t' S i.--1 1.1,i,S r`q g Other: 25.02
City/State/ZIP: Gv' r ,,,,,r) 0.4_ 9•l/Giv Subtotal .6)A.70
Minimum permit fee: $72.50
Phone:(ST; ) (D 2`1 1'36 5 Fax:( )
Plumbing Lic.no.: 7.$-Ii,
Plan review (25%of permit fee)
CCB Lic.: el z 4
A
State surcharge(12%of permit fee) 37.5 A
Authorized signatu : .; TOTAL PERMIT FEE a '°12
Print name: Date: 1 This permit application expires if a permit is not obtained within 180 days
�t 1GµrLr(_ /�� f [ after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-46161(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site
Qty. Fee(ea) Total Square Footage: Permit Fee:
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 Medical Gas Systems:
Water Service-each additional 100' 37.52
Storm&Rain Drain-1st 100' 62.54 V uation: ; 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 Qty. Fee{ea) Total each additional$100.00 or fraction thereof,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 fust$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 ftflui Bing Installations
Quantity byFixture 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 ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial
0 Any multipurpose fire sprinkler system.
Domestic ❑ 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" 41 I! c 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 1
-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
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\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:
9000 SW DURHAM RD, TIGARD, OR, 97224
Record Type: Record ID:
Commercial - Plumbing PLM2017-00103
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor