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Permit (80)
CITY OF TIGARD PLUMBING PERMIT . COMMUNITY DEVELOPMENT Permit#: PLM2017-00170 T[G AR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/18/2017 Parcel: 1 S 136AD04000 Jurisdiction: Tigard Site address: 11531 SW PACIFIC HWY Project: Spring Massage&Spa Subdivision: VILLA RIDGE Lot: 7 Project Description: Adding(1)clothes washer& relocating(1)lay&(1)water closet. Contractor: SKOOKUM PLUMBING LLC Owner: MCLELLAN ESTATE CO 11575 SW PACIFIC HWY#176 707 OLD COUNTRY RD TIGARD, OR 97223 BELMONT, CA 94002 PHONE: 971-231-9071 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Clothes Washer 05/18/2017 $25.02 Specifics: 1 ea Lavatories 05/18/2017 $25.02 1 ea Water Closet 05/18/2017 $25.02 Type of Use: COM 1 12%State Surcharge- 05/18/2017 $9.01 Class of Work: ALT Plumbing Type of Const: Occupancy Grp: Stories: Total $84.07 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Noti _• Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or dir- questions to • NC •y calling 503.232.1987 or 1.800.332.2344. Is ued By: ., ,, Permittee Sign- . e: Call 503.639.4175 by 7:00 a.m.for the next available inspecti• date. This permit card shall be kept in a conspicuous place on the job site unti completion of the project. Approved plans are required on the job site at the time of each inspection. Iflay. 03.2017 11:45 AM Skookum �P'llumbing 5037476145 PAGE. 1/ 2 Plumbing Permit Apnlicati ESL 61.(L) ©1700/v J Building Fixtures FOR OFFICE [151.: ONLY IN City of Tigard MAY 3 2017 Received - , 13125 SW Mall Blvd.,Tigard,OR 97223 7 AP )� Permit No,: �_ I� ,� 7ji Phone: 503,718.2439 Fax: 503 trgg�� �tt� pian Review C1 Inspection Lina: 503.639.4175 'I"�F j� � Date/By: Other Permit No.: i �. /7_ 'x, �� 11 k,A it I) s Dote Reedy/By: cit) Internet www,ttgttrd•or,gov ` t 121 See Page 2 or 1 i 1 1 I i Notified/Method: 7 i � n r�, :;;:1",'"..:,',.:,'.:::!;•.'.:1,. � So lomeninl tntormanms .i.::;.:i/, ^� 1l i ori.N t 0 a ti...,1rT01�l a. ,Y (, . a vi ,.y Y�, syy7 ry , * r i4a "f" W r r .1.,,,„:;,.:0','1;:"":!..'''',:.,!,,1, .. 0 Demolition _ - t''yl+brspeci nformationyuse checklist, „.tit < Jr a„ ,.s.. i, a a, o New construction �'"" �� .t ;ut Descriptio[ ub s iQtv j New 1- E1s. Total 0 Other: dttndly dwclPncludes 100 a32it connection � i � •.,ts , �o ,�"0'. 04$-# � �n� "' Iv ' SFR(1)bath 12,70 ❑1-and 2-family dwelling P.' Commercial/Industrial SFR(2)bathMil 437.78 ❑Accosory building ❑Multi-family SFR(3)bath _ 500.32 ❑Master builder —" Each additional ba h/kitchen 25,02 ❑Other: MI j�M1 Fire sprinkler C sq.ft.) Page 2 • 6 :i ..'4'' """e.°I,Ie t.. *ra.-V'.1 0 i"i ', .3 !'9,,NIA ,, Sitetitllltlurt _ Job site address: / ~* 'atCr. G / A Catch basin or arca drain 18.76 City/State/ZIP: 77.9a f'�_ // 9 7 -2 — Drywcll,leach line,or trench drain 18.76 n Footing drain(no,!Incur ft: ) Page 2 U — Suite/bldg./apt,no.: Project name: LI ,„l� tmulbctured home utilities 50.03 Cross street/directions to job site: t> �� � /-70,< %Manholes 18,7E e Rain drain connector 18.76 _ Sanitary sewer(no,linear ft.:_,,) Page 2 Storm sower(no.linear ft.;__,-••) Page 2 •------, Water service(no.linear ft,: ) Pagc 2 Subdivision: Lot no.: Fixture or Item: Tax mop/parcel no.: /.51 3‘0 RD 0 ei000 (Backflow prcvcnter 31,27 4e,;1,7, A,',, r Ir a aOn'' n S0),0A.o ,i, f, a f, , '/ Backwater valve IIBEI `DD t CD 1 l_Lo�}l S �a.,.a �cQ w l ` ,.,0 Clothes washer g 25.02 ,„2 5702- Dishwasher 25,02 i I A I Lk. ° is Lo CA-11 t3 Co t, Loi J ` I) LJft e, _ Drinking fountain 25.02 liC, .`6.. TiEjeelors/sump � zs,ozjr,.'- i@lio I Q , r ` '*rs IiNAN",ii—T7,77='-"/ _ .,1 „ Expansion tank 12"51 Name: Fixture/sewer cap 25,02 IIIAddress: Moor drainlfloorsink/hub 25.02 — Garbage disposal City/State/Z1P; 25,02 Hose bib 25.02 — 1• Phone ( ) 7 ?� Fax ( ) Ice maker '12,51 �''''y i.:� 4g� „s V.t.,.,�!C.Sr. 'CT,y: k UN lnturcoplor/grease trap � � � 25,02 rBusiness mine: O2 " 7,4(Am /-I . L/ Medical gas(value:$_ ) rage 2 �YContaot name: a,/'z�� �J ( — Printer 12,51 Roof commercial Address: /i575-&ZJ 4916:444. . /76 (commercial) 12.51 Sink/basin/lavatory i 25.02 at 6-..02- City/Statc/ZiP: —77‘a, ' 7.7 j Z 3 Solar units(pota'Sle water) 62.54 --., hone:f77 )6:9V 7/ Fax::( ) Tub/showor/shower pun _ 12,51 I ' E-mail erv�cQe 4'a�,l 't,t, 7,,7,ai pfrib,/,l✓• c,a Urinal 25.02 ( ,% f � i N F ,. r' ,c04,04 °, ;y(,; 'y t ,,i,:,.,' Water closet / 25.02 ,:5j..67- water healer Business name: (54/11 • . _ 37.52 Address: Water piping/DWV 56.29 �� /ir' ...... 25.02 City/State/ZIP: "-'- % B�- tw r ._ .r OKA 5cs7C , , Subtotal 7s Phone:( ) Fax:( - 17 ' /y?�- Minimum PO nit ice: $72.50 CCB Lie.: .410 Plumbing Lie,tto.:./'' ' t. '6-7. Plan review (25%ot`purntit fee) —- Authorized signs t `� 5 /C/7 State surcharge(12%of permit feel 9:� /��/ TOTAL PERMIT FEE , g`fr9'�' 1478 1 Date' ' 'tisk permit application expires if a permit is not obtained within 181)days aner it hes been aseeptcd as complete. Teo methodology set by Tri-County[Building Industry Sorvleu[Board, r1a41l1dINTermII61P1.MU•rm'InItAppdao 10/O1/a9 .140.4616'l(10102/COM/W1313) May. 03.2017 11:46 AM Skookum Plumbing 5037476145 PAGE. 2/ 2 Plumbing Permit Application - City of Tigard Page 2-Supplemental Information Fee Schedule: Residential n �aFira•�Su4ed nsesseon stems: ms• ,,} ir�, l : e@ayl : yy ( u (wi�iae,` fu,'-'t2;.5v�4M , i as i. xSf..1,.,rye„a� �1� i.r. r . , "� 4' Footing drain•le 100' 50,03 o to 2,000 $121.90 Footing drain-each additional 100' 37.52 - 2.001 to 3,600 $169.69 Sewer-1st 100' 62.54 3,601 to 7,200 �� $233,20 Sewer-each additional 100' 37.52 7,201 pad orator $327,54�R Water Service-1st 100' 62.54 Water Service-each additional 100' 37.52 1VIed>ical Gas Systems: Storm&Rain Drilla-1st 100' 62,54 x a � 'x ''?��i i �I :r}' 6A�i; ” q+r ,r€ Fif1 Storm&Rain[)rein-each additional 100' S2 - to$5,000,00 Minimum fee$72.50 additional '` y 'i Yp37. .a�a ? .::;; -fit00to $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for 1� r. 1" , t t (h r `,'r6f each additional$100,00 or fraction thereof,to Inspection orexisting 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 ttnd$1.54 for minimum charge-1/2 hour) each additional$100.00 or fraction thereof,to Inspections outsidegoof normal business 90,O- and including$25,000.00. hours ust charge-2 hours) $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for Reinspection Fees _ 90,00/1,, 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 first$50,000.00 and$1.20 for (minimum()Nov-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*. Wxtare ri'ormddr.. C• ivaa It b ]tlx_re ._c a , ; �FlYture'Iy l'r', . Rstanec/. ' � ped • Added *Ware Plan review Is required for any of the following. Ba tistry/Font Please check all that apply, Bath -Tub/Shower "— 0 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 0 New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator - as defined in OAR918-780-0040, Dishwasher -Commercial 0 Medical gas and vacuum systems for health care facilities. -Domestic 0 Any multipurpose fire sprinkler system. Drinking Fountain 0 Any complex structure as defined in OAR918-780-0040. Bye Wash . Floor Dral:/sink -2" Submit 2 sots of plans with any of the above. -3" Car Wash Drain _ „,; „4:•:;,o,',;,,; oviin yy�i {gi; fl' '1.., Garbage -Domestic-non-food ❑ Isometric or riser diagram is required for now buildings Disposal -Domestic-food related at meet the •ualificatlons above. -Commercial-food related - / to -industrial-food related / F Ice Much./Rofrlg,Drains . Oil Separator(Gas Station) Comments regarding fixtur work: Ree,Vehicle Dug)Station Shower -Gang r'+( Sxai r,i!. fis'M*[kr ti -5m115t --......k,-...— GL r�S Y ,A�t.1t� Q et �rcss Sink/Lav -Non-food related _ ---1------ .4 ! '(f;I -Bradley cr'a.rJ ( ,. 1 Lor ___ ., _ . „__. 6 -commercial-food related -Service .140111...1`1101M.. •�-, ! - amu: 0-O ._V'i�ir+►IMI 1 Swimming Pool Filter 57/07 Washer-Clothes ri, — *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-'ibilet '" - xi, fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: /+L". C:\Users\Chris\Doeutnents\P1-MF PermitApp,doe 2 W City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 11531 SW PACIFIC HWY, TIGARD, OR, 97223 Record Type: Record ID: Commercial - Plumbing PLM2017-00170 Inspection Type: Inspector: 399 Plumbing final Don Sylvester Result: PASS - NoCofO Comments: 1 . Corrections are complete, plumbing final approved Violation Summary: Inspector Contractor