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Permit (138) CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit#: PLM2017-00276 T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/12/2017 Parcel: 2S102AD02700 Jurisdiction: Tigard Site address: 8970 SW BURNHAM ST Project: Pacific Rim Martial Arts Academy Subdivision: BURNHAM TRACT Lot: 5 Project Description: Backflow preventer for irrigation system. Contractor: MTZ LANDSCAPE LLC Owner: MARTYN PROPERTIES LLC 2060 S BEECH ST 17051 SW RIVENDELL DR CORNELIUS, OR 97113 PORTLAND, OR 97224 PHONE: 503-929-3042 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Backflow Preventer 07/12/2017 $31.27 Specifics: 1 12%State Surcharge- 07/12/2017 $8.70 Plumbing Type of Use: COM 41 ea Minimum Fee Adjustment- 07/12/2017 $41.23 Class of Work: OTR Plumbing 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 • "cation ':•ter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or• ect questions to OU • a g .: .232.1987 or 1.800.332.2344. Is-ued By: /i � 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 RECEIVED FOR OFFICE USE ONLI' City of Tigard Received Date/By: 7 I , /7 A . J Permit No.: 101109.105/7�-& 274 13125 SW Hall Blvd.,Tigard,OR g'4t3 1 2 2017 Plan Review e 0 Date/By: Phone: 503.718.2439 Fax: 503.598.1960 Other Permit No.:,sem„4 /0�en Inspection Line: 503.639.417C1Ty OF TIGARD Date Read /B Juris: ® See Page 2 for TIGARp Ready/By: Internet: www.tigard-or.goBUI DING DIVISION Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE Ef slew construction ❑Demolition For special information use checklist Description Qty. Ea. I Total El Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTTRUUCTION SFR(1)bath 312.70 El1-and 2-family dwelling .ommercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building El Multi-family Each additional bath/kitchen 25.02 El Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 89. }-0 5.-“,/ s�j.,„A a s Catch basin or area drain 18.76 City/State/ZIP: �j�a�-d Drywell,leach line,or trench drain 18.76 �/ /� Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name: (' 21// nit��� 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 us-i4Q^ Tax map/parcel no.: Backflow preventer / 31.27 Ce f/cDESCRIPTION OF WORK ` Backwater valve 12.51 k'" Clothes washer 25.02 X.L? ,w /j5 5C1ie19r[ei- Dishwasher 25.02 /Q r Jt/ # a'/ o f Drinking fountain 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER .' , � ,TENANT ?x Expansion tank 12.51 Fixture/sewer cap 25.02 Name: AE e //cifilift by 1 Floor drain/floor sink/hub 25.02 Address: 65970 stv kj aiti .4c-1. Garbage disposal 25.02 City/State/ZIP: , 36,7v.r/ ©/C Hose bib 25.02 Phone:( ) Fax ( ) Ice maker 12.51 ,,' I C a CONTACT PERSON s Interceptor/grease trap 25.02 Business name: r /;1� �c�/j� 66... Medical gas(value:$ ) Page 2 Contact name: C 'i _Primer 12.51 iv-6;c 7 L , Lpy� jA. ? Roof drain(commercial) 12.51 Address: 20 60 S. lee„-"Ci/ S I_ Sink/basin/lavatory 25.02 City/State/ZIP: Co a,v&11 v$ 0/2 97//J Solar units(potable water) 62.54 Phone:Cs-0, 912 ..7V y 2 Fax::( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 1 v 1`cin C4 c L.C ce aA:0 e. .- GG - Water closet 25.02 ;, _ CONTRACTOR Water heater 37.52 Business name: Water piping/DWV 56.29 Address: 5,il- :- Other: 25.02 City/State/ZIP: Subtotal Phone:( ) Fax:( ) Minimum permit fee: $72.50 7,/,SCS , CCB Lic.: 0 a/jig(t 8 Plumbing Lic.no.: Fri-0Plan review (25%of permit fee) , .----- r3"' / State surcharge(12%of permit fee) t.70 Authorized signature: ��� m CZ > ir-a TOTAL PERMIT FEE 8 C, Print name: r/�� TTT/// Date:, ` This permit application expires if a permit is not obtained within 180 days (� /�Z/�l/N - /� 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 Qty Fee(ea) Total Square Footage: Permit Fee: Footing drain-1st 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 Valuation: Permit Fee: 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 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 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 fo Plumbing Installation 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 0 Any new commercial building with water service 2"and Baptistry/Font greater,except systems designed and stamped by licensed Bath: -Tub/Shower -Jacuzzi/Whirlpool engineer. Car Wash: Each Stall ❑ 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" Isom ' I 0*: ser 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/Sery/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 fees assessed for the sewer increase must be paid before the Water Extractor 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: 8970 SW BURNHAM ST, TIGARD, OR, 97223 Record Type: Record ID: Commercial - Plumbing PLM2017-00276 Inspection Type: Inspector: 399 Plumbing final Don Sylvester Result: PASS - NoCofO Comments: 1 . 1 " Wilkins DC model 350, serial #A563572, for irrigation, located in front of Bldg. by gas meter - ok with test Violation Summary: Inspector Contractor