Permit (60) PLUMBING PERMIT
CITY OF TIGARD
i
Permit#: PLM2017-00285
COMMUNITY DEVELOPMENT Date Issued: 09/27/2017
f,iAB D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 25101 DA01900
i
Jurisdiction: Tigard
Site address: 7000 SW VARNS ST VARNS ACRES Lot: 3
Project: Madrona Recovery Subdivision:
Project Description: Plumbing for added kitchen area: Adding(1)dishwasher,(2)2"floor drains/s mess )3"floor d heater.inks,(2)
food prep sinks,(1)service sink,(1)backflow preventer,(1)grease trap,(4)p
Owner: NELSON VIAL LLC
Contractor: OREGON CASCADE PLUMBING 7155 SW VARNES ST#120
1728 22ND ST SE TIGARD, OR 97223
SALEM, OR 97309
PHONE:
PHONE: 503-588-0355
FAX: 503-364-2276
FEES
Quantity Description
Date Amount
1 ea Backflow Preventer 09/27/2017 $31.27
1 ea Dishwasher 09/27/2017 $25.02
Specifics: 09/27/2017 $100.08
4 ea Floor Drain/Floor Sink/Hub
Type of Use: COM 1 ea Interceptor/Grease Trap 09/27/2017 $25.02
ea Primer 09/27/2017 $50.04
Class of Work: ALT 4 37.52
1 ea water Heater 09/27/2017 $
Type of Const: 41.28
Occupancy Grp:
1 12%State Surcharge- 09/27/2017 $
Stories: Plumbing
3 ea Sink 09/27/2017 $75.06
Total $385.29
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 Signatur
111111011
Call 503.639.4175 by 7:00 a.m.for the next available i, pection 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 Applica ' �
' Building Fixtures "EINE
i. ^ !)
�., FOR OFFICE USE ONLY
Received111 PennitNo.'� � `
City of Tigard �� 1- 8 2017 DateBy:7/4c6/17 Mr\✓ 7 ,�/��
x 13125 SW Hall Blvd.,Tigard,OR 97 Plan Review
- Other Permit No �aQ1?+v`�0�
Phone: 503.718.2439 Fax: 503.598.1960 DateBy:
Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By tuns 0 See ea
TIGARD Notified/Method. I uppemen mates
for
or
I Ilnfor n
Internet www.tigard-or.gov or gov i . A�� �,i �, i� �:i �
r w1 d int ! '" EE-,*- - F
� .„ � � -•--�
❑New construction ❑Demolition For special information use checklist.
Description 1 Qty. I Ea. I Total
New 1-2-family®Addition/alteration/replacement III Other: dwellin s(includes 100 ft.for each utility connection)g 312.70
' A a A�O4R,, CC*I Rf . , % SFR(l)bath
SFR(2)bath 437.78
❑ 1-and 2-family dwelling ®Commercial/industrial SFR(3)bath 500.32
❑Accessory building El Multi-family Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
%z,�R, A A, @ JOT3 „TJ Ji l' ,„,,1 t, k,. aaa Site utilities:
Catch basin or area drain 18.76
Job site address:7000 SW Varns St. Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97223 Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name:Madrona Recovery Redmodel Manufactured home utilities 50.03
18.76
Cross street/directions to job site:If youre going South on SW 72nd Ave. Manholes 18.76
Rain drain connector
Turn left onto Varns St.and 7000 SW Varns St.is at the end of the street. 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:
4/
Backflow preventer 1 31.27 31.27
Tax map/parcel no D (Q
Backwater valve 12.51
�$ 1 25.02
' �� °, �� Clothes washer
Plumbing remodel of Madrona Recovery Center. Dishwasher 1 25.02 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
ill
l, T/ ,; Expansion tank 12.51
P O" Yi ' ,-. - . �. .r, =a��, 25.02
' " Fixture/sewer cap
Name:Madrona Recovery Center Floor drain/floor sink/hub 4 25.02 100.08
Address:7000 SW Varns St. Garbage disposal 25.02
City/State/ZIP:Tigard,OR 97223 Hose bib 25.02
Fax ( ) Ice maker 12.51
Phone:( ) ERSOf Interceptor/grease trap 1 25.02 25.02
0. 0 [ APIEI ANF l „,io ,, . , i:., Page 2
Medical gas(value:$ )
Business name:Oregon Cascade Plumbing&Heating Primer 4 12.51 50.04
Contact name:Cameron Henderson Roof drain(commercial) 12.51
Address:1728 22"d St.SE Sink/basin/lavatory 3 25.02 75.06
Solar units(potable water) 62.54
City/State/ZIP:Salem,OR 97302 - 12.51
Phone:(503)588-0355 I Fax: :( ) Tub/shower/shower pan 12 S I25.02
Urinal
E-mail:cam.henderson@oregoncascade.com Water closet
25.02
0 C "& tR 'y Water heater 1 37.52 37.52
Business name:Same as applicant Water piping/DWV 56.29
Other: 25.02
Address:
Subtotal 344.01
City/State/Z1P: Minimum permit fee: $72.50
Phone:( ) Fax:( ) Plan review (25%of permit fee) 46449*
CCB Lic.:1 z i Plumbing Lic.no.: 2.4, 3.3 ps State surcharge(12%of permit fee) 41.28
Authorized signature:x TOTAL PERMIT FEE 4,11
This permit application expires if a permit is not obtained within 180 days
Print name: Date: after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry See Board„.... J�
'
1-\Building\Permits\PLMU-PermitApp doc 10/01/09
440-4616T(I0/02/COM/W EB) 3V
•
► 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 dram-I' 100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3.600 $169.69
3,60!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 �t� Fee(ea) '1 otal 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 $25,00.1.00 to 550,000.00 5379.50 for the first 525,000.00 and$I.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) I each additional$100.00 or fraction thereof.
Subtotal:
Other Fixtures: I I I
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*.
Uuantit'b ffxture'Fyne
Fixture Type for tiopiaeel N Plan Review for Plumbing Installations
Work ork Performed: Cut±ted Added Rekwate
BaptistryiFont Plan review is required for any of the following.
Bath -Tub/Shower Please check all that apply.
Jacuzzi/Whirlpool ❑ Any new commercial building with water service 2"and
Car Wash Each Stall greater.except systems designed and stamped by licensed
-Drive Thru engineer.
Cuspidor/Water Aspirator ® New exterior plumbing site utilities for arty complex structure
Dishwasher -Commercial Vit 1 as defined in OAR918-780-0040.
-Domestic ❑ Medical gas and vacuum systems for health care facilities.
Drinking Fountain 4 ❑ Any multipurpose fire sprinkler system.
Fye Wash _ ❑ Any complex structure as defined in()AR918 780-0040.
Floor Drain/sink -2"
._ oa,..7>_____
Submit 2 sets of plans with any of the above.
-4„
Car Wash Drain Isometric or Riser Diagram
Garbage -Domestic-non-food
Disposal -Domestic-food related .._ - 0 Isometric or riser diagram is required for new buildings
-Commercial-food related that meet the qualifications above.
-Industrial-food related
Ice Mach./Rcfrig.Drains
Oil Separator(Gas Station)
Rec.Vehicle Dump Station Comments regarding fixture work:
Shower -Gang
-Stall
Sink/l..av -Non-trod related
-Bradley
-Commercial-food related a, /901 .4.'.7 -6-:-.1..',,,,,„ / e----6-“, 4e. - -t
Swimming Pool Filter ,¢ t?.-,--i,s t" _
Washer-Clothes
Water Extractor ''`Mote: If the fixture work under this permit results in an
Water Closet-Toilet - increase of sewer EllUs,a sewer permit will be issued and
Urinal fees assessed for the sewer increase must be paid before the
O:1Small Projects Division\JobsUobs In Progress\2017 Jobs Billed(AwaitLttg Payment)\S17150-Madrona Recovery-Primer Remodaling\City of
Tigard Plumbing Permit(Kitchen Work).doc
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
7000 SW VARNS ST, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2017-00285
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
1 . Corrections are complete, plumbing final - approved
Violation Summary:
Inspector Contractor