Permit (127) CITY OF TIGARD PLUMBING PERMIT
04
COMMUNITY DEVELOPMENT Permit#: PLM2017-00392
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/10/2017
Parcel: 2S 101 AD03200
Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY 290
Project: Thenell Subdivision: WEST PORTLAND HEIGHTS Lot: 9-25,PT
Project Description: Plumbing fixtures for tenant improvement: ADD(1)dishwasher,(1)garbage disposal,(1)non-food related sink,
and(1)water heater.
Contractor: POWER PLUMBING CO Owner: PACIFIC REALTY ASSOCIATES
PO BOX 19418 ATTN: N PIVEN
PORTLAND, OR 97280 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-244-1900 PHONE:
FAX: 503-244-8825
FEES
Quantity Description Date Amount
1 ea Dishwasher 09/27/2017 $25.02
Specifics: 1 ea Garbage Disposal 09/27/2017 $25.02
1 ea Sink 09/27/2017 $25.02
Type of Use: COM 1 ea Water Heater 09/27/2017 $37.52
Class of Work: ALT 1 12%State Surcharge- 09/27/2017 $13.51
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $126.09
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.
...
.0,--
Plumbing Permit AuplicatioriREC,
.---i
Ev ED
Building Fixtures FOR OFFICE USE ONLY
SEP 2 6 2017
....
City of Tigard
Reed',AV 7 ,g, Permit vpi.,,,,,20,7.-evsg,2..
. r, 13125 SW Dail Blvd_Tigard.OR 9722" TY OF fiGARD---',ue'Y-L., _/
Phone: 503,718.2439 Fax: 503.59'
IN
.Nan Reerew
Other Pei 7114
1DING DIVISION.Aly
".1110L Inspection Line: 503,639.4175
el TIGARD Date Ready/By: 7/.., / , J,,,i,,, Ell See Page 2 for
internct: www.tigard-origuy
Nmirie4/Nlethrid:f .."`"7/// 40i1. Supplemental Information
TYPE OF WORK47.1,1/4 ,eiteis776- FEE* SCHEDULE IN
-
0 New construction
0 Demolition
_
Deseriptio-n Foe sr/aria!laformation use checklist. gl
rt3t7.-T Ea. Total
Addition/alteration/replacement 0 Other: '-i-.
New 1-24iimily dwellings(includesl 00 ft.for each utility connection)
bath
0 1-and 2-family dwelling
CO
0 Accessory building
CATEGORY OF CONSTRUCTION SFR(I)bath
11 M ITI.CFC inVindustrial SFR
5N7iiirtilfamily _ (2)
. 312.70
437.78
SFR(3)bath
500,32
V
'1
Ct
0 Master builder ______
0 Other: -- Each additional bath/kitchen
Fire sprinkler( sq.14.) -- /5 202
Page . t.
_ Ckt
- ----- -
•-•:;,,,„,' JOB SITE INFORMATION AND LOCATION Site utilities:
i
Joaddress: 12909 SW 68th PCatch basin or area drain 18.76 1 L.
.....•414, b site k wy
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR -
1 --- ----1----:-.-:- . ----- ....,.. Footing drain(no.linear ft.: ) Page 2
. .
Suite/bldg./apt no.:290 I y,Project name: 17-772 /1.1-6--A4-44., £4.40
Manufactured home utilities 50.03
Cross street/directions to job site:
Manholes
4
Rain Main connector 1836 18.76
1
Sanitary sewer(no.linear ft: ) Page 2
'i.i.
___ Storm sewer(no. linear It.: ) Page 2
-
"le ------ --- _ Water service(no.linear ft.: ) Page 9
_-- -._. .
SUbdiN ki.011: 1..01.no.: Fixture or item:
il Tax map/pareel no.: Backflow presenter 31.27
__-.
- * 7-- -777----- Backs/atm./alve
DESCRIPTION OF WORK ---"--- ' --
12.51-------- " ---------- Clothes waslicr 25.02
..., Jenant Improvement
_ ___ Dishwasher 25.02 '), Cf
, ...._....... .
-- - _
Drinking fountain
./5.07
Hjectors/sump -
25.02
„..._ _
0 PROPERTY OWNER El TENANT
Expansion tank 12.51
---- -----
Fix turc/sesver cap 25.02
Name:
floor drain/floor sink/hub 25.02
Address:
-
Ciarbage disposal 1 25.02
City/State/ZIP: -
.. ._.
Hose bib
25.0.2
1 ,Phone:I ) Fax:( ) Ice maker 12.51
0 APPLICANT 0 CONTACT PERSON 1 Interceptor/grease trap 25.02
-- --
Co
Medical gas(value:S 1 Page 2
_
' t Business name:Power Plumbing
__ ___
;Primer 12.51
Contact name:Mike Warren __
-
__ _ _ _ -------- ---- Roof drain(commercial) 12.51
Ackss ._ --
hc :P.O.Box 19418 _
Sink/basin/hivatmy I 25.02
'- Citv/State/Z80 IP:Portland,OR 972
Solar units(potable water)
1------
,
62.54
Phone:(5031 244-1900 Fax::(5031 244-8825 'Inb/showerishower pan 12.51
. ,
-----
'It E-mail:servieeqrpowerplumbingeo.com 'Urinal 25.02
- -1- -
- - Water closet 25.02
CONTRACTOR
----
_ Water heater 1 37.52 ..--i 2 5-2,
Business name:Power Plumbing Co.
Water piping/DWV 56.29
____ _ _
Address:6611 SW Multnomah Blvd _
Other: `)501
City/State/ZIP:Portland,OR 9723
Phone:(5037 244-1900
Fax:(503)244-8825 _ _ ____ „
Subtotal
1-2';
___________
Minimum permit feeS:uSb7t2.501t
_ 581-
_ ._ ___ _ ___
[((B lie.:52378 Plumbing Lk.no.:34-150PB ___„___ Plan review (25%of permit fee)
___ _____ _ _
State surcharge(12%of'permit fee)
„_____
Authorized signature: -.<--,,.( ,; L.-(''..., 4 :i)41114,ze: 64.,":.'"
TOTAL PERMIT FEE
, 2
Print name:Kristie Bramwell
Dag:9.25-17 -1 This pertUil4plication expires if a permit ix nordbtained within 180 days
_ _ after it has been accepted as complete.
-Fee methodology set by'Fri-County Building Industry Service Board.
f:',.B.0 ild iniAR'rrn a,t1M 511:-1,..1 w AN,.dos: 5511M9 449 46 1..CD1wo2,,,I 0515551,11,
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Su ression Systems:
Site Utilities Qty. Fee(ea) Total S uare Footage: Permit Fee:
Footing drain- I 00' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600
5169.69
3,6
- 1st 100' 62.54 ...,3e20011 and trrcater s$321.236( (2'9
73540
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 Dram- 1st 100' 62.54
$1,00 to$5.000.00 Minimum fee$72.50
Stonn&Rain Drain-each additional 100' 37.52 55.001.00 to$10,000.00- $72.50 for the first 55,000.00 and$1.52 for
Other Inspections or Fees Qty. Fee(en) Total each additional$100.00 or fraction thereof,to
and including$10,000.00.
Inspection of existing plumbing or for 510,001.00 to$25,000.00 S148.50 for the first 510,000.00 and S1.54 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 S379.50 for the first$25.000.00 and 51.45 by
hours(minimuin charge--2 hours) each additional S100.00 or baction thereof,to
Reinspection Fees 90.00/hr and including$50.000.00.
Additional plan eviev.,16r e
jxwhr
S50,001.00 and up 5742.00 for the first 550,000.00 and S1.20 for
rrvisions
(minimum charge-• I/2 hour) each additional$100.00 or traction 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*.
Quantity by Fixture Type Plan Review for Plumbing Installations
Fixture Type for Replace/
Plan review is required for any of the following.
Work Performed: Capped Added Relocate
Please check all that apply.
Baptistry/Font
Bath :rub/Shower Any tress cofranercial buildine with water service 2"and
-Jacuzzi/Whirlpool greater.except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial El Medical gas and Vacuum systems for health care facilities.
-Domestic I Any multipurpose fire sprinkler system.
Drinking Fountain 0 Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink - Submit 2 sets of plans with any of the above.
Isometric or Riser Diagram
Car Wash Drain
Garbage -Domestic-non-food Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice MachiRefrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station e.„00VP/'/Ze--147?_ 7771-617
Shower -Gang
• -
-Stall
Sink/Lay -Non-food related I 4.-)177'f
-Bradley
-Commercial-food related
-Seix
Swimming Pool Filter
*Note: If the fixture work under this permit results in an
Washer-Clothes
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-"foilet lees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtui es:
CAUsers\Laura\Do wnloads\11,MF_PermitApp(2).doc
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12909 SW 68TH PKWY 290, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2017-00392
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor