Permit (41) CITY OF TIGARD PLUMBING PERMIT
e ' ! COMMUNITY DEVELOPMENT Permit#: PLM2017-00423
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/17/2017
Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9461 SW WASHINGTON SQUARE RD A13
Project: Lids Subdivision: None Lot: None
Project Description: CAP(2)non-food related sinks and(1)mop sink;ADD(1)water heater under lavatory.
Contractor: BEAVERTON PLUMBING INC Owner: PPR WASHINGTON SQUARE LLC
13980 SW TV HWY PO BOX 847
BEAVERTON, OR 97005 CARLSBAD, CA 92018
PHONE: 503-643-7619 PHONE:
FAX: 503-643-7620
FEES
Quantity Description Date Amount
3 ea Fixture/Sewer Cap 10/17/2017 $75.06
Specifics: 1 ea Water Heater 10/17/2017 $37.52
1 12%State Surcharge- 10/17/2017 $13.51
Type of Use: COM Plumbing
Class of Work: ALT
Type of Const:
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: ex) ic /
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 Applicati`
Building FixturesRECEIVED) FOR OFFICE USE ONE,'
,,'. ' City Of Tigard iieved '?
oar 1 20 7
Date/By:/i/(7-, permit No!' �- /7-6 0y,O�-5
13125 SW Ha11 Blvd.,Tigard,OR 97273 y'
C Plan Review
Phone: 503.718.2439 Fax: 503.59 ,y Date/By, Other Permit No.:
Inspection Line: 503.639.4175 v F FIGARQ
T 4 G'�'li[7' P . Date ReadyBy: J 444.----]uric: ® See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Melhod!��7/�7 �(� ('
Supplemental Information
T/PE OF WORK &74- j_ FEE' SCHEDULE
❑New construction 0 Demolition )C'/e'CFor special information use checklist
Description I Qty. I Ea. I Total
®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 {
❑ 1-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
❑Accessory building ElMulti-familySFR(3)bath 50032
0 Master builderEach additional bath/kitchen 25.02
0 Other: Fire sprinkler( sq.ft.) Page 2 V
.2 Vee,,„ / JOB Silt INFORMATION AND LOCATION Site utilities: l
.
Job site address 25141*WASHINGTON SQUARE STREET NA13
Catch basin or area drain 18.76
Drywcli,leach line,or trench drain 18.76
City/State/ZIP:PORTLAND,OREGON 97223 tl
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.:A13 I Project name:LIDS#5655 §',
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: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION Or WORK Backwater valve 12.51
SAFE OFF AND CAPPING OF ALL PIPING/FIXTURES DEMOED BY Clothes washer 25.02
nrrr.n•na IATO'♦z r Dishwasher 25.02
OTHERS.INSTALL A NEW POINT OF USE HOT WATER HEATER UNDER Drinking fountain 25.02
LAVATORY Ejectors/sump 25.02
PROPERTY OWNER 1 0 'TENANT Expansion tank 12.51
Name: Fixture/sewer capes 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
0 APPLICANT El CONTACT PERSON Interceptor/grease trap 25.02
Business name:BEAVERTON PLUMBING,INC Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:JACKIE STEWART
Roof drain(commercial) 12.51
Address:13980 SW TUALATIN VALLEY HWX
Sink/basin/lavatory 25.02
City/State/ZIP:BEAVERTON,OREGON 97005 Solar units(potable water) 62.54
Phone:(503)643-7619 Fax::(503)643-7620 Tub/shower/shower pan 12.51
E-mail:jackie®beavertonplumbing.com Urinal 25.02
' Water closet 25.02
CONTRACTOR
- Water heater 1 37,52 37.52
Business name:BEAVERTON PLUMBING,INC Water piping/DWV 56.29
Address:13980 SW TUALATIN VALLEY HWY Other: 25.02 i .�[4q
City/State/ZIP:BEAVERTON OREGON 97005 Subtotal li ,34 3�
Phone:(503)643-7619 Fax:(503)643-7620 Minimum permit fee: $72.50
CCB Lie.:12889 Plumbing Lic.no.:34-4PB Plan review (25%of permit fee) 5
State surcharge(12%of permit fee) 13'.,8 0
Authorized signatur • J.�i (,� VO- f TOTAL PERMIT FEE
Print name:JACQ LINE STEWART Date:10/12/2017 This Permit application aspires if■permit it not obtained within 180 days t��
after it has been accepted as complete. 1.'�{`�
*Fee methodology tel by Tri-County Building Industry Service Bum. ,�y(j///
IABuildingtPermitE1PlM[}PermItApp.doe 10/01/09 410-4616T(I0/02/COMAVEB)
Plumbing Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities ,
Qty. Fee(ta) Total Square Footage: Permit Fee:
Footing drain-I"100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $23320
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) To 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*.
Quantic}by Fixture Type Plan Review for Plumbing Installations
Fixture Type for Replace/ Plan review is required for anyof the following.
Performed: Capped Added Relocate 9
Baptistry/Font Please check all that apply.
Bath -Tub/Shorter ❑ 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 Tluu ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial ❑ 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.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
-3,.
- Isometric or Riser Diagram
Car Wash Drain
Garbage -Domestic-non-food 0 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 Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
-
Shower -Gang _
-Stall
Sink/Lav -Non-food related 2
-Bradley -
-Commercial-food related
-Service mop sink 1
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-Toilet fees assessed for the sewer increase must be paid before the
Urinalplumbing permit can be issued.
Other Fixtures:-u) -' i & *.C- 1
httpJ/www.tigard-or.gov/document_center/Building/PLMF_PermitApp.dS
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9461 SW WASHINGTON SQUARE RD A13,
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2017-00423
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor