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Permit (88) CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit#: PLM2017-00458 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/07/2017 T t =ll t�.T 9 Parcel: 1 S 135BD00300 Jurisdiction: Tigard Site address: 9735 SW SHADY LN 201 Project: Whole Body Health Physical Therapy Subdivision: None Lot: None Project Description: CAP(3)non food related sinks(laboratory and exam sinks);ADD(1)laundry tray and(1)clothes washer. Contractor: CASCADE PLUMBING CO Owner: TIGARD MEDICAL MALL LLC 15765 SW 74TH AVE PO BOX 98 TIGARD, OR 97224 POULSBO,WA 98370 PHONE: 503-289-7095 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Clothes Washer 11/07/2017 $25.02 Specifics: 3 ea Fixture/Sewer Cap 11/07/2017 $75.06 1 ea Laundry Tray 11/07/2017 $25.02 Type of Use: COM 1 12%State Surcharge- 11/07/2017 $15.01 Class of Work: ALT Plumbing Type of Const: Occupancy Grp: Stories: Total $140.11 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: �r • Call 503.639.4175 by 7:00 a.m.for the next available inspection .ate. 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 Y_., City of Tigard ° J ti.� YReceived � �� Date/By:1�7�/� Permit N Z/ /7,- SOF 13125 SW Hall Blvd.,Tigard,OR 97 Plan Review Ph Phone: 503.718.2439 Fax: 503.598.1960 r Other Permit N / �C1=1^� Date/By: �7`L% S,,S Inspection Line: 503.639.4175 \,4`N T 1 1,n Ii I-) )v z,i Date Ready/By: Juris ® See Page 2 for Internet: www tigard or.gov 1 i 4 x r' No ified/Method: Supplemental Information 7 of WORK Off, yH c ' ❑New construction ❑ 11144 • For special information use checklist. p Description I Qty. Ea. I Total ®Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) I RY CSF'CONS' U ( ) �j"«�� SFR 1 bath 312.70 � . , .. "��� � 7. ... Tri ❑ 1-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 Jl- `ri. 1N)FO 'TION ANA -4., t N„ ,'}. Site utilities: Job site address:9735 SW Shady lane Catch basin or area drain 18.76 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.:201 I Project name: Manufactured home utilities 50.03 Cross street/directions to job site: 1"1/C'LC 434',AY Ci` G-/' Manholes 18.76 / 7 --ri 9G Tff7-72, y7y 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: 1 Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 . '' Backwater valve 12.51 m , PI Ri JON'OF IP . . ..,-, r R'. Clothes washer J 25.025, Rou1gh in and install plumbing fixtures Dishwasher 25.02 e,1 P ( Drinking fountain 25.02 Ejectors/sump 25.02 .- [j PROPERTY OW -1! i Expansion tank 12.51 �. .,.�^s�,t.va„, - .,,,,,,,,„,44,..,..,',, s. ,. .,. .x':.4a� fix.�... t%�` Name: Fixture/sewer cap oi 25.02 75. C 6p 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 Il APPLICANT , , 1:1.,,SONTACT;PERSON LL Interceptor/grease trap 25.02 Business name:Quality West Plumbing DBA Cascade Plumbing Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:Bekka Greer Roof drain(commercial) 12.51 Address:15765 SW 74th Ave Sink/basin/lavatoryNJY 1 25.02 City/State/ZIP:Tigard Or 97224 Solar units(potable water) 62.54 Phone:(503)2897095 Fax::(503)2839514 Tub/shower/shower pan 12.51 E-mail:Cascadeplum@yahoo.com Urinal 25.02 CONTRACTOR Water closet 25.02 Water heater 37.52 Business name:Quality West Plumbing ( C 4:6 l= / -yr/yv2.)IA) -6--- Water piping/DWV 56.29 Address: 15765 SW 74th Ave#110A Other: 25.02 City/State/ZIP:Tigard Or 97224 Subtotal / 5 /0 Phone:(503)2897095 Fax:(503)2839514 Minimum permit fee: $72.50 CCB Lic.:204392 0 /I r Plumbing Lic.no.:PB1528 Plan review (25%of permit fee) a� State surcharge(12%of permit fee) /-�.C/ Authorized signature: G,n 0 f/ TOTAL PERMIT FEE i5<©, // Print name:Bekka Greer Date:11/7/2017 This permit application expires if a permit is not obtained within 180 days 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) !Z_ 7.-' 7/C(7) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site` 't es Fee ) Total` A) � :,- lztiare,fOOtai'e; � Nradt Footing drain-Is'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 S stems: Water Service-each additional 100' 37.52 ' a a n. rnnkf ee. 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 .:.. - each additional$100.00 or fraction thereof,to � Odt x.. $p ions ot`. ees • Fuss' � � r �" 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*. Quart# ►YFixtulrily'pe . PII #BCW f*Plambing 1 tallat4fls x-s dor ' Plan review is required for any of the following. Work Performed: Capped Added`,= Relocate Baptistry/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. Eye Wash Floor Drain/sink -2" Submit 2 sets of plans with any of the above. 4>, Isometric or Riser Diagram Car Wash Drain 0 Isometric or riser diagram is required for new buildings Garbage -Domestic-non-food 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 J L � ' `Slnllc (z Exil"1 Shower -Gang /`4)62///G j L ct/JAIL/ 7724-/ ((� "lc�7/./TS -Stall 1 Sink/Lav -Non-food related 3 -Bradley 72E:74 C' %!fir -Commercial-food related -Service Swimming Pool Filter *Note: If the fixture work under this permit results in an Washer-Clothes / increase of sewer EDUs,a sewer permit will be issued and Water Extractor Water Closet-Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: C:\Users\Cascade Main\Downloads\PLMF_PermitApp(8).doc 2 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 9735 SW SHADY LN 201 , TIGARD, OR, 97223 Record Type: Record ID: Commercial - Plumbing PLM2017-00458 Inspection Type: Inspector: 399 Plumbing final Don Sylvester Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor