Permit (163) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2017-00480
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/04/2017
TL }tR_ Parcel: 2S113AB01201
Jurisdiction: Tigard
Site address: 16290 SW UPPER BOONES FERRY RD
Project: Oregon State Treasury Subdivision: None Lot: None
Project Description: Relocation of(1)catch basin and addition of(1)catch basin.
Contractor: NORTHWEST EARTHMOVERS INC Owner: PACIFIC REALTY ASSOCIATES LP
PO BOX 1609 ATTN: N PIVEN
SHERWOOD, OR 97140 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-625-3100 PHONE.
FAX: 503-625-3108
FEES
Quantity Description Date Amount
2 ea Catch Basin or Area Drain 12/04/2017 $37.52
Specifics: 40 If Storm Sewer 12/04/2017 $62.54
1 12%State Surcharge- 12/04/2017 $12.01
Type of Use: COM Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $112.07
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 nspecti• date.
This permit card shall be kept in a conspicuous place on the job site,un ' ompletion . the project.
Approved plans are required on the job site at the time of each inspection.
, Plumbing Permit Application
Site Utilities � � � FOR OFFICE I;SE ONE)
.,.,. t." Received A.
City of Tigard 3a /7 Permit Nc
Ihill I i 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: �/ / /�L/� �-�'7{y�
Date/By:
Phone: 503.718.2439 Fax: 503.598.1960 N O V 2 2017 Y 5'r�F? /7 ®0e2.7�
Other Permit N
Inspection Line: 503.639.4175
TIGARD Date Read/By Jur s: 0 See Pagee 2 for
Internet: www.tigard-or.gov CITYO1 • Notified/Method:
. Supplemental Information
TYPE OF WORK II I,i"'``'"' FEE* SCIIUDULE
NNew construction 0 Demolition For special information use checklist
Description I Qty. I Ea. I Total
O 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
0 1-and 2-family dwelling Z Commercial/industrial SFR(2)bath 437.78
buildingSFR(3)bath 500.32
0 Accessory 0 Multi-family
Each additional bath/kitchen 25.02
O Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Catch basin or area drain 2- 18.76 37. '.3 1-
Job
Job site address: LiI L/ 5w 3 Ne �c rfv�s -Ry R .
Drywell,leach line,or trench drain 18.76
City/State/ZIP: 'lll, 7Uj�
� Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name: U ',C,n:., Sr)+-ciJ11Z fl V/ Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
0w A- .-rf- (aN$'T <11 0i=-- 117D1..-:JlaVCt
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.: '1-L) 1 Page 2 (c 2.54
Water service(no.linear ft.:_) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
,. ac water va ve 12.51
DESPTION OF WORK .,,
._ Clothes washer 25.02
let 1t .4 L` I A-7.34-> M)v"1°'J t r- Dishwasher 25.02
i 6.44-rL.k% i3'1' S i N . Drinking fountain 25.02
Ejectors/sump 25.02
( PROPERTY OWER 1 - I �❑ TENANT Expansion tank 12.51
PFixture/sewer cap 25.02
�t��
Name: R� IAN.,. Ay a c_ L 1'
_ Floor drain/floor sink/hub 25.02
Address:
/S3'r�t; 5 r S E 4 t o PKC:'/ 1:0-30 D
Garbage disposal 25.02
City/State/ZIP: PO N�14h.a r) U 9'7 -2_4- Hose bib 25.02
Phone:(S0 ) ( ) e 2.4- '77 sT Ice maker 12.51
�Lf� �,��� Fax: S�3
, ; APPLICANT ❑ CONTACT'PERSON Interceptor/grease trap 25.02
Business name: A./c tz_r t„, -s-f- EI4-1zf71YsrSV evt-S, IA)L Medical gas(value:$ ) Page 2
,
Primer 12.51
Contact name: .i prpx-p �'-- . 7 e�5
Roof drain(commercial) 12.51
Address: j70 A c,X /6,01Sink/basin/lavatory 25.02
City/State/ZIP: S/1 )2.1 Oc P, 012 ,-) 14° Solar units(potable water) 62.54
Phone:( 5.--C.;) 6,11.-- Si O is Fax::( c 3) 641- 5 i O 8 Tub/shower/shower pan 12.51
1 Sinal 25.02
E-mail:
A '-Ci fes' Alt.,�'}1-12 rlI2ir cv-I.-S.coL-z+t:..
w xx Water closet 25.02
CO
r Water heater 37.52
Business name: /S pcyy&? 4' �aeLt -t '`) V Water piping/DW 56.29
Address: ` Other: 25.02
City/State/ZIP: Subtotal Wi ; ,
Minimum permit fee: $72.50
Phone:( ) Fax:( ) 1--
Plan review (25%of permit fee) ---
CCB Lic.: t Z-'(o i Plumbing Lic.no.: 34- +(f F1' State surcharge(12%of permit fee) I),, 01
Authorized signature: I-P / TOTAL PERMIT FEE /12
Print name: ii 1 Tom'', c Date: 11/2‘ 'l'1 This permit application expires if a permit is not obtained within WI 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)
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-1't 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, Fee(ea) Total
each additional$100.00 or fraction thereof,to
l� 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*.
Quantityb Fixture TypePlan Review for Plumbing Installations
Fixture Type for Replace/
Work Performed: Capped Added , ,Relocate, Plan review is required for any of the following.
Baptistry/FontPlease 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 ❑ 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 ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ 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
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
Shower -Gang
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial-food related
-Service
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
Urinal plumbing permit can be issued.
Other Fixtures:
I:\Building\Permits\PLMU PermitApp.doc 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16290 SW UPPER BOONES FERRY RD, May 1 , 2018 at 9:52:34 AM
TIGARD, OR, 97224
Record Type: Record ID:
Commercial - Plumbing PLM2017-00480
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor