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Permit (63) CITY OF TIGARD PLUMBING PERMIT IN...- Ili 11 COMMUNITY DEVELOPMENT Permit#: PLM2017-00517 T f AR o 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/13/2017 Parcel: 2S 101 DA00102 Jurisdiction: Tigard Site address: 13221 SW 68TH PKWY 500 Project: Centene Corporation Subdivision: None Lot: None Project Description: Interior plumbing for TI:Adding(1)sink,(1)ice machine,and(1)2"hub drain; Installing(1)electric tankless water heater and(1)primer. Contractor: GRIDLINE PLUMBING Owner: GK TRIANGLE CORPORATE PARK III L 14844 SW 109TH AVE ATTN KBS REALTY ADVISORS TIGARD, OR 97224 P 0 BOX 28270 SANTA ANA, CA 92709 PHONE: 971-275-6167 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Floor Drain/Floor Sink/Hub 12/11/2017 $25.02 Specifics: 1 ea Ice Maker 12/11/2017 $12.51 1 ea Primer 12/11/2017 $12.51 Type of Use: COM 1 ea Sink 12/11/2017 $25.02 Class of Work: ALT 1 ea Water Heater 12/11/2017 $37.52 Type of Const: 1 12%State Surcharge- 12/11/2017 $13.51 Occupancy Grp: Plumbing 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: ...00°. 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 Application I IA ;' i , . is . re_ Building Fixtures ' � FOR OFFICE LSE Oyl.V City of Tigard Received 13125 SW Hall Blvd.,Tigard,OR4� 5 '- Date/By: (� it / Permit _ T O Plan Review fir- p '7_005:7 Phone: 503.718.2439 Fax: 503.598.1 �, ,, Date/By: Other Permit No.:43)4,4/0.64/ T 1 G A RD Inspection Line: 503.639.4175 ",:?:.:-,t,„ �),; 5- s pe ; Date Ready/By: Juris: ® See Page 2 for Internet: Line:www.tigard-or.gov ' x,..l� - r � t° 1'' Notified/Method: 1 i'• /4_0 Supplemental Information - TYPE OF ivijik " NT4 FEE* SCHEDULE, 0 New construction 0 Demolition For special information use checklist Description Qty. Total lAddition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft foreach utility connection) - CATEGORY Or CONSTRUCTION SFR(1)bath 312.70 ❑ 1-and 2-family dwelling mercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 ❑Master builderOther: Each additional bath/kitchen 25.02 ❑Other Fire sprinkler( sq.ft.) Pae 2 JOB SITE INFORMATION g AND Lf�CAT�ON Site utilities: ,9,713--/Job site address: /,9,713--/ Catch basin or area drain 18.76 - City/State/ZIP: �, � ��� � Drywell,leach line,or trench drain 18.76 Suite/bldg./apt.no.: Project name: �-�- Footing drain(no.linear ft.:_) Page 2 �{ Z: Manufactured home utilities 50.03 Cross street/directions to job site: / , -/ Gt Manholes 5 an18.76 ,vim //T Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 /"Lt+rtil"C_ Storm sewer(no.linear ft.:_) I Pae 2 `Q� 6JV i7�' i�iti '41 b "�V i4''1 Water service(no.linear ft.: ) 1I Page 2 Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 4 DES lift Tibi op*' i�C :; '''',P: ') Backwater valve 12.51 f "'/ Clothes washer 25.02 Dishwasher 25.02 /^ Q /G ) Drinking fountain 25.02 A � {_ Ejectors/sump 25.02 04 PttOPERTYr O NEtt ,. � N s ., ,3 fix, j w r, s,�'; �xT�NAI,NT :/0.$407.., Expansion tank 12.51 Name: !` Fixture/sewer cap 25.02 Address: - Floor drain/floor sink/hub / 25.02 5.4.X Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax ( ) Ice makerry 12.51 /1-5/ 0 Apppe 1 T ElER CONTACT i SDN ; ,, Interceptor/grease trap 25.02 / Business name: Medical gas(value:$ ) Page 2 fob 4 S- `rets+-J Contact name: Primer i 12.51 12-5--/ Address: Roof drain(commercial) 12.51 Sink/basin/lavatory i 25.02 (� t} City/State/ZIP: r Solar units(potable water) 62.54 Phone:( ) I Fax::( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 Water closet CONTRACTOR 25.02 Business name: ���` Water heater / 37.52 3 A./ �� Water piping/DWV Address: (�j�( 56.29 /( v l \ /62,1 Other: 25.02 City/State/ZIP: 7-4.791% .-,0-4- 6 �! �y 72 2,..1-re Subtotal Phone:(77/) /L. 5 // 7 �''Fax:( < ) Minimum permit fee: $72.50 CCB Lic.: 74z/©S /rP 'lumbing Lic.no.:� G�� Plan review (25%of permit fee) no.:,,Z..../.4/9"...,e/ State surcharge(12%of permit fee) /) � . Authorized signature: AO � i TOTAL PERMIT FEE /?4O'( Print name;, I iA Date:/ // 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) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: _t. .. Qty Fee(ea) Total Sate�pleS , , Square Footage: Permit Fee; $121.90 Footing drain-151 100' 50.03 0 to 2,000 37.52 2,001 to 3,600 $169.69 Footing drain-each additional 100' 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 Total ' each additional$100.00 or fraction thereof,to p Qty. Fee(1t) and including$10,000.00. Other Inspections ar Fees ' � 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. $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for Additional plan review for revisions 90.00/hr each additional$100.00 or fraction thereof. (minimum charge-1/2 hour) 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*. 4 . e for tiu„m'bing Installations `, ``. :, Quantity by Fixture Type, Plan review is required for any of the following. Fixture Type for RePIaeei ' Please check all that apply. Any Work Performed: Capped Added Relocate 0 new commercial building with water service 2"and Baptistry/Font greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool 0 New exterior plumbing site utilities for any complex structure Car Wash: -Each Stall as defined in OAR918-780-0040. -Drive Thru 0 Medical gas and vacuum systems for health care facilities. Cuspidor/Water Aspirator 0 Any multipurpose fire sprinkler system. Dishwasher: -Commercial 0 Any complex structure as defined in OAR918-780-0040. -Domestic Drinking Fountain Submit 2 sets of plans with any of the above. Eye Wash Floor Drain/sink: -2>' v -3" son!etric< Riser Diagram 4" 0 Isometric or riser diagram is required for new buildings -Car Wash Drain that meet the qualifications above. Garbage -Domestic non-food Disposal: -Domestic food related -Commercial food related -Industrial food relatedIc Oil SeparatorComments regarding fixture work: OMach (GastorfDrains Station) C fy ,4r ry�V4/kV. ,h:7O O Rec.Vehicle Dump Station 11[ A,12 e W Ie- ,,-,40-of e ' d/is Shower: -Gang /1 t„ty,LJ,trT -Stall / / Sink: -Lav/Bar non-food related -Bradley -Com/Serv/Util food related -Service *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and Washer-Clothes fees assessed for the sewer increase must be paid before the Water Extractor plumbing permit can be issued. Water Closet-Toilet Urinal Other Fixtures: I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2