Permit (51) CITY OF TIGARDr 111 PLUMBING PERMIT
2 COMMUNITY DEVELOPMENT Permit#: PLM2018 00066
T I C.AP D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/22/2018
Parcel: 1 S 134AA01900
Jurisdiction: Tigard
Site address: 10105 SW NIMBUS AVE
Project: Burger King Subdivision: IKOLL BUSINESS CENTER,TIGARD Lot: B
Project Description: Repairing 80 ft.of sanitary sewer.
Contractor: APOLLO DRAIN&ROOTER SERVICE Owner: ROBINSON, JERRY CHRISTOPHER TRUS
2208 NW BIRDSDALE#8 DIETRICH, NANCY BISHOP
GRESHAM, OR 97030 9701 SE MCLOUGHLIN BLVD
MILWAUKIE, OR 97222
PHONE: 503-239-8801 PHONE:
FAX: 503-669-9568
FEES
Quantity Description Date Amount
80 If Sanitary Sewer 02/22/2018 $62.54
Specifics: 1 12%State Surcharge- 02/22/2018
$8.70
Plumbing
Type of Use: COM 10 ea Minimum Fee Adjustment- 02/22/2018 $9.96
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.6Q 332.2344.
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Feb. 20. 2018 3: 18PM
Plumbing Permit ApplicatiltiE,C FIVEJ) P. 1
Site Utilities i , l()tt (,t l ti t: :\lo:4306n
City of Tigard � � ��1�
Received
11 f a 13125 SW Heli Blvd,Tigard,OR 7 , .<. DaleBy: 1 PermitNo.:p� i�. y•
Phone: 503.718.2439 Pax: 541,4911194,,Q,...,r GAR Plan Review -`�� /-
r i, ? Inspection line: 503.639.4175 ; r S+ O Dale/Re: Other Permit No.:
far
Internet: www.tigard-nr.gov 503-or.gq`v i i"ILI Dale Ready/By: kis; See
Pe 2Inf
� . .' ., 'TlP - Notified/method: I Supplemental Information
0 New construction 0 Demolition For spedal information use cheakllsL
1 Addition/alteration/replacementDescription I Qty. I Ea. I Total
0 Other' New 1-2-family dwellinga(includes 100 R for each utility connection)
:'•;. .ls.:`;, i641*04*.i0ir tLFill4'$ 'g`i Ql�'"::: : SPR(1)bath
" � 312.70
0 1-and 2-family dwelling MCommercial/industrial SFR(2)bath
437.78 _
0 Accessory building 0 Multi-family SPR(3)bath 500.32
, Hach additional bath/kitchen 25.02
El Master builder 0 Other:
JOB.SITE:109104040.40- er t_sq.ft.) Page 2
Fire 9prinkl
LOCE*.N' :, Site utilities:
lob site address: i Ot0S- s W lj r;...kb La.-S AV - Catch basin or area drain 18.76
City/State/ZIP: Pow � 0 till !Drywall,leach line,or trench drain 18,76 _
Suite/bldg,/apt,no.: Project name; Footing drain(no.linear$.:T) Page 2
�� �\►AManmPaClured home utilities 50.03
Cross street/directions to job site:
Manholes 16.76
Rain drain connector 18.76
- Sanitary sewer(no.linear ft.:80) j, Page 2 2.VI.
N Storm sewer(no.linear It: ) Page2
Subdivision: Water service(no.linear ft.: ) Page 2
Lot no.: Fixture or item:
Tax map/parcel no.; Backiow preventer
31.27
b�$ 70N b�:'1?VR1tK Backwatervalvc 12,51
04 r- -ra��i Jet GT; 0 r Clothes washer 25.02
s: r� Dishwasher 25,02
,. / i •C' , Drinking fountain
25.02
P-,leCWrs/sump 25.02
PROpERTy:O d..:. ,,;,'_ Expansion tank
. �'N�!'r .•..: �`` ,, �':`:':': T 12,51
Name: (,B v k O // g viA / 4.L. Fixture/sewer cep
L.�? W _ 25.02
Address: 5-Z. cs J s- °- L1 t,e. �. Its-
Garbage vFloordisposal sink/hub IIIII 25.02
City/State/ZIP: � +1 ,, , ,f �i1 f`� 97 toll 25.02
��f s^�^�^ (1 1 Hose bib
Phone:(ray) 710 It",tea Pax:( 5.52
'.:.!'`.:12-1.,..,.:::.''..:,::•....,. .. Ice maker
12. 1
',0,,APPLICAN`,[' '.''.:; . ''' . .,O::coNTACT P)3,g89)V:-: Interceptor/grease trap
_ 25.02
Business name: ,t,i Q rGl(h 4 Medical gas(value:$ ) p age 2
Contact name: art c_ 1 Q 1 S�•v1
Primer 12.11
Address: l ry 1 �� Roof drain(commercial)
�� ,A-� Eiit�( Sink/basin/lavatory 25.02
. 1�. �� g 12.51
City/State/ZIP: r
dares-tt QR._ 170320 Solar units(potable water)
Phone:(To) 3 ( _ /9`T Fax:: 62.54
( O3)(p41 sot Tttb/shower/shawerpan 12.51
E-mail:
c•2_.€.; / it, Urinal 25.02
t) * Water closet
25.02
Business name: Apo 1c �l otic brae �„ u; ' Water heater 37.52
Address; �� �� 8 Waterpiping/DWV 56.29
+, . �� e, flit- e.. Other
5.02
City/State/ZIP; ,%. ,e5� � O� total
Phone;( `�7D3o
Subtotal ,L
5Zt3)3S`I - 9 q 72_ I Fax;(s-o3)
f G fo Q ^ So Minimum permit fee: $72.50 ~7 ,
CCB Lic.: y9 H/8/ Plumbing Lie.no_:X , Plan review (25%of permit fee _
Authorized signature: I� ��~� State surcharge(12%ofpermit fee)
W(n.�.. TOTAL PERMIT FEE '.
I Print name: -T•-I V
Date: �, p lea This permit application expires it a permit is not obtained vii ,is 150 days /
tt77 after it hos been accepted as complete,
"Fee methodology set by Tri-County Building Industry Service Board.
I:1Huildime1PermilAPLMU,PeutnitApp.doo 16e1/o9
440-4 a r 6r f1 o/ovCOMnvag)
? Feb. 20. 2018 3: 19PM No. 4306 P. 2
Plumbing Permit Application - City of Tigard
Page 2-Supplemental Information
Fee Schedule:
Residential Fire Suppression Sxstems:
f ditties ,... ;7.;. `::9#!2,".-1 s ;T'ar>ii.
Footing drain-1°'100' 50.03 Oto 2,000 $121.90
Footing drain-each additional 100' 37.52- 2,001 to 3,600 5169.69
Sewer 1st 100° 62.54 3,601 to 7,200 $233.20
(flZ•511 7,201 andpeatcr 5327,54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54
Water Service eachMedical Gas Systems:
additional 100' 37.52 ,
Storm&Rain Drain-1st 100' 62.54 r f� :'--00014.:$407: 1,:.: ',''
-. $1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52
,.„ .,.,,. . .�; ,•; ,^. $5,001.00 to S10,000.00 $72.50 forthc $5,000.000d1.e�for
0 00first an
;:Q'UJtik bigpecbpns on F e s• '+= : +;eti(e5) :!T lat': each additional 5100. 0 or fractionthereof,to
J'" " 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 Pas is specifically indicated 90.00/hreach 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 525,000.00 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*,
1' ae''i ;.for!Plum in. Ins alta
k[ure'lypehi.;.... ... ... .` g $IOriS{
Quantity bW:Fizrure Tempe '�„ PIan �
ge�pplacN Plan review is requiredany g
WarfcPerfOrrued, Captpep: Added Ttelocate for of the following.
Baptistry/Font Please check all that apply.
Bath -Tub/Shower ❑ 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 _ ❑ Now 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 ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR915-780-0040-
Eye Wash . -
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
-3"
Car Wash Drain ",-.,,Yso ,cl);ric l r,0,iser.Dira' ra
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./Refri&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
SwimmingFool Filter ---
Washer Clothes ""Note: If the fixture work under this permit results in an
-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:
C:1Userslapol1o\Downloads\PLMU_pormitApp.doc 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10105 SW NIMBUS AVE, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2018-00066
Inspection Type: Inspector:
505 Sanitary sewer Aaron Cillo-Gobel
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor