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Permit (168) CITY OF TIGARD PLUMBING PERMIT 6 Permit#: PLM2018-00121 COMMUNITY DEVELOPMENT Date Issued: 03/23/2018 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S101DA00101 Jurisdiction: Tigard Site address: 13190 SW 68TH PKWY 130 Project: Spec Space Subdivision: VARNS ACRES Lot: 9 Project Description: Plumbing fixtures for new break room: ADD(1)dishwasher,(1)2"hub drain,(1)primer,(1)break room sink,and (1)water heater. Contractor: WESTERN PLUMBING Owner: PACIFIC NW PROPERTIES LIMITED PA 9460 SW TIGARD AVE SUITE 101 STERN FAMILY LIMITED PARTNERSHIP TIGARD, OR 97223 STERN, HELEN R REVOCABLE TRUST 6600 SW 105TH AVE#175 BEAVERTON, OR 97008 PHONE: PHONE: 503-639-5296 FAX: 503-684-9015 FEES Quantity Description Date Amount 1 ea Dishwasher 03/22/2018 $25.02 Specifics: 1 ea Floor Drain/Floor Sink/Hub 03/22/2018 $25.02 1 ea Primer 03/22/2018 $12.51 Type of Use: COM 1 ea Sink 03/22/2018 $25.02 Class of Work: ALT 1 ea Water Heater 03/22/2018 $37.52 Type of Const: 1 12%State Surcharge- 03/22/2018 $15.01 Occupancy Grp: Plumbing Stories: Total $140.10 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: 4 .- --9. Permittee Signature: 1A/ D/ r %��i-i�0,i • 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 Building Fixtures Ez ►(>►z 0111( 1 1 'J OyI City of Tigard Rate;vetl c �./ Pcnn;t�vy 13125 SW Hall Bivd.,Tigard,OR 97223 Datc/Bv: �� o��i��«� Phone: 503.7)8,2434 1'ax: 503.59R,196O1111 MAR 2 0 2018 Plan Review �� Dalclpy: Other Penn;t�tA j/�� �� I�,,�1;i 41 Inspection Line: 503.639.4175 ��® Internet: www.ti rd-or. ov �y I Dale Read /B•. !?a g CITY OV" 4 ( y J /i_ ,c17/ ,Ju;s I 0 See Page 2 for 1 i j�a,�i-u 9 voulicd/Method:` TYPE OP°WiL?Jl {F �J( ;fit+.' Supplemental Information 13�� 1�ifFf. IEE* SCHEDULE C ❑New construction ❑Demolition For special information use checklist f Addition/alteration/replacementDescription I Qty. f Ea. � Total 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) i 'tATECORY OF CONSTRUCTION SFR(1)bath 312.70 2-family dwellingSFR(2)bath I-and 2-�fa4Commercial/industrial 437.78 SFR ❑Accessory building (3)bath 500.32 ❑Multi-family ❑ Master builder Each additional bath/kitchen 25.02 ❑Other Fire sprinkler( sq.ft.) Page 2 JOBrSITE INFORMATION AND•L(CAT"ON Site utilities: Job site address: '&ab SW vocgt,‘cy. Catch basin or area drain 18.76 City/State/ZIP (\t a Q 0� - r-ICU llrywell,leach line,or trench drain 18,76 Suite/bld /a t.no.: `'1 O (�__ Footing drain(no.linear ft.:_) Page 2 @ PProject name SIP �k Manufactured home utilities 50.03 Cross street/directions to job site: ,j G- Jf ? Manholes 18.76 Rain drain connector _ 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.: ) Page 2 Subdivision: Water service(no.linear ft.:_) Page 2 r I Lot no.: Fixture or item: Tax map/parcel no,: Backflow preventer 1 31.27 DESC1".r 1 wN't3P WORIK Backwater valve 12.51 VAX-10`r-"j, A rczo a%✓.c-,q _00� Clothes washer 25.02 Dishwasher to 25.02 c I Drinking fountain 25.02 (' ( Ejectors/sump 25.02 0 PROPERTY OWNER . S 0 TENANT 1 Expansion tank 12.51 Name: Fixture/sewer cap 1 25.02 Address: Floor drain/floor sink/hub 25.02 arj 02 Cit),/State/ZIP: Garbage disposal 25.02 Hose bib Phone:( ) 25.02 Fax:( ) ice maker It12.51 APPLICANT . ,.Q CONTACT PERSON Interceptor/grease trap 25.02 Business name: tOtSkvy‘TIU ityilV yt inc.., Medical gas(value:$ ) Page 2 ' Contact name: ,.��� n Primer 12.51 ta<ji Address:� � "�'1 p� 1 ,+�p Roof drain(commercial) 12 51 „ _ "-� �^''`� ��` ink/basin/lavatory City/State/ZIP curd i r\ otigg, 1 25.02 p2 �y� o° Solar units(potable water) 62.54 Phone:( � l Fax::6b*-5 10 -qb,S pan12.51 �k7�0 ) Tub/shower/shower l-mail: Qy l:�J�. yri pL A m bim inc.,°oY�') _ Urinal 25.02 C N!`RACEOR Water closet 25.02 Business name:Western Plumbing,Inc. Water heater 37 52 `2j1 5.L1 Water piping/DWV 56.29 Address:9460 SW Tigard Street,Suite 101 Other: 25.02 City/State/ZIP:Tigard,OR 97223 Subtotal jam, Phone:(503)639-5296 Fax:( ) Minimum permit fee: $72.50 CCB Lie.:2439 Plumbing Lie.no.:3429PB Plan review (25%of permit fee) Authorized signature: ��r ( t State surcharge(12%of permit fee) 1Cj,O\ '- * r i� �i l TOTAL PERMIT FEE / li) JO Print name: �,a �JU Mill This permit application expires if a permit is not obtained within 180 days .r' ""'�' after it has been accepted as complete. *Fee methodology set by Tri-County Building industry Service Board. 1.'•.Building\Permits\PLMU-PermitApp.doc 10/01/09 440-461(,T(10!OVCOM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty: Fee'{ea:} Total Square°l ootalge: "ermi t.Fele: Footing drain-I" 100' 50.03 0 to 2.000 Footing drain-each additional 100' $121.90 37.52 2.001 to 3,600 $169.69 Sewer-1st 100' 62.54 3,601 to 7,200 $233.20 Sewer-each additional 100' 7.201 and greater $327.54 37.52 Water Service- 1st 100' 62.54 Water Service-each additional 100' 37.52 Medical Gas Systems: Storm&Rain Drain-1st 100' 62.54 ! Vattiation:' Permit ee: Storm&Rain Drain-each additional 100' $1.00 to$5,000.00 Minimum fee$72.50 • 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' 1eE'(ea) Total each additional$100.00 or fraction thereof;to Inspection of existing plumbing or for and including$10,000.00. $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 (minimum charge-1/2 hour) each additional$100.00 or fraction thereof,to Inspections outside of normal business 90.00/hr and including$25,000.00. hours(minimum charge-2 hours) 525.001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/In Additional plan review for revisions and including$50,000.00. 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*. Ype Quantity by Fixture R pe Plan P a t Re �:fi r °t'!iil<m frig Installations Fixture T far Work Performed: Capped Added Rebate Plan review is required for any of the following. 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 ❑ Medical gas and vacuum systems for health care facilities. -Domestic k ❑ Any multipurpose fire sprinkler system. Drinking Fountain 0 Any complex structure as defined in OAR918-780-0040. Eye Wash Floor Drain/sink -2'}-N,kbrtkJ. fj Submit 2 sets of plans with any of the above. -3" 4" -Car4..Wash Drain er get k©r Riser is,) $Rq,' Garbage Domestic-nun-loud 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: Ree.Vehicle Dump Station Shower -Gang -Stall Sink/t,av -Non-food related -Bradley -Commercial-food related -Service Swimming Pool 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 - C)rinarl plumbing permit can be issued. hftp://www.tigard-or.gov/document_center/Building/PLME_PermitApp.dIC City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13190 SW 68TH PKWY 130, TIGARD, OR, 97223 Record Type: Record ID: Commercial - Plumbing PLM2018-00121 Inspection Type: Inspector: 399 Plumbing final Don Sylvester Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor