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Permit (129) • CITY OF TIGARDPLUMBING PERMIT 41 ✓ 0i COMMUNITY DEVELOPMENT 'S `�� Permit#: PLM2018-00172 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/19/2018 T t p"O g Parcel: 2S113AB00600 Jurisdiction: Tigard Site address: 16160 SW UPPER BOONES FERRY RD Project: Phytelligence Subdivision:COUNCIL VIEW ACRES(LOTS 21-44) Lot: 30 Project Description: Plumbing fixtures for new tenant. 6/21/2018:REPRINT to correct fixture items: CAP(1)mop sink,RELOCATE(1) break room sink,ADD(1)2"floor drain,(3)break room sinks,(1)trough sink(1)hand sink,(2)emergency eye wash,(1)lay,and(3)primers. Contractor: ALWAYS FAITHFUL PLUMBING LLC Owner: PACIFIC REALTY ASSOCIATES LP PO BOX 757 ATTN: N PIVEN WILSONVILLE, OR 97070 15350 SE SEQUOIA PKWY#300 PORTLAND, OR 97224 PHONE: 503-780-9486 PHONE: FAX: FEES Quantity Description Date Amount 2 ea Fixture/Sewer Cap 04/19/2018 $50.04 Specifics: 6 ea Sink 04/19/2018 $150.12 1 12%State Surcharge- 04/19/2018 $37.53 Type of Use: COM Plumbing Class of Work: ALT 1 ea Floor Drain/Floor Sink/Hub 04/19/2018 $25.02 Type of Const: 3 ea Primer 06/21/2018 $37.53 Occupancy Grp: 1 ea Lavatories 06/21/2018 $25.02 Stories: 50 Misc Other Fee 04/19/2018 $50.04 0 12%State Surcharge- 04/19/2018 $3.00 Plumbing Total $378.30 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 - +UNC by calling 503.232.1987 or 1.800.332.2344. Issued By: r r 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. Plumbing Permit Application Building Fixtures RECEIVED FOR OFFICE USE ONE1' Ciof Tigard Received Date/By: b,/P / �,644`� '--Permit N�L/7 ��"`�/��_ 13125114 .1 SW Hall Blvd.,Tigard,OR 97223i UN 21 2018 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 ¢ , Other Permit No.: Inspection Line: 503.639.4175 CITY OF IP + Date/By: T I G A R D q Date Ready/By: Juris: H See Page 2 for Internet: www.tigard-or.gov Ell UJ DING DIVISION Notified/Method: Supplemental Information TYPE OF WORK '",- £4 ' FEE`•,SCHEDULE.. .«gin � ;-0 New construction 0 Demolition For special information use checklist. Description Qty. Ea. Total .Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) ';471;:, CATEGOR'i'SOF CONSTRUCTION SFR(1)bath 312.70 0 1-and 2-family dwelling commercial/industrial SFR(2)bath 437.78 ❑Accessory buildingMulti-family SFR(3)bath 500.32 0 Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFO ON AND LOCA QNSite utilities: Job site address: 1(Q` „rh, 5c„ lA.Q. O F Catch basin orr area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: 1(alt} 6e. ci Page drain(no.linear ft.:_) Pa e 2 Suite/bldg./apt.no.: Project name: � �� c/QJ Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 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 CRIPT.� O - >e" Backwater valve 12.51 iK n t° 'v;.. . Clothes washer 1 i9 -i� '76 E '1..5 Al 6- f 7// hwasher 25 1 9 Q(1 YI t'_q- Drinking fountain 25.02 k..-A-. Ejectors/sump 25.02 a ❑ PROPERTY O 15:,:z.;':`❑ TENANT Expansion tank 12.51 Name: V,Ac y,--jy- Fixture/sewer cap 25.02 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 jv Interceptor/grease trap 25.02 Business name: ((4piu 5 cat rNFAi, p ,,l3il� Medical gas(value:$ ) Page 2 Primer WI 12.51 Contact name: conc 1 C. rky+ &(atk t p Roof drain(commercial) 12.51 Address: Sink/basin/lavatory I 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:(ri j) ?-S'ti) Gl'L('`( o Fax: :( ) Tub/shower/shower pan12.51 E-mail: ` Urinal 25.02 Water closet25.02 CTO ' Water heater37.52 Business name: Water piping/DWV 56 29 Address: eC) v>L ' - Other: 25.02 City/State/ZIP:Usi1..::: 3 1)I'-L.6 O4 _. ` il`'� Subtotal �- Phone:(54 ) vo q ii(gCo Fax:( ) Minimum permit fee: $72.50 CCB Lic.: 1' _ (ZLk Plumbing Lic.no.(g 14,L4 Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name: Q E ��`( -t 6 fU Date: This permit application expires if a permit is not obtained within 180 days Y after it has been accepted as complete. /6 *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 tl*t a :� Qty. FA-00 - Total Square Footage: Permit Fee: }.. Footing drain-1'100' 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 Va�iaaton: . Per>�iit Fees 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 ©thee jusriettions or Fees tee ea) 3iotal". each additional$100.00 or fraction thereof,to 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 :.o- mrd accurately report fixtures could result in increased sewer fees*. .`Ian Review for plum bi g"Installa;io Quantity by FixtureType Plan review is required for any of the following. Fixture Type for Replatel Please check all that apply. Work Performed: Capped ` Added Rel Bate Baptistry/Font ❑ Any new commercial building with water service 2"and greater,except systems designed and stamped by licensed Bath: -Tub/Shower -Jacuzzi/Whirlpool engineer. Car Wash: Each Stall 0 New exterior plumbing site utilities for any complex structure Drive tall as defined in OAR918-780-0040. Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities. Dishwasher: Commercial 0 Any multipurpose fire sprinkler system. Domestic ❑ Any complex structure as defined in OAR918-780-0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: -2" 3" 1$0j11*e"7 i a. .+fir.lI ° . ':t' 4" 0 Isometric or riser diagram is required for new buildings -Car Wash Drain Garbage Domestic non-food that meet the qualifications above. Disposal: -Domestic food related -Commercial food related -Industrial food related Ice Mach./Refrig.Drains Comments regarding fixture work: Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: -Gang -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 Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2 Plumbing Permit Application ' ` &, <. t Building Fixtures IIIR 01 I I( I 1 51 ON l l ceQ City of Tigard A P R �i I i �Re�By.ived yif � Permit N ..f�/„2,,,/e,rDO/7,2_ 13125 SW Hall Blvd.,Tigard,OR 97223 INPhone: 503.7182439 Fax 503598`19 8 t f g9; p lan Revy;ce Other Permit jLliQ /,.--egQ0o, Inspection Line: 503 639.4175 o t Res !a Seep 2 for I nc q i v. , Ready/By: ice. Internet www.tigani-or.gov Ci , [ '1... it Notified/l4l_e4thod•/ v Supplemental Information " TliE OF O -...,,f,' ,-,,,C. y /L1a, x EE* S EDP _ ‘,..e, ti,. ❑New construction 0 Demolition For special information use checklist Description I Qty. I Ea. I Total 14 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) agt '''.17 ' '- AT O) OF CONS :* : ;p SFR(1)bath 312.70 , 121!1-and 2-family dwelling Conunercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 50032 Each additional bath/kitchen 25.02 o Master builder 0 Other. Fire sprinkler( sq.ft.) Page 2 SiNFO MON ) A 11 ".•. r Site utilities:r ,: A , Catch basin o r area drain 18.76 Job site address: l(0( J uCm � ea "eJce�. Drywell,leach line,or trench drain 18.76 City/State/ZIP: II(01( O 00. q--iFooting drain(no.linear ft.: ) Page 2 Suite/bldgJapt.no.: I Project name: th TEU(E(J(-5 Manufactured home utilities , 50.03 Cross street/directions to job site: V)Act_ 5DMX ( Doo, nvco (, Manholes 18.76 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: f Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 Fikkii.. . . Backwater valve 12.51 Clothes washer 25.02 Rebe.p r£ i gRea<S DitC-/{1:0403"A(JS.iic j 3 ow5'AhcS Dishwasher 25.02 1 TfZow6 tI 50..)K, a Qtn,EP,it. ¢^Sr� i 0120. H. M3f)5�ILL'i _Drinking fountain 25.02 3 ` � S Ejectors/sump 25.02 y '' '^ ; mi- .' v lif -f Expansion tank 12.51 .-lint// 0� � �l s Name: O S� Fixture/sewer cap ✓ 25.02 Floor drain/floor sink/hub 'J ✓25.02 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 :,' 1 Aftodblio.,i- ;^ 'trojor >E Interceptor/grease trap 25.02 Business name: !T e- n s r 1)Alli FAA=106iiiila Medical gas(value:$ _) Page 2 Primer Contact name: gyp,, Cii-m 6E Roof drain(commercial) 12.51 Address: `"'11Sink/basin/lavatory (p ✓ 25.02 City/State/ZIP: e f" •) Solar units(potable water) 62.54 Phone:(50 ) ' W 61't,KO Fax::( ) Tub/shower/shower pan pnatitley '> 12.51 E-mail:_. y`�ys` �'n4 � §0104.400,60(i. Urinal �7L 25.02 4 { �.. Watea closet 25.02 Water heater 37.52 Business name: v ai s FA n44 u- P1,.u1,th iv 0Water piping/DW V 56.29 Address: PQ Box -35.4. - Other: : 76' ft/eSif t.2 25.02 City/State/ZIP: �l 00 km..L.E �, -90'TO Subtotal gid., 7S . Minimum permit fee $7230 Phone:(rj- leo 4 ti lKM`f Fax:( ) Plan review (25%of permit fee) CCB Lic.:t i--4.2 y4, Plumbing Lic.no.: pcf31q",lIJ T State surcharge(12%of permit fee) 37.53 Authorized signature: , TOTAL PERMIT FEE Ace , Print name:Lo CAI A DateQ t-, This permit application expires if a permit Is not obtained within 180 days tv V yt after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Buildiog\PermiIs\PLMU-PermitApp.doc 10/01X19 440-4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression S stems: e 13til tlel ' ' ,;n :, Y.`,e44(a)4., T `'f l : 9 ia1o,Fooiage:. ;: . hr.{• - .., -Footing drain-1' 100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 Sewer-1st 100' tit 3,601 to 7,200 $23320 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 ! t ;. > Storm&Rain Drain-1st 100' 62.54 ..luAt..n: .,;`, ''PB . . , 4 ;: . _.. $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 y.� ._ .��a .. :. _ each additional$100.00 fraction thereof,to 8 o{ j'I s ns,,9r Fyees�,, i, =` ', i til 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$120 for (minimum charge-1/2 hour) each additional$100.00 orf action thereof. Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. l> ',=V. v`+ r'r h i i '{s r) ; ,li, r,, 3'1 '}uait ,1 1Rre. Plan review is required for any of the following. Fixture Type for ,� C :x Please check all that apply. Work Performed: :'. 'r Baptistry/Font . ‘ El Any new commercial building with water service 2"and greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool Car Wash: -Each Stall ❑ New exterior plumbing site utilities for any complex structure as defined in OAR918-780-0040. -Drive Thru Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities. ElDishwasher: Commercial Any multipurpose fire sprinkler system. Domestic 0 Any complex structure as defined in OAR918-780-0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: -2" 1 V , -4" • Isometric or riser diagram is required for new buildings -Car Wash Drain that meet the qualifications above. Garbage -Domestic non-food Disposal: -Domestic food related -Commercial food related -Industrial food related Ice Mach./Refiig.DrainsGP Comments regarding fixture work: Oil Separator(Gas Station) e Rec.Vehicle Dump Station eShower: -Gang -Stall et/ Pliti-1 Sink: -Lav/Bar non-food related A 5 6 -Bradley -Com/Se v/Util food related 7e dr -Service 1'14 I v Y$ *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 Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 CITY OF TIGARD PLUMBING PERMIT ' COMMUNITY DEVELOPMENT Permit#: PLM2018 00172 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/19/2018 T t r�I�T g Parcel: 2S113AB00600 Jurisdiction: Tigard Site address: 16160 SW UPPER BOONES FERRY RD Project: Phytelligence Subdivision:COUNCIL VIEW ACRES(LOTS 21-44) Lot: 30 Project Description: Plumbing fixtures for new tenant: CAP(1)mop sink, RELOCATE(1)break room sink,ADD(3)2"floor drains,(3) break room sinks,(1)trough sink and(1)hand sink. Contractor: ALWAYS FAITHFUL PLUMBING LLC Owner: PACIFIC REALTY ASSOCIATES LP PO BOX 757 ATTN: N PIVEN WILSONVILLE, OR 97070 15350 SE SEQUOIA PKWY#300 PORTLAND, OR 97224 PHONE: 503-780-9486 PHONE: FAX: FEES Quantity Description Date Amount 2 ea Fixture/Sewer Cap 04/19/2018 $50.04 Specifics: 3 ea Floor Drain/Floor Sink/Hub 04/19/2018 $75.06 1 ea Primer 04/19/2018 $12.51 Type of Use: COM 6 ea Sink 04/19/2018 $150.12 Class of Work: ALT 2 ea Tub/Shower/Shower Pan 04/19/2018 $25.02 Type of Const: 1 12%State Surcharge- 04/19/2018 $37.53 Occupancy Grp: Plumbing Stories: Total $350.28 Required Items and Reports(Conditions) Thispermit is issued to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other subject9 9 pp ty 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: � .e____ Permittee Signature: ,A/ '97'°/.°4-," �z�e)�,,� 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 Applicatioif r ?' * -, Building Fixtures FOR OFFICE USE ONLY City of Tigard APR1 ' f S d i/ N �� 49,174.--- Permit N/207,7261/4e,r�p/7 13125 SW Hall Blvd.,Tigard,OR 97223 Date/ByReceive: 7 - Pl 111Phone: 503.718.2439 Fax: 503.598'.1960 -: Dan RevOther Permit A, o20,41-‘27/0 T I G A R D Inspection Line: 503.639.4175 r Date Read/B Internet: www.tigard-or.gov %'' Ready/By: ' Juris: H See Page 2 for NotiSed Method �7 �� *r Supplemental Information TYPE OF WORK /L : FEF* SCHEDULE t, 0 New construction 0 Demolition For special information use checklist Description I Qty. I Ea. Total Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) ATFOORY OF CONSTRUCT ON: .,' SFR(1)bath �* ., . 312.70 0 1-and 2-family dwelling C4 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 ❑Master builderEach additional bath/kitchen 25.02 0 Other: Fire sprinkler( sq.ft.) Page 2 loft SITE INFORMATION AND LOCATION Site utilities: Job site address: ill vo(p (5,0 twee_ 1.i%UK)s 4=en p...1) Catch basin or area drain 18.76 City/State/ZIP: ( �� r Drywell,leach line,or trench drain 18.76 -f Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name: `..0 TELA LE/6 , Manufactured home utilities 50.03 Cross street/directions to job site: D�C.mL S 11 tiCri1 Nota... _N c.... Manholes 18.76 � 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: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 Ey ON'OF iii0A , ,, Backwater valve 12.51 w, ✓ , � �0 s -- 17 Clothes washer 25.02 Retuc. rE i giZEo l.../<. Dzolo 31t 5j GC"_ 3 lvrer.'r S'aL%4S Dishwasher 25.02 1 i1Zo�,6 ti 51")0(�P O,E q 6t c)-10..r �' ✓ f�^� ► t 1flN�s i+t�-- Drinking fountain 25.02 CLO tett NS / •& �� Ejectors/sump 25.02 ieL ktOP RT',OW; E, ' - P TS Expansion tank 12.51 Name: PA[.Z `� Fixture/sewer cap ✓ 25.02 Floor drain/floor sink/hub ;2) ,/25.02 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax ( ) Ice maker 12.51 � .)° r A�it `} "... LI Or A J P oy' .4' Interceptor/grease trap 25.02 Business name: A-1 ,,,n15 1nA pti„, relz, Medical gas(value:$ ) Page 2 Contact name: W P 1 C t-n-laE A, �yi(� Primer ' / 12.51 Address: G �I�c, I� �� Roof drain(commercial) 12.51 Sink/basin/lavatory ll/ ,/' 25.02 Iii Solar units(potable water) 62.54 Phone:(505 ) Tas, Fax::( ) Tub/shower/shower pan 12.51 E-mail: fi wc93 �"R l T t iciA- 1111 .4),/,y/94,106.60 Urinal '`�yL. 25.02 .. Water closet 25.02 ., ... t. Water heater 37.52 Business name: 4L (i s FA t4 ciA L, 91.14016N tp Water piping/DWV 56.29 Address: P() 00x -35-4. Other: 25.02 City/State/ZIP: 1....\(N,50 0 Vv.:Le, 02_ 9 Subtotal 26,7,. 7,5 Phone:(r 0) -78.0 q g go Fax:( ) Minimum permit fee: $72.50 CCB Lic.: 1.7 ,5'"1, Plumbing Lic.no.: Re,i-1 q, Plan review (25%of permit fee) -10 State surcharge(12%of permit fee) 37,$3 Authorized signature � � TOTAL PERMIT FEE 3 r n� cy r all Print name:/ w (k{ri,,15-F t l Date- iQ- . This permit application expires if a permit is not obtained within 180 days t 1 1 t.Jlitv�T�, (17 l 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: . Qty. ee;ea)x 'r Total �.; Site Utilities ,: Square Footage: Per ni# "ee:,. Footing drain-1s`100' 50.03 0 to 2,000 $121.90 2,001 to 3,600 $169.69 Footing drain-each additional 100' 37.52 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 'Valuationi's -Permi ,F+ : 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 'tither Inspections or Fees ` Fee'(ea) ° 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 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*. x Plan Review for Plut biug Install a io Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for : Replace/ Please check all that apply. Work Performed: Capped Added, Relocate ❑ Any 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" 1 V -3" ,�,!S0lnetr3c o « xpoiraA 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 related Comments regarding fixture work: Ice Mach./Refrig.Drains „cP Oil Separator(Gas Station) r' Rec.Vehicle Dump Station r�� Shower: -Gang 11/41°1j A,� -Stall lr� f'"" Sink: -Lav/Bar non-food related Fj I ,L,-0/44.> -Bradley -Com/Serv/Util food related mer -Service Ell I I" 'le # *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 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 16160 SW UPPER BOONES FERRY RD, TIGARD, OR, 97224 Record Type: Record ID: Commercial - Plumbing PLM2018-00172 Inspection Type: Inspector: 399 Plumbing final Aaron Cillo-Gobel Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor