Permit (98) CITY OF TIGARDli PLUMBING PERMIT
114 ' COMMUNITY DEVELOPMENT Permit#: PLM2018-00236
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/17/2018
TtGA"�l�l 9
Parcel: 2S 101 AB03100
Jurisdiction: Tigard
Site address: 12115 SW 70TH AVE
Project: Red Rock Center Subdivision: 2012-009 PARTITION PLAT Lot: 3
Project Description: Installing backflow preventer in northeast corner of landscaping.
Contractor: AFFINITY NW LANDSCAPING INC Owner: TIGARD TRIANGLE PARTNERS LLC
8536 SW ST HELENS DR SUITE C 18187 SIERA DR
WILSONVILLE, OR 97070 LAKE OSWEGO, OR 97034
PHONE: 503-807-8213 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 05/17/2018 $31.27
Specifics: 1 12%State Surcharge- 05/17/2018 $8.70
Plumbing
Type of Use: COM 41 ea Minimum Fee Adjustment- 05/17/2018 $41.23
Class of Work: OTR 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 1.800.332.2344.
1
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.
Plumbing Permit ApnlicatioRECEIVEP
Site Utilities FOR OFFICE USE ONLY
City of Tigard MAY 14 2018Received
13125 SW Hall Blvd.,Tigard,OR 972�3, Date/By:__57/4, /e , Permit Nroz� /, /1
■ Phone' 503.718 2439 Fax 503.598 9 OF TIGARDiligi
Plan Review L�
Inspection Line: 503,639.4175 Ik tvBy: Other Permit No.:
TIC ARD g� CTn ate Ready113y: Inns: See page 2 for
Internet: www.tigard-or.gov 15UILD►ING DIVI IO 4//�/�i `,
oufiedlMcthod. Supplemental Information
TYPE OF WORK e"?-10}!L fg4i.- .y FEE* SCHEDULE `
®New construction 1 ❑Demolition i For special information use checklist.
Description
0 Addition/alteration/replacement ❑Other: � Qty Ea { Total
New 1-2-family dwellings(includes 100 R.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
❑ 1-and 2-family dwelling ®Conlmercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
❑Master builder 0 OEach additional bath/kitchen 25.02
Other: • Fire sprinkler( sq.ft.) Page 2
Site utilities:
JOB SITE INFORMATION AND LOCATION-
es;
Job site address "d t/ Catch basin or area drain 1$.76
�vZ//S fGi.�
City/State/ZIP:Tigard,OR 97223 Drywell,leach line,or trench drain 18.76
Suite/bldg./apt:no.: I Project me:Red Rock Center Footing drain(no.linear ft.: ) Page 2
na
Manufactured home utilities 50.03
Cross street/directions to job site:On corner of 72nd and Dartmouth 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. a SIO/ 3a(i'd Backflow preventer 1 31.27 31,27
DESCRIPTION OFWORK Backwater valve 112.51
Installing backflow preventer in NE Corner of landscaping. Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
J PROPERTY OWNER J 0 TENANT Expansion tank 12.51
Name:Emmett Phair Construction Fixture/sewer cap 25.02
Address:6305 SW Rosewood Rd,Suite E Floor drain/floor sink/hub 25.02
City/State/ZIP:Lake Oswego,OR 97035 Garbage disposal 25.02
Hose bib 25.02
Phone:(503)572-8606 Fax:( ) Ice maker
12.51
o APPLICANT
CONTACT PERSON Interceptor/grease trap 25.02
Business name:Affinity NW Landscaping Medical gas(value:-$ ) Page 2
Contact name:Ashley WincheliPr
'me1 12.51
Address:8536 SW St Helens Dr,Suite C Roof drain(commercial) 12.51
Sink/basin/lavatory 25.02
City/State/ZIP:Wilsonville,OR 97070 Solar units(potable water) 62.54
Phone:(503)826.5124 I Fax::(844)335-8258 Tub/shower/shower pan 12.51
E-mail:ashleya@affinitynw.biz Urinal 25.02
CONTRACTOR Water closet 25.02
Business name:Affinity NW Landscaping Water heater 37.52
Water piping/DWV 56.29
Address:8536 SW St Helens Dr,Suite C
Other. 25.02
City/State/ZIP Wilsonville,OR 97070 Subtotal 31.27
Phone:(503)826-5124 Fax:(844)335-8258 Minimum permit fee:-$72.50 72.50
CCB Lic.:210308 y Plumbing Lic.no.: Plan-review (25%of permit fee)
Authorized signature. ly State surcharge(12%of permit fee)
'�`' a__. TOTAL PERMIT FEE 72:50
Print name:Ashley WinChell Date:5/7/2018 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.
tAnundinglPemtits\PLMU-PermitApp.deo i0/0I/09 440-4616r(10/02/CObr/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"100' 50.03 0 to 2,000 $12190
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' 62.54Medical 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& 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
Qty, Fee(ea) Total each additional$100.00 or fraction thereof,to
Other Inspections or Fees 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: 7Z.h[,>
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to i
accurately report fixtures could result in increased sewer fees*.
Quantity by Fixture Type Plan Review for Plumbing Installations
Fixture Type for Replace/ Plan review is required for any of the following.
Work Performed: Capped Added Relocate Please check all that apply.
Baptistry/Font -
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 Tliru 0 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 0 Any multipurpose fire sprinlder system.
Drinking Fountain 0 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
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12115 SW 70TH AVE, TIGARD, OR, 97223 June 7, 2018 at 9:33:24 AM
Record Type: Record ID:
Commercial - Plumbing PLM2018-00236
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
1 " Wilkins irrigation backflow device located on northeast corner of building approved
with test report.
Violation Summary:
Inspector Contractor