Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT71
Permit#: PLM2018 00291
Date Issued: 06/13/2018
T I G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S 13/201 8000
Jurisdiction: Tigard
Site address: 14210 SW BARROWS RD
Project: World Championship Tai Kwon Do Subdivision: RUSSELL'S SCHOLLS FERRY Lot: 3
Project Description: Add(2)new bathrooms for new tenant space: ADD(2)2"floor drains,(2)lays,(2)water closets and(1)water
heater.
Contractor: PROLINE PLUMBING&SEWER Owner: BARROWS PLAZA LLC
3214 NE 58TH STREET PO BOX 8880
VANCOVER,WA 98663 KETCHUM, ID 83340
PHONE:
PHONE: 877-376-2713
FAX:
FEES
Quantity Description Date Amount
2 ea Floor Drain/Floor Sink/Hub 06/13/2018 $50.04
Specifics: 2 ea Lavatories 06/13/2018 $50.04
2 ea Water Closet 06/13/2018 $50.04
Type of Use: COM 1 ea Water Heater 06/13/2018 $37.52
Class of Work: ALT 1 12%State Surcharge- 06/13/2018 $22.52
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $210.16
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By:
<621 / 4.}4C_______ Permittee Signature: ird,iT A4?/PL�'��9-77e7h,,/
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
...
Plumbing Permit APD.,ca .
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Building Fixtures tkl
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City of Tigard JUN 1 2 2018 Received 6 /3j/ce 'I'''': P.iitilPif7,2 t,/,-4 0.o?V
,..„-.4 13125 SW Hall Blvd.,Tigard,OR 9722
': Phone: 503.718.2430 Fax: 502537113'n--
1)4 Date/By:
Review
. t-ii i 1
3 .;11- I I(6i AR D DSI/BY
. Other Penni g reg.)420.e?
,,,,r. ) Inspection Laic: 503.639.4175m I 1 1 ,...,11\in aivisiot\I Due geenyigy, i r e., ,44.„..kiris: e See Page 2 for .
Internet: www.tigard-or.gov :k-DC.J11-t,J I. ‘-..' Nerinedrmerkiniko 5 --'-r,r 1 Supplemental Infomation
.-,...-,
. ,
441;:'"' -'''':'',Z111;''''',7i.‘-'" ',sle-,,i-,,, ii!„.:'!ti-', ilvo z 4,,.,--,,---_ „:„..-11,,,t1,$'2 :-.-.43,;:i-- , --,-..,.:or",, ,,,-_,,- , 1:„.. • ,
0 New construction- 0 Demolition For special'btformadon use clteclilist.
Description I Qty. t Ea- I Total
0 Addition/alteration/replacement 0 Other: New 1-2-1amily dwellings(includes 100 ft.for each utility connection)
itcotir C 4 If! ;: t 1-4;;if4-r ,12115,1-:? 6-'•14 t-6.1-6 ...:::a f SFR(I)bath 312.70
0
1-and 2-family dwelling ‘Commercial/industrial -SFR(2)bath 437.78
SFI1,(3)bath 500.32
0 Accessory building 0 Multi-family ---
Each additional bath/kitchen 25.02
•0 Master bUilde .... _Odle!: ,,,.. CI,. iik Fire sprinkler( sq.ft.) Page 2
I :41;0',..ti ,'7'4-$:{4;:',7+13 A kit'4,.. 1 P 6 i ib!''''' 6 164„1-1, ) brii6oi,illfg '.'4 1.6116 f site utilities: t..
''''''.'6.' - "'''''' ' ' ' Catch basin or area drain 18.76
Job site address: ria ,c uu, i'R....„or ,..-n..1,0,c R ,cArt 18 76
!:31;;$kasi,c
11
City/State/ZIP:
,..,,....„„4.„, jct., 0.„.._10, DForyotiwnegli.direaainch(nbon,el,ineertrtreftn.c:h drain) Page- 2
we,
Suite/bldg./apt.no.: Project name: - - rim r-Irt I..- -..-- - if Manufactured home utilities 50.03 ...1, .
, . •.
Cross street/directions to job site: I.2. .-a) ,..e- +k, pk....kit y,((I LA Manholes 18.76 ‘'N
Rain drain connector 18.76
ed(9/2-4-6 e1716,t/P/t/liffill/P r/9I AL14/0,1 41)/)
Sanitaty sewer(no.linear ft.:..,._ ) Page 2
Storm sewer(no,linear ft.:.._,.....) Page 2
Subdivision: j Lot no.: Fixture or item:
Backflow preventer 31.27
Tax map/parcel no.:
ffigititilFPF60y.w6v*-
Backwater valve 12.51
,.„ - ._A,, clothes washer
25.02
Rck.c.k): a-u3() r\e-AA) k-\atjnice:KSYY-IS 413 Dishwasher 25.02
tr\i',7}4.._
tritillAt Drinking fountain 25.02
1231
Ejectors/sump 25.02
iliteliT&Ii6Ty 0.)iii.E6'it -=',6, )1 1 'ill 16'1- :::66:11E11P4OTL 6S;11P,;..6 6 Expansiontank
,,....„Thra-t-71:,... 41 - -.-
Fixture/sewer.sewec c
25.02
n wet al)
Name:
Floor drain/floor sink/hul, 66.? - 25.02 *17).4f-1
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
. 45' Interceptor/grease trap
-ket,;:VON ,,,, 25.02
- ,.. ,, page 2
Medical gas(value:$ )
Business name: 2,11).1c,.(Ng. W,y\ekbli\r\a‘ i.....1,,.( , Primer 12.51
Contact name: c..jtkc,,..,..- y-Nri IA j t.t Si"
Roof drain(commercial) 12.51
..-, . t K t" ‘
Address: G'.1L4 i\-of.,e ,)•W OF% .° . , swuiratcninklbasariserVilltii6a'ev(amto)ry.linear ft: ) 9" Pa22g55e..00222
City/State/ZIP: itliPAy‘Q..C).‘,14„\Je.,,Y %M tek-- qgte(0...- Solar units(potable water) 62.54
1 v-
12.51
Phone:a--110 %-14_ a,-).t3 I Fax::( ) Tub/shower/shower pan ,
E-mail: (2;V: cArik (6.-- lit ii 1/4...,,,,..\(\9 ,y\\,:zi,.\ 0) at ap. $pit,)81twater closet a. 23.02 srs,64
-6,"4'ti-': 6;icil6P ' 64666Z', 6-661 1 66- --- Ay
".,,. - ' - 1,$ s Water heater 37.52 5.-1,C5>-
Business natne: pret..A....v\ND .ck.‘,/i(Xsi\cii 1,..-1, ....C.....
L----" t..-1.,‘, Water piping/DWV 56.29
Address: , ..3,k,4 1.,vc. Ggii.., Sk„. Other: 25.021 sri,kit
City/State/ZIP: \..),.1-\( iSkk1/410,,K) LA.Y1141 qq1SubtotalQ1Q3
Minimum permit fee.. $72.50
Fax:(3,tett)atty.-.41 Dip Plan review(25%of permit fee)
CCB Lic.: a t4 Plumbing Lic.no.:TE)1-MS .1
Slate surcharge(12%of permit fee) ..1.2_5..2...
Authorized signature: ,,iii4 Arlit,,..,lui31.0.0..- TOTAL PERMIT FEE ,l/a, /g
\<,,,,,Gy
Print name: (.3 thy0„, kki Date: ...,1 I ere, This permit application expires if a permit is not obtained within 180 daAcifr,fr-/
8, l (D 1 i 1141, I'arb) after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
13BuildfirtglPennits‘PLIMIU-PermitApp.doc 10/01t09 .440-4616T(10Al2/COM/WEB)
.
Plumbing Permit Ann[icatiQn - City of Tigard
Page 2- Supplemental Information
Fee Schedule:
Residential? .t F �'� t>!al Fire Su, ,reason S stems:
ad
Footing drain-I'd I00" NI ,-:, a .121.90 ' 1,,I ..
50.03 0 to 2,000 $121.90
Footing drain-each additional 100' - 37.52 2,001 to 3,600
Sewer-1st 100' $169.69
62.54 3,601 to 00 $233.20
Sewer-each additional I00' 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' ; ' l:
2.54 0 Alt, im .It a .t,,;� E , -`
Storm&Rain Drain each additional 100' $1.00 to$5 000,00
37.52 Minimum fee$72.50
$5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
;IIN60the l pectliin�s or Fees'��: +Qiy:'il Fee ea} ;ilrt6 i , each additional$100.00 or fraction thereof,to
Inspection ofexisting plumbing or for s q1' 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.
bourn(minimum charge-2 hours) $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.43 for
each additional$100.00 or fraction thereof,to
Reinspection Fees 40.00/hr
Additional plan review for revisions , and including$50,000.00.
90,00/hr $50,001.00 and up $742.00 for first$50,000.00 and$1.20 for
(minimum chargehour) 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*.
o 3'.bib t lQnantit/'1 tura i Pla21. dl S a �i mid "w».�
Fixture Type for - ��,I�i,� is • f01 w e �g�ilSte e a
Work Perin- d carpe , dd ,' >�ute' Plan review •required for any of the followi
Baptistry/Font g.
Please check all that apply.
Bath Tub/Shower " 0 Any new commercial building with water service 2"and
-Tub/Shower
Whirlpool gt'eater,except systems designed'and stamped by licensed
-JacuCar Wash -Each Stall
allengineer.
Drive t 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 sprinkler system.
Drinking Fountain Q Any complex structure as defined in 0AR918-7$0-0040.
Eye Wash
Floor Drain/sink -2" Submit/sets of plans with any of the above.
`ie_ ��0 fl$t�ti'Ie XL. tINItgEa 1 Car Wash Drain
Garbage -Domestic-non-food - i 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 fl to a work:
Rec.Vehicle Dump Station (s
Shower -Gang Q n- 't(err GI CA A ii ( �
-Stall �e, •
Sink/Lav -Non-food related 1(06 i 1 nC Ca Ir tk,A i 1
Bradley (1' t,s;,,; „k9- i/'�.00L.i{' -.
mmereinl-food related f C
-Co
Service 1i t l(\c} .
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-Toiletfees assessed for the sewer increase must be paid before the
Urinal plumbing r
Other Fixtures: P g pe snit can be issued.
/Users/prolineplumbing/Downloads/PLMF PermitApp.doc,
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
14210 SW BARROWS RD, TIGARD, OR, 97223 July 3, 2018 at 10:22:20 AM
Record Type: Record ID:
Commercial - Plumbing PLM2018-00291
Inspection Type: Inspector:
399 Plumbing final Chip Barnett
Result:
PASS - NoCofO
Comments:
Previous corrections completed
Violation Summary:
Inspector Contractor