Permit (201) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2018-00322
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/25/2018
T t c_.;ti R t7 g Parcel: 2S113B000600
Jurisdiction: Tigard
Site address: 16580 SW 85TH AVE
Project: Clean Water Services Subdivision: None Lot: None
Project Description: 0&M Phase 2-Main building remodel/addition and new conference room plumbing site utilities.
Contractor: DA NEAL CONSTRUCTION INC Owner: CLEAN WATER SERVICES
36296 NE WILSONVILLE RD 2550 SW HILLSBORO HWY
NEWBERG, OR 97132 HILLSBORO, OR 97123
PHONE: 503-547-8150
PHONE: 503-625-6802
FAX:
FEES
Quantity Description Date Amount
3 ea Catch Basin or Area Drain 07/25/2018 $56.28
Specifics: 6 ea Rain Drain Connector 07/25/2018 $112.56
25 If Sanitary Sewer 07/25/2018 $62.54
Type of Use: COM 350 If Storm Sewer 07/25/2018 $175.10
Class of Work: ALT 212 If Water Service 07/25/2018 $137.58
Type of Const: 1 Plan Review 07/25/2018 $136.02
Occupancy Grp: 1 12%State Surcharge- 07/25/2018 $65.29
Stories: Plumbing
Total $745.37 I
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: Permittee Signa e: „0/(j/1!c'�
„,-4{
Call 503.639.4175 by 7:00 a.m.for the next available i tion 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 —
Site Utilities m-t
Phone:Cit
1of 037al Blvd Fax: 503.598 296 tl Received — /!�
a yTigard t) 28 Date/By: ` t Permit No. ,/, fr !''1�.z
13125 SW Hall Blvd.,Tigard,OR 97223 i! �G%LI,zQl (�L(f
• .plan Review
5 s a t5:,-;.--,A)--,,' ate/By: 7-11-i ,0 4 Other Permit No.:
Inspection Line: 503.639.4175 s a; _
7 I( ,A K h ,11, 1 ?1\<< � ) y e Ready/By ii-, Juris: 0 See Pae 2 for
Internet. www.tigard-or.gov = �� ) ��i �e S
Notified/Method:ied/Method. Supplemental Information
__._TYPE OF WORK i L L'd /L4- FEE* SCHEDULE
®New construction
❑Demolition For special information use checklist.
DescriptionEa. 11 Total
®Addition/alteration/replacement ❑Other —__ __l ?__.1. ._.i_1._
_._ -- New 1=2-family dwellings(includes 100 R.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ i-and 2-family dwelling gJ Commercial/industrial SFR(2)bath 437.78
0 Accessory building _ SFR(3)bath 500.32
❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other:
___ _ -- _.. Fire sprinkler( sq ft.) Page 2
JOB SITE INFORMATION AND LOCATION — -"
____-__- Site utilities:
Job site address: ._.— Catch basin or area drain 18.76
CG 5D , _— sr
City/State/ZIP: OR 97224 Cl6 t ' Drywel) leach line,or trench drain 18.76
h` 16965-SW 85th Ave Tigard, ,� J t.--� — __— _ __.
Footing dram(no.linear ft.: ) Page 2
suite/bldg./apt.no.: Project name:$'MPFi-- Rem-go —___—
m_ m_ Manufactured home utilities 50.03
Cross street/directions to job site:SW DurhaRoad
Manholes
18.76
Rain drain connector 6 18.76 1 0.56 ,,-
Sanitary sewer(no.linear ft.:25) 1 Page 2 62
Storm sewer(no.linear ft.:
.iZ ,� 3 Page j
Water service no linear ft: I' ) I Fa e 2 r
Subdivision: I Lot no.: — ( /'��"
Fixture or item
Tax map/parcel no.2S113B000600 Tigard Backflow preventer 31,27
Backwater valve
DESCRIPTION OF WORK 12.51
'emodel and small addition of Existing Operations and Maintenance .ui .i g Clothes washer 25.02
Dishwasher 25.02
ew Construction of a Conference Building -
_ __ Drinking fountain 25.02
Ejectors/sump 25.02
PROPERTY OWNER 0 TENANT Expansion tank 12.51
Name:Clean Water Services Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25,02
Address:2550 SW Hillsboro Hwy �_.
Garbage disposal 25 02
City/state/ZiP: Hillsboro,OR 97123 _._
Hose bib
,3
-_ ___.
Phone:(503 )547-8150
❑ APPLICANT Fax:( ) Ice maker 25.02
12.51
_
0 CONTACT PERSON Interceptor/grease trap 25.02
Business name: Medical gas(value:$ }
Primer
Roof drainco
P&C Construction Page 2
12.51
Contact name: Will Somme
(commercial) 12 51
Address: 2133 NW York Street
( )
(� City/State/ZiP:
Sink/basin/lavatory 25.02
i97210-2108 - --
Portland OR Solar units(potable water) 62.54
Phone:(503) 665-0165 Fax::( ) Tub/shower/shower pan 12.51
Email: WSOrltmt?@bU111bypandC.COm Urinal 25 02
-- - - — . --1.2 [ _2 Water closet
CONTRACTOR 25 02- - _ Water heater 37.52
Business name: wilt_ el�4t'1l/�fl fj/O f t1 -�^
__- /!its Water piping/DWV 56.29
Address: 5� 21 i, /VJ /....', r
_. yLt9U/L G/G Other: 25.02
Gt /State/ZIP: —
y �✓b �vc e�r2 ?I Z subtotal yy
Phone:t 503 4,Z$- U . C)2,. Fax:( 1 j) &.) ,5"-7�3(,, Minimumpennit fee: $72.50
i. CCB Lie,, q"764e,11A PlumbingLic Plan review 25%of ermit fe"764e, State surcharge(12%of permit fee) �,5
Authorized signature: , i1...___
•
- TOTAL PERMIT FEE 1715:311
Print name. 4 Y/0jl Al' r6/2.4711,rThis permit application expires if a permit is not obtained within 180 days
j���� i Date: after it bas been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I.WuiidmglPermits\PIM1)-PernitApp.doc 10/01/09 440-46 I61(io'021CoM/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-l' 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' 1 62.54 62.54 3,601 to 7,200 $233.20
7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 1 62.54 62.54
Water Service-each additional 100' - Medical Gas Systems:
37.52 �fs04 Valuation: Permit Fee:
Storm&Rain Drain-1st 100' 1 62.54 62.54
$1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 3 37.52 112.56 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
Inspection of existing plumbing or for and including$10,000.00.
which no fee is specifically indicated 90.00/hr $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
(minimum charge-1/2 hour) each additional$100.00 or fraction thereof,to
Inspections outside of normal business 90 00r
and including$25,000.00.
hours(minimum charge-2 hours) $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
Reinspection Fees 90 00/ltr each additional$100.00 or fraction thereof,to
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: 37S;a
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*.
Quantity by Fixture Type Plan Review for Plumbing Installations
Fixture Type for Replace/
Work Performed: Capped Added Relocate 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 0 Medical gas and vacuum systems for health care facilities.
-Domestic 0 Any multipurpose fire sprinkler 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"
-4"
Car Wash Drain Isometric or Riser Diagram
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./Refrig.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
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
Urinal plumbing permit can be issued.
Other Fixtures:
I:\Building\Permits\PLMU_PennitApp.doe 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16580 SW 85TH AVE, TIGARD, OR, 97224 March 14, 2019 at
10:38:25 AM
Record Type: Record ID:
Commercial - Plumbing PLM2018-00322
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Previous corrections completed
Violation Summary:
Inspector Contractor