Permit (199) CITY OF TIGARD PLUMBING PERMIT
1111 COMMUNITY DEVELOPMENT Permit#: PLM2018-00433
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/17/2018
E1R. 9 Parcel: 25101 BC00700
Jurisdiction: Tigard
Site address: 12280 SW HALL BLVD
Project: Just Compassion Center Subdivision: KNOLL ACRES Lot: 2
Project Description: (1)water closet and(2)sinks for a new homeless shelter.
Contractor: ACT PLUMBING INC Owner: JUST COMPASSION CENTER
702 SE PAROPA AVE 12280 SW HALL BLVD
GRESHAM, OR 97080 TIGARD, OR 97223
PHONE: 503-103-4511
PHONE: 503-912-0758
FAX:
FEES
Quantity Description Date Amount
2 ea Sink 09/17/2018 $50.04
Specifics: 1 ea Water Closet 09/17/2018 $25.02
1 12%State Surcharge- 09/17/2018 $9.01
Type of Use: COM Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $84.07
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:l✓�� / Permittee Signature: RSC E \2v(��r,�S'�"
.ems CCC
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 _ FOR OFFICE USE ONLI'
Cl}�,of Tigard t Received
`J g x Permit No.:1)&111.q.)/ 'a
41 13125 SW Hall Blvd.,Tigard,OR 9�� Date/By: ��0 7�J j� .07}-- �1� ��
e Plan Review
IIII11 Phone: 503.718.2439 Fax: 503.598.1960 r 7 Other Permit No.:
Inspection Line: 503.639.4175 SEP 1 # f-o� Date/By: r)Ig'ClL'7Z�7
T 1 l A R f0 Date Ready/By: oris: See Page 2 for
Internet: www.tigard-or.gov ARID Notified/Method: Supplemental Information
1V vAI Iiia '
` '-- TYPE OF WO1 . i Si�
5.��. . .% . � � "., FEE* SCHEDULE:, a ��:£;�
�l l,, For s ecial information use checklist.
El New construction einolition f
Description �� Qty. Ea. Total
Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONST2>CJCTION �. ,- SFR(1)bath 312.70
1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
0 Accessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
0 Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
---
',' JOB,VTE INFORMATION ANA/ LOCATIONx: r - Site utilities:
Job site address: I22$O 5utj gel/I tot Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: "t-iGtAYO ('j J" °(-122.3 Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: dd j Project name: gT .C)VMe g o 0 a 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
r t Backwater valve 12.51
` I)ESCIUPTION OE~`. "ORK a °� ,,
.. � . , �,. Clothes washer 25.02
RIL)t\" QVC LAv e OAri6 9IIJk 5TTI Poll y Dishwasher 25.02
p W 1�1.K/ ?••,0%./'6 L� `by 9'\ _ Drinking fountain 25.02
�' C.`0C-A T V C31^ 0 ‘,%b T e CC groijt>V t Ejectors/sump 25.02
II!':'-
P,it jpyphJETt.,,; 0 i'E, Expansion tank 12.51
Name: ti Z/A .J j .��A . ,A v ; Fixture/sewer cap 25.02
FAddress: k5-5 $ Q cs*U SIA ow y pw l L Ad Garbage
drain/floor sposink/hub 25.02
/ Garbage disposal 25.02
City/State/ZIP: 3-eAvrov. 0 N2 RID 0/I- Hose bib 25.02
Phone:t O.3) 5. ()- 'to 2.$ Fax:( ) Ice maker 12.51
7- APPLICAN . 41 i t.. ACT P {)1T Interceptor/grease trap 25.02
Business name:
Medical gas(value:$ ) Page 2
•
Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 2.. 25.02 SZ LAI
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
,x - r ... . Water closet 1 25.02 .iJ.),
CON'1 R TOR
7. Water heater 37.52
Business name: Ac PkutAA14, 1C Water piping/DWV 56.29
Address: 1-4,0.2„ 5e 9 AY
(y p,L1 a . L
� - Other: 25.02
(�
City/State/ZIP: T.t S�/1 a 0 IV qrl 0 $() Subtotal '7 57,ar.,
Phone:(9ST)P - C Z -p"1 $ Minimum permit fee: $72.50
l Fax:( )
CCB Lic.: Zo 9 l co s Plumbing Lic.no.p5 l to 2;1- Plan review (25%of permit fee)
State surcharge(12%of permit fee) I,a
Authorized signature: 1 \�vo�.. , to" '
rS� 0TOTAL PERMIT FEFI j
Print name: 39 ^���\...e •eKS Date: 4 ri- 1 g This permit application expires if a permit is not obtained with& 18 days
Y 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:
Site Utilities Qui. Squ�re Footage. ax . Pe Yee
Fee lea) Total �
Footing drain-151 100' 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 hhatioFOnrait'Fee:
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
4;1 each additional$100.00 or fraction thereof,to
OHIO Ins c or Fees Q� ) '�
1j�. � �t. .. _:� w�... ; 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
accurately report fixtures could result in increased sewer fees*. Plan k Plui a. 'g I:
Quantity by Fixture Type Plan review is required for any of the following.
fixture Type fr _ Replace/ Please check all that apply.
Work Performed:=; Capped ; fdded 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
Car Wash: -Each Stall 0 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.
Dishwasher: Commercial
0 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"
3" k * ISOl T 1:11'4 I r. agra l�
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
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12280 SW HALL BLVD, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Plumbing PLM2018-00433
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
1 . Correction is complete, plumbing final approved.
Violation Summary:
Inspector Contractor