Permit CITY OF TIGARD PLUMBING PERMIT
114 ■ COMMUNITY DEVELOPMENT Permit#: PLM2018-00576
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/31/2018
Tlc�a1.17 g Parcel: 1S134BC00100
Jurisdiction: Tigard
Site address: 12100 SW SCHOLLS FERRY RD
Project: Greenway Town Center Subdivision: None Lot: None
Project Description: Install 40'of 4"ABS&3034 Piping to code. Backfill and compact to grade. Run 1"water feed from in ceiling and
install ball valve for new connection.
Contractor: NORTHWEST CENTRAL PLUMBING CO INC Owner: ATLAS GREENWAY LLC
2870 SE 75TH AVE#206 333 NW NINTH AVE,STE 1009
HILLSBORO,OR 97123 PORTLAND,OR 97209
PHONE: 503-642-2067 PHONE:
FAX: 503-642-5954
FEES
Quantity Description Date Amount
40 If Sanitary Sewer 12/31/2018 $62.54
Specifics: 1 12%State Surcharge- 12/31/2018 $8.70
Plumbing
10 ea Minimum Fee Adjustment- 12/31/2018 $9.96
Type of Use: COM Plumbing
Class of Work: ALT
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 NC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: ,G/C 77
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.
r. Plumbing Permit Applicata
Building Fixtures I OR OH l( 1. I sl_ 11y1.1
DEC 262018Da _
City of Tigard '�
; �e/gy % fr 4/' Permit No.pt - 020/„ des/(e!
• 13125 SW Hall Blvd.,Tigard,OR 972gmy v r i, Plan Review
_ Phone: 503.718.2439 Fax: 543. It r,,". Other Permit No.:
5
Inspection Line: 503.639.4175 i;' L sVi � ate/By:
t i c,\I.f) Internet: www.ti or.d-or.gov Date Ready/13y: kris: 0 See Page 2 for
$
Notified/Method: Supplemental
l Information
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❑New construction 0 Demolition For special information use checklist
Description I Qty. I Ea. I Total
®Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
...cA1QitP Nri1Q1!l , SFR(1)bath 312.70
❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
i a =.IOBI SITE 1NFORMA'TION,;OD, LOCATION Site utilities:
Job site address:12100 SW Scholls Ferry Rd Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97223 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name:Greenway Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: 1 Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: J Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
�, - -r , Backwater valve 12.51
i)E ,CRTP]It1 F VQ11K
a> Clothes washer 25.02
Install 4"ABS&3034 Piping to code.Backfill and compact to grade
Dishwasher 25.02
Run 1"water feed from in ceiling and install ball valve for new connection Drinking fountain 25.02
Ejectors/sump 25.02
Cl Vit},;• ,OWNER i. ,V,.t Expansion tank 12.51
Name: 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
0 APPLICANT I ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name:Local Plumbing co Medical gas(value:$ ) Page 2
Contact name:Haley Shannon Primer 12.51
Roof drain(commercial) 12.51
Address:2870 SE 75th Ave
Sink/basin/lavatory 25.02
City/State/ZIP:Hillsboro,OR 97123 Solar units(potable water) 62.54
Phone:(503)601.3717 Fax::( ) Tub/shower/shower pan 12.51
E-mail:haleys@localplumbingco.com Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business nam, r.. of DI..m6i..n.('.e .-- !AI et-A/77244. n4 l// 62
�T"Water piping/DWV 56.29
Address:2870 SE 7591 Ave Other: 25.02
City/State/ZIP:Hillsboro,OR 97123 Subtotal
Phone:(503)601.3717 Fax:( ) Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lie.:72253 Plumbing Lic.no.:34-197PB
State surcharge(12%of permit fee)
Authorized sir) ature: TOTAL PERMIT FEE
�,fil t r r This permit application expires if a permit is not obtained within 180 days
Print na 1 J- Date:'' oJ'
after it has been accepted as complete. 1
I "Fee methodology set by Tri-County Building Industry Service Board.
1:/Building`\Permits\PLMU-PennitApp.doc 10/01/09 440-46161(10/OM-OM/WEB) j !i,
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site uottisqtyFee(ex) Total ` Square Footage; Permit; ee:
Footing drain-I°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' 1 62.54
7,201 and greater _ $327.54
Sewer-each additional 100' 37.52
Water Service-1st loo' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52 ~~
Storm&Rain Drain-1st 100' 62.54 Permit Fee:
$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
11 #he
' r'Inspec kr Fees QtY., Fee Total each additional$100.00 or fraction thereof to
; ns o '
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*.
Quantiy by Fixture Type Plan Review for Plumbing Installations
Fixture
Work Performed: Capped Type for 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"
a" Isometric or Riser Diagram
Car Wash Drain ❑ Isometric or riser diagram is required for new buildings
Garbage -Domestic-non-food g
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/Lay -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:
C:\Userslhaleys\Downloads\PLMF_PermitApp.doc 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12100 SW SCHOLLS FERRY RD, TIGARD,
OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2018-00576
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor