Permit (97) CITY OF TIGARD PLUMBING PERMIT
-III ' COMMUNITY DEVELOPMENT
Permit#: PLM2019-00049
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/07/2019
T i r_ ;E i<.1) 9 Parcel: 1S 1260000300
Jurisdiction: Tigard
Site address: 9757 SW WASHINGTON SQUARE RD D04
Project: Na Hoku Subdivision: None Lot: None
Project Description: Removing and replacing(1)mop sink on existing rough in.
Contractor: QUALITY WEST PLUMBING LLC Owner: PPR WASHINGTON SQUARE LLC
23050 SE FULQUARTZ LANDING PO BOX 847
DUNDEE, OR 97115 CARLSBAD, CA 92018
PHONE: 503-289-7095 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Sink 02/07/2019 $25.02
Specifics: 1 12%State Surcharge- 02/07/2019 $8.70
Plumbing
Type of Use: COM 47 ea Minimum Fee Adjustment- 02/07/2019 $47.48
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 to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ,, . ermittee Signature: C / / 4.- t-,
C/)j
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.
111,
Plumbing Permit Applicatiai ,
Building Fixtures },N 9 0 2019 i olz 011 1( 1 icl /y
Received G 71 /��/V` 1(I!l
City of Tigard Receiv : Privy(0,
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14,� 13125 sW Hall Blvd.,Tigard,050R3.5997,2;9.3 Plan Review Other Permit No.:
Phone: 503.7182439 Fax: Q`:s N Date/By:
inspection Line: 503.639.4175 Date Ready/By: kris: RI See Page 2 for
i' Internet: www tigard or gov YNotified Mettnod: 5 lemental Information
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For special information use checklist.
ElNew construction 0 Demolition Description Qty. Ea. Total
®Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
II
r SFR(1)bath 312.70
.
SFR(2)bath 437.78
❑I and 2-family dwelling ®Commercial/industrial 500.32
SFR(3)bath
❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02
❑Master builder ❑Others Fire sprinkler( sq.ft.) I Page 2 I
• •vp �, ' r "�t a �� e i+ w s frr , 1 .'t Site utilities:
Catch basin or area drain 18.76
Job site address:9757 SW Washingon Square Rd Drywell,leach line,or trench drain 18.76
City/State/ZIP:Portland Or 97223 Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.:pj-'� Project name:Na Hoku Jewelry 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: Lot no.: Fixture or item:
Backflow preventer 31.27
Tax map/parcel no.: 12.51
A' Backwater valve
u •. Clothes~ washer 25.02
removing and replacing(1)mop sink on existing rough in Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
xr ~ Expansion tank 12.51
P rx*TO. - Fixture/sewer cap
25.02
Name: Floor drain/floor sink/hub 25.02
Address: Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
12.51
Phone:( ) Fax:( ) Ice maker25.02
tr+ APPLiCiiI . 0 cONTA,�r' PERSON Interceptor/grease trap
Medical gas(value:$ ) Page 2
Business name:Quality West Plumbing DBA Cascade Plumbing Primer 12.51
Contact name:BekkaRoof drain(commercial) 12.51
Address:23050 SE Fulquartz Landing Sink/basin/lavatory 1 25.02
City/State/ZIP:Dundee Or 97115 Solar units(potable water) 62.54
Phone:(503)289-7095 Fax::( )
Tub/shocker/shower pan 12.51
Urinal 25.02
E-mail:Cascadeplum@yahoo.com Water closet 25.02
CONTRACTOR heater 37.52
Business name:Same as above Water piping'DWV 56.29
Address: Other: 25.02
Subtotal
City/State/ZiP:
Minimum permit fee: $72.50
Phone:( ) Fax:( ) Plan review (25%of permit fee)
CCB Lic.:204392 Plumbing Lic,no.:PB1528 State surcharge(12%of permit fee)
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Authorized signature: Q ...i TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180 days
Print name:Bekka Greer Date: 1/30/19 after It has been accepted as complete.
Tee methodology set b)Tel-County Building Industry Service Board.
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440-46161110cefOMttot
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Plumbing Permit Application - City of Tigard
Page 2- Supplemental Information
Fee Schedule: Residential Fire Suppression S stems:
Footing drain-I"100' 50.03 0 to 2,000 $121.90
2,001 to 3,600 $169.69
Footing drain-each additional 100' 37.52 3,601 to 7,200 $233.20
Sewer-1st 100' 62.54 7201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' b2.54 Medical Gas S stems:
Water Service-each additional 100' 37.52 it' r, E
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 55,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
each additional$100.00 or fraction thereof,to
E a • t" .-,,? •. '• .;fin ,2,;•.`• "4 •41,":`,,,V ,_ 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$120 for
each additional$100.00 or fraction thereof.
(minimum charge-1/2 hour)
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*. hi, a4 ,� r t} ,
;.w � n,bY,. Type •a., ' i
Fixture Type for ' requiredany
Plan review is for of the following.
Work Performed • C Added orate
Please check all that apply.
Baptistry/Font 0 Any new commercial building with water service 2"and
Bath -Tub/Shower greater,except systems designed and stamped by licensed
-Jacuzzi/Whirlpool engineer.Car Wash -Each Stall
-Drive Thm 0 New exterior plumbing site utilities for any complex structure
as defined in OAR918-780-0040.
DiCuspidor/WaterwCoiralor
Dshwashherer -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" Isometric or Riser Diagram
Car Wash Drain 0 Isometric or riser diagram is required for new buildings
Garbage -Domestic-iron-food
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:
Ree.Vehicle Dump Station Mop sink
Shower -Gang
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothee, increase of sewer EDUs,a sewer permit will be issued and
Water Extractor fees assessed for the sewer increase must be paid before the
Water Closet-Toilet
Urinal plumbing permit can be issued.
Other Fixtures: I
C:\I kers\Caccadu MainlDou'nloads\PI.MF PermitAnn(141.doc 1
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9757 SW WASHINGTON SQUARE RD D04,
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2019-00049
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor