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Permit
CITY OF TIGARD PLUMBING PERMIT • COMMUNITY DEVELOPMENT Permit*I: PLM2019-00064 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/21/2019 T"r C.A I t: 9 Parcel: 2S110DCO2300 Jurisdiction: Tigard Site address: 11515 SW DURHAM RD E-5 Project: Willowbrook DHS Subdivision: 1998-128 PARTITION PLAT Lot: 1 Project Description: Installing(1)lavatory,(1)ADA toilet,(1)break room sink,and(1)insta hot. Making connections to existing plumbing only. Contractor: BEAVERTON PLUMBING INC Owner: HIP WILLOWBROOK LLC 13980 SW TV HWY BY HARSCH INVESTMENT CORP BEAVERTON,OR 97005 PO BOX 2708 PORTLAND, OR 97208 PHONE: 503-643-7619 PHONE: FAX: 503-643-7620 FEES Quantity Description Date Amount 1 ea Sink 02/20/2019 $25.02 Specifics: 1 ea Lavatories 02/20/2019 $25.02 1 ea Water Closet 02/20/2019 $25.02 Type of Use: COM 1 ea Water Heater 02/20/2019 $37.52 Class of Work: ALT 1 12%State Surcharge- 02/20/2019 $13.51 Type of Const: Plumbing Occupancy Grp: Stories: Total $126.09 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: .�,/ifir Permittee Signature: 5r,-r 77,%.LF�G / Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Plumbing Permit Application Building Fixtures ,, v7"-` hOR orrlcL t'sr O L) ' City of Tigard ,.}g l Received ^ !/ // P�/)__ �� ) r� 13125 SW Hall Blvd.,Tigard,OR 97 1, Date/By: vJt[. slv [ JYjyT y Plan Review 1111 Phone: 503.718.2439 Fax: 503.598.1960 ate/B Other Permit No.: T i c n iz D Inspection Line: 503.639.4175 y's�3� y. Internet: www.tigard-or.gov , ,i spr lieadyBy• Juric: See Page 2 for _Jr- 1 p �1b'fied/Method: Supplemental Information TYPE OF WORK .:$,,,P , \‘‘,4,. • FEE" 8CIIED1JLE ' For special construction 0 Dh�p�E�on P cial infornuuion use checklist Description I Qty. I Ea. I Total ►I Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORYCATFOODY.OF CO RUCTION , • , SFR(1)bath 312.70 ❑ 1-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 ❑Master builderEach additional bath/kitchen 25.02 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address:11515 SW DURHAM ROAD Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:TIGARD,OREGON 97224 Footing drain(no.linear ft.: Page 2 Suite/bldg./apt.no.:5 , Project name:WILLOWBROOK DHS 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.:_J Page 2 Water service(no.linear ft.:__1 Page 2 Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 4,-:',.,`-,..4.;.•., ,DESCRIPTION OF' OR[ a# Y ',"-.1,,Y.,.,� Backwater valve 12.51 Clothes washer 25.02 PROVIDE AND INSTALL 1 BATHROOM SINK,1-ADA TOILET, Dishwasher 25.02 1 BREAKROOM SINK AND 1-INSTA HOT-WE ARE ONLY MAKING Drinking fountain 25.02 CONNECTIONS TO EXISTING PLUMBING Ejectors/sump 25.02 k,t ,: 0 rROpr' owi n 1 13 Tp,,uorT 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 4PPLJCANT COspor;PERSON Interceptor/grease trap 25.02 Business name:BEAVERTON PLUMBING INC Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:JACKIE STEWART Roof dram(commercial) 12.51 Address:13980 SW TUALATIN VALLEY HWY i Sink/basin/lavatory 2 25.02 50.04 City/State/ZIP:BEAVERTON,OREGON 97005 Solar units(potable water) 62.54 Phone:(503)643-7619 Fax::(503)643-7620 Tub/shower/shower pan 12.51 E-mail:jackie@beavertonplumbing.com Urinal 25.02 Water closet 1 25.02 25.02 Water heater 1 37.52 37.52 pp Business name:BEAVERTON PLUMBING INC. Water piping/DWV 56.29 Address:13980 SW TUALATIN VALLEY HWY Other: 25.02 City/State/ZIP:BEAVERTON,OREGON 97005. Subtotal 112.58 Phone:(503)643-7619 Fax:(503-)643-7620 Minimum permit fee: $72.50 CCB Lic.:12889 fI Plumbing Lic.no.:34-4PB Plan review (25%of permit fee) State surcharge(12%of permit fee) 13.51 Authorized signature;,-,,11 d ..-,,,e_„//,.r \ 2 _�j� TOTAL PERMIT FEE 126.09 This permit application expires if a permit is not obtained within 180 days Print name:JACQUELINE STEWART Date:01/14/2019 after it has been accepted as complete. y *Fee methodology set by Tri-County Building Industry Service Board. 1:\Budding\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) ¢t .. ' 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-1e 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 Vitiation: Permit 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 Other:inspections ar'F Oty; 1Fee ) Total each additional$100.00 or fraction thereof,to 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 (minimum charge-1/2 hour) each additional$100.00 or fraction thereof. Subtotal: Commercial Fixture Work: I Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to , s accurately report fixtures could result in increased sewer fees*. i Quantity by Fixture Type } Ptutt w. c l'Igmb ag i�a�l talt �ti©1n8. . i Fixture Type for `le Plan review is required for any of the following. Work Performed. Capped Added Relocate Please check all that a I t Baptistry/FontpP y 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. 1 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. 1 Eye Wash Floor Drain/sink -2" Submit 2 sets of plans with any of the above. -4>, i S '�agrani Car Wash Drain � 11et ^�,Or' a 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 1 -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Comments regarding fixture work: € Rec.Vehicle Dump Station I Shower -Gang -Stall Sink/Lav -Non-food related 2 -Bradley -Commercial-food related -Service Swimming Pool Filter *Note: If the fixture work under this permit results in an Washer-Clothes Water Extractor increase of sewer EDUs,a sewer permit will be issued and a WaterCloset-Toilet 1 fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. f, Other Fixtures: 1 t http://ems4.revize.com/revizeltigardtdocument_centerBuilding/PLMF_PeritApp.doc f. 1 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 11515 SW DURHAM RD E-5, TIGARD, OR, 97224 Record Type: Record ID: Commercial - Plumbing PLM2019-00064 Inspection Type: Inspector: 399 Plumbing final Don Sylvester Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor