Permit (185) a CITY OF TIGARD PLUMBING PERMIT
IIE COMMUNITY DEVELOPMENT Permit#: PLM2019 00323
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/13/2019
Parcel: 2S 115BA00100
Jurisdiction: Tigard
Site address: 16200 SW PACIFIC HWY N
Project: Landlord Work Subdivision: None Lot: None
Project Description: Landlord work to install 100'of sanitary sewer,400'of water service and(2)water heaters for new suites N&M.
Contractor: NORTHWEST CENTRAL PLUMBING CO INC Owner: TECOLOTE RESOURCES INC
2870 SE 75TH AVE#206 KELLY'S LEGACY LLC, ET AL
HILLSBORO,OR 97123 BY HESSLIN HOLDINGS INC
23421 SOUTH POINTE DR STE 270
LAGUNA HILLS, CA 92653
PHONE: 503-642-2067 PHONE: 503 764-7595
FAX: 503-642-5954
FEES
Quantity Description Date Amount
100 If Sanitary Sewer 08/13/2019 $62.54
Specifics: 400 If Water Service 08/13/2019 $175.10
2 ea Water Heater 08/13/2019 $75.04
Type of Use: COM 1 12%State Surcharge- 08/13/2019 $37.52
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $350.20
Required Items and Reports(Conditions)
- — a
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
0// Mn ill L/ . 77 GA/
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each Inspection.
Plumbing Permit ApplicatiaECE'vED
Building Fixtures AUG 8 2019 FOR OFFICE USE ONLY'
City of Tigard CITY OF TIGARD Received
•• •PAa-�� Permit
li • 13125 SW Hall Blvd.,Tigard,OR Wail.
' DING DIVISION 1 °L�1a2Er,9'"�O °'�3
I Phone: 503.718.2439 Fax: 503.5Plan Review
Date/By: Other Permit No.:
Inspection Line: 503.639.4175 �`� /9
T I�]A R D Internet: www.ti -Or. ov Date Ready/By: lura: S See Page 2 for
8 Notified/Method Supplemental Information
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►ii New construction 0 Demolition For special information use checklist
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
w 6 � ® -4:-,,,,,,,,,,,,,,,,„,,‘,,,,,,,,,,,,,,,,..,,,,.` SFR(1)bath 312.70
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Plumbing Permit Application - City of Tigard
Page 2-Supplemental Information
Fee Schedule: Residential Fire
Sup ression
ession Systems
r1ra ,Lb +
y$w1F "" r4 ,44 400:14r
Footing drain-l"100' 50.03 0 to 2,000 rC
$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' 7.52
Water Service-i st 100' q 62.54 Medical Gas Systems
Water Service-each additional 100' l 37.52
Storm&Rain Drain-1st 100' 62.54m iAV � _ •,,.,ai
$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
8 i 0'' i 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
(minimum charge-1/2 hour) each additional$100.00 or fraction thereof,to
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*.
latish AD iAtureT e 4 E R # w x i
.�� - In�'�,itatlai3ons
1FlAtuire7'ype for ;:?4•0*,,k Attoki Plan review is required for any of the following.
Vork'Performed.:'�� N!l .
Baptistry/Font Please check all that apply.
Bath TubfShower
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.
Car Wash Drain
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 MachiRefrig.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 *Note: If the fixture workunderthis permit results in an
Washer Clothes
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:
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