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Permit (6) CITY OF TIGARD PLUMBING PERMIT 7111 1 . COMMUNITY DEVELOPMENT Permit#: PLM2019-00409 T-i[;r4 R I) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/16/2019 Parcel: 2S102AB05900 Jurisdiction: Tigard Site address: 9249 SW TIGARD ST Project: City of Tigard Subdivision3TREET HERRITAGE TRAIL PLAZA RE Lot: 2 Project Description: Interior plumbing for a new public restroom between the Chamber of Commerce building and parking lot near 12345 SW Main St:Adding(2)2"floor drains,(2)sinks,and(2)water closets;Installing(1)hose bib. Contractor: OLSON CUSTOM PLUMBING Owner: CITY OF TIGARD 572 OPAL ST SUTHERLIN 13125 SW HALL BLVD SUTHERLIN, OR 97479 TIGARD, OR 97223 PHONE: 541-591-4233 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Hose Bib 10/16/2019 $25.02 Specifics: 2 ea Primer 10/16/2019 $25.02 2 ea Sink 10/16/2019 $50.04 Type of Use: COM 2 ea Water Closet 10/16/2019 $50.04 Class of Work: ALT 1 12%State Surcharge- 10/16/2019 $18.01 Type of Const: Plumbing Occupancy Grp: Stories: Total $168.13 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. 987 or 1.800.332.2344. .,Issued By: Permittee Signature: (; ` wok. f r" - 1 1i 1, 11 ,o) ' Call 503.639.4175 by 7:00 a.m.for the next available inspection date. >4.....7.., 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 Application ,,dl - ),fit Building Fixtures 9 2019 Received Permit No.: r` !y City of Tigard ReceivDateiBe. c e1 it fl/v-i c �°�'t'ir'tt: )F TIGARD 13125 SW Hall Blvd.,Tigard,OR 97223 ; 111 g g•.�tp ! Review Other Permit No.: C- , Phone: 503.7182439 Fax: 503 598.1960 -t DiVISION Planate/By: fel ��' X1,3^7t,' D m inspection Line: 503.639.4175 Date Ready/By: ruts: 65 Ser Pace 2 for Internet: www.tigard-or.gov NotifiedtMethod: Sapplemental lofermatiao TYPE OF WORK FEE* SCHEDULE ©New construction 0 Demolition For special Information use checklist 0 Addition/alteration/replacement 0 Other: Description 1 Qty. I Ea. I Total CATEGORY OF CONSTRUCTION New 1-2-family dwellings(includes 100 ft for each utility connection) SFR(1)bath 312.70 0 1-and 2-family dwelling ®Commercial/industrial 437 78 SFR(2)bath 0 Accessory building 0 Multi-family SFR(3)bath 500.32 ❑Master builder ❑Other: Each additional bath/kitchen 25.02 JOB SITE INFORMATION AND LOCATION Fire sprinkler(_sq.ft.) Page 2 Job site address:parkinglot next to 12345 SW Main St Site utilities: ( �� / r `) Catch basin or area drain i 18.76 City/State/ZIP:Tigard,OR 97223 / Drywall,leach line,or trench drain 18.76 Suite/bidglapt_no.: I Project name:Tigard St Restroom /( f 7. di `#Footing drain(no.linear ft.:_J Page 2 Cross street/directions to job site:Parking lot at NW corner of Tigard St rtt/ Manufactured home utilities 50.03 &Main St int.(next to Chamber of Commerce/Symposium Coffee building) Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.: ) Page 2 Subdivision: I Lot no.: Water service(no.linear ft.: ) , Page 2 Tax map/parcel no.:2S102AB05900 Fixture or item: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 1251 Installing plumbing supply piping,drainage piping,venting and fixtures within Clothes washer 25.02 the pre engineered building Dishwasher 25.02 Drinking fountain 25.02 0 PROPERTY OWNER I 0 TENANT Ejectors/sump 25.02 Expansion tank 12.51 Name:City of Tigard Fixture/sewer cap 25.02 Address:13125 SW Hall Blvd Floor drain/floor sink/hub 25.02 City/State/ZIP:Tigard,OR 97223 Garbage disposal 25.02 Phone:(503)718-2466 Fax:( ) Hose bib 1 25.02 25.02 ® APPLICANT ❑ CONTACT PERSON Ice maker 12.51 Intenxptor/grease trap 25.02 Business name:City of Tigard Medical gas(value:$ ) Page 2 Contact name:Jeff Peck Primer 2 12.51 25.02 Address:13125 SW Hall Blvd Roof drain(commercial) 12.51 City/State/ZIP:Tigard,OR 97223 Sink/basin/lavatory 2 25.02 50.04 Phone:(503)718-2466 Fax:=( ) Solar units(potable water) 62.54 'rub/shower/shower pan 12.51 E-mail:jeffpq),tigard-or.gov - z5.02 Urinal CONTRACTOR Water closet 2 25.02 50.04 Business name: �/ C U / t}$t 4 e.`' Water heater 37.52 Address: ,,C 7 2, 0 pt . 1 7--,� y Water piping/DWV 56.29 City/State/ZIP: cci e.p.-/ t/ ` "'a �) Other: _ 25.02 �+t / Subtotal -). 11-1.0.1J Phone:(5 j) 5 l--t Z Fax:( ) ilI66 a-y Minimum permit fee: $72.50 CCB Lic.: z 7j+ . ''''.-6111111 plumbing Lie.no.: Plan review (25%of permit fee) Authorized signature 0:-� .__ State surcharge(12%of permit fee) _ i Print name: s FT Bate I 0/44//GJ # TOTAL PERMIT FEEi.>/4,1/ ( Plumbing Permit Application - City of Tigard Page 2 -Supplemental information Fee Schedule: Residential Fire Suppression S stems lit 11 . moot- ��°-. Footing drain-1°100' 50.03 0 to 2,000 v$121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 Sewer-1st 100' 62.54 3,601 to 7,200 $233 20 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Water Service-each additional 100' 37.52 Medical Gas Systems: Storm&Rain Drain-1st 100' k J 62.54 �' �„ �� '�' Storm&Rain Drain-each additional 100' 37.52 $1.00 to$5,000.00 Minimum fee$72.50 r n f + $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for sr. . - ,.. . each additional$100.00 or fraction thereof,to Inspection of existing plumbing or for and including$10,000.00. which no fee is specifically indicated 90.00/hr $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 fur (minimum charge-1/2 hour) each additional$100.00 or fraction thereof;to Inspections outside of normal business 90.00/hr and including$25,000.00. hours(minimum charge-2 hours) $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for Reinspection Fees 90.00/hr each additional$100.00 or fraction thereof;to Additional plan review for revisions 90.00/hr and including$50,000.00. (minimum charge-112 hour) $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for Subtotal: _ each additional$100.00 or fraction thereof. Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to sF rk .t 4 - accurately report fixtures could result in increased sewer fees*. " ` ". Plan review is required for any of the following. Please check all that apply. Wirk;t? 3ormedy 'a oC* ❑ 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 El New exterior plumbing site utilities for any complex structure Car Wash Each Stall as defined in OAR918-780-0040. -Drive Thru ❑ Cusuidor/Weter Aspirator Medical gas and vacuum systems for health care facilities. Dishwasher Commercial ❑ Any multipurpose fire sprinkler system. Domestic Cl Any complex structure as defined in OAR918-780-0040. Drinking Fountain Eve Wash Submit 2 sets of plans with any of the above. Floor Drain/sink -2" 3" F1Gp1Eill' 1► SL f -4" L Isometric or riser diagram is required for new buildings Car Wash Drain q Garbage -Domestic-non-food that meet the qualifications above. Disposal -Domestic-food related -Commercial-food related -Industrial-food related Ice Mach./Reliig.Drains - Comments regarding fixture work: Oil Separator_(Gas Station) Rec.Vehicle Dump Station Shower -Gang -Stall Sink/Lav -Non-food related Z -Bradley -Commercial-food related Service *Note: If the fixture work under this permit results in Swimming Pool Filter Washer-Clothes an Water Extractor increase of sewer EDUs,a sewer permit will be issued and Water Closet-Toilet 1 fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: 4-}-h Sre 1<=.i lo CAUserslSabrina\AppData1LocallPackages\microsofl.windowscommunictgionsapps_8wekyb3 d8bbweU,ocal StateWiles\50143781Attachments\PLMF _PermitApp-TSHT Restroom[5444].doc