Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2019-00487
T I G r1 R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/10/2019
Parcel: 2S115AB01900
Jurisdiction: Tigard
Site address: 16200 SW PACIFIC HWY G
Project: Spec Space Subdivision: 1994-028 PARTITION PLAT Lot: 2
Project Description: Interior plumbing prior to TI: Relocating(1)water closet&(1)lavatory with point of use water heater.
Contractor: R A WARNER PLUMBING Owner: SN PROPERTIES PARTNERSHIP
PO BOX 820785 1121 SW SALMON ST
VANCOUVER,WA 98682 PORTLAND, OR 97205
PHONE: 360-772-2490 PHONE:
FAX: 360-263-5354
FEES
Quantity Description Date Amount
1 ea Sink 12/10/2019 $25.02
Specifics: 1 ea Water Closet 12/10/2019 $25.02
1 ea Water Heater 12/10/2019 $37.52
Type of Use: COM 1 12%State Surcharge- 12/10/2019 $10.51
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $98.07
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:
Permittee Signature:
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.
Plambins Permit AnDlicatia {j 4-i\4 r-r
Building Fixtures
DEC 4 2019i, ,
City of Tigard Darer 44/5' /Cf 6 ; P Nor i./'9�0/9 vaz?7
E 13125 SW Hall Blvd.,Tigard,OR 97223 /
1�-- ( r3, .i Plan Reviow
i Phone: 503.7182439 Fax 503.598.1%0 `' 15 r' " Dagy_ Other Permit No.:
Inspection Line: 503.639.4175 ' "� Dare / 2arili H So 2 for
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TYPE OF WORK FEE* SCHEDULE
0 New construction 0 Demolition For special infoinge:km use checklist
Description I Qty. I Ea I Total
®Addition/alteration/replacement ❑Other New I-2-family dw'elliugs(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
❑1-and 2-family dwelling III Commercial/industrialSFR(2)bath 437.78
SFR(3)bath 50232
❑Accessory building 0 Multi-family Each additional badukitchen 25.02
❑Master builder 0 Other. Fire sprinkler( sq.IL) Paget
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 16200 SW Pacific Hwy Catch basin or area drain 18.76
City/StatePd[P Drywell,leach line,or trench drain 18.76
Tigard.,__,OR 97224 Footing drain(no.linear ft.:_) Page 2
Suite/bldgiapt no. � Project name:Tigard Town Square Manufactured home utilities 50.03
rust,street/directions to jab site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear it.: ) Page 2
Stonn sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Badcllow preventer 31.27
. . •
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Relocating(_I)water closet&(1)restroom lavatory with Dishwasher 25.02
point of use water heater. Drinking fountain 25.02
Ejectors/sump 25.02
PROPERTY OWNER k 0 TENANT 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:( ) ke maker 12.51
0 APPLICANT 0 CONTACT PERSON Intimxpha/grease trap 25.02
Business name: RA Warner Plumbing Co., Inc. MOd' t"'I1e $_) Page z
Primer 12.51
Conte name:3erime Maloney
Roof drain(commercial) 12.51
Address: PO Box 493 Sinkibas n/lavatory I 25.02 25.02
City/State/ZIP: Camas,WA 98607 Solar units(potable water) 62.54
Phone:(360) 772-2490 Pax::(360)210-4739 Tub/shower/showerpan 12.51
E-mail:rawarnerplumbing(@,potail.com urinal 25.02
Water closet 1 25.02 25.02
. • CONTRACTOR Water heater 1 37.52 37.52
Business same:RA Warner Plumbing Co.,Inc. Waterpiping/DWV •56.29
Address:PO Box 493 Other 25.02
City/State2>F: Camas,WA 98607 subtotal 87.56
Phone:( Fax:(360)210-4739 Minimum permit fee: $72.50
360)772-2490
Plan review(25%of permit fee)
CCD Lie,: 151329 Plumbing Lic.no.:37-521 PB State surcharge(12%of permit fee) 10.51
Authorized signatu '..geyejA„.,.. TOTAL.PERMIT Frr 98.07
s permit ap Jiiom expires Ida pest is not obtained within too days
Print name Rhonda cehm hate: 12/4/2019 This i after it has been accepted as complete.
"Fee methodology set by Tri•Counry Building tad entry Service Board
I'BuiltagTerirres\PLNIII-PerneitApe doe 10J01.94 440-4616T(10ULtOtdiWEB)
. Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee tea) Total Square Footage: Permit Fee:
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' 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
Valuation: 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 or Fees Qty. Fee(ea) 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:
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*. Plan Review for Plumbing Installations
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate
Baptistry/font El Any new commercial building with water service 2"and
Bath:pt -Tub/Shower greater,except systems designed and stamped by licensed
engineer.
-Jacuzzi/Whirlpool
ElCar Wash: Each Stall New exterior plumbing site utilities for any complex structure
Drive Thin as defined in OAR918-780-0040.
❑
Cuspidor/Water Aspirator Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial CI Any multipurpose fire sprinkler system.
Domestic CI Any complex structure as defined in OAR918-780-0040.
Drinking Fountain
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink: -2"
3" Isometric or Riser Diagram
4' ❑ Isometric or riser diagram is required for new buildings
-Car Wash Drain that meet the qualifications above.
Garbage -Domestic non-food
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
Ice Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall Sink: -Lay/Barnon-food related X
-Bradley
-Com/Serv/Util food related
-Service *Note: If the fixture work under this permit results in an
Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and
washer-clothes fees assessed for the sewer increase must be paid before the
Water Extractor
Water Closet-Toilet X plumbing permit can be issued.
Urinal
Other Fixtures:
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