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Permit
CITY OF TIGARD PLUMBING PERMIT e . COMMUNITY DEVELOPMENT Permit #: PLM2009 -00187 T I G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/29/2009 Parcel: 2S 101 AB01200 Jurisdiction: Site address: 7275 SW HERMOSO WAY Subdivision: Lot: 0 Project: KEYWAY OFFICE CONVERSION Project Description: Site plumbing for onsite parking and filtered catch basin. Connect existing structure to sanitary sewer and storm service. In Sewer Reimbursement District #15. Owner: FEES FRANK, BRIAN L & Quantity Description Date Amount KRAFVE, KENT B, 7275 SW HERMOSO WAY TIGARD, OR 97223 1 ea Catch Basin or Area Drain 10/29/2009 $16.60 PHONE: 100 If Sewer Service 10/29/2009 $55.00 100 If Storm and Rain Drain 10/29/2009 $55.00 1 12% State Surcharge - 10/29/2009 $15.19 Contractor: Plumbing HI PRO EXCAVATING INC 35795 SE SQUAW MT RD ESTACADA, OR 97023 PHONE: 503 - 317 -6021 FAX: Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $141.79 Required Items and Reports (Conditions) 1 Pln Gen 1. MODIFIC • • • ` • IRES APPROVAL 2 Pln Gen 2. - . ■ DE SITE PLAN /STREET TREES 3 Pln Gen . - r OVIDE LANDSCAPE PLAN 4 Pln Gen 4. SUB • CILITIES SCREENING PLAN 5 Pln Gen 5. SUBMIT GA ? • GE SCREENING PLAN 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 -0100. You may obtain a copy of the rules or direc = • • to OUNC by calling 503.246.6699 or 1.800.332.2344. Issue. = ,/ f Permittee Signature: Call 503.639.4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the p sect Approved plans are required on the Job site at the time of each inspection. X . '7g75 c l.0 Aigaio5O Wil- Plumbing Permit ApnlicatEr � °�� Site Utilities L. V II � ,.„._,,,,-_„,r Received FOR OFFICE USE ONLY Illh City of Tigard 15 2009 Dates : , Permit No �� (�12 �.� • ` fr I • it 13125 SW Hell Blvd., Tigard, OR 9721 a Phone: 503.639.4171 Fax: 503.598.1960 Plan ew Other Permit No. � �pgQ e 9 ooQ' Inspection Line: 503.639.4175 CITY OF TIGARD D ate R eady/ey 4i\7 65 Sec Page 2 for l' 1 G i11L D Internet www.tigard- or.gov , I S k NotIGed/Met od: IIV " OQ .h MI Supplemental Information ,-. „., 'Y,a3 * ±.s.crx st 'ry -- .." . :.. .n. "7:A- ,� F; i.• -7' -'- '!_^ a'=. y.�..� 14 n r1 9 ThO r 0 .a•�` '""`q'a+' . a+ +„� c _ w..�y++wu _ .;.- a Jl dr ` C).t G L r- : ..,, _.pc QA Off 'n'�`�'� r � �r s'� x� --- � J.w.r.-� ,� ;�-- ' �v; -;� �. f �,7!- visa- .�..i ± " _ . New construction ❑ Demolition For special information use checklist. Description I Qty. I Ba. I Total (g Addition/alteration /replacement ❑ Other: New 1 - 2- family dwellings (includes 100 ft. for each utility connection) Mx. + -; � t+e +-: wt.�r+ir �. .r_s -ay,� '��- . .' 3+ �..' r � � la �vu � + Y 1 SPR(1)bath ." -+ 249.20 ...----• ❑ 1- and 2- family dwelling 'Commercial/industrial SFR (2) bath ...--.• 350.00 •---*+ ❑ Accessory building ID Multi-family SFR (3) bath +-+ 399.00 •`" Each additional bath/kitchen .--• 45.00 .►• ❑ Master builder ❑ Other: 1 � s� _ �, Fire sprinkler L_ sq. fL) r Page 2 ..r• --,? ++-.,''''--.,- -I(OfiS�y{It t,l O 1 ". -, 1' r °`7i h „ 1 n � 0 ��. t -- , t--- Site utilities Job site address: 72.75 S. u', 0 62.17 5b k/A 7 Catch basin or area drain I 16.60 Ay, (pp City/State /71P: ?'i ci,, t OQ, 97 223 Drywall, leach line, or trench drain .--. 16.60 i Suite/bldgJapt. no.: I Project name: Ow*? tMeg fit„ ti�b, Footing drain (no. linear ft.: .......j �-+ Page 2 .....--• ka Manufactured home utilities 110.00 +---' Cross street/directions to 'ob site: J Manholes ......- 16.60 S. () * IAiR `? * 72" Rain drain connector 16.60 ■ Sanitary sewer (no. linear ft.: 54..) j Page 2 ,SS.O0 Storm sewer (no. linear ft .:41) ) 1 Page 2 sir. OD I' Subdivision: j! m ss /9AB, K I Lot no.: 2,..... Water service (no. linear fL: _} . - I Page 2 -� Fixture or item Tax F-77---;.7-71:4.:-"-- map/parcel no 2, / 1 (� !ZOO .^• 16.60 --• _ Absorption valve 7 _ -, 7 . 1 ; r -f ct 4 r _n F i m` 07 ' i _ s ,; . ,:::" .. ":,'"": - . ' ` I Backflow preventer Page 2 .--• Q 4" SPA; i tI t Y LATiMAL. bit 7 Att. A tAirato Backwater valve - 16.60 -.. C Ate A /maw./ . Cb Js it me, Ea foals b. rye- 0.04 ow Clothes washer i1 16.60 - et) • T m A4 V e. P�N4 � , Dishwasher -� 16.60 ,-�, �� , . 16.60 . = Drinking fountain r• �. �1 i.i f oi.,, r1 7Ti\ 1„ 4\ ' t j , _ n ., w�� ri ~r ": - Name: 17 L. , �(�/ (- 'r j2. Vol ' e Expansion tank 16.60 •� y f Will Expansion tank •-. 16.60 Address: s arta J4 CD ` Fixture/sewer cap 16.60 -•--. City/State/ZIP: --- 11,64.4) OL - Floor drain/floor sink/hub - 16.60 Phone: 63 ) .+` `e. Fax: 542Z) & ....66,,cCD Garbage disposal 16.60 -• I _ -- s l ) :i�ltc''\ J I-i coi yt -aC V.I'ill - keli ' ::1 Hose bib 16.60 r..� Ice maker 16.60 ..�. Business name: ,I(e Y;10ih'i COLP. Interceptor /grease trap .►• 16.60 •--» Contact name: >be o r i Q p F Vg Medical gas (value: $ _) ...---* Page 2 Address: 72.75 S. 0. agaotD$1, "147 J Primer ✓s 16.60 City/State/ZZIP: TIGAt12� D e. 7?.Z3 Roof drain (comnretcial) ....... 16.60 �- Sink/basidiavatory .---• 16.60 Phone: (5b3) 6 84 .. 6'Joo I Fax:: ( 5 , 3) 76D - 1395 Tub/shower/shower pan •�'• 16.60 ---+ E -mail: Urinal 16.60 •- . � c t ' o. P i Ti utCn ;;�,,+ '' T,.; Water closet �• 16.60 --+ Business name: . ' J ` s. _ J Water heater ammo. 16.60 Rd., �� other: - .00.4 -- Address: 35'Iq se- SQ,t�Aw fr 4.. Rd., Subtotal /264(010 ••• ∎a. City /State/ZIP: E g + ft t;R cIA © R i 7 o - � Minimum permit fee: $72.50 r - Phone: ($03) B11..,1 j, o 2.1 Fax: ( ) MIA _ Residential backflow minimum permit fee: $36.25 r CCB Lic.: + 2 to PI mbing Lic. no.: 8730 I - Plan review (25% of permit fee) ; �K - e l , 1 State surcharge (12% of permit fee) i,s, Ili oe Authorized signature: TOTAL PERMIT FEE , , ' I r-f1 I Print name: to E P t. vk iv, E x . I Date: 1 IA /09 This permit application expires if a permit is not obtained within 180 days after It has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. 1:' Buadlag%PamhalPi.MU- PenmfApp.doc 12/2756 440-4616r(1OW22COtd/WEB) , M ~ Plumbiniz Permit Application - City of Tigard Page 2 - Supplemental Information Free Schedule: Residential Fire Su pression Systems: -.q 1NV• ty. 3 O ~1 T i legal Ou irk ~•i:x alp@ %I~AIJl1G t - Footing drain - 1 a 100, 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 _ Sewer -1st 100' 55.00 SSOO 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas S stems' _ Water Service -each additional 100' , 46.40 Y illl doll P~ 0_v t Storm & Rain Drain -1st 100' 55.00 ~i $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' r 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each 77 t1Y 7 r'te a i Tot `1L additional $100.00 or fraction thereof, to and 1Jli OI including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to minimum permit fee $36.25 27.55 and including $25,000.00. Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for each additional $100.00 or fraction thereof, to Inspection of existing plumbing or and including $50,000.00. eciall requested inspections - per hour 72.50 $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for Subtotal: 10. p7 each additional $100.00 or fraction thereof, 11 t:w Commercial Fixture Work: ~y. fo', n t >I w. ME_ Are you capping, adding or replacing fixtures? If "yes", Plan review is required for any of the following, please indicate work performed by fixture. Failure to Please check all that apply. accurately report fixtures could result in increased sewer fees*. ❑ Any new commercial building with water service 2" and - ` _ greater, except systems designed and stamped by licensed ll. d' u ~b ter Stu ~ti engineer. LM, Sul ❑ New exterior plumbing site utilities for any complex structure lice jQUer Baptistry/Font as defined in OAR918-780-0040. Bath -Tub/Shower ❑ Medical gas and vacuum systems for health care facilities. -Jacuzzi/Whirlpool ❑ Any multipurpose fire sprinkler system. 1 Car Wash -Each Stall ❑ Any complex structure as defined in OAR918-780-0040. -Drive Thru Cu idor/Water Aspirator Submit 2 sets of plans with any of the above. Dishwasher -Commercial Domestic s Drinking Fountain Qlll@il o ,nn_. A Eye wash ❑ Isometric or riser diagram is required for new buildings Floor Drain/sink 2" that meet the qualifications above. 3" 4" Car Wash Drain Garbage -Domestic Comments regarding fixture work: Disposal -Commercial -Industrial Ice Mach./Refri . Drains Oil Separator Gas Station Rec. Vehicle Dump Station Shower -Gang -Stall Sink -Bar/Lavatory -Bradley *Note: If the fixture work under this permit results in an -Commercial increase of sewer EDUs, a sewer permit will be issued and -Service fees assessed for the sewer increase must be paid before the Swimming Pool Filter plumbing permit can be issued. Washer - Clothes Water Extractor Water Closet -Toilet Urinal Other Fixtures: http://www. tigard-or. gov/city-hall/departments/cd/does/PLMU-PermitAp2.doc