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Permit PLUMBING PERMIT n CITY OF TIGARD COMMUNITY DEVELOPMENT Permit#: PLM2009-00353 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/16/2009 Parcel: 2S113AA00700 Jurisdiction: Tigard Site address: 16600 SW 72ND AVE B10 Subdivision: OREGON BUSINESS PARK I Lot: 0 Project: Benchcraft Project Description: Install (1) clothes washer, (1) drinking fountain, (1) expansion tank, (2) 2" floor drains, (1) 2" floor hub, (2) primers, (7) lavs, (2) urinals, (6) w/c, and (1) w/h. 1/28/10, adding backflow preventer. Owner: FEES PACIFIC REALTY ASSOCIATES Quantity Description Date Amount 15350 SW SEQUOIA PKWY #300 PORTLAND, OR 97224 1 ea Clothes Washer 12/16/2009 $25.02 PHONE: 503-624-6300 1 ea Drinking Fountain 12/16/2009 $25.02 1 ea Expansion Tank 12/16/2009 $12.51 3 ea Floor Drain/Floor Sink/Hub 12/16/2009 $75.06 Contractor: 2 ea Primer 12/16/2009 $25.02 ASSOCIATED PLUMBING CO 7 ea Lavatories 12/16/2009 $175.14 P 0 BOX 301362 2 ea Urinal 12/16/2009 $50.04 PORTLAND, OR 97230 6 ea Water Closet 12/16/2009 $150.12 PHONE: 503-331-0582 1 ea Water Heater 12/16/2009 $37.52 FAX: 503-331-0581 1 12% State Surcharge - 12/16/2009 $69.05 Plumbing 0 12% State Surcharge - 01/28/2010 $3.76 Plumbing Type of Use: COM 1 ea Backflow Preventer 01/28/2010 $31.27 Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $679.53 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 Notific enter-_Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain a copy of the rules or direct estions to OUN ng 503.246.6699 or 1.800.332.2344. Issued By: Permittee Sign ure:1 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 project. Approved plans are required on the job site at the time of each inspection. '. -' CITY OF TIGARD PLUMBING PERMIT ' a COMMUNITY DEVELOPMENT Permit #: PLM2009 00353 ;!TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/16/2009 Parcel: 2S113AA00700 Jurisdiction: Tigard Site address: 16600 SW 72ND AVE B10 Subdivision: OREGON BUSINESS PARK I Lot: 0 Project: Benchcraft Project Description: Install (1) clothes asher, (1) drinking fountain, (1) expansion tank, (2) 2" floor drains, (1) 2" floor hub, (2) primers, (7) lays, (2) urinals, (6) w /c, and (1) w /h. Owner: FEES PACIFIC REALTY ASSOCIATES Quantity Description Date Amount 15350 SW SEQUOIA PKWY #300 PORTLAND, OR 97224 1 ea Clothes Washer 12/16/2009 $25.02 PHONE: 503 624 -6300 1 ea Drinking Fountain 12/16/2009 $25.02 1 ea Expansion Tank 12/16/2009 $12.51 3 ea Floor Drain /Floor Sink/Hub 12/16/2009 $75.06 Contractor: 2 ea Primer 12/16/2009 $25.02 ASSOCIATED PLUMBING CO 7 ea Lavatories 12/16/2009 $175.14 P 0 BOX 301362 2 ea Urinal 12/16/2009 $50.04 PORTLAND, OR 97230 6 ea Water Closet 12/16/2009 $150.12 PHONE: 503-331-0582 1 ea Water Heater 12/16/2009 $37.52 FAX: 503 - 331 -0581 1 12% State Surcharge - 12/16/2009 $69.05 Plumbing Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $644.50 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 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: n d Permittee Signature: -AP P • 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 project. Approved plans are required on the job site at the time of each inspection. 01/26/2010 14:30 5033310581 ASSOC PLUMB CO PAGE 01/01 Plumbing Permit Applicati Building Fixtures FOR OFFICE 1.15E ONLY Received City of Tigard p A' �� �� Permit No.: .1.1/. , fi�D/•�OD,3S3 n 13125 SW Hall Blvd., Tigard. OR 97223 �AN 1 0 Dntc/By: I • Ph one: 503.639.4171 Fax: 503.598 19 0 Plnn Review Other Permit No i Dnie/By: TIGARD Inspection Line: 503.639.4175 Ci OF TIGARD Dntc Reedy /By: )nr 0 S ee e Internet: www.tigard- or._gov BUILDING DIVISION Notified/Method � Supplemental Pagi Information 17 , ,., .. ;., . : !.. E S .. , . r>t cl�nin r Q New construction ❑Demolition For .cpecialInformation use dreckliyt. Description I Qty. I Ea. 1 StAddition/alteration/replacement ❑ Other; New I- 2- family dw•ellins (includes 100 ft. for each utility connection) 'C o r CO1�' STR I JCTLON _SFR (I) bath 312.70 ❑ I - and 2 - family dwelling ,commercial /industrial SFR (2) bath - 437.78 El Accessory building SFR (3) bath 500.32 g ❑ Multi - family Each additinnnl ham/kitchen 25.02 ❑ Master builder ❑ Other: F . ! 4 ) Page 2 Ire sprinkler ( s . 1Z, pa e .. OR 0f£:' A'1VT1 •.I;i0: Site utiliticv: lob site address; Catch basin nr area drain 18.76 ..../ ...g .6 ..•-, 00 54... 7Z«-.,r . Drytvell- leach line, or trench drain 18.76 City /State/ZIP; =cA O 4 7 ZZ --- Z _ Footing drain (no. linear I),; �) PaP,C 2 Suite/bldg. /apt. no.: ,- P_ r_oject name; Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 r Sanitary sewer (no. linear fl.: _) Page 2 Storm Sewer (no. linear ft.: ) Page 2 Water service (no. linear Ii. _) Page 2 Subdivision: t,ot no.: Fixture or item: Tax map /parcel no. Back Fl nw proven er :..: ;, :,1 : : ' : r aC 12 51 (water valve l r I "' Clothc5 Wa5hCr 25,02 _...®-�.�►"., _ fir--+- -•- rL a 1 z..3,69- G Dishwasher 25.02 - Drinking fountain 25.02 Ejectors /sump _ 25.02 • '@lI:;PR'OPT)I TY, O • : 0 TENANT Expansion t ank , :.:. � .... .. 12.51 Name: Fixture /sewer cap _ 25,02 Address: •' • Floor drain/floor sink/huh 25.02 - ^ - Garbage disposal 25.02 City /State /ZIP; _._ -� (lose hih 25.02 Phone: ( ) Fax: ( ) ^ Ice maker 12.51 - •; APP�:I'C.�NT' I 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: Medical gas (value: $ ` ) Page 2 Contact name: '• - Primer 12,51 .- - - Root' drain (commercial) 12.51 /Address: Sink /basin/lavatory 25,02 City /State/7IP: Solar units (potable water) 62.54 Phone; ( ) Fax: : ( ) Tub /shower /shower pan 12,51 E -mail: Urinal 25.02 l Water closet I : CO TRAG`rOR - 25.02 Business nam Water heater 37.52 ` . �JO/ o Water piping/I)W V 56.29 - Address: Snh / 25,02 �d �� �� /�O �- Other: _ City � .�?i_� /_ �/� 5 2 Subtotal 3/. Phone: (s' 3.37-,, 5-r-1_ - Fax: (5,-z, y/ Minimum permit fee; $72.50 CCB Lie.: C;"5 Plumbing Lie. no.: - / Z ,,� Plan review (25 " /nnfpcmtit fee) .,_ � it fee) 2. 7 State surcharge (12% of permit Authorized signature; �^ _ I TOTAL P _ ERMIT FEF n p, Print name; Thin permit a 1/ I ) . �/y .e�,l,/� •� Datc;� 2e --4, 1 pe application expires If s permh Is not obtained within 180 days I rater it uns been accepted OA complete. "Fee methodology set by 1 'n- Connty Building Industry Service "board. I.111”""tt Perm umrt•Mt1. Perm aApp.doc I run Imo A41)-IA I GT( I C112/C0M/WP'a) • 12/14/2009 12:15 5033310581 ASSOC PLUMB CO PAGE 02/03 Plumbing Permit Application C $ Building Fixtures ilv.V FOR OFFICE USE ONLY Cit • of Ti ZDO9 Rc . Permit No City and �' DEC 1 4 A ..1p/ V1/1 �1 m et , Q Untc /i3 N 1� t 1�J"j pp 3 N n 13125 SW Hall Blvd„ Tigard, OR 97223 �-( I)n RCVICw V • Phone: 503.639.4171 Fax; 503,598.1960 nspect ne; 5 Tl - Apial :ite /13r Other Permit No. Inspection LiO3,639.4175 Y O F TIGARn CIT ^1 E t± dy /fay. y . See Pore2for Internet. www.tignr(lor.gov FN ( milled /Method `_ Supplemental information TYPE O WO . FEE* SCHEDULE For special in ormntinn use checklist - r 0 New construction ❑ Demolition Description I Qty_ Ea.. I Total ...... difinn /alteration /replacement ❑ Other: New I- 2- family dwellings (includes 100 ft, for each utility connection) CATEGORY 01 CONSTRUCTION . SFR (1) bath 1 249.20 0 1- and 2- family dwelling l9mmercia)/industrial SFR (2) bafl, 350.00 - SFR (3) hath 399.00 ❑ Accessory building ❑ Multi - family _,__... I - :nch additional bath /kitchen 45.00 ❑ Master builder ❑ Other; ,_ Fir sprinkler ( sc), 0,) Page 2 JOB SITE iNFORMATION AND LOCATiO\ Site uNIINcs 41' Job Sile address: /l6G�3 G 7 �j/ - ..•_. Catch basin or arca drain 16,60 . _ City /State /71P;---���� 7' ,,,,,f- T z1y Drywcll, leach line, or trench drain 16.60 � ,-,j1(72 Footing drain {nn. linear fl,; Suite/bldg./apt. (bldg. /rcpt. n Proicct name: -'7::: _ • _ ._ . ) Page 2 Manufactured home utilities 110.00 Cross street directions to job site: - -•- - - -- •-- 1 Manholes - • _ 16,60 Rain drain connector 16.60 Sanitary sewer 1110. linear ft.: _) Page 2 - Storm sewer (no. linear ft.; ) Page 2 ' Water service (no. linear fl.: �)- Page 2 Subdivision: Lot no.: Fixture or item L Tax map /parcel no.: m Absorption valve 16.60 DESC11Y11'TION OF WORK - Back 'low prcvcntcr _ Page 2 - _ - tu.:flr 'T. X. o'--..% .r t ,��, yam, 4,me 4 Backwater valve 16.60 V d Clothes washer / 16,60 /,y - .- Dishwnsber 16,60 Drinking fountain / 16.60 /Gi! 2? n PROPERTY OWNER 0 TENANT - -_ ,._...,._ ____.,... f )ccaors /sump 10.60 Name: -- -,.._ F,xpans(on tank / 16.60 /6r Address; •_ Fixture /Sewer cap 16.6f) City /State /ZiP: Floor drain /Boor sink/hub 16 ri0 G6 yb Phone, ( ) Fax: ( ) Garbage disposal ,- 16.60 1]', ,APPLICANT ' ; CI !CONTACI' .1'`ERSON _ Hose bib 16.60 ' Ice maker 1 6.60 Business name: Interceptor /grease trap f 6.60 Contact name; _ - Medical pits (value: S ) Page 2 Address: Primer _ _• 16.60 , City/State/ZIP: Roof drain (commercial) 16.60 __....... Sink /basinilavato Phone: ( ) L 11x:: ( ) ^� D 7 16.60 / 0 „ 4 4 , 24,.... Tub /shower /shower pan 16.60 E -mail: 1 Urinal 2- LO CONTRACTOR 1 . 61) Water closet I G 9,I� w 7 Business name: a �7, M �`^ Warcr heater J 16.60 !6 d� F.7 SJ/l/�6 G0. . st i l Address: / 3 6 L M CityJ$t Other. - etc /7_iP; Subtotal I \l. Minimum permit Ice: 572.50 Phone: 0753) )7/ -0S 1 Fax: (57.9 ) 33/. -d5 / 1 + l Residential backtiow minimum permit Ice; $36.25 CCB Lic•: S`j �ja l Plumbing Lie. no.: '16 --y /Z ,29" Plan review (25% ofpermit fee) f� - - State surcharge (12% of permit fcc) /�/ .1. Authorized signature. TOTA PERMIT FEE o �k Print Hama, s ��� Dale: � r This permit n Ire Trion ex rres ;in permit l= mit iv not obt nc(f within 180 days after it has been accepted AS complete. "Fee methodology set by Tri- County Buildin); industry Service Board. 1\ Itrinp \rermns \PLsrr- rormitAppdoc I?')7/06 440.45 /02 /COMAS'6Rt 6 r0tel e r& ‘ A OO ad pl u mbif, Co. ce� ' -50 12/14/2009 12:15 5033310581 ASSOC PLUMB CO PAGE 03/03 Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: :'Site Utilities. Qty. Fee (ea) Total S uar_e__Footage: Permit Fee: Footing draill - 1 ° 100 55,00 0 to 2,000 $115,00 Pooling drain • each additional 100' 46.40 _2.001 l0 3,600 $160.00 3.601 to 7,200 $220.00 Sewer- 1st 100' 55.00 µ 7.20l andgrcater 5309.00 Scwcr - each additional 100' 46,40 Water Service - is) 100' 55.00 Medical Gas Systems: Water Service - cnch additional 100' 40,40 Valuatiott: Perin it Fee: Storm & Rain grain • 1st 100' 55.00 $I,On to 55.000,00 Minimum fcc $72.50 Storm & Rain Drain • each additional 100 46A0 55.001.00 to 510,000.00 572.50 for the first 55,000.00 and $1.52 for cnch Qt . Fee (ea) Total additional $100.00 or fraction thereof. to and >'i�CtllrE!dF XtL�Cf1° including $1(l.(100A0. Commercial Back Flow Prevention Device 46.40 210.001,00l0 525.000,00 $148,50 for the first $10.000.00 and S1.54 for Residential f3ackflow Prevention Device each additional 5100,00 or fraction thereof. to minimum permit fcc 536,251 27.55 and includin 525.000.00. Rain Drain, single gamily dwelling 65.25 525,001.00 to 550.00(1,00 5379.50 for the first +25.000.00 and 51.45 for each additional 5100,00 nr fraction thereof. 10 Inspection of existing plumbing or — and including $50,000.00. specially requested inspections - per hour 72.50 550,001,00 and up $742.00 for the first 550.000.00 and 5 1.20 ft,r Subtotal: each additional 5100.00 or fraction thereof. Commercial Fixture Work: Plan•Review for Plumbing Installations Are you capping, adding or replacing fixtures? if "yes ", flan review is required for any of the following. please indicate work performed by fixture. Faihirc to Please cheek all that apply. accurately report fixtures could result in increased sewer fees*. El Any new commercial building with water service 2" and Quantity by '(Flxttore) Work Performed greater, except systems designed and stamped by licensed TlYtnreType Replace , engineer. . • , fhevioui ,, Ctlpped, ,.•Adited.: . rxtat•in0 : © New exterior plumbing site utilities for any complex structure 13aptisty /Font as defined in OAR918 780.0040. — Rath - Tub /shower ❑ Medical gas and vacuum systems for health cart facilities. - .Iacu7i /Whirlpool Q Any multipurpose fire sprinkler system. Car Wash -Each Stall ❑ Any complex structure as defined in OAR918 780 - 0010. - Drive Thrtt Cuspidor /water Aspirator Submit 2 sets of plans with any of the above. Dishwasher -Commercial - Domestic Drinking Fountain ■ isometric or Riser Diagram • Eye Wash El isometric or riser diagram is required for new buildings Floor Drain /sink - 2" 2 that meet the qualifications above. a Car Wash Drain Garbage - Domestic Comments regarding fixture work: Disposal - Commcrcinl - industrial _ !cc Mach. /Refrig. Drains Oil $cparator (Gas Station) Rec. Vehicle Dump Station Shower -Gang -- .. -Stall -_ Sink -Bar /Lavatory , - Bradley * Note: If the fixture work under this permit results in an - Commcrcinl 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 er Water Pxtractor Water Closet - Toilet h Urinal 2— Othcr Fixtures: ,r/L,? P A iMhildin \Per slPLM.Pcrmit A pp. eoc 12/21/x6