Permit CITY OF TIGARD PLUMBING PERMIT
"- COMMUNITY DEVELOPMENT Permit #: PLM2011 -00286
TIGARD. 13125 SW Hall Blvd , Tigard OR 97223 503 718.2439 Date Issued: 09/14/2011
Parcel: 1S 134AA01800
Jurisdiction: Tigard
Site address: 10240 SW NIMBUS AVE L6
Project: Almar Contracting Subdivision: IKOLL BUSINESS CENTER, TIGARD Lot: 2
Project Description: Interior plumbing Capping (1) sink and replacing (1) sink.
Contractor: BEAVERTON PLUMBING INC Owner: KG INVESTMENTS
13980 SW TV HWY 10240 SW NIMBUS AVE SUITE L3
BEAVERTON, OR 97005 PORTLAND, OR 97223
PHONE 503 - 643 -7619
PHONE: 503 - 245 -7100
FAX. 503 - 643 -7620
FEES
Quantity Description Date Amount
1 ea Fixture /Sewer Cap 09/14/2011 $25 02
Specifics: 1 ea Sink 09/14/2011 $25 02
1 12% State Surcharge - 09/14/2011 $8 70
Type of Use: COM Plumbing
Class of Work: ALT 22 ea Minimum Fee Adjustment - 09/14/2011 $22 46
Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $81 20
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days ATTENTION Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503 232.1987 or 1.800.332 2344
r
Issued By: ,i%" ermittee Signature:
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i' i
Call 503.639. 175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbi, ng Permnit APPlicat on r
Building Fixtures . Fulz OFFICE USL O\L)
City of Tigard SE P 1 3 2 011 Reeceived `
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III 41-1- + �, 1t
13125 SW Hall Rlvd Tigard OR 97223
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Data /By, Mil 'tea -, % _ J��fl�
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Phtnc 503 - 718.2439 Pax: 503.59$.19bf1, �� � Plan Rrview
� Date/By Other PermiI Nu.: If' ,107/ _ (r) I
1 rc ,,, 1; 1 , Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By: Juris SI See Pnyr t fur
lntemet: www. ur.gov I3otificd/Mcthod. . /y[> , Nupplrmeninl Information
„'11 ; ' I ,_ 'C ,'ny1/ • •6iilw , , , rr..,' - FE „ U Y14 r� „
n. •
❑ New construction ® Demolition For aperiai infnrmru'iun use ehear -fist.
Description I Qty. Ha. Tota
IS Addition/ altoration/replacement ❑ Other: New 1- 2 -family dwellings (includes 100 It for each utility connection)
.. ' Ii •'i00!:' i 1 1i ►O ' - : , t' :,QP,i$'J'1IJ'CTitiN. ' i SFR(1)bath 312,70
❑ t- and 2-family dwelling ® Commercial /induslrial Sf R (2) bath . 437.78
SFR (3) bath 500,32
❑ Accessory building 0 Multi - family
Each additional bath /kitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2
: „ , : ;i •:;JoA11 9i, ° IN$0 l0 ANO ,1,.00,ATION Site utilities:
Job site address: 10240 SW NIMBUS Catch basin or arcs drain j 18.76
City /State/ZW: TIGARD, OREGON Drywell, leach line, or trench drain 18.76
Footing drain (no, linear ft.; ) Page 2
Suite/bldg. /upt. no. :1.6/1.7 I Project name: SCIIOLLS BUS. CENTER Manufactured home utilities 50,03 —
Cross strect/dircctions to job site; Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Water service (no. linear II. ) Page 2
Subdivision: 1 Lot no.: Fixture or item:
Tax map/parcel no.:
Hacktlow preventer _ . L 31.27
,, " Backwater valve 12.51
Clothes washer 25.02
DEMO 1 SINK Dishwasher 25.1)2
INSTALL I SINK Drinking fountain 25.02
Ejectors/sump 25.02
'' ' .E1,:PRC ER` ',1VN!'R',;d ' ,dIY , -,!IG1 r , „o,!, ,ol+r, .. k.1, ; *Noi 1;. . • ; ' Expansion tank 1231
Name. Fixture /sewer cap 1 7 r 25.02 R 6,2
Floor drain /fltxsr sink/hub 25.02
Address: Garbage disposal 25.02
City /Statc/ZIP: N Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12,51
, ' d , APPLICANT' '• ' ] CONTACT PERSON : Interceptor /grease trap 25.02
Business name: BEAVERTON PLUMBING, INC Medical gas (value: $ ) Page 2
Contact name: CASEY STEPFTENS Primer 12,51
Roof drain (commercial) 12.51
Address: 13980 SW TUALATIN VALLEY HWY Sink/basin/lavatory 2f-lt 25.02 a.5; /
City /Statc/ZIP: BEAVERTON, OREGON 97005 Solar units (potable water) 62 -54
Phone: (503) 643.7619 Fax: : (503) 643.7620 Tub /shower /shower pan 12.51
E -mail: Sue(aJ.beavertonplumbing.com Urinal 25.02
„)il` 0.:::.1 ,. fl ::.. 1 :: • •Jl 1 1,11 ,IVL` . .,, Water closet 25.02
Water heater 37.52
Business name: BEAVERTON PLUMBING, INC Water piping/DWV 56,29
Address: 13980 SW TUALATIN VALLEY HWY Other: 25.02
City/State/ZIP: BEAVERTON, OREGON 97005 Subtotal
Phone: (503) 643.7619 Fax: (503) 643.7620 Minimum permit fee: $72.50 -- 17, . j
CCB Lie.: 12889 Plumbing Lie. no.: 34 -4PB Plan review (25% of penult fee)
State surcharge (12% of permit fee) $ ,1{_
Authorized signature: , ,,x .\ TOTAL PERMIT FEE tpl ,7 C>
Print name: SUSAN DEAN Date: 9/9/11 This permit application expirrn it "a "permit is not ubtuined within 180 days
after it bus been mumpted as complete
"Fee methodology at by Tri- County Building Industry Service Board.
t.\ Building \Pemutu\.PLMU- PwmitApp doe 10/01/09 440-46161110/02/11361M1-114)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental information
Fee Schedule: t� � p _ Residential Fire Suppression Systems:
i tiir 7'. 4. 4' j6 �y ;��rv. '�"J' �h �r � �' Q�,yy �+p��'�j ryi/� p -'a A y � �-
.
'�' J,6I .Illf'nd h Vn4 "'J1�I�k, • u,r, wl�lik 'n6iHory �.fIV'' fli'1 „ ''7D -^^f{I40. T0IIf*�t ,' '4 U 0001 , i e;
Footing drain - 1a 100' �,ai�i vft�loiC „1
F °isi,;,
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 - Est 62.54 7,201 and KrCat $32727 ,54
Sewer - each additional 100' 37.52
Water Service - 1st 100' 6154 Medical Gas Systems:
•
Water Service - each additional 100' 37.52 �r • :'' ',u', °r „p �Wai�° �,
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 n' k ectiani or Fees Q ' _ Fee (ea) . T 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,(100.00 anal $1.54 ft>r
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.
normal outside of nmal 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. T n
Quantity by Fixture. Type ;�' �i 1u�e :x, 8,1100 " nZ $la »s
Fixture Type for I Replace! .' C i
• Work Performed: Capped Added Relacata Plan review is required for any of the following.
Baptistry/Mont Please check all that apply.
Bath - Tub/Shower ❑ 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 ❑ New exterior plumbing site utilities for any complex structure
Cuspidor /Water Aspirator as defined in ()AR91 S -7$0 -0040,
Dishwasher - Commercial ❑ Medical gas and vacuum systems for health care facilities.
- Domestic 0 Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918- 780 -0040.
ttyc Wash
Floor Drain /sink - 2” Submit 2 sets of plans with any of the above.
-4 „
Car Wash Drain Isometric or Rise` DiAgraw
Garbage - Domestic - food ❑ Isometric or riser diagram is required for new buildings
Disposal -Domestic related that meet the qualifications above,
- Commercial -fond related
- Industrial -food related
Ice Mach. /ltefrig. Drains
Oil Separator (Gas Station) Comments regarding fixture work:
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink /Lac - Non -food related 1 1
- Bradley
- Commercial -food related
- Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer - Clothes er P
Water Extractor increase of sewer EDUs, a sewer permit will be issued and
Water Closet - Toilet fees assessed for the sewer increase must he paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
http: / /www.tigurd -or. gov/ city_ hal Udepartments /cd /docs/PLMF- PcnnitApp2doc