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Permit CITY OF TIGARD PLUMBING PERMIT t "` COMMUNITY DEVELOPMENT Permit #: PLM2011 -00345 'TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/17/2011 Parcel: 26113AB01400 Jurisdiction: Tigard Site address: 7376 SW DURHAM RD Project: AMEC Environmental Subdivision: COUNCIL VIEW ACRES (LOTS 21 -44) Lot: 30 Project Description: CAP (1) drinking fountain, REPLACE EXISTING (17) sinks /lays, (2) urinals and (9) water closets. Contractor: WOLCOTT PLUMBING Owner: PACIFIC REALTY ASSOCIATES LP 1075 W HISTORIC COLUMBIA RIVER HWY ATTN: N PIVEN TROUTDALE, OR 97060 15350 SW SEQUOIA PKWY #300 PORTLAND, OR 97224 PHONE: 503 - 667 -1781 PHONE: FAX: 503 - 667 -9891 FEES Quantity Description Date Amount 1 ea Fixture /Sewer Cap 11/17/2011 $25.02 Specifics: 6 ea Sink 11/17/2011 $150.12 11 ea Lavatories 11/17/2011 $275.22 Type of Use: COM 2 ea Urinal 11/17/2011 $50.04 Class of Work: ALT g ea Water Closet 11/17/2011 $225.18 Type of Const: 1 12% State Surcharge - 11/17/2011 $87.07 Occupancy Grp: Plumbing Stories: Total $812.65 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: `i Permittee Signature: / eA/ �/°L/ C }y7ON Call 503.639.4175 by 7:00 a.m. for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Plumbin ' Permit Application �ECE�IED Building Fixtures Tigard of Tr City NOV 1 6 1: " ""iv"<I • INI `� �' I l V Y 6 2011 Dine /By; //// // Ir Put NYW §-00 - eu 13125 SW Hull Blvd,, 'Tigard, OR 97223 Plun Revi"w - , r�I/ L l a. . phone: 503.7182439 Fax' 503.59 UIUw'PvrwiINo,l Inspection Line; 503,6394175 tJ OF TIGARD lx " / By. __ T I G A R D Date Ready /By; ill' 1 n See Noe 2 for I nternet: www,tigurd- ur.ov BUILDING DIVISION NVI(hnd /Mntlod; wig Supplemental information • 7 I 1, ',r(1 i ' 1 I 1 1 1�y�� �ry �171,,�� 1f!q$ ::;'!:• 1C1 I I ' 1 I I ,. !,(, 1 .. .. L.. p�, ," I 1 :i ii`j ` ■in i ,^ r ,r {! 11 il!OiYi'„!',i{ �;J ; V ; ,i0;ii• 9M H!:9 TP, A! l i, x!1 I ! � Ir , 1 ,, { I 1 I! I 1 , ' ', I ; ,A ' ■ III ,( I f' ,�,iRinr,Y I � II I i1, fi"P 10fl ! 11 ,, © New uunslructiun ❑ Demolition For special irtforniatlou use checklist. -- -. -- - Description _ Qty. Ea. 1 Total El Addition /alteration/replacement El Other; New 1- 2- 1'uutily dwellings (includes 100 11, for each utility connection) ' ':' ' r ✓. 'i:,' itii;ll'.; i ll!"''i! 777.:r n e�g , ,,, , r „ , .. `77 77 ,- •"(', ,., 7 , 7,*C!7 *,'Mh;mr;v 17.7 ?^; . 777 ,.7 7!:. ,"??fn �. (r7 V,.1 r7i 1 '�!n .,V Yn7�i� 1 Shlt(I) bulb 312.70 I, '. II11 yrl(!d, �' i. r I IRYrh7i�filDrinM1Y! I��II TP+ Ij ^r�n����'.1"r^Yr��:T*�IryIT �' ,r. '! I {.' .1,;x �._- ,,,._ SFR (2) both 437.78 I:1 1- and 2- family dwelling El Commercial /industrial - _ SFR (3) bath 500.32 0 Accessory building El Multi-family . - ___ --- - -"°--- _..� Each additional bath /kitchen 25.02 0 Master builder ❑ Other: Fire sprinkler sq. 't. Page ,. ::';ii ',,' ' ?'T It.' rii �N; . 1, ' Ni : :: ::49 ' ' 1 . i.' :: ' ' Site utilities: _ ;;r;, . ,,,, . :'• �11% il�,. � �i'�,;Ii'..,�.,,�.��! {�;�t.,�.. t��'�., �-!. ,i,t�h�r.��..I; „L• „` -- ,............�.. Job site address: 7376 DURHAM ROAD QLDG Catch basin or area drain I$ �_ Cr Dryweli, leach line, or trench drain 18.76 City/ State /"GIP: PORTLAND, OR 97224 -'W- ' -- . Footing drain (no. linear It,; ) Page 2 Suite/bldg. /apt. no,: C -197 - Project name: AM EC ENVIRONMENTAL Manufactured home utilities _ ^- 50.03 Cross street/directions to job site: Manholes 18,76 -. - - .... -", - Rain drain connector 18 -76 Sanitary sewer (no. linear ft.; .) Page 2 - Storm sewer (no, linear 1).,: _) Page 2 Water service (no. hne i' ft.' _ I Page 2 Subdivision: Lot no.: lrixture or heat; _ ,- - Tax map /parcel no.: ,,,,S d B4 l �j' 13acldlow preventer - � I r,...Ir,r,1!'I - (17 ! ' 'I " !'ilGi: iq i(!i' ''' r , ,i1 . 7777:177.17777 7 . 7 . 7 77.7 1 t ackwuler valve , :$:; /: :! :.`: l }ii{I111rii :'lii,hii. :i4 i'�Y {i ti ..� Y 1l r : :i : r r:,�:: :!k1'!! �.�.�..,. l.. rr,l,..r,e I r,.�n if;:,1 i r „.;; ?C ,..,. �.d Clothes washer 1.1 25.02 REMOVE AND REPLACE WITH NEW FIXTURES Dishwasher 25.02 100 - A 0004 1,3 valIe rr tq- .i'ro'n) S -To E ■►At( Drinkingibuntain _ 25.02 (I) CAME - 1r 9-J AV M f ) c E S Ejectors /sump 25.02 p"T"Prn?�,!;dr�"F 7re r, ,. ..„�, if . I ,r.7: � ,',lrl, V.Ir n 7,7. ..aa;1_,IL. ;. n i" ,.I • !1 , ' ,.r ,:hr 1 x WiSiotl Lank 12,51 , ,Ire, RBI �ll'l ' '���I 'I'I" f'1' '"''){� { , I I (. , r,) l,l:igPiAll P'/10, � J R .:' p �- Name: Fixture /newer cup 2S/20.//046,- 25.02 25.02 Floor draiii/lloor sinldhub F 25.02 Address: Garbage disposal 25.02 City /Stale/ZIP: Hose bib 25.02 Phone: ( ) Fax: ( ) lee maker 12,51 ,?:y,a4, Y,.i „:, "k I ,' i � ry :,;I q ,rp y ,�r.� j1 1(�.,, r , V ,��„I t ,,�. 1 �' ):' �'I�'ri'��IE•L .�'•�e,�! I'; L0. . i• .illfr for /'eabe 25,02 , ,e ''ll,, �IIy;�;h;' { i 1 I + e 2�E;'�! M � 1' i i. � :�, � `.110 �RIi%i' it interceptor] br trap . _,- Business name: WOLCO'1"1" PLUMBING. Nledioul gas (value; $ ) Pa 2 Printer 12.51 Contact name: CLIFF BOWMAN 7f� : ' Root drain (commercial) / umercial) 12 „51 Address: 1075 W HISTORIC COLUMBIA RIVER HWY Sink /basin /lavatory 0. 1--i 25,02 425.34 City /State /21P: 'I'ROU'I'DALE, OR 97060 Solar units (potable water) - 62.54 Phone: (503) 667 - 178:1 X381 Fax: : (503) 667 -9891 Tub /shower /shower purr 12.51 " Urinal . 2 25.02 - 50 .04 E-mail: . .... y,•.l' Il i',IFq, b!f, lli)I I , .I; .:'t +l:;.. „ r "yh7r5 T "'.1+; ', r , In I vJ.! ,lr s' clo . , 22 . I Ern { 7 I I 1 Wale 25 U2 5 18 �u i i 1 17 7 a• ,:,, 'r {i ^R4 � ,, 1 I ii I i . I, ,,,., •. 1 , 1. I11! y ' 1 1 , �', Y,'JI 1 1 11 ; !.:,:!!:,.!.!.!!.!:!(5.,,.,:.,:.i: Water heater 37.52 Business name: WOLCOTT PLUMBING Water piping/DWV 56 29 Address: 1075 W HISTORIC COLUMBIA RIVER HWY Other; "- _T 25.02 City /State/ZIP:'1'ROUTDALE, OR 97060 Subtotal 725.5$ Phone: (503) 667• - 1781X381 Fax: (503) 667 -9891 Minimum permit fee: $72,50 Plan review (25% of permit feu) r � ' C CB Lie.: 112220 ~ Plumbing Lic. no.: 26 -824PB State surcharge (12% of permit fee) 87.07 / Authorized signature. /J7 TOTAL PERMIT FEE 8 (2.65 �/ / • This permit application expires if a permit' is net obtained within 100 days Print name; CLIFF BOW M Date; 1146-11 attet' It has botu accepted us complete. 'Fee nrelirudeingy set by Tri- County Building Industry Service Board. I;\ BuildinglPermits \PLIvIU- PennitApp,doc le /e1 /es ed0.4eI6T(I0 /02 /CUM /WLkd) £O /T0 39 c1 ONISWf1d 11O010M T686L99£O5 VO :9T TTOZ /9T /TT Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information F ee Schedule: R � f �� nn Residential Fire Sur ression �, '' ,'1fni "'.1 I :Ii'.. I „� . i� :��R.)r't,�T,m„'�r!i:i:l!,'il� l �n. ,i ” ,.�,, . I'., �'q i i.r '.'1... . .1. " . ton Systems: I S Q.i;; i l"sa h�rK : t ,, er g . , . r ,,.. . r. ' s�� "i�,�11�•Nfi1F� 'I,;;,�:i;�;i�; ,,:: ?..,,i;,n : �, �,�',, „!f �i. I „'1: �, ,,ee nn , ' a�T4,I+'.4f, ,IC�,_ki >�aat�`�'i, �1�> ,i, Footing drain - 1" 100' 1 50.03 0 to 2,000 $121,90 Footing drain - each additional 100' 37.52 22,001 to 3,600 $169.69 ' Sewer 1 sf 100' r 62,54 3,601 to 7,200 $233,20 7,201.utd realer $377.54 - Sewer - ouch additional 100' 37.52 - -- - WaCLrSefVlCe 1st 1QQ' 62,54 Medical Gas S stems: Water Service - each additional 100' 37.52 .� ^r ,; . . •; .. .,,,. ras,7rr -s -r? r^,ya �R':'f111 0 ;i Vi; i :i ' ; I� ' erm' ''.i�n ,: Storm & Rain Drain - 1st 100' 62,54 . 1l�Il., : '.: >+ ;;:';,; ,bl'�..:.,., :'::•!''; ;c; ,:' : i', &Rain Drain each additional 100' $1.00 to $5,000.00 Minimum Ibe $72.50 Storm _ 37.52 $5,001.00 to $10,000.00 $72,50 for the first $5,000.00 and $1.52 for 1 .l' 'KYI ;! : ' I , 9, ' I I 1 i j" f „r ,1, % , t ) ,f i� I,,, lie II PRIttiltll I ,i110??; 1 ; '�!i : ' ;;' { h l : ' � l .a,' ' „�Y t each addibonal $100.00 or fraction thereof, to ! "' u d inchidiq' $10,000,00. Inspection of existing plumbing or for $10,001.00 to $25,000.00 $148.50 Per the first $10,000.00 and $1.54 for which no feu is specifically indicated 90,00 /hr each additional $1.00.00 or fraction thereof, to (minimum charge - 1/2 hour) and including $25,000.00. Inspections outside ol' nornlal 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 charoe - 2 hours) each additional $100.00 or fraction thereof, to Reinspection Pees 90,00 /hr and including $50,000.00, Additional plan review f for revisions 90.00 /hr 550,001,00 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 * . uairt b tune "' � }�ixturc Type air 4 t� .4,:•:.. .. . , ,,. , � :. , ' !Replace .. :; ��. � ?'�a�'t �; ,,, ° .'. PUurkerl'uraitic�l: " :. „ CuhlhFll .. ctQctl;,i. Plan review is required for any of the following, as tistr /Font - Please check all that apply. 13ath -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 OAR918. 780 - 0010. Dishwasher - Commercial [f Medical gas and vacuum systems for health care facilities, - Domestic ❑ Any multipurpose fire sprinkler system. Drinking Fountain — X 1 ❑ Any complex structure as defined in OAR918- 780 - 0040. _t ye Wash Floor Drain /sink , 2" Submit 2 sets of plans with any of the above. C , l `NI ;ii; "' <It u11 04.1,>! ' •q,:,,. ' � , Cur Wash Drain ; "` SIC# #!: ; : ' ' : : : Garbage - Domestic - nun -food ❑ Isometric or riser diagram is required for new buildings Disposal - Domestic - food related that meet the ualilications above. - Commercial - food related "' - " - "- - Industrial -food related Ice Mach. /Refrig. Drains Oil Separator (Gas Station) Comments regarding fixture work: Rec. Vehicle Dump Station Shower -Gang --- —" - Stall _ Sink /Lae - Non -rood related /7 ' -Bradley - -Commercial-food related - - - Service Swimming Pool Filter -- Washer Clothes *Note: 11' the fixture work under this permit results in an Water Extractor increase of sewer EDUs, a sewer permit will be issued and Water Closet - Toilet - fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: - hap : / /www ur.gov/ city_ hal l /depaar •talents /cd/ducs /PLMF- Perm doc E0 /Z0 3go'd JNI13Nfl1d 110010M T686L99E05 170 :9T TIOZ /9T /TT '' Accumulative Sewer Tally 1rd - Tenant Name: AMEC Environmental SWR # N/A ` - r- i Site Address: 7376 SW Durham Rd., G PLM # PLM2011 -00345 li1.100.0 j 1 ��` -- = =1j Parcel #: 2S113AB01400 Fixture Value Previous Previous Credits Capped Fixture Fixture New New # value count ca )ed #s value count added # added value total #s total values Ba.tise /Font 4 0 0 0 0 0 Bath: - Tub /Shower 4 0 0 0 0 0 - acuzzi /Whirlsool 4 0 0 0 0 0 Car Wash: - Each Stall 6 0 0 0 0 0 - Drive throu.h 16 0 0 0 0 0 Cus »idor /Water As.irator 1 0 0 0 0 0 Dishwasher: - Commercial 4 0 • 0 0 0 0 - Domestic 2 0 0 0 0 0 Drinkin. Fountain 1 0 1 1 0 -1 -1 Eye Wash 1 0 0 0 0 0 Floor Drain /Sink: - 2 inch 2 0 0 0 0 0 - 3 inch 5 0 0 0 0 0 - 4 inch 6 0 0 0 0 0 - Car Wash 6 0 0 0 0 0 Garbage Disposal: - Domestic (to 3/4 HP) 16 0 0 0 0 0 - Commercial (to 5 I-IP) 32 0 0 0 0 0 - Industrial (over 5 HP) 42 0 0 0 0 0 Ice Machine /Refrigerator Drain 1 ' 0 0 0 0 0 Oil Sep (Gas Stat4on) 6 0 0 0 0 0 Rec. Vehicle Dump station 16 0 0 0 0 0 Shower: - Gang (per head) 1 0 0 0 0 0 - Stall 2 0 0 0 0 0 Sink: - Lav /Bar - Non -Food Related 2 0 0 0 0 0 - Bradley 5 0 0 0 0 0 - Com /Sery /Util - Food Related 3 0 0 0 0 0 Swimming Pool Filter 1 0 0 0 0 0 Washer - Clothes 6 0 0 0 0 0 Water Extractor 6 0 0 0 0 0 Water Closet - Toilet 6 0 0 0 0 0 Urinal 6 0 0 0 0 0 Previous EDU Count 0 0 Capped EDU Credit 0 TOTALS 0 0 1 1 0 0 - - Current Fixture Value -1 divided by 16 = -0.1 Current EDU 1 EDU = $4,500.00 Previous Fixture Value 0 divided by 16 = 0.0 Previous EDU Change -1 divided by 16 = -0.1 over (under) $ (450.00) Enter EDU Change Here -0.1 Notes: 0.1 EDU CREDIT Authorized Name /Signature: Dianna Howse Date: 11/17/2011 Building Division Note: The property owner shall retain the ORIGINAL sewer tally record. If credits exist, this document will serve as a voucher which must be submitted to the City of Tigard Building Division to redeem credits towards future system development charges. I: \Building \Sewer Tally \SewerTallySheet- 4500.xls 07/01 /11