Permit - CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2011 -00363
T[GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/07/2011
Parcel: 25101 BD00200
Jurisdiction: Tigard
Site address: 8001 SW HUNZIKER RD
Project: Tigard Distribution Center Subdivision: 1994 -025 PARTITION PLAT Lot: 2
Project Description: Interior plumbing: Replacing water piping.
Contractor: BEAVERTON PLUMBING INC Owner: TIGARD DISTRIBUTION CENTER LLC
13980 SW TUALATIN VALLEY HWY 4800 SW MACADAM, STE 120
BEAVERTON, OR 97005 PORTLAND, OR 97239
PHONE: 503 - 643 -7619 PHONE:
FAX: 503 - 643 -7620
FEES
Quantity Description Date Amount
1 ea Water Piping /DWV 12/07/2011 $56.29
Specifics: 1 12% State Surcharge - 12/07/2011 $8.70
Plumbing
Type of Use COM 18 ea Minimum Fee Adjustment - 12/07/2011 $16.21
Plumbing
Class of Work: ALT
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.
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.
Plumbing Permit Applies R 1
' CIED
Building Fixtures " E V FOR OFFICF 1.81. ONLY
City of Tigard
13125 SW Hll Blvd.. Tigard, DR 97 DEC 2 2011 Rcccived /or
1' I
ii 'T Permit No.: /Mk it-c5
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. . Phone: 503.718.2439 Fax: 5C131tS
11 Date/By:
Plan Revkw
tir TIG Other Permit No.:
ARD Datc/Ry: -. .
, ,. Inspection line: 503.639,4175 t• Date Ready/By: ' EI See l'age 2 for
TI G A '( ') Internet: www.tigard-orgov BUILDING DIVISION Notified/Method: 11" T.4il Supplemental Information
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4iiii: ...:;,:,:.. ::.:.. :.:.:: ..::: . •::.: ; :::! .,.:,. ::7 : 7 . ..:: .. T . .. .:.E SCHEDULE .:...::. :, .. :;.,..".•.,:..:.: ..' •.: ..
D New construction 1:1 Demolition For special Information use checklist.
Description 1 i.,L I Ea. I Total
2 ci Other New 1- 2-family dwellings (includes 100 IL for each utility connection)
. .:....,..::.:; :,..,:::..:........:,' :; . ,,:
.L. _.__ CATEGORY 9V, C:01.1RUctitoisi. : . ::: ..::: . .. . . '' SFR ( bath 112.70
.__, •
0 I- and 2-family dwelling latommerci ul/induAtial SFR (2) bath 437,78
SFR (3) bath 500.32
Li Acces.:sory building D Multi-family
Each additional bath/kitchen 25,02
0 Master builder 0 other: Fire sprinkler ( sq, ft) Page 2
•..;:..:;,,', ..• ,.- :..;:.:::,:::: • • : • JAB . SIO;;,104jR*Ti0Nio .:,:.''.: . .;.:;• ..: . .:...,: Site utilities:
Catch basin or area drain 18.76
Job site addre,ss: SccA '54,) \\ V,_e', IC -
Drywell, leach line, or trench drain 1R.76
City/State/ZIP: - 7 ‘ i ,..,,, , a CW- Footing drain (no. linear ft.: ) Page 2
Suite/bldg./apt. no.: Project name: T•C Q\ S Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear IL: ) Page 2
Storm sewer (no, linear It: ) Page 2
Water service (no. linear It.: _ ) Page 2
Subdivision: I Iol. no.: Fixture or item:
Tax map/parcel no.: 1:lac:know preventer 31.27
• , • . •••• .: .. • .•:: . •••",:. ::*... ,•.,... ..:.p:. , , .r4 3..k.". 33330^ , 33143' . a .'.3 . '., '']1T ','''.,':" ''..,:. '.:!,'::' '' Backwater valve 12.51
Clothes washer 25.02
12-e-2\cc.c c.%\ ■ 'C Icsk \ncsl- Q C,,,4-\ %...-_,Nsi-Vvt_INI Dishwasher 25,02
Vi.: .‘ NCAVC: ( i° )cc( \ › Drinking fountain 25.02
2 _ i k7045 / k i e.a.t l!X Ejectors/sump
- 25.02
,:',. • . :.: 0...olitoiii ' .•:.': : .• .;:. ,..•. • .....:::ti:::• ..: : ::. Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/huh 25.02
Aildres:
Garbage disposal 25.02
CiLy/State/ZTP:
Hose bib 2502
... .
Phone: ( ) Fax: ( ) Ice maker 12.51
. .
.,,‘ .,.......:.:.: ..
C] APPLICANT .•:::',. .:::••.•• ...::•: : : •::::1:1! Intereeptor/grcase trap 25.02
Medical gas (value: S _) Page 2
Business name: ,_, .,,,,,,,
12.51
Contact name:
- Roof drain (commercial) 12.51
Addmss: V1?- 7. V . V Sink/basin/I ayatory 25.02
City/8 tatc/ZTP: Solar units (potable water) 62.54
Phone: L4(...\ -7 - ) - 1( r, \C.-% Fax: : 'r- IL 'fah/shower/shower pan 12.51
Urinal 25.02
E - mail: C. @ 1 pec.u.e...sc krcr "NDV. wv \\:>Ltr c c-N-Y-1 water dont 25,02
• . .......::::..' ::i.:. ':01'..*::'':!Okjdik6i(j kp
ri i,o, :4F •:::...:,,,: i„;:: ,..t. .:,:!:w: ..:0: ,,,
Waler heater 37.52
Business name: z ...., p \ ( 3 ,,,,, i - - ecrater 12 / 56.29
Address: \( fL,- --v,.3..1-\\,6 Other: 25.02
City/State/ZIP: erk .4 --. \ 4 ....„ ( ..., c Subtotal
Minimum permit fee: $72.50 70,...5 ..
Phone: -
c L k - .1, \ c Fax: Pon WA:A -
Plan review (25% of permit ) -
CC'B Lie.: \ Plumbing Lic. no.: . 1..1 - C fcc
AP CO
State surcharge (12% of permit fee) Tc 7-S
Authorized signature:
*001 VM TOTAL PERMIT FEE , s- , ( , ../---
Print nume;_,,,,c.r.rkS,Th Of...C rl I Date: R •z_ II i Thia permit tapplitnlittn expire% if u !permit ix rani obtained within 180 days
after it has beeu accepted 253 complete.
"Fee methodology act by Tri-County Building Industry Service Board.
mnadin Ml I-Pennit App. floc 3U/0 i/00 440-4616T(1062/COM/WED)