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Permit I . 7 r ' R CITY OF TIGARD PLUMBING PERMIT .' COMMUNITY DEVELOPMENT Permit #: PLM2009 -00146 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/12/2009 Parcel: 2S101 DB00100 Jurisdiction: Tigard Site address: 7320 SW HUNZIKER RD 203 Subdivision: Lot: 0 Project: Supplemental Health Services Project Description: Adding (1) sink. Owner: FEES HILLTOP BUSINESS CENTER LLC & Quantity Description Date Amount HUNZIKER LLC, 9430 NW KAISER RD PORTLAND, OR 97231 1 ea Sink 06/12/2009 $16.60 PHONE: 1 12% State Surcharge - 06/12/2009 $8.70 Plumbing 56 ea Minimum Fee Adjustment - 06/12/2009 $55.90 Contractor: Plumbing WESTERN PLUMBING 9460 SW TIGARD, AVE STE 101 TIGARD, OR 97223 PHONE: 503 - 639 -5296 FAX: 503-6849015 Type of Use: COM 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 Notifica • nter. 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 UNC by calling 503.246.6699 or 1.800.332.2344. Issue By: / Permittee Signatu e: 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. 06/11/2009 14:49 5036849015 WESTERN PLUMBING INC PAGE 01/06 I_ 1 ECEIVED Plumbing Permit Application JUN 1 1 2009 • FO11; OFFICE USE ONI,Y , $ / Tigard Received Date U g�x�/y� • City of � II 13125 SW Hall Blvd., Tigard, OR 972 ,'3' O TIG A RD p ; fi p t o , 1 .• Phone: 503.639.4171 Fax: 503.5981196 IMO Permit No ut . tt� � I N G DI IS IdN! Date/py: two ' gA Inspection TIGARf) Line: 503.639.4175 Date Ready/By; iurei: id See Page 2 for W r uet: www.tigard -or.gov Nntified/i�tethp .,:_' ., : . ......._ �,,.. ,,. . .., Information . ... ,_.........,,, r „,.... t. .t,:::a..... , � ,...,.., . , . ....: :.. .. �.... ,., � ...:...:.. ...,.:� ..... �^e•. ea a;- r�1.......... rc..,.^ �w.. �. e�::., :,, � ~ ".... 4 ,, ..� - .,- s.:::- . :.�. r: _y�::^: C w. 1re , ..r:: r ,,, ;'. n:.:.• ,,,v...,..•.. .. ) T . a. .,, pv, :. <: �.:: ea ..,,. , ..,.,,. M � C` tr ..; � r .�u� �, a��ak... 1 , . r . � , v.� .mK� � - n � ^ �. ,F n,^., f S; "T D �;_ r;r!«.v + ; : .r{. "L{ i\ v, -. �.,.t] - R Ki ^d 1 •rMn...... ,.{ ,,, C_� 1 auH'"...,.)t, r ,' �r r .; "� . ... _ {1 1, w4.a. ,., :.,...,z;° g'.i a:g4:1, °.: it t :., : Ittr .9.T :hi %'1.e.,. tin.,. t }SU r -a. W i:r f r. ` s,ft: f '�� l.a,f 1 nn .,, r ,, , _ F : ,.,:1 � 5 C "` i ,, _..:r.....�:.'a,�o%�aµa. � � } , ....n au,. iaa., r .:.G�,,.xwJziwS'J.,:::2 . ;�o�!�� > •nwwl d'4' El New construction 0 Demolition For special infOrnation use checklist. 11167 Addition/alteration/ -- .... Description _ Qty, Ea. I -- -lotai © other: ft. ) ,w.v,:� New 1- 2- family dwellings (includes 100 .. ix:�i':'' .. '. .. � . .......,.,. A^ r . �. �, �, �.. xa , :a ..._:::.::,::,�s >.;,: :: r.,r „r w . - ::- ..,...,, _,_. - .::.::..::::...,,.. ,N h >•_..z _pmt; k: ^ !h " ".t, 3fis, s FOTi..:-z........A ....1.....,_..... 1 4::...._,...,_,•..e ^,. } , . "�:M;:::::, ) , .._,: .,,.; _.... R ., v . ; . i .. ,...._. v�.... a 4,.. °i�.> ..i , S ,�'.: "",,;. �iXro ._.. for each utility connection ..,fr : 1-: ; ....t'_.... �! ✓^...,.�.....+,•,.� (:: � �'1 (� 1f� ^' 4 ti r.• k , h',':l: ? : : .'-i. r:M ; : ;..:. :.. . . :.: he.�•;n- :,'.S. i c,e ',, r.i ; a��» �, , : 4u `�a/ <� ',a. �' fi«1`� I �:�:., � y, � � y .� : w �'r s S�' <r;� ;.;�' SFR (I) bath 24920 ❑ 1- and 2 - family dwelling 1:1 Commercial/industrial SFR (2) bath 350.00 ❑ Accessory building SFR (3) bath 399.00 rY g ❑Multi- fattuly ❑ . -- . Each additional bath/kitchen 45.00 Li Master builder Other: - ,:.,:: c ,- .,, _,...., :_ gym,,- Fire sprinkler ( s . ft. }7 1.tv , t S^, uric l 4 +t w Sr L1 I -,r ll } „ i7 y 1 v"4r 1 .s5d n " ? w a , ,51s - p �l ) - Page 2 ti ..31':.1" `tW { .�u! S' i .:7: ",a ., r� ;.;.7 i4 ;i :x.� ; :.i∎.4ni4:1 : :�"`f' mM r , .rz h.:∎i _.._. Site utilities Job site address: _ _..,. '.. mt . fly , . _ ,, ; , . • ._. K! i3� Catch basin or area drain 1 6.60 City /State/ZIP: \ . • m e, ii, • Drywoll, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Project name: (` m y Footing drain (no. linear ft.: __) Page 2 41 ru F • � Manufactured home utilities 1 10,00 Cross street/directions to job sire: mm 4 , r . ` I Q C 1 Manholes 16.60 -_ Rain drain connector 1 6.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear fl.: ___,) Page 2 Subdivision: 1 Lot no.: Water service (no. linear ft ) - Page 2 Tax map/parcel no.: 1 v '� l ©l J 60 o 100 Fixture or item rg;.'.,= ru +'I'.Ay +xM.' p " ?*- ; -' :{y: r,.„ :y'. v w ... r :, r «,,, ........ Absorption 16.60 i?kk yt. a( ,..a s'^jr:^P: 'fie � �<�m2.c S�ar �� \ �� ^, ( � a'�w /tc uY �.. l' IOn V VG i,..�t}(( ,ti" !.r. 1! f S.ii. N: :,`.s,,C ti " i 2 lw �Backflowpreventer Page • S��arvh.'.. Yl.. � v,jx Arvv. �.G �� 4Y4,;..a fiat. 'C ....:... i�. "S "'C 4 { S G � G. - Backwater valve 16.60 • . VI tr . AiiAi i.11 Clothes washer 16.60 wµ I ,x::.:. = r - , m l� a' :.:r,.'`q p( v ;!.ti !",.^: Y ...::""::2^;"'"Y"". - . er , .r' . w . w ,..,,., . ; w Dishwasher a 16.60 p j iS y t °� M1 P3 S �F9rf J 1 ( it { l� l a b hp r: tf s� p t` el Drin fountain 16.60 I ;. ,) 43 i:;l. T, .. i . ,,, I;, .d1 ., 21. i∎ : : . l ] _:.1t., °a } ,.} 4 1..r; a�+P; r 1' .5 „ ( , 2,': E; i ectors ^ _ Ej/sump 16.60 Expansion tank I6.60 Address: Fixture /sewer cap 16.60 City /Slate /ZIP: Floor drain/floor sink/hub 16.60 Phone: ( ) P ( ) Garbage disposal 16.60 }gfitii �i �:T 7 .., _ '. y i ; r i3't r x r {, ; :.:« w . . mt . ar v Hose bib 16.60 x ca ,..a,.,x,✓,w ._.... ,.zr;'�",.r, , r 'tSd,,_, _1.�.,hs,: /, ice maker 16.60 Business name: .. - Interceptor /grease trap 16.60 Contact name: Medical gas (value. S ) -- Page 2 Address: Primer _ 16.60 City /State/ZIP: Roof drain (commercial) 16.60 Phone: ( ) P an:: ( ) Sink/basin/lavatory i 16.60 /(p p( --• Tub /shower /shower pan 16.60 E-mail: 16.60 ..}. .n It -:. .... t _r..c`,:a_ ..�2 "" .""r T .::..; .- a- ::S.;,...}.. 1t 441.8 1iWilta { 1 1 1 - • -al' i ` w . a� + " ' *Is �,j ;;. w ; f 2 � ' : :II :: 1� 4' Water closet 16,60 :;,;- :ylr:., ,, )t _ ,r. ,t^.,.Zr,\t,;ar.' ,.,'1 c�! 'T4c, , "`,,;n;'...w.S,Jc^.r'• .....,�., . .._i.., , Business name: Western Plumbing, Inc. Water heate . 16.60 Address: 9460 SW Tigard Avenue, Suite 101 Other: City /State /ZIP: Tigard, Oregon 97223 Subtotal Minimum permit fee: $72.50 Phone: (503) 639 -5296 Fax: (503) 684 -9015 Residential backfiow minimum permit fee: $36.25 ( CCB Lie.: 2439 Plumbing Lic. no.: 3429F11 Plan review (25a/ of permit fee) Authorized signature / 1) _ State surcharge (12% of permit fee) i • !�/ .4 . _ . Li . i �� .� TOTAL PERMIT FEE Print name: Dana Jensen 'r r: This ! MI!` his permit application expires if a permit is not obtained zithin c,,, • 180 days after it has been accepted as complete. - 6.2o ' ` "Fce methodology set by Tri- County Building Industry Service Board. J 1: 1Huildinp ipmmi,.\triM- wrmitApp,4. 04..oa 4 W ,4dl ar(1 otgweosvwth ) ca-( E by r. 06/11/2009 14:49 5036849015 WESTERN PLUMBING INC PAGE 02/06 i �' lunibin Perm t A.p lip cation - City of Tigard Page 2 - Supplemental Information Fee Schedule: ' r -::, r.,,...... ,,,,::::r<,:.: ... „.. ..... ::::.:.... ..= ; f , 74 rte:.,.. -- Fire .,. � ,.:,. ,- .,.;:.�_ r Su � r S stems: -,: -,_ , . ,,..... ..,.� ...... ......................a...�,. v,....:.:�1 •.,., "T..! . ... ,:,....u�:a , , ..c! Residential s�^^ .. ..,a�:..- -.^�:. c. : r.�._aw'a\u• ^:.asw�::r..r.:.,. e ression 4. r . ,, ^ ...., ,p.., r., t , C. c ....., ter.... rnw s w^ z�r.. �. � .r.r�.....F .. . a . .............- .w�,....5.,.. ......'B,. ... .,.. {... . 5 , , ,_.,.....;.�', �,»1 mrr `-, .r:�.. ,.v...,.t """'""�F n.2 ?, f .:.1. l � ._,,._..,. r..,;. : i&'. i . ,,...., .. . . t,� „n..r ; .. .., ,.., C a ?n v., „ - . ,,........, :_1t :R. P ,•; .; !Y .. . `.: ''..2r,, K.._....,,.......,...Ma -, .� ,���'1.. .... ,.. � � _i_..._....,.. �_ : ".,...- .......... ...........y: �, ?a 1'f . 1 a ..,r.. �adl „� , . ''�: h i ; a: - z �..,..,.. �1.,..,.S..n.,�, .w. w �hu....._....`_.._,.. r ............:.:. � i.. .,.......;5r_.. .......,..:..,,.,... : - I ,.I. ....f�:,�tk -c ....a ..... .,. ..,. ,.�: �N1 it�r4 .:Il. .. .�t.,- .i..�....w,a>,, Pt7te.,� e�,. ii��4., �.. s�• ................_,, rk�:: r:: s=: s, � isa,,!,. t.,.. �• M;.. ..,. �.,, x„__: ��' �:; �;. �r ,.,,ecY6 Footing drain - P' 100' 55.00 0 to 2,000 _$115.00 Footing drain - each additional 100' 46.40 111111.111 2,001 to 3,600 $160.00 � Sewer - 1st 100' Mill 55,00 3 601 to 7 200 $220,00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 ” """ ” Water Service - 1st 100' 55.00 Medical Gas S - stews. Water Service - each additional 100' 46.40 � `c`'h�;� ��yCy' FlinuS z Storm & Rain Drain -1st 100' 55.00 $1,00 to $5 000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' MN 46,40 '�' —., ......_.......,...,, -, 01,00 to $1 0.00 1 u, .,,« <s, y , q a.,,.. ,..>_:.:�:::_•.�.:::..� dal , n . ;;,�`: """""`t?.irc:,�i"„�:`:^ additional $104irst $5 o0D D � $5,000.00 and $1.52 for each 0 .... , ,P.;M:., s i::r!� i !.i, .., t :M , h� ^.. a0i „ 40 or fraction thereof re and r. r , x,.,., u.:. a� ,�'.��f'wa,::::. <t�,:::.:_:::.. �YWf r.M.v.: a:::::..`..::_,. -: °, �.f �p •j ;'� r, �.. . a .. _ s!t::,~.:�ir',�;�t. ;r�;,�r:. 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 13ackflow Prevention Device =- each additional $100.00 or fraction thereof, to minimum . crmit fee $36.25 _ and including $25,000.00. Rain Draw, single family dwelling _ 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for Inspection of existing plumbing or each additional 5100.00 or fraction thereof, to s . eciall r re. uested ins, actions - • en hour 72 50 11111 and including $50,000.00. Subtotal: _ $50,001.00 and up $742,00 for the first and 51.20 for each additional $100.00 .00 or or fraction thereof • G cn , s .. r .....^ .. x � mti cr..,;:::: °ri: ?'acS w r:r: ..g, s:”, ... n Fixture Work: M ei ` q, y tz;�xh° �.._�.. � ^�� t�tai ;� ,r 4 "Wtl ti, � t!d P�"�"n u3r�„�ru "� �.li.�i%^�r /J P�P: L�: �? �rsYa +�r�taw,as ,r,Y�,os 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 re ort Fixtures could result in increased sewer fees CO Y new commercial building with water service 2" and ;!:;.,fk:fivi ;;: -r~:::. ;,:4:• st:• . , i ' {s,.r,..:>:a�: ill eater, ace i ae °h , as - i2 , av Y ' rte it i s 1si,I .l. r� +s 2 P>' except systems designed and stamped by licensed t,,i, w {i `\99Y`rilt y + C 1 a' \ . t,, �z,r 5 5 , � P v F ° r . ili!a, CnglnCer. 14 ,•�•r: x r .�.... ` r�,d,.:c.,„' Y i 't a'" i� u. e r2.al ,rsgii' raxr,�!- ' l t . i ) rwkui'dsihJlr� ....._��11.�i ' fir.. ,. -L ,�., �:6A�,�'.r.. aC:�d'�'��v�,, t^?�c;r .,- .�1..�Yr.�.....1.Y,.a „rJ„ Any new exteri or plumbing site utilities. B> kistr /Font = =— Medical gas and vacuum systems for health care facilities. Bath -Tub/Shower • 0 Any multipurpose fire sprinkler system. uz - Jaczi /Wbirl,00l - - Any cot lox structure as defined in OAR918- 780 - 0040. Car Wash -Each Stall - -� y F - Drive Thru MEM Cus,idorfWater .._NEM Submit 2 sets of plans with any of the above. Dishwasher - Commercial IMMIE— :,- . ,yy � sz . . ...... i .. y ... ... .,, ,,:,.. , { -Domestic �� -- i;, :4- ^, ;,i ( ! �'" ,{ Nfi ,y M ll .x tn" \S ijr3ht �i . r � !k"` M ,: c n mm Drinkln. Fountain -' '.... �.....tt.. . - [] Isom ettic or riser diagram is required for new buildings Floor Drain/sink - 2 "� �- that meet floe • ualifications above. • - , MINE111 - MIMI Comments regarding fixture work: Car Wash Drain NM Garbage - Domestic . -- ... Disposal - Commercial , - Industrial - - -- Ice Mach./Refii•. Drains _- Oil Se.arator Gas Station MIME Rec. Vehicle Dun)) Station - - -- Shower -Gang - St l "Note: If the fixture work under this permit results in ass Sink - Bar /Lavatory increase of sewer EDUs, a sewer permit will be issued and - Bradley 11M111111111111111 fees assessed for the sewer- increase must be paid before the - Commercial - - MM11•11•11 plumbing permit can be issued. - Service - -� Swimmii • Pool Filter IIIIII. Washer - Clothes - - -- Water Extractor M Water Closet - Toilet - Urinal _ — • Other Fixtures:- - ∎;\ BVU6Nts , Pmmitn \PLMd'wmitApp.doo 092: /oa