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Permit 40 ____4______At (..A.-. . 0-k., -- -- .eits- .,, A CITY TIGAR PLU BING PERMIT � P ERMIT #: PLM2005 -00696 �� D EVELOPMENT SERVICES DATE ISSUED: 12/29/2005 1 13125 SW Hall Blvd., Tigar OR 97223 503 - 639 -4171 PARCEL: 1S134AA -01900 SITE ADDRESS: 10115 SW NIMBUS AVE 150 ZONING: C -G SUBDIVISION: 1 KOLL BUSINESS CENTER TIGARD LOT: 001 JURISDICTION: TIG Project Description:. T.I. Replacement of fixtures. CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 3 URINALS: GREASE TRAPS: 1 LAVATORIES: OTHER FIXTURES: 0 TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES ROBINSON, WILLIAM R /CONSTANCE A Description Date Amount ROBINSON, LYNN + BELL, KAY ET BY ELLIOTT ASSOC [PLUMB] Permit Fee 12/29/200E $72.50 PORTLAND, OR 97204 [TAX] 8% State Surcharl 12/29/200: $5.80 Phone : Total $78.30 • Contractor: AMERICAN PLUMBING SERVICES INC 5905 N INTERSTATE AVE REQUIRED ITEMS AND REPORTS PORTLAND, OR 97217 Contact # : PRI 503- 289 -6498 Reg #: LIC 151062 PLM 26 -567PB This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 1 -0011 - ou • • • ,t- - 952 -0001 -0100. You may obtain copies of these ryJes or direct questions to OUNC by call g 503 - 246 -669 • 332 -2344. G • 1 Iss C By: 41_, �� __ P ermittee � .g.1-4:LLS Sign re 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. /0 l / S S"c- - N', ► •...b, & d, tOuilding Fixtures Plumbing Permit A i LC E'v' I olt OFFICE I ■SE ONLY v City of Tigard / permit o.: !/�/ 13125 SW Hall Blvd., Tigard, OR 97223 �Y l/✓ �� dd� i� / F1 6 Phone: 503.639.4171 Fax: 503.598.1960��,, 2005 o H., r. :,,,,.111‘ Plan Review Date/By. Permit No.: 24- Hour Inspection Line: 5 03.639.4175 ,uri,: Internet: www.ci.tigard.or.us CITY �'OOFF TIGA' = - No V, ) i �i S SI pp�lemental Information TY k 'ORK IVISIQN FEE* SCHEDULE ❑ New construction ❑ Demolition For special information use checklist. Description I Qty. I Ea. I Total g Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (I) bath 249.20 ❑ I- and 2- family dwelling (g] Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi - family SFR (3) bath 399.00 ❑ Master builder Each additional bath/kitchen 45.00 ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: k01 \5 5 GU (\I ( t Ciil Catch basin or area drain 16.60 City / State/ZIP: - CA...kRl, 0 k ".73V.A.--S Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Project name: CA e6 ,t,k 1--A, Footing drain (no. linear ft.: ) ' Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: IC u 0 I ., - Vt PN Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no.: Absorption valve 16.60 DESCRIPTION OF WORK Back flow preventer Page 2 I kufv) % 4 C Backwater valve 16.60 ll�i� Clothes washer 16.60 Dishwasher 16.60 ❑ PROPERTY OWNER I fil TENANT Drinking fountain 16.60 Ejectors/sump 16.60 Name: 1 <o n A co e 6 1 Q& Expansion tank 16.60 Address: g 4cys .S, c.„ i 2,04(1G t &4 Fixture/sewer cap 16.60 City /State/ZIP: ��.4 i l • 0 K 'el )-"kr r, Floor drain/floor sink/hub 16.60 Phone: (54 ) 's 1 1043C____1_.....- � o Fax: ( Garbage disposal 16.60 ❑ APPLICANT igi CONTACT PERSON Hose bib 16.60 , i$) A Ice maker 16.60 Business name: 41 "l Interceptor/ ease trap- i 16.60 Contact name: knCI Rp v S I!, Medical gas vie: ) Page 2 Address: 7 F� 1 \ Primer 16.60 City /State/ZIP: Roof drain (commercial) 16.60 Phone: ( ) I Fax: : ( ) Sink/basin/lavatory 3 16.60 Tub /shower/shower pan 16.60 E-mail: Urinal 16.60 ONTRACTOR Water closet 16.60 Business name: IN SL` , lin1111..v_. , Water heater 16.60 Address: ..[ i ' , '� /r S Other: - I \ w C ti V Subtotal City / State/ZIP: - 77 C r•+ p, •4,. )' � �' Minimum permit fee: $72.50 Phone: (g o3) h' 9 S 2 Q t . : ( ) ` Residential backflow minimum permit fee: $36.25 CCB Lic.: A 201 Plum.' g Lic. no. :,31.4. A - , Plan review (25 %ofpermit fee) State surcharge (8% of permit fee) Authorized signature: _ i a TOTAL PERMIT FEE Print name: �� te. i A - ATS g'. This permit appiicadon expires if a permit Is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. i:\ Building \Permita\PLINF- PennitApp.doe 06105 440.46161(10/02/COM/WEB) ■ Plumbing Permit Application - City of Tigard t om' Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee: Footing drain - 1 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $ 160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' • 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas Systems: Water Service - each additional 100' 46.40 Valuation: Permit Fee: Storm & Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 . Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each Fixture or Item Qty. Fee (ea) Total additional $100.00 or fraction thereof to and Commercial Back Flow Prevention Device 46.40 including for the first $10,000.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device each additional $100.00 or &action thereof to (minimum permit fee $36.25) 27.55 - and including $25,000.00. Rain Drain, 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 $100.00 or fraction thereof to specially requested inspections - per hour 72.50 and including $50,000.00. Subtotal: $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for each additional $ 100.00 or fraction thereof • Fixture Work: Plan Review for Complex Structures • Are you capping, adding or replacing fixtures? If "yes", A "complex structure" is defined as an installation of a plumbing please indicate work performed by fixture. Failure to system that meets any of the.following criteria accurately report fixtures could result in increased sewer fees *. Please check all that apply. Quantity by (Fixture) Work Performed CI Any new commercial building. Fixture Type: Replace ❑ Any new exterior plumbing site uiilities. Previous Capped Added Existing ❑ A commercial building with installation, alteration or addition Baptistry/Font of nine (9) or more new or relocated plumbing fixtures. Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities - lacuzzi/Whirlpool providing services to human beings. Car Wash - Each Stall Plumbing installations; alterations or additions,to food service - Drive Thnt facilities where new plumbing fixtures, including interceptors, Cuspidor/Water Aspirator are being installed for the food service area. Dishwasher - Commercial ❑ ' Any new residential building containing three (3) or more - Domestic dwelling units. Drinking Fountain ❑ Any NFPA 13 - D multipurpose fire sprinkler system. Eye Wash Floor Drain sink - 2" Submit 2 sets of plans with any of the above. -3" -4" Car Wash Drain Isometric or Riser Diagram Garbage - Domestic ❑ Isometric or riser diagram is required for new buildings Disposal -Commercial three (3) or more stories in height. - Industrial Ice Mach./Refiig. Drains Oil Separator (Gas Station) Comments regarding fixture work: Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar/Lavatory / - Bradley -Commercial / - Service Swimming Pool Filter - Washer - Clothes *Note: If the fixture w under this permit results in an Water Extractor p Water Closet - Toilet increase of sewer EDUs, a sewer permit will be issued and Urinal - fees assessed for the sewer increase must be paid before the Other Fixtures: plumbing permit can be issued. is\ Building \Pennits\PLM- PvmitApp.doc 07/06/05 CITY OF TIGARD BUILDING DIVISION - , PERMIT #: PI M2005- 08696 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/29/2005 Phone: (503) 639 -4171 �9 4u �,� l�l Inspection Requests (24 Hrs.): (503) 639 -4175 W INSPECTION WORKSHEET FOR DATE: 2116/2006 TIME: 7:04AM PAGE: 13 SITE ADDRESS: 1011±1 SW NIMBUS AVE 160 CLASS OF WORK: . SUBDIVISION: 1 KOLL BUSINESS CENTER TIGARD LOT #: OQ1 TYPE OF USE: PROJECT NAME: CAFE PERSIA DESCRIPTION: T I Replacement of fixtures. OWNER: ROBINSON, WILLIAM R /CONSfANCE A, PHONE #: CONTRACTOR: AMERICAN PLUMBING SERVICES INC PHONE #: 503_289_6 Inspection Request Scheduled For: Date: 2/15.2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 02692 &01 503- 515 -7000 Y Corrections /Comments/ Instructions: ., / / SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Si. Date: " I / Phone #: (503) 718- �/ 11,