Permit •
111 CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2012 -00082
TIC AR D 13125 SW Hall'Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/12/2012
Parcel: 2S 101 DA00102
Jurisdiction:
Site address: 13221 SW 68th PKWY 450
Project: Spec Space Subdivision: VARNS ACRES Lot: 9
Project Description: TI - creating new spec space.
Contractor: TAPANI PLUMBING Owner: GK TRIANGLE CORPORATE PARK III
PO BOX 2350 P.O. BOX 130174
BATTLE GROUND, WA 98604 CARLSBAD, CA 92013
PHONE: 360 - 687 -3983 PHONE: 503-221-1900
FAX: 360 - 687 -4494
FEES
Quantity Description Date Amount
1 ea Dishwasher 04 /12/2012 $25.02
Specifics: 1 ea Floor Drain/Floor Sink/Hub 04 /12/2012 $25.02
1 ea Ice Maker 04/12/2012 $12.51
Type of Use: COM 1 ea Sink 04/12/2012 $25.02
Class of Work: ALT 1 ea Water Heater 04 /12/2012 $37.52
Type of Const: 1 12% State Surcharge - 04/12/2012 $15.01
Occupancy Grp: Plumbing
Stories:
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Total $140.10
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 . ification , .ter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a c..y of the rules
or . ect questions to OU b - g x3.232.1987 or 1.800.332.2344.
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Is ued By: , L ,/ 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.
4/11/2012 7:15 P11 (GMT) From: Tapani Plumbing E -Fax 360- 334 -95548 To: 15035981960 Page 1 of 2
Pltumbint? Permit Application . A , 0/.9 _e'ep3
Building Fixtures RECEIVED FOR OFFICE USE ONLY
City of SW Received LV y / P - PermitNo.: Z. / a/A -a Xi 1325 SW HaII Blvd., Tigard, OR 97223 APR 1 1 201
C Phone: 503.718.2439 Fax: 503.598 -19
Date/By: :
Other Permit No,: ,A0-40Q6c :.
T I G A R D Inspection Line: 503.639.4175 CTTY OF TIGARD Date Ready /By: Juris: HI See Page 2 for
Internet: www.tigard r.go
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❑ New construction ❑ Demolition For special information use checklist. •
Description I Qty. I Ea. I 'total
IN Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
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` F " f CATEGORY OP CONSTRUCTION - `' / SFR (1) bath 312.70 •
❑ I - and 2- family dwelling ® Commercial /industrial SFR (2) bath 437.78 •
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❑ Accessory building ❑ Multi- family SFR (3) bath 5()0.32
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
" :dOB SITE INFOR) ATJON'AND LOCATION �' , . , Site utilities:
Job site address: 13221 SW 68th Parkway Catch basin of area drain 18.76
City/State/ZIP: Tigard, Oregon 97223 Drywell, leach line, or trench drain 18.76
Footing drain (no. linear Ii ; _ ) Page 2
Suite/bldg. /apt, no.: 450 I Project name: Space Prep Suite 450 _ _ _ ��_ Manufactured home utilities 50.03
Cross street/directions to job site: SW 68 Parkway and SW 66 Ave 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 ft.: ) Page 2
Subdivision: I Lot no.: Fixture or Item:
Tax map /parcel no.: A `Q( 'off 6)0/69-, Backflow preventer 1 31.27 -
Backwater valve �.:�: ....:;,,,;;... ,_. 2.51
?DESCR ��ON ' =WORK_';` -
- IP,'I'I F.,
...:.. :.:: �;.- - . _,.: : - s:�a. �,:: >':= =' %'� '` "` _ ,
Clothes was her 25.02
Remodel of existing office space
Dishwasher 1 25.02 OZSC- ,
Drinking fountain 25.02
Ejectors/sump 25.02
14. PROPERTY OWNER � r . ® TENANT s si Expansion tank • 12.51 '
Name: GK Triangle Corporate Park III L Fixlure/sewer cap 25.02 , •
Address PO Box 130174 Floor drain/floor sink/hub I 25.02 L s. °?'
Garbage disposal 25.02
City/State/ZIP: Carlsbad, CA 92013 Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker I - 12.51 /2.5/
®- APPLICANT ®CONTdCTrPBRSOIrI , Interceptor /grease trap 25.02
Business name: Tapani Plumbing Inc Medical gas (value: $ _) Page 2
Primer 12.51
Contact name: Kurt Schmeusser ,
Roof drain (commercial) 12.51
Address: PO Box 2350 Sink/basin/lavatory I 25.02 A5-.e.
City/State/ZIP: Battle Ground Wa 98604 Solar units (potable water) ° 62.54
Phone: (360) 772 -2032 I Fax: : (360) 687 -8147 Tub /shower /shower pan 12.51
E -mail: kurts(j)tapaniplumbing.com Urinal 25.02
25.02
Weterhtater 1 37.52 37,57 -
Business name: Tapani Plumbing Inc.
Water piping/DWV 56.29
Address: PO Box 2350 Other, 25.02
City/State/ZIP: Battle Ground WA 98604 Subtotal 425 ,04
Phone: (360) 687 -3983 Fax: (360) 687 -8147 Minimum permit fee: S72.50
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CCB Lic.: 60958 Plumbing Lic. nu.: 8581JP Plan review (25% of permit fee)
State surcharge (12% of penu It fee) / �j , Ol
Authorized signature: TOTAL PERMIT FEE 1 L/0.IG n expires if a permit Is not obtained within 188 days
I ,,/)
Thi permit a pplicatio •
Print name: Kurt Schmeusser Date: 3 -12 -12 after It has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
I: Building Permits.PL11U•PemitApp.doc 1001 09 4401616T(1002 •
4/11/2012 7:15 PM (GMT) From: Tapani Plumbing E -Fax 360- 334 -9548 To: 15035981960 Page 2 of 2
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
..Sfte,.Utilfties ...:.... ._. _.:.....,... ( ,:
u
.. :..... _. .. .. , .....,.... �S are:Foota
Footing drain - I" 100' 50.03 0 to 2.000 $121.90
Footing drain - each additional 100' 37.52 2,001 to 3,600 S169.69
3,601 to 7,200 5233.20
Sewer - 1st 100' 62.54 7201 and greater $327.54
Scwcr - each additional 100' 37.52
Water Service -1st 100' 62.54 Medical Gas Systems:
Water Service - each additional 100' 37.52
'dal u d S
o
Storm & Rain Drain - 1st 100' 62.54
$1.00 to $5,000.00 Minimtun fee $72.50
Stonn & 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
s y f2tY_ Fee;(e� Total'.:: 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 $14S.50 for the first $10,000.00 and $1.54 for
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.
Inspections outside of normal 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 rotas) each additional $100.00 or fraction thereof, to
Reinspecuon 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 fnr
(minimum charge - 12 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 *.
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0.4= e;, e�;4:o10.uni Ufit sktiaiisNYS
eplacel., Plan review is required for any $ of t he following.
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Baptistry/Font 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 m ❑ New exterior plumbing site utilities for any complex structure
Cuspidor /Water Aspirator as defined in OAR918- 780 -0040.
Dishwasher - Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918 780 - 0040.
Eye Wash
Floor Drain/sink - 2" / Submit 2 sets of plans with any of the above.
-3"
C`
.....::....... .
sQmEal or
Car Wash Drain
Garbage - Domestic -non -food ❑ Isometric or riser diagram is required for new buildings
Disposal - Domestic -food related that meet the qualifications above.
- Commercial -food related
- industrial -food related
Ice MachfRefrig. Drains
Oil Separator (Gas Station) Comments regarding fixture work:
Rec. Vehicle Dump Station _
Shower -Gang
-Stall
Sink/L.av - Non -food related 1
- Bradley
- Commercial -food related
- Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Waster - Clothes P
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:
T: \Projects\Active Jobs \State Farm - Tigard\Project Managing \Permits\PLIvvF- PennitApp Suite 450.doc