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Permit w m CITY OF TIGARD PLUMBING PERMIT 1 111 1 • _u ' g COMMUNITY DEVELOPMENT Permit #: PLM2012 -00108 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/08/2012 Parcel: 2S112DC00701 Jurisdiction: Tigard Site address: 15955 SW 72ND AVE Project: Guitarish Music/Advantage Point Subdivision: FANNO CREEK ACRE TRACTS Lot: 39 Project Description: Remove (1) breakroom sink, add (1) toilet, (1) lay, (1)mop sink & (1) drinking fountain. 2/13/12, reprinted to correct address and project name. Contractor: PLUMBING CONCEPTS INC Owner: PACIFIC REALTY ASSOCIATES PO BOX 1068 ATTN: N PIVEN CLACKAMAS, OR 97015 15350 SE SEQUOIA PKWY #300 PORTLAND, OR 97224 PHONE: 503 - 658 -5232 PHONE: 503 624 -6300 FAX: 503 - 658 -5232 ' FEES Quantity Description Date Amount 1 ea Drinking Fountain 05/08/2012 $25.02 r. Specifics: 2 ea Sink 05/08/2012 $50.04 1 ea Lavatories 05/08/2012 $25.02 Type of Use: COM 1 ea Water Closet 05/08/2012 $25.02 • Class of Work: ALT 1 12% State Surcharge - 05/08/2012 $15.01 Type of Const: Plumbing Occupancy Grp: Stories: • Total $140.11 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. N Issued By: C) - =ee9=: gj_____ Permittee Signature: / 7 / 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. CITY OF TIGARD PLUMBING PERMIT • COMMUNITY DEVELOPMENT Permit #: PLM2012 -00108 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/08/2012 Parcel: 2S112DC00701 Jurisdiction: Tigard Site address: 15957 SW 72ND AVE Project: Advantage Point Subdivision: FANNO CREEK ACRE TRACTS Lot: 39 Project Description: Remove (1) breakroom sink, add (1) toilet, (1) lay, (1)mop sink & (1) drinking fountain. Contractor: PLUMBING CONCEPTS INC Owner: PACIFIC REALTY ASSOCIATES PO BOX 1068 ATTN: N PIVEN CLACKAMAS, OR 97015 15350 SE SEQUOIA PKWY #300 PORTLAND, OR 97224 PHONE: 503 - 624 -6300 HONE: 503 - 658 -5232 FAX: 503 - 658 -5232 FEES Quantity Description Date Amount 1 ea Drinking Fountain 05/08/2012 $25.02 Specifics: 2 ea Sink 05/08/2012 $50.04 1 ea Lavatories 05/08/2012 $25.02 Type of Use: COM 1 ea Water Closet 05/08/2012 $25.02 Class of Work: ALT 1 12% State Surcharge - 05/08/2012 $15.01 Type of Const: Plumbing • Occupancy Grp: Stories: Total $140.11 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 Notificatlo&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 q stions to NC by calling 503.232.1987 or 1.800.332.2344. Issued B , l ,� [I n Permittee Signature: , @PN(S\-V 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. May 07 2012 10: 15AM PLUMBING CONCEPTS INC 5036585232 p.1 Plambine Permit Application 6 P,,g°" .2 -oo'q/ Site Utilities 1 ..) t: (i 1 11(-1 t I l i. „ City of Tigard Date v 6 -1/B �� permit No.: a 6/0/2-ee /OS 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Other Permit No 41 1 8i Phone: 503.7182439 Fax: 503.598.1960 Date/By: Inspection Litre 503.639.4175 Date peady/By: hoar B See Page 2 for ` �: 1 internee www.tigard- or.gov Notified/Method: . elemental Information t 2 w R .".,+ 77.-i `.)., .. 4 `.: _ ..� _ . E "'=• ►f it ., µr.li.t /. erll ! L`' 13 N ew construction ❑ Demolition For spedat k famtation use checklist Description i OW. 1 Total ® Addition /alteration/replacement ❑ Other: New 1- 2 -famil dwellings includes 100 ft. for each utif connection) -M O 312.70 s � 1 ry >` -, :a .`n : `! ? SFR 1 bath SFR (2) bah :1 . 1 .� Commercial/industrial SFR (3) bath 500.32 Accessory 1 I 1 1_ Each additional batMdtchen 25.02 0 Master builder ■ O' Fire sprinkler (__ sq. ft.) Page 2 1 �Z( u rg. .;i Q£ r j LIVI : :v. ;,1 ale E\r`Q ? r ; .' "r', 1 , Site gallica: iY-4 2r� I'" iC��.'r`F - .5 1is, - Jx J :: �'• `.""� J iS -•�"''` Catch basin or area drain 18.76 Job site address: 15957 S.W. 7Y° Ave. Drywall, teach line, or trench drain 18.76 City/State/ZIP: Portland, Or. 97224 Footing drain (no. linear ft.: _J Page 2 Suite/bldg./apt. no,: A I Project name: Advantage Point inc. Manufactured home utilities 50.03 Cross street/directions to job site Manholes 18.76 Rain drain connector 18.76 Sanitary sewer (no. linear ft: _J Page 2 Storm sewer (no. linear ft.: Page 2 Water service (no. linear it.: Page 2 Subdivision: 1 Lot no.: Fixture or item: 7-7 Backflow preventer 31.27 Tax map/parcel no.: r� �• l� :r:: ! -;..,x��� ".'S� y`< ;y ' Fo� Q4.' M... Bact►YBter valve ►1 Remove breakroom sink, rough in new toilet, lay, mop sink and drinking fountain. l _ 25.02 Drinking fountain 1 25.02 25.0 Ejectors/sump ► , - ;0 ,,,, ..„ S-" y •T, - ` ..' : " 4-t.mt v,::.*.::::;:,:::::::,:.:: I :y 1 tank Fixture/sewer cap 25.02 Name: Pac Trust Property drairt/floor r Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone: ( ) Fax: ( y ) 1 25.02 name: Business name: Duras Construction, LLC. Medical gas (value: $ _ ) Page 2 Primer 12.51 Contact 11 Address: 15836 Upper :IIi t' Oswego, l 97035 Solar 1 •. (potable water) 62.54 Phone: (503) ( Tub/s1wwer/shower pan 12.51 Urinal 1 `t , . .. .'�.;• � „. 3 v,. ti .r . - :, Win-- .. ,.... 01. i .•. +,...'.', ; : ' -.4 Water heater lyl.- - Y�..pJ7ia�, rt� C' . .r Business name: Plumbing Concepts, Inc . Water piping8DWV Address: P.O. Box 1068 Other: 25.02 City /State/ZIP: Clackamas, Or. 97015 gubmtid / 6 O Minimum permit fee: $72.50 "---' Phone: (5013) 658-5232 Fax: (M3) 65$ -8553 Plan review (25% of permit fee) CCB Lie.: 97587 3 I I g mbingLie. no.: 3-293PB o State f _ ^ Authorized signatoreC —� --- FR r • 1/ kris permit application expire; if a permit is not obtained within 180 dal Print name: Jesse Zamudio Date: 5-7 -2012 after it ho teen accepted as complete "Fee methodology set by Tri- County Building Industry Service Board. Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee: Footing drain - 1 100' 50.03 0 to 2,000 $121.90 Footing drain - each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer - 1st 100' 62.54 7,201 and greater $327.54 Sewer - each additional 100' 37.52 Water Service - 1st 100' 62.54 Medical Gas Systems: Water Service - each additional 100' 37.52 Storm & Rain Drain - 1st 100' 62.54 Valuation: Permit Fee: $1.00 to $5,000.00 Minimum fee $72.50 Storm & 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 Q ty. Fee (ea) Total each additional $100.00 or fraction thereof, to Other Inspections or Fees and including $10,000.00. Inspection of existing plumbing or for $10,001.00 to $25,000.00 $148.50 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 hours) each additional $100.00 or fraction thereof, to Reinspection 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 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 * . Plan Review for Plumbing Installations Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replace/ Please check all that apply. Work Performed: Capped Added Relocate Baptistry/Font ❑ Any new commercial building with water service 2" and greater, except systems designed and stamped by licensed Bath: - Tub /Shower Jacuzzi/Whirlpool engineer. Car Wash: -Each Stall ❑ New exterior plumbing site utilities for any complex structure Drive Thru as defined in OAR918- 780 -0040. Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities. Dishwasher: - Commercial ❑ Any multipurpose fire sprinkler system. Domestic ❑ Any complex structure as defined in OAR918- 780 -0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: - 2" 3" Isometric or Riser Diagram 4 " ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain Garbage Domestic non -food that meet the qualifications above. Disposal: - Domestic food related - Commercial food related - Industrial food related Ice Mach./Refrig. Drains Comments regarding fixture work: Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower: -Gang -Stall Sink: -LavBar non -food related ( ( - Bradley - Com/Serv/Util food related - Service *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer EDUs, a sewer permit will be issued and Washer - Clothes fees assessed for the sewer increase must be paid before the Water Extractor WaterCloset - Toilet I plumbing permit can be issued. Urinal Other Fixtures: I:\Building\Permits\PLMF- PermitApp.doc 08/04/2011 2 Plumbing Permit Application Building Fixtures FOIL OIIlcI.: USE ONLY City of Tigard R eceived Permit No.: Date/By: co III 13125 SW Hall Blvd., Tigard,OR 97223 Plan Review 0 Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.: Inspection Line: 503.639.4175 Date Rea B Juris: 61 See Page 2 for f I G A Ii D Internet: www.tigard - or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑ New construction ❑ Demolition For special information use checklist Description f Qty. I Ea. I Total ❑ Addition/alteration /replacement ❑ Other: New I- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 312.70 ❑ 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 437.78 building SFR (3) bath 500.32 ❑ Accessory g ❑ Multi- family Each additional , .th/kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler sq. ft.) Page 2 JOB SITE INFORMA • N AND LOCATION Site utilities: Job site address: Catch basin .r area drain 18.76 City /State /ZIP: Drywell, I- ach line, or trench drain 18.76 Footin: , rain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: 1 Project name: Manu'• ctured home utilities 50.03 Cross street/directions to job site: M. ' oles 18.76 • in drain connector 18.76 . anitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Water service (no. linear ft.: ) Page 2 Subdivision: . 1 L. no.: Fixture or item: Tax map /parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors /sump 25.02 ❑ PROPERTY OWNER 1 ❑ TEN • •'T Expansion tank 12.51 Name: Fixture /sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: k • bage disposal 25.02 City /State /ZIP: Ho - bib 25.02 - Phone: ) - Fax:-( ) - - Ice•m er - I.2 -5l- - ❑ APPLICANT ❑ ' ONTACT PERSON Intercept grease trap 25.02 Business name: Medical gas value: $ ) Page 2 Primer 12.51 Contact name: Roof drain (comm cial) 12.51 Address: Sink/basin/lavatory 25.02 City /State /ZIP: Solar units (potable wa -r) 62.54 Phone: ( ) Fax: : ( ) Tub /shower /shower pan 12.51 E -mail: Urinal 25.02 Water closet 25.02 CO RACTOR Water heater Business name: Water piping/DWV Address: • Other: 25.02 City /State /ZIP: Subtotal Phone: ( ) Fax: ( ) Minimum permit fee: $72.50 CCB Lic.: Plumbing Lic. no.: Plan review (25% of permit fee) State surcharge (12% of permit fee) Authorized signature: TOTAL PERMIT FEE Print name: 1 Date: This permit application 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 \Permits\PLMU - PennitApp.doc 10/01/09 440- 4616T(10 /O2ICOM/WEB)