Permit gi
IN r, , CITY OF TIGARD PLUMBING PERMIT
y
n' • COMMUNITY DEVELOPMENT Permit #: PLM2013 00073
T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/05/2013
Parcel: 2S 110DCO2200
Jurisdiction: Tigard
Site address: 15532 SW PACIFIC HWY C -2
Project: Supercuts 9471 Subdivision: 1997 -016 PARTITION PLAT Lot: 2
Project Description: Replace (2) hair wash sinks, add (1) new sink.
Contractor: EVOLUTION PLUMBING LLC Owner: TRC MM LLC
7715 NE 33RD DR SUITE D 5973 AVENIDA ENCINAS STE 300
PORTLAND, OR 97211 CARLSBAD, CA 92008
PHONE: 503 - 655 -3388 PHONE:
FAX: 503 - 305 -8373
FEES
Quantity Description Date Amount .
3 ea Sink 03/05/2013 $75.06
•
Specifics: 1 12 %,State Surcharge - 03/05/2013 $9.01
Plumbing
Type of Use: COM
Class of Work: ALT
Type of Const:
. Occupancy Grp:
Stories:
Total $84.07
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 ques • OUNC by calling 503.232.1987 or 1.800.332,2344.
Issued B : — (.. 6 r Permittee Signature ��T
C2�6CCT �c
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.
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Plumbing Permit Application
Building Fixtures CEIVED
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3 1 of Tigard , _/Z G f Id •�00
� � �.j+' Prnnil No
13125 SW Hall Blvd., Tigard, OR 97223 MAR 4 2013 Plan Rovrow
o Phone: 503.718.2439 Fax: 503.598.1960 Other Permit No.: 5-'44.5-OF
I , �, 1;17 Inspection Line: 503.639.4175 CITY OF TIGARD Dated Road /By: tun ® See Page z ror
Internet: www.li�dnrd- ar,gov Ri TI! rnNr. rn_y_rS Notified/Metltod: 1 ' Supplemental lntormatlon
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... _ , C, 1 : ' ; FEE_zSCREDi]LE ': .. .,
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❑ New construction ❑ Demolition FOP sped a! Infamathn use thecbJlsi. Q
Description 1 Qty, 1 Fu, ( Total •'•■
® Addition/alteration/replacement 0 Other; Ncw 1.2- family dwellings (includes 100 >ti for each utility connection) Q.N
'•' 5 y wCATEG01t .OFY .it �, _ ;.: ' x " SF 1 bath
:, `.: .. Xr. . CONS�tUC�'ION;, !`xr�T. �:� 312.70
❑ I- and 2- family dwelling ® Commcrciulindustrial SFR (2) bath 437.78 O
❑ Accessory building 0 Multi - family SFR (3) bath 50032 O
❑ Muster buildv Each additional bath/kitchen 25,02 f O
❑ Other: Fire sprinkler R. Page 7J
,�, p �s9• ) _ ag 2
• M,FORM TION 'CI rl, u
"rOB:5r1E. :'i►tYD�JfACA ON`• .s,•'': = -, R' , < ;,i Site utilities: Cn
Job site address: 15532 SW Pacific Flwy Catch basin or area drain 18.76
Drywall, leach line, or trench drain 18.76
City/State/ZIP: Tigard OR 97224 Footing drain (no. linear R,: ) Page 2
/ Suite/bldg./apt. n . I Project name: Supercuts Manufactured home utilities 50.03
iJ Cross strceUdircctions to job site: Manholes 18.76
Rain drain connector 18.76
-
Sanitary sewer (no. linear R.: _) Page 2
Storm sewer (no. linear ft.: _) Page 2
Water service (no. linear ft.: Page 2
Subdivision: 1 Lot no.: Fixture or Item:
Tax map /parcel no.; ey S / /0 a `d00 Backllow urevente' 1 J 31.27
; .. -i ,1• {. �, . 1 ° S� w� 1! ;W ^s i., : ls;s•:;4 , .•;•r r- Backwater valve 12,51
:,....1... .: ,., . ... ':..1. �ti.'.,5:� E `+.ua,��,��l�.y0 01�..• 'r�J ^r•�'
Replacing 2 hair wash sinks, rough in 1 new sink
a ": Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump I 25.02
0;:'?'''''' s ` PRO PE RTY OW,NER1 I ,❑:" trii,NT;?!`� :`rY1 ;;, Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Address;
Floor drain/floor sink/hub 25.02
Garbage disposal 25.02
City /Suite/ZIP: Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12,
'�1 - i�014 ANx "2 f ;, ma .:Yfls I nter tor/ ease trap 2
.. �® _�r_�rt' NCOIVTAC,_[; aP er P 502 �
Business name: Evolution Plumbiag LLC Medical gas (value: $ _ ) Page 2
Contact name; Rich Pine
Primer 12.51
Roof drain (commercial) 12.51
Address: 7715 NE. 33 Drive Suite D Sink/basin/lavatory 3 25.02 75.06
City /State/ZIP; Portland OR 9721 Solar units (potable water) 62.54
Phone: (503) 655 -3388 Fax:: (503) 305 -8373 Tub /shower /shower pan 12.51
E -mail: rlcb.pine voplumbing.nct Urinal 25.02
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'ya' 't , �I S: „aa•�:,�aaF .�: Water closet 25.02
i.- s 4: fw.1;? a 3 CO IV CRACTOR,�� i t a ; it, �.t 1:.: =n
Water heater 37.52
Business name: Evolution Plumbing LLC _ Water piping/DWV 56.29
Address: 7715 NE 33 Drive Suite D Other: I 25.02
City/State/ZIP; Portland OR 97211 Subtotal '7SA6
Phone: (503) 655.3388 Fax: (503- 305 -8373 Minimum permit fee: 572.50
CCB Lie,; 189876 AID in ic. no.: PB834 .('
Plan review (25% of permit fee)
State surcharge (12% of permit fee) 57.0/ -
Authoriic4 signature: /v" TOTAL. PERMIT FEE R y. o 7
Print name: Denise C. ice l Date: 3/4/13 This penult application expire. Irn permit 6 nut obtained within 1x11 days
after It has been atecnted u■ enmpletc,
*Foe methodology Oct by Tri.County Building Induatrry Salvia', Board,
1: WulldirrgtPermi uMLM11- PermhMp,doe toro1m9 / / 440.4oicrowovcommun) C 9 -L � /t✓i1 f ,- K//
u�-1 !o ' � (040' s40/2_. E7 2 ` Sul -u- �q,,�
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PLM $y
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Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: , Fire Suppression Systems:
"Site' 1•tilitie <'+ : ', �.:.:w 4 �� y..-,,.<, _
;�,. � ..; P - �. .� � { T?��,.,, ,• -� - »Sgliarc:Foota�e:ti�,��;r{�
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
3401 to 7.200 $233.20
Sewer - 1st 100' 62.54 7,201 an�rcater $327.54
Sewer - each additional 100' 37,52
Water Service -1st 100' 62.54 Medical Gas steins:
-
Water Service - each additional 100' 37.52
Storm & Rain Drain - add
Ion' Valuation:'. rf`lro 47 erimlit'Y+ ee : ? ', ` )';':'.. • :.0 lst
62.54 $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
Other Iiispectiomis or "ees lr-' Q�'���''`F )' ' ; .',; • _ _ � _ each additional $100.00 or fraction thereof, to
c
- ciii �.:.Total�:. and including $10.000.00.
Inspection of existing plumbing or for 510.001,00 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
mnmum charge- 1/2 hour
L ii h 1/ � _ and including $25.000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to 550,000.00 $379.50 for the first $25,000.00 and 51,45 for
hours (minimum charge - 2 hours) each additional $100.00 or fraction thereof, to
Reinspcction 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 51.20 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 scwcr fees * .
Quantity by Fixture c' "' 't 1
' : ; , ,.VIai�Reviea�foi l iiiibiiii stallati ..
Fixtu Type for Resew OnS
Work Performed: " :, •C*ppcd added Relocate.
Plan review is required for any ol'the following.
Please check all that apply,
Baptistry/Font
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 Thru ❑ New exterior plumbing site utilities for any complex structure
Cuspidor /Water Aspirator us 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.
Eyc Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
-3"
1
Car Wash Drain : Isoriiitt leika scr a'giaID'' , . ..• ...:'•::'.
Garbage - Domcstio-non -food - ❑ Isometric or riser diagram is required for new buildings
Disposal - Domestio-l'ood related that meet the qualifications above, _
- Commercial -food related
- Industrial -food related
Ice Mach./Rcf, Drains
Oil Separator (Gus Station) Comments regarding fixture work:
Rec. Vehicle Dump Station
r
Rough in one dispensary sink and replac
Shower -Gang 2 shampoo sinks
stall
Sink/L.av -Non-food related I 2
- Bradley
- Commercial-food related
-Service
Swimming Filter *Note: If the fixture work under this permit results in an
Washer - Clothes uner IPe
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: -
http;/ /www.tigard- or,gov /city hallJdeparbments /cd/docs/PLMF•PermitApedoc
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plumbing, IIc
OR CCB # 189879 " WA Ltc# EVOLUPL908DK
T FAX COVERSHEET
Date: March 4, 2013
To: City of Tigard
Attn: Community Development Dept.
From: Denise C. Pine
Fax: 503- 598 -1960
Subject: Plumbing Permit Application
And Credit Card Authorization Form
* * * * * are * ***** * * ** * ** * *, tai************** ********** ***** ** *** ***rra,t**** * * **
The following is our Plumbing Permit Application and Credit Card Authorization Form.
Please contact me with the total EDU fees before processing payment.
Thank you,
4110
Denise C. Pine
Total # of pages (including coversheet) 4
Office 503. 655.3388 " Fax 503 - 305. 8373 NE 33ro Drive Suite D , Portland, OR 97211