Permit CITY OF TIGARD PLUMBING PERMIT
III
COMMUNITY DEVELOPMENT Permit #: PLM2013 -00132
1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/25/2013
T I �; A R i7 9 Parcel: 1 S136CC00100
Jurisdiction: TIGARD
Site address: 8200 SW PFAFFLE ST
Project: Westside Christian High School Subdivision: 2006 -016 PARTITION PLAT Lot: 3
Project Description: Install approximately 200 feet of sanitary sewer line to connect temporary classroom to existing sewer for the
duration of construction. (Temp structure contains 4 water closets, 2 urinals & 4 lays)
Contractor: TAPANI PLUMBING Owner: WESTSIDE CHRISTIAN HIGH SCHOOL
PO BOX 2350 4565 CARMEN DRIVE
BATTLE GROUND, WA 98604 LAKE OSWEGO, OR 97035
P
PHONE: 503 - 697 -4711
PHONE: 360 - 687 -3983
FAX: 360 -687 -4494
FEES
Quantity Description Date Amount
200 If Sewer Service 04 /25/2013 $100 06
Specifics: 1 12% State Surcharge - 04/25/2013 $12 01
Plumbing
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $112.07
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 N. •. 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 dir= t questions to oUNC b calling 503.232.1987 or 1.800.332.2344.
Issu =d By: / A / / r Permittee Signatur : ' )
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.
PlumbinE Permit Application
Building Fixtures RECEIVED tnlc ( 11 1 1( 1 i ..1 t)ss 1 1
City of Tigard Received aBd Permi No.: 1)04 9-0 1 d d (j ON
Date/B : /
• 13125 SW Hall Blvd., Tigard, OR 972234 PR 2 5 2013 Plan Review _
• ' Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No (� Q '
T I G \ R l) Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: orris: gi see /age 2 for
; Internet: www.tigard or.gov Notified/Method: i i Supplemental Information
BUILDING DIVISION
TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist
Description I Qty. I Ea. I Total '6
p Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 312.70
La"
El mm
1- and 2- family dwelling gCoercial/industrial SFR (2) bath 437.78
SFR (3) bath 500.32
❑ Accessory building ❑ Multi - family
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 W
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: D S i� Catch basin or area drain 18.76
Drywell, leach line, or trench drain 18.76
City/State /ZIP: '\-- i p U (� I 0 es. Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: I Project name: Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear ft.: 2, ) Zc() Page 2 /X.60
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.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
OVA-- I 'V r'y ° rary ` GlG.SS rbOr \ �D CAS�15 Dishwasher 25.02
SZyJCr .•f'titie of Drinking fountain 25.02
COAStDU ? CY\ . AtPr , LF dF y. sew -f-- Ejectors /sump 25.02
❑ PROPERTY OWNER ❑ TENANT Expansion tank 12.51
Name: Fixture /sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City /State /ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
a APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02
Business name: - 1 - 6,,p0. Ai 19 I l J.A5 0 A3 , T -t �., Medical gas (value: $ ) Page 2
- 1 1S
r s A /� r
Primer 12.51
Contact name: ,
4C v \ Roof drain (commercial) 12.51
Address: - aka - aka s'L it a---- - - /kvc Sink/basin/lavatory 25.02
City/State /ZIP: g G- I V✓l't CIS CO Li Solar units (potable water) 62.54
Phone: (Tip ) 400 ,07... 3q g3 Fax: : ( ) Tub /shower /shower pan 12.51
C e l -L _ C E;) 601-- \ 2 9 Urinal 25
E -mail: -
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: - T' c Oai /11) 4 Water piping/DWV 56.29
t,
Address: Z 03 " S E !V' H-vt Other: 25.02
City/State /ZIP: &tf[, G''fO tle■ 1 IAA C+ g6 f _ Subtotal lob • de
Phone: ( ) t17 -- 3Rgy Fax: ( )
Minimum permit fee: $72.50
CCB Lic.: Q � CJ g Plumbing Lic. no.:37 q Pg Plan review (25% of permit fee)
State surcharge (12% of permit fee) (a. 7/
Authorized signature: �� TOTAL PERMIT FEE t ?, .c7
Print name: Lars /k ^d 6. CiZor\ Date: y / s/i 3 This permit application expires if a permit is not obtained within 1180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:\ Building \Permits\PLMU- PermitApp.doc 10/01/09 440- 4616T(10/02/COM/WEB)
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
Valuation: Permit Fee:
Storm & Rain Drain - 1st 100' 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 Inspections or Fees Ins Qty. Fee (ea ) Total each additional $100.00 or fraction thereof, to
P 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
❑ Any new commercial building with water service 2" and
Baptistry/Font greater, except systems designed and stamped by licensed
Bath: - Tub /Shower
engineer.
- Jacuzzi/Whirlpool
Car Wash: -Each Stall ❑ New exterior plumbing site utilities for any complex structure
as defined in OAR918- 780 -0040.
-Drive Thru
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
❑ 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: - Lav/Bar 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
Water Closet - Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF- PermitApp.doc 08/04/2011 2
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
8200 SW PFAFFLE ST, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
2013-12-24 00:00:00
PLM2013-00132
PASS - No C of O
Disconnection, at both ends and abandonment of sewer pipe was also inspected on
permit number PLM2013-00121 pass
Violation Summary:
Inspector Contractor