Permit •
I • q CITY OF TIGARD PLUMBING PERMIT
li a •• COMMUNITY DEVELOPMENT Permit #: PLM2013 -00149
T f G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/15/2013
Parcel: 1 S 134AA01800
Jurisdiction: Tigard
Site address: 10260 SW NIMBUS AVE M8
Project: ESC Subdivision: IKOLL BUSINESS CENTER, TIGARD Lot: 2
Project Description: (1) water piping /DWV Replacing water line and drain line to existing sink and ice maker
Contractor: LOVETT EXCAVATING INC. Owner: HANSON, RONALD D
PO BOX 86280 ROBINSON, CONSTANCE A
PORTLAND, OR 97286 ROBINSON, CHESTER TRUST ET AL
203604 EAST FINLEY RD
KENNEWICK, WA 99331
PHONE: 503 - 504 -2847 PHONE:
FAX: 503 - 288 -1630
FEES
Quantity Description Date Amount
1 ea Water Piping /DWV 05/15/2013 $56.29
Specifics: 1 12% State Surcharge - 05/15/2013 $8.70
•
Plumbing
Type of Use: COM 16 ea Minimum Fee Adjustment - 05/15/2013 $16.21
Plumbing
• Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
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.
Issued By: Permittee Signature: ,k
Dk( /470/06/611-776(..1
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. 14. 2013 2:10PM Lovett Excavating No. 7380 P. 1
Plumbing Permit Application D ECE . i
Building Fixtures ���L ��tt FOR OFFICE tltit•: ONLY
M AY 1 J nate/By: b/ S / 3 3 /
City of Tigard 2 0 eceited u ' p ermit No -: P LJU ,:70 t [ �
v 13125 SW Hall Blvd., Tigard, OR 97223
IN IORev1ely Other Penult No.:
Phone: 503.718.2439 Fax: 503.598.1960 C11'y OFTIG , e aln�y:
T I G A It D Inspection Line; 503.639 BUILDING DIMS Am Aeady/ily: 1°j See Page 2 for
Internet: www.tigard- or.gov t lied/Method: hi l, Su Information
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❑ New construction ❑ Demolition For special infornmilon use checklist.
Description 1 Qty. 1 Pa. 1 'total
10 Addition /alteration/replacement [1 Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
<'; CATEGORI' :'OF; COr S -.--• 1 Y k' ;ry : r1 Fi'..'. �•'tTii i.0 $ FR ( I ) b 312.70 utility.
connection)
and 2- family dwelling ® Commercial/ industrial
SFR (2) bath 437.78
El Accessory building ❑ Multi - family SFR (3) bath 500.32
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other; Fire sprinkler sq• ft.) Page 2
' °., y' : -`'t t � ,4 4 ^'OD: at TB'`N' ORMA'�TQN `X LQ'CAT10N { ' . ' ' ` ..'• Si to utilities: •
Job site address: 10260 SW Nimbus Ave Catch basin or area drain 18.76
Dowell, leach line, or french drain 18.76
City /State /ZIP: Tigard/ OR/ 97223
Fooling drain (no, linear P.; Page 2
Suite/bldg. /apt. no.: M CK I Project name: IE.S Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sower (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.: 1 5 4 1 N4 Q , go) Backflow preventer 31.27
.: ; ;, c" , Backwater valve 12.51
:
�'. DCRIPTI N'O$ ; : t: e •' :', ,:•: t , ;°: i <r
Clothes washer 25.02
Cut and Install drain and watt • 1 , , , , , , • : , , ,' :Ink and automatic cam, Disasher 25.02
r on back side of restroom. A-E./O `C //t,/G Lv97 / ranking fountain 25.02
1.-/NE 4 4 11/2,44 , ,,/ G //✓' 7 Ekf ,f6 Sf v/c 1 Ejectors /sump 25.02
l '*' ° ''` (]. E O WNER ' ", �" " <, pansion tank 12.51
.t • Fixture/sew r cap 1°r 25.02
Floor draln/floorsink/hub 25.02
Address: -
- • Garbage disposal 25.02
City /State /ZIP: Hose bib 25.02
Phone; ( ) Fax: ( ) Ice maker 12.51 •
y
. •
�: r -- ®z;Ap,P1,iIhA1Y1' ��; . -,. f : `(]; CO1H'C'e1iC'1<,` P*it9bAt' ., Interceptor /grease trap 25.02
Business name: Lovett Medical gas (value: $ ) Page 2
Printer 12.51
Contact name: Patricia Smith
Roof drain (commercial) 12.51
Address: P.O. Box 82680 Sink/basin/lavatory 25.02
City /State/ZIP: Portland/ OR/ 97286 Solar units (potable water) 62.54
Phone: (503) 548 -0039 . Fax:: (503) 288 -1630 Rib/shower/shower er pan 12.51
E-mail: patricln.s n„ lovettserviees.con► Urinal 25.02
`: '3`' f CI OR: Water closet 25.02
° " Water heater 37.52
Business name: Lovett • Water piping/DWV ' 1' 56.29 56.29
Address: P.O. Box 82680 Other: _ 25.02
-
City / State/ZIP: Portland/ OR/ 97286 Subtotal
Phone: (503) 548 -0039 Fax: (503) 288 -1630 Minimum permit fee; $72.50 72.50
CCI3 Lie.: 12550 - Plumbing Lic. no.: 26-773PB Platt review (25 °/d of permit fee)
�� State surcharge (12% of permit fee) 8.70
Authorized sigaatu TOTAL PERMIT PEE 81.20
Print name: Patricia Smith Date: 5/14/2013 This permit application expires if a permit is not obtained within 150 days
after it has been accepted ns complete.
*Fee methodology set by Tri- County Building Industry Service Board.
I:\ DuildirtgTetmits \PLi,MU- PermitApp.doc 10/01 /09 440- 46 16T(10/02/C0M/1V5a)
May. 14. 2013 2:10PM Lovett Excavating No. 7380 P. 2
Plumbing Permit Application - City of Tigard •
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
r.Tdl,if'%
.�- � =.
Footing drain - 1 °' 100' 50.03 0102,000 $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 °.k ::; """ F .� • "" ` .;;;•. :..::. ;,
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
each additional $100.00 or fraction thereof, to
Qtbt;sr "�lilS Y . 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 -112 hour) and including $25,000.00,
Inspections outside of normal business 90.00/1r $25,001.00 t0 550,000.00 $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 Pees 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.
Subtolalr
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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 * .
Q uantiry'by Fixture Type
:�.. •:: � Xa?a ev�ei�:: o... i ..l��� . std a "t oas: >;,; ::•;
;?iti�i c „'Mac for, Replace/ Plan review is required for any of the following.
;:`��'pikYetfprmCd; 'Capped Added. " "Relocate g'
Baptistry/Font Please check all that apply.
Bath - Tub/Shower El 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
Cus'idor/1VaterAs irator as defined in 0AR918- 780 -0040.
Dishwasher 'Commercial ❑ Medical gas and vacuum systems for health care facilities.
- Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complet stn►eture as defined in 0AR918- 780 -0040.
Eye Wash
FloorDrain/sink -2" Submit 2 sets of plans with any of the above.
•3 >
Tsomefric`or:`'iserDarm
Car Wash Drain
Garbage - Domestic-non -Good ❑ Isometric or riser diagram is required for now buildings
Disposal - Domestic-food related that meet the qualifications above.
- Commercial -food related
- Industrial -food related •
leo Mach./Refrig. Drains
Oil Separator (Gas Station) Comments regarding fixture work:
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related
- Bradley
- Commercial -food related
- Service
Swimming Pool Filter *Note; If the fixture work under this permit results in an
Washer • Clothes
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:
C:1Usersloslnith\AooData \Local \Tetno\PLMF- PcrmitAoo.doe
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
10260 SW NIMBUS AVE M8, TIGARD, OR,
97223
Commercial - Plumbing
399 Plumbing final
05/21/2013 00:00
PLM2013-00149
PASS - No C of O
Violation Summary:
Inspector Contractor