Permit CITY OF TIGARD PLUMBING PERMIT
• COMMUNITY DEVELOPMENT Permit #: PLM2013 -00179
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/10/2013
Parcel: 1 S135BD00100
Jurisdiction: Tigard
Site address: 9600 SW OAK ST
Project: Plaza West Subdivision: ASHBROOK FARM Lot: PTS 5 &
Project Description: Remodel restrooms on 5th floor common area. Replace (4) lays, (5) toilets & (2) urinals.
Contractor: JAMES ROOD PLUMBING INC Owner: SUN LIFE ASSURANCE CO OF CANADA
125 S 1ST AVE #542 BY NORRIS BEGGS & SIMPSON
HILLSBORO, OR 97123 121 SW MORRISON ST #200
PORTLAND, OR 97204
PHONE: 503 - 648 -3907 PHONE:
FAX: 503 - 681 -2196
FEES
Quantity Description Date Amount
4 ea Lavatories 06/10/2013 $100.08
Specifics: 2 ea Urinal 06/10/2013 $50.04
5 ea Water Closet 06/10/2013 $125.10
Type of Use: COM 1 12% State Surcharge - 06/10/2013 $33.03
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $308.25 •
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 . - ons o ' • C by cal . ng 503.232.1987 or 1.800.332.2344. `
Issu =d By: / I f Permittee • *gnature:
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.
. Plumbing Permit A.pnlicatio
Building Fixtures FOR OfPIC:I.; USU. U,.LI
City of Tigard 5 mi tei°ea
• 131 SW Hall Blvd, Tigard, OR 97223 JUN 0 2 13 1> s y: ( /3 i Pamir No.: �'� ;)o ! 3- ._ l7
Plan Review
Phone: 503.718.2439 Fax; 503.598. UFTIGARD Other Permit No.: � d g G / 3,.� 0 Fr
Date/By:
T I C ,\ it n Insp ection Line: 503.639.4175 � D ate Readv/By. suds: ® See Page 2 for
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l�oti£ed/Method: Su • •Iemental Information
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❑ New construction ❑ Demolition For special information use chccirlist
Description I Qty. I Ea. I Total
on/replaoem nt ❑ New dwellings `� • dditi0n/alter'eti a Oth ew am y lltugs (includes t 00 ft for each utility connection)
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r 1 t ? ti .iU� SFR /1 312.70
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SFR (2) bath 437.78
ID 1- and 2- family dwelling r : Coutmercialrmdustrial ,
ID Accessory budding ❑ Multi - family SFR (3) bath 50032
Each additional bath/kitchen 25.02
❑ Master builder
tn, x.13., :_r. . 7 �• -_• - - sq. ft.)
. ;. t 1. ;�. ..I >r i L' ; 7t•� r vim .a . -t. Other: ��..as : ?3ri? i :fir .. : : :-�y Fire sprinkler ( S ft Pa
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Job site address: O 3 oak- Catch basin or area drain 18.76
Drywell, leach line, or trench drain 18.76
City/State/ZIP: � r
Suite/bldg. /apt no.: � I Project name: 5 *C fit. R g y � M pL ( Mann Footing drain (no.
borne inn e uti l ie P 2
Manu homlities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear ft: ) Page 2
Storm sewer (no. linear R: ) Page 2
Water service (no. linear ft.: ) Page 2
Subdivision: 1 Lot no.: Fixture or item: _
Tax map /parcel no.: Backflow preventer 31.27
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<' :• :�:1.� . :.. :'. ,,y..y - - °s..'- �_;;.Y•;c��r«; 1�'. =T Backwater valve 12.5
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alr. _ a_ r.., . :.. r:v-: 7r. ". :: r,, r. , ., rate. 1 , I Y. ... ,t r il.. ''I Clothes washer 25.02
Dishwasher . 25.02
Drinking fbuntain 25.02
Ejectors/sump 25.02
F-`' `.'f:: r.i%, -' iy4 I h.S. .'.I: T- : - :+ -.r.. i�;u f.s,7,t � -` ;;I ,t r
i t ` i ' a k, ' , -.� :ar.iii;.'..4 : ?. ; ii ,l . • 'a;i ::: rl :,-� : : : : � ; ,. (.t .=; SniT'. ;',: Expansion tank 12.51
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Name: Fixture/sewer cap 25.02
Address: .
Floor drain/floor sink/hub 25.02
Garbage disposal 25.02
City/State/ZIP:
Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12.51
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.. 1'..r l Interceptor/grease trap 25.02
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Business name: Medical gas (value: $ ) Page 2
Contact name:
Primer 12.51
Roof drain (commercial) 12,51
Address: Sink/bas' avatary 4 25.02, /6D, 0)
City/State/ZIP: Solar units (potable water) 62.54
Phone: ( ) I Fax: : ( ) Tub/shower /shower pan 12.51
E -mail; • Urinal ,P....,. 25.02 s, OY
m t: t- - :- - fr-,�a: a closet t�t1"tY- ta :[ir i�f��.�t� ri! :� C':� :" ::i6: � .;�, fir.. • .!t r: :r!�_: ".I.i::' : . 1 � : '� e �' .r- � : :r : ' P : :� ` "' S : : . Water Cl 25.2
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�__ ..... ,.: 1. _.. l .._ I, a.r Water heater 37.52
Business name: 4414.e) a 1 ~ / TAT-- Pi Water piping/DWV 56.29
Address: /.2. S S. psi` alit Other: - 25.02
City/State/ZIP: hf1 //S y0 1,--' 9 7I2--' Subtotal
Phone: (e ) 5y7- pyq� Fax: ( $03) Sys- r t Minimum permit fee: $72.50
CCB Lie.: Plan review (25% of permit fee)
/1 PlumbingLic.no.: Paste
State surcharge (12% of permit fee) 31, n 3
Authorized signature r� TOTAL PERMIT FF_E 3, Z�
Print name V 4� 't !/j �� Date s' f' / This permit application expires if a permit is not obtained within ISO days
VVV �� "rr "" after it his been accepted as complelm /
*Fee methodology set by Tri-Cotmty Building Industry Service Board. �D"
1:1 BuildinggPermita \PLMU- PermitApp.dae 10/01/09 440- 4616T(IW02/COMIWEB) ���PPP
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Su , , ression stems:
r ,r {' Y�i'^ °. fps "_- '_,;,• �F3n�i =7_° -:i ". itT.,.- 773, i"Ct'. , 1 :� ,.. i , ! - , -- 7 :, - • __ , .;r' `::.1' •:5r: 1 •
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FJCnit.! rbz ?..:o!tkr. ?cc•.:n �:!ii•�:. ",.Z- ....:'G a<. .u. �F� t(( n '� „ •�`'�i.,,41ci1: l 0 �e _ - .• t , �. � ft•ITrtf +a
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Footing drain - I" 100' 50.03 0 to 2,000 $121.90 J
Footing drain - each additional 100' 37.52 2,001 to 3,600 $169.69
1st 100' 62.54 3,601 to 7,200 $233.20
Sewer
_ 7,201 and grater $327.54
Sewer - each additional 100' 37.52
Water Service - 1st 100' _ 62.54 -
Medical Gas S stems: Water Service - each additional 100'
37.52 - `.•.1�:ti.�f v: .fir.. r.'._ ±� i F ' :'-tr' = '.'.:.'.:q-ii .T _ _: !, ` .3 , 7: 7. , •�-- -
Storm & Rain Drain -1st 100' _ 62.54 = ''` t r; 1 • r .: -.,: ; i"5,% a �i ;ri <_. s .:. _. .. -
•.`- 'ra:..1/4::,.,, i.�t;::.s i:- ::1'ca:d. :i!}i in �r- _- •::.Y%:: :t, i.. [
$1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for
_
t fi -r o :� r :x rI! :iFi-{ . ' - , _ � : , ; -:- x: 5117: .. r, r ;;71735, _� I each additional
�;ir'< ; t� ? cr'f�j i . ' � ; '���j; .t;; ;Y,.. ,1 %7' ::a:i CY.= •I�fl�• $1(111.C1110CfraCtl00thertO�,tO
.'sl % ;T- :�,.:rr:,:s. ,,.w'�j , r.•; ,: = . ..;_.E =,._ -.� : ft, i :ti - : . :- a
: �i 5.;.2.l 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 $1000 or fraction thereat; to
(minimum ch::e -1 /2 hour
and including $25,000.00.
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 char:e - 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 chat: e -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 *.
, r t Ft r . r "- -i r , S `. r . v .,'fit -7 3•Ti ,•:i. �, rV,'� . Y :.. .: ,nr �k ...ern t M ..
4 1 { yr �7�,, ".��tiF3'cw;; -�`i iii'•�.�� �� ; <i� r;�.:!- �v�.u'�1.'n:�i�. {vl� �.•�.ESL'�1:,7~'�`'' .`a ` :;rr, � �' i t �-i ° s'-' i �• -xa rt `' � l � a ✓ ��i h � ° ; ..� 11 "f� & tu t .�� ff'�i:;' �f_= 9
! . il' ?: . } !•i �. r {''; 4 t L s t Y.i': t:'- �.n,r -i.,4- �:, ^ i_ --,,,-.....----:.--4-.....,--- ?n rk' 4 - h 14 e �i ^::: -,I'� 3r�w 1:. ,•= 4.
u,1- w;l`r^i,"ti kR ',' ll� rh , ;; , '_ :t �� " ' ' Plan review is required for any of the following.
- Eat Please check all that apply.
Bath -7ub /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, ❑ 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 g sets of plans with any of the above.
- 3"
- 4 + Iii
F , t1 i J ar
7,: t: T.E;?..p. 2
.7 - , .,•,r, , .. : ; e -= fi r. ..., ..;• .�, :; *.e,° ,V . : n _
fi t: H, . :tt P r , ' 1 r di .+ r r } 1 ; 1. .n y ' .. l , ,, fi ! t ,:lt"ieQy;,., 2
Car Wash Drain _....- ;y 1}�w,� n.. -., F. :�. t.L±...n�.71. +--,:. tr .;.2:...::"::- 4 �1'�ttl;Y::';;
Garbage - Domestic - non - food ❑ Isometric or riser diagram is required for new buildings
Disposal - Domestio-food related that meet the r ualifications above.
- Commercial -food related
- Industrial - food related
Ice Mech./Rettig. Drains
Oil Separator (Gas Station) Comments regarding fixture work:
Rec. Vehicle Dump Station
Shower -Gang . /
-Stall , r G i ar .
Sink/Lav - Non -food related
- Bradley ilLf d 4d• C
-Commercial -food related )
- Service
Washer Swimming Pool Fitter *Note: If the fixture work under this permit results in an
Washer - Clothes p
Water Extractor increase of sewer EDUs, a sewer permit will be issued and
Water Closet - Toilet - 5 fees assessed for the sewer increase must be paid before the
Urinal a plumbing permit can be issued.
Other Fixtures:
C:1Uscrsljim\ Downloads \PLMF- PetmitApp(14).doc 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
9600 SW OAK ST, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
06/19/2013 00:00
PLM2013-00179
PASS - No C of O
Violation Summary:
Inspector Contractor
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
9600 SW OAK ST, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
06/19/2013 00:00
PLM2013-00179
PASS - No C of O
Violation Summary:
Inspector Contractor