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Permit CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit #: PLM2013 -00235 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/11/2013 Parcel: 25101 DB00100 Jurisdiction: Tigard Site address: 7340 SW HUNZIKER RD 102 Project: Interim Physicians Subdivision: VARNS ACRES Lot: 3 Project Description: Add (1) new breakroom sink Contractor: WESTERN PLUMBING Owner: HILLTOP BUSINESS CENTER LLC 9460 SW TIGARD AVE SUITE 101 HUNZIKER LLC TIGARD, OR 97223 9430 NW KAISER RD PORTLAND, OR 97231 PHONE: 503 - 639 -5296 PHONE: FAX: 503 - 684 -9015 FEES Quantity Description Date Amount 1 ea Sink 07/11/2013 $25.02 Specifics: 1 12% State Surcharge - 07/11/2013 $8.70 Plumbing Type of Use COM 47 ea Minimum Fee Adjustment - 07/11/2013 $47.48 Plumbing Class of Work: ALT Type of Const: Occupancy Grp: Stories: • • Total $81.20 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or direct question o OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By / Permittee Signature: • Call 503.639.4175 by 7:00 a.m. for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. 07/09/2013 13:42 5036849015 WESTERN PLUMBING INC PAGE 01/03 ti Plumbing Permit A li • EIVED B uilding Fixtures ' :. .:.... . .. FOR f"iFFlf`F. USE . O \.1;1`:..:. :. - ..:.- ...:.'::: ;:= -:.:, : . :,. City of Tigard I II I : , OR 97223 Received 9 2013 a it No: �L Haag 3 . 13125 SW Ball Etivd. T• y. l / 3 3� 00 g Flinn 503.639.4171 Fax' - UrTIGARD B Yl eyvlew Other Pamir No -: / � c� 2ao` "`� Sy • T t G A k1 Inspection Line: 503. Dote Ready/By lade: 0 See Paige 2 far Internet www.t�d ar.gov BUILDING ftvISION Noli5ed : Supplemental Information TYPE OP WORK . FEE SCHEDULE. • ❑ New construction 0 Demolition For special information we checklist Description Addition /alteration/replacement ❑Other New t 1- 2-family Qty. R for I Es nr each utility J Total dweliinga (includes 100 lity co taeaion) CATEGORY OF C0$STRUCTION SFR (1) bath 312.70 ❑ I- and 2- family dwelling 51 Commercial/industrial SFR (2) bath 437.78 j ❑ Accessory building SFR (3) bath 500.32 1 ry g ❑ Multi- family Each additional bath/kitchen 25.03 ❑Master builder El Other: Fire sprinkler (__ sq. R.) Page 2 ' Q .:. IOW SITE INFORMATION AND LOCATION Site utilities: Job site aadFa r ��� Catch basin or area drain 18 -76 City/State/ZIP: '� ('�7i [� '� D leach lino, or trench drain 18.76 .1 i ll , `-' F.� `l • Footing drain (no. linear ft-:. _ _) , Page 2 Suite/bldg./apt. no.: / /d,� I Project name: -. ■....,6 /,�1tEQa H 41111 UA c ` Menufkeuued home utilities 50.03 Cross strcet/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary &ewer (no. linear ft.: Page 2 T - Storm sower (no. linear ft: ) Page 2 Water service (no. linear ft: _,_•) Page 2 Subdivision: . Lot no.: ' Fixture or - Tax map /parcel n,: to to 116 ab / oo Backflow preveoter 31.27 DESCPTzoN . OP : WORK valve 12 -51 ` �jp Clothes washer 25.02 `(''S? V Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 d PROPERTY OWNER I ❑ TENANT ExFairlicm tank _- 1151 Name: FiXture/eewer cap 25.02 Floor floor siat/hub 25.02 Address: Garbage disposal 25.02 City /State•/ZIP: dose bib 25.02 Phone: ( ) Fax: ( ) lee maker 12.51 0 APPLICANT El. : CroNI ACT PERSON . _ Inter /grease trap . 25.02 Business name: Medical pa (value: $ ) Page 2 Prima- 12 -5I Contact name: Roof drain (commercial) 1231 Address: Sink/basindavatory i 25.02 (9,-),D City/ State /ZIP: Solar units (potable water) 62.54 Phone: ( ) Fat: ; ( ) Tub/showe (shower pan 12.51 k: mail: Urinal 25.02 . Water closet 25.02 Water heater _ 37.52 Business name: Western Plumbing, Ism Water pipiag/DWV 56.29 Address: 9460 SW Tigard Avenue Suite 101 Other: 25.02 r� City /5tate/ZIP Tigard, OR 97223 Subtotal , ) Phone: (503) 6395296 Fax (503) 684 -9015 111mitmtm permit fee: $72 -50 Nan CC13 lac,: 2439 Plumbing Lie_ no.: 34-29PB review (25 % tfpermit fee) til State surcharge (12% of pernnt fee) �j ays Pri Authorized signature: ��� TO AL PERMIT FEE ,.1, r �. (� / This penult applkatlon esphra 1 a p ermit a not obtained wttbin 180 d »t name: Dana Jensen D ate: ( ` artsr 1t ens Ceetl ac cepts& as comptem aA....uKi..vl.dnev on 6, T.i1`n.nw Rnil,lino rnAnary •.nrir. rLwr4 07/09/2013 13:42 5036849015 WESTERN PLUMBING INC PAGE 02/03 Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: S.itei: . _ Qty. : iteeolo Ta Sq are footage :. . Permit Fee: Footing drain -1 a 100' 50.03 0 to 2,000 $121.90 ' Footing drain - each additional 100' 37.52 2 to 3,600 $169.69 3 601 to 7,200 $233.20 Sewer -1st 100' 42,54 _ 7 ,201 andpxeater $327.54 Sower - 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: Peknii ',Feu: $1.00 to $5,000.00 Minimum fee $72 -50 ___ Storm & Rain Drain - each additional 100' 37.52 $5,001.00 to 510,000.00 $72.50 for the that $5,000.00 and $1.52 for 1 . Other InsPeetions or Fees Qty. tree (ea) 'rOtal each additional $100.00 or fraction thereof, to 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 far 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 90:00/11r 550,001.00 and up $742.00 for the fast $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", : Pla t:Reitiew f0•A" Plitnibing I please indicate work performed by fixture. Failure to Plan review is required for any of the following. accurately report fixtures could result in increased sewer fees*. Please check all that apply. ititanatlixliy (Fixfuiie) . Wo;rk Perforated 0 Any new c minercial building with water service 2" and Fliturs 3ype:.. Repines greater, except systems designed and stamped by licensed 1'rivteui .. 1 ttpded E>lttlnst eaaema"- 13atxisrsy/Fom 0 New exterior plumbing site utilities for any complex structure Bath - Tub /Shower - as defined in OAR918- 780 -0040. - Jacuzzi/Whirlpool Car Wash -Each Stall 0 Medical gas and vacuum systems for health care facilities. -Drive Thu © Any multipurpose fire sprinkler system. — Cuapidon'Water _ ❑ Any complex structure m defined in O,AR91 8480 - 0040. Dishwasher - Coffiatacial _ Domestic Submit 2 sets of plans with any of the above. Drinking Fountain - Eye wash _ TSometrie,or. Ri er Diagram Floor Drain/sink - 2" ❑ Isometric or riser diagram is required for new buildings 3., that meet the qualilfications above. Car Wash Drain Garbage - Domestic Disposal -Commercial -Industrial Comments regarding fixture work: Ice Macb.JRefrig. Drains Oil Separator (Gas Station) . Roc. Vehicle Dump Station Shower -Gang _ -Stall - • - sink - 14arfI.avatory - , - - Bradley _ -Commercial *Noce: !T the fixture work under this permit results in an xvic0 increase of sewer EDUs, a sewer permit will be issued and Swimming Pool Piker fees assessed for the sewer increase must be paid before the Ii shes ping permit Water Extraotar can be issued. Water Closet - Toilet Urinal Other Fixtures: