PermitLocation:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11850 SW 67TH AVE STE 200, TIGARD, OR,
97223
Commercial - Plumbing
399 Plumbing final
2013-10-25 (null)
PLM2013-00304
PASS - No C of O
Violation Summary:
Inspector Contractor
II CITY OF TIGARD PLUMBING PERMIT
III - COMMUNITY DEVELOPMENT Permit#: PLM2013 00304
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/17/2013
Parcel: 1S136DD05300
Jurisdiction: Tigard
Site address: 11850 SW 67TH AVE, STE#200
Project: Kronos Subdivision: WEST PORTLAND HEIGHTS Lot: 9
Project Description: Adding(1)dishwasher,(1)ice machine&(1)sink.
Contractor: WESTERN PLUMBING Owner: PNWP LLC#2
9460 SW TIGARD AVE SUITE 101 PNWP LLC
TIGARD, OR 97223 6600 SW 105TH AVE#175
BEAVERTON, OR 97008
PHONE• 503-639-5296 PHONE.
FAX 503-684-9015
FEES
Quantity Description Date Amount
1 ea Dishwasher 09/17/2013 $25 02
Specifics: 1 ea Ice Maker 09/17/2013 $12.51
1 ea Sink 09/17/2013 $25 02
Type of Use: COM 1 12%State Surcharge- 09/17/2013 $8 70
Class of Work: ALT Plumbing
Type of Const: 10 ea Minimum Fee Adjustment- 09/17/2013 $9.95
Occupancy Grp: Plumbing
Stories:
Total $81.20
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090 You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
08/28/2013 08:49 5036849015 WESTERN PLUMBING INC PAGE 01/03
, .c, 1
Plumbing g Permit Annlication
Building Fixtures 4�` 0�0 i E; 0,-.1,1(...F. r .ti► ()MN
City of Tigard 9 ®-'N..'7";-- 307/5 flh / =Ir .4,,5-,,,...
1 _ Phone: 503.639.4 503.599.1960 ��®\\ a other Perms Ito:, ;eo)/5. jir1
Inspection lime: 503.639.4175
1<<";1;1,
Interact www.ti�d-�®w 6� �� Hare xe�ay�By ��j hap. . 1t soy a mr
`�® Notifi ed��f 57//3�'% Supplemental Wa marie�, fi
❑New construction ❑Domoli�iion For we 0
,Description Addition/alteration/replacement ❑Other 1 Qey. i Ea. 1 Total - .
Ncw 1-2- 1y dwellings(includes 100 ft. oath utility connection) V)
' CATEGORY Or • S3'giJCf* v SFR(l)bath 312.70
❑1-end 2-�amatly dwa$mS Corn citJTmdo:strial SFR(2)bet 437.78
❑Accessory building ❑Multi-family s1 R )barb 50032
❑Master builder ❑Other Each additional 25.62`
Irmo (_a4$) Page 2
JOB'FATE,INVOR a# xo 'AND.1; 11TON sa.
Job site addro6ss-:�\\ . \P•-�tA �A p 4 lL � Catch basin or area drain 18.76Y
City/State/Z_ •1 1 (}u"�>� Cy...) �J ,lead laps,or trench dram 1s.76
0 , Footing drain(no.linear fl.: ) Page 2
Suite/bldg apt no.: Project name: �Xb y1(�S"T-1
M bona 50.03 `Q
Cross street/directions to job site: , boles 18.76 f .
' Rain drain connector 18.76 (,
SsoItery sewer(no.linear 8:_) Page 2
Storm rewcr(no..New R;_) Page 2
Water service(no.linear it:_) Page 2
Subdivision: Lot no.: Fixture or item
o prov er 31.27 map/parcel no.: S.
. • 11fE '1Fl21 Olr QVOBK Backwater valve I2.51
Clothes washer 25.02 ,
lv , Dishwasher as.oa _ s
Drinking fountain 25.02 ■
Ejec orthump 25.02
.. ' 13)6iTR Y.,011eint .• ..Q.0,NAiiT, Expansion brat 12.51
Name: Fixwna/sewer cap 25.02
Address: .
Roar drain/floor sink/hub 25.02
City/State/ZIP:
Garbage disposal
S
Hose bib 25.02
Phone:( ) Fax:( ) Toe maker \ 1 12.51 10,4'5\
' - • D,AAPIiCANT • , O.COMM•P ON J - ' ratercePtodgcaes ixap J 25.02
Business name: Medical gas(value:$ ) Page 2
Contact ne:
der 12.51
am
Roof drain(commercial) 12.51
Address: Siuldbasinflayalory \ 25.02 ,,(SD.-
City/State/ZIP: Solar amity( potable water) 62-54
Phone( ) 1 Fax:( ) Tub/shower/shower pa 12.51
E-mail: Urinal 25.04
... water closet 25.02
Business name:Western Plumbing,Inc. Water r piping/DWV 37.52
yr Water pipiug/DWV 56.29
Address:9460 SW Tigard Avenue Suite 101
other: 25.04
City/State/ZIP:Tigard,OR 97223 Subtend Id)5r-b
Phone:(503)639-5296 Fax(503)634-9015 Minims permit fen 572.50 'ao),
CCB Lie.:2439 Plumbing Lie.no.:34-29PB Film review(25%of permit fee)
Authorized signature: UA„
Qmsk �, Tana.i R1 FE
Tta Rem►apit
nnatr
.v. rge
a li sa
wyw %b a , �ars
wo Cd fEw
n.- Pn18.
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11/Prat name Dana Jensen ) I
08/28/2013 08:49 5036849015 WESTERN PLUMBING INC PAGE 02/03
Plumbing Permit Application- City of Tigard
Page 2-Supplemental Information
Fee Schedule: ��}} Residential Fire Suppres��syyi��o�n��Systems: _
-•�'':'4•e(eTJ'' r,tal .., Ce'; , '_periiiit"Fte: -•
Footing drain-1"100' 50.03 0 to 2,000 $121.90
Footing chain-each additional 100' 37.52 2,001 to 3.600 $169.69
3,601 to 7300 5233.20
Sewer-tat 100' 62.54 7,201 and greater -$327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 6154 ' Medical Gas Systems:
Water Service-cacti additional 100' 37.52
Storm&Rain Drain-let 100' 62.54 Valli thiiii. 'its i:�ee:.`.,
$1-00 to 55,000.00 Mmimtmt fce$72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the Bust$5,000.00 and$1.52 for
- ' each additional$100.00 rs fraction thereat to plsttter rupeci4ns a Fees, • ..�' - 'Feg(arki Tom
Inspection ofexi g plumbing or $14 including e first 100.
which no fee is specifically instated 90.00/hr $10,001.00 to$23,000.00 SI48.5o for the that$10,000.00 and$1.54 for
(minim -1/2 how) each additional$100.00 or fraction thereof to
and including$25,000.00.
loam:lions outside of normal business _90.00/hr . $2.5,001.00 to$50,000:00 $379.50 for the fast$25,000.00 and$1.45 for
m�
hours(minimum charge-2 haws) each additional$100.00 or fraction thereo'P,to
Reinspection Fees 90.00/hr , and including$50„000.00.
Additional plan review Sr revisions 90 00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
(minimum charge-1R hoar) each additional$100.00 or fraction theme
Subtotal: -
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes", ., ,
please indicate work performed by fixture. Failure toihmn$-
PLin review is required for any of the following_
accurately n:pvrt fixtures could result in increased sewer fees'. Please check all that apply.
Attioettl4l � rWaak d ❑ Any new commercial building with water service 2"and
>? x pe: W' greater,except systems designed and stamped by licensed
. �' engineer.
0 New exterior plumbing site utilities fbr any complex structure
1
JaoWS b/wlmlpool as defined in QAR918-780-0040.
Car Wash -Each sou ❑ Medical gas and vacuum systems for health care facilities.
0 An multipurpose
Cuspidor/Water - 0 Any complex structure as defined X18-780-0040.
Dishwasher -Commercial
..Domestic i Submit a sets of plans with any of the above.
Driokbig Fountain -
Eye Wash T , ,• 'OiA 044.** ,
Floor Drain/sink -2"
-3„ -r ❑ Isometric or riser diagram is required for new buildings
-a" that meet the qualifications above.
•
Car Wash Drain .,
Garbage -Domestic - .
Disposal -Commercial
-Industrial Comments regarding fixture work;
Ice Mach./Refrig.Drains
Oil Separator(Gas Station)
Roc.vehicle Dump Station .
-Gang .
-Stan
-Sink -Bet/Lavatory
-Bradley
•
1 "Note„ If the fixture work under this permit results in an
swimming Pool Fitter - increase of sewer EDIIs,a sewer permit will be issued and
Washer-Clothes fees assessed for the sewer increase must be paid before the
water Extractor plumbing permit can be issued.
Water Closet-Toilet
Urinal -
Other Fixtures: r