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Permit q CITY OF TIGARD PLUMBING PERMIT X • COMMUNITY DEVELOPMENT f Permit#: PLM2013-00404 T[GARB 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 �� Date Issued: 11/13/2013 Parcel: 2S102AB04800 Jurisdiction: Tigard Site address: 12460 SW MAIN ST Project: Jeffrey Allen Decor Subdivision: KINGSTON Lot: 2 Project Description: CAP(2)lays and(2)water closets;ADD(1)tub/shower,(1)dishwasher,(4)lays,(2)water closets and(1)urinal. 3/20/14,REPRINTED to revise:adding the capping of(1)lay&(1)water closet and the addition of(3)2"floor drains. 4/21/14:Reprinted permit to add 90 ft.of rain drains.6/23/14,Reprinted to add(5)hose bibs. Contractor: MANZHURA PLUMBING Owner: LUONG, PETER& HIEU PO BOX 820429 113 KINGSGATE R VANCOUVER,WA 98682 LAKE OSWEGO,OR 97035 PHONE: 360-772-8145 PHONE: FAX: FEES Quantity Description Date Amount 4 ea Fixture/Sewer Cap 11/13/2013 $100.08 Specifics:, 3 ea Floor Drain/Floor Sink/Hub 03/20/2014 $75.06 1 ea Ice Maker 11/13/2013 $12.51 Type of Use: COM 4 ea Lavatories 11/13/2013 $100.08 Class of Work: ALT 1 ea Tub/Shower/Shower Pan 11/13/2013 $12.51 Type of Const: 1 ea Urinal 11/13/2013 $25.02 Occupancy Grp: 2 ea Water Closet 11/13/2013 $50.04 Stories: 1 ea Water Heater 11/13/2013 $37.52 1 12%State Surcharge- 03/20/2014 $49.54 Plumbing 2 ea Fixture/Sewer Cap 03/20/2014 $50.04 0 12%State Surcharge- 03/20/2014 $6.00 Plumbing 90 If Storm and Rain Drain 04/21/2014 $62.54 8 12%State Surcharge- 04/21/2014 $7.50 Plumbing 5 ea Hose Bib 06/23/2014 $125.10 Total $728.55 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 Notific- •• -nter. 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• estions to Ob C b :king 503.232.1987 or 1.800.332.2344. Issu d By: Permittee Si•-• -�� S 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 Application Building Fixtures fECE1VED FOR OFFICE USE ONLY Received City of Tigard � . Permit No ri Q 13125 SW Hall Blvd.,Tigard,OR 9 Date/By: s �" L� 8 ZI 2 3 2014 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No I Inspection Line: 503.639.4175 CITY( i�GAHL Date Ready/By: Juris ® See Page 2 for I■J ALI) v lJf �7I711LJ Y Y K Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF INN;I VIRI/ l FEE* SCHEDULE ❑New construction ❑Demolition For special information use checklist Description I Qty. I Ea. I Total ❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility correction) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 El 1-and 2-family dwelling El m Comercial/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 JOB S TE INFORMATION AND LOCATION Site utilities: Job site address: Catch basin or area drain 18.76 KJ City/State/ZIP: Drywell,leach line,or trench drain 18.76 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.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: 1 Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 (.5) Jl.L-161-.CJ Y� Clothes washer 25.02 Dishwasher 25.02 t_I1, 1-0/ ^00 6/0 9 Drinking fountain 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER I ❑ 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 5 25.02 1,01 57/0 Phone:( ) Fax:( ) Ice maker 12.51 ❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name: Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 37.52 Business name: H 4-N Z 1#u2k _��{ Q t o c Water piping/DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal 1625,/O Phone:( ) Fax:( ) Minimum permit fee: $72.50 �• CCB Lic.: f l I-7 4 f PI ' g Lic.no.: Plan review (25%of permit fee) State surcharge(12%of permit fee) /5--Al Authorized signature: y TOTAL PERMIT FEE 1.76). If Print name: Date: 6/3.5/y This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. "Fee methodology set by Tri-County Building Industry Service Board. 1:\Building\Permits\PLMU-PermitApp.doe 10/01/09 440-46I6T(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-I"100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 Sewer 1st 100' 62.54 3,601 to 7,200 $233.20 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 Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to I� 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 Baptistry/Font El Any new commercial building with water service 2"and 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 Drive Stall as defined in OAR918-780-0040. Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities. Dishwasher: Commercial 1:1 Any multipurpose fire sprinkler system. Domestic El 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 4" ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain that meet the qualifications above. Garbage -Domestic non-food 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 CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit#: PLM2013-00404 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 ► Date Issued: 11/13/2013 C;,\FL TtT 9 I '. Parcel: 2S102AB04800 .7; Jurisdiction: Tigard Site address: 12460 SW MAIN ST Project: Jeffrey Allen Decor Subdivision: KINGSTON Lot: 2 Project Description: CAP(2)lays and(2)water closets;ADD(1)tub/shower,(1)dishwasher,(4)lays,(2)water closets and(1)urinal. 3/20/14,REPRINTED to revise:adding the capping of(1)lay&(1)water closet and the addition of(3)2"floor drains. 4/21/14:Reprinted permit to add 90 ft.of rain drains. Contractor: MANZHURA PLUMBING Owner: LUONG, PETER&HIEU PO BOX 820429 113 KINGSGATE R VANCOUVER,WA 98682 LAKE OSWEGO, OR 97035 PHONE: 360-772-8145 PHONE. FAX: FEES Quantity Description Date Amount 4 ea Fixture/Sewer Cap 11/13/2013 $100.08 Specifics: 3 ea Floor Drain/Floor Sink/Hub 03/20/2014 $75.06 1 ea Ice Maker 11/13/2013 $12.51 Type of Use: COM 4 ea Lavatories 11/13/2013 $100.08 Class of Work: ALT 1 ea Tub/Shower/Shower Pan 11/13/2013 $12.51 Type of Conet: 1 ea Urinal 11/13/2013 $25.02 Occupancy Grp: 2 ea Water Closet 11/13/2013 $50.04 Stories: 1 ea Water Heater 11/13/2013 $37.52 1 12%State Surcharge- 03/20/2014 $49.54 Plumbing 2 ea Fixture/Sewer Cap 03/20/2014 $50.04 0 12%State Surcharge- 03/20/2014 $6.00 Plumbing 90 If Storm and Rain Drain 04/21/2014 $62.54 8 12%State Surcharge- 04/21/2014 $7.50 Plumbing Total $588.44 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. Plumbing Permit Aaalication Building Fixtures FOR OFFICE USE ONLY City of Tigard VS) Date/By: /� Permit No.. �j M�I J + 13125 SW Hall Blvd.,Tigard,OR 972 DateBy: 1( ;if t(^137-7- E'�7/ /�/� 3-e 'Wit Phone: 503.718.2439 Fax: 503.598. Plan Review Other Permit No.: Date/By: Inspection Line: 503.639.4175 9,A.�O T I G A R D Date Read B y n VI See Page e 2 for Internet: www.tigard-or.gov R f Notified/Method: Supplemental Inf ormation ormation _ TYPE OF WORK O`CTtGtk FEE* SCHEDULE ❑New construction ❑D ll� For special information use checklist ♦ rvoiGAO Description Qty. Ea. I Total ❑Addition/alteration/replacement ❑ 1 N:1 WI" 1 New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTIO 11 144a SFR(1)bath 312.70 * ❑ 1-and 2-family dwelling ❑Commer� , t . . 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 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: /VI(40 sit./ tW Catch basin or area drain 18.76 City/State/ZIP: Drywell,leach line,or trench drain 18.76 7`f�<s�af b / Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: i/ Project name: J akAi Manufactured home utilities 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 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 C+' C 1 ImoJ qo t 1, 4ve.1 r\/''S pot'✓M71- Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: Fixture/sewer cap 25.02 Floor drain/floor siric/hub 25.02 ' Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 ❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name: Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax: :( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 CONTRACTOR Water closet 25.02 Water heater 37.52 Business name: Water piping/DWV 56.29 Address: . 1�ti �(/1'/� Other: 25.02 City/State/ZIP: 0 1, N Subtotal _S-7-7 Phone:( ) Q L L Fax:( ) Minimum permit fee: $72.50 CCB Lic.: Plumbing Lic.no.: Plan review (25%of permit fee) State surcharge(12%of permit fee) 7 Authorized signature: _� _� TOTAL PERMIT FEE t- '7c,. 0 Print name:��,�F� !/p.vP� Date: A///f This permit application expires if a permit is not obtained within 180 days j- after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1:\Building\Permits\PLM1J-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 s'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 ,_i 77/ $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 Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to 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$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 Drive tall as defined in OAR918-780-0040. 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: -LavBar 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 WaterCloset-Toilet plumbing permit can be issued. Urinal Other Fixtures: 1:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 • CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT I Permit#: PLM2013 00404 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/13/2013 Parcel: 2S102AB04800 Jurisdiction: Tigard Site address: 12460 SW MAIN ST Project: Jeffery Allen Decor Subdivision: KINGSTON Lot: 2 Project Description: CAP(2)lays and(2)water closets.ADD(1)tub/shower.(1)dishwasher. (4)lays, (2)water closets and(1)urinal 3/20114.REPRINTED to revise-adding the capping of(1)lay&(1)water closet and the addition of(3)2"floor drains. Contractor: MANZHURA PLUMBING Owner: LUONG, PETER& HIEU PO BOX 820429 113 KINGSGATE R VANCOUVER. WA 98682 LAKE OSWEGO, OR 97035 PHONE 360-772-8145 PHONE FAX FEES Quantity Description Date Amount 4 ea Fixture/Sewer Cap 11/13/2013 $100.081 Specifics: 3 ea Floor Drain/Floor Sink/Hub 03/20/2014 575 06 1 ea Ice Maker 11/13/2013 512.51 Type of Use: COM 4 ea Lavatories 11/13/2013 $100 08 Class of Work: ALT 1 ea Tub/Shower/Shower Pan 11/13/2013 $12.51 Type of Const: ea Urinal 11/13/2013 $25.02 Occupancy Grp: 2 ea Water Closet 11/13/2013 $50.04 Stories: 1 ea Water Heater 11/13/2013 537 52 1 12%Slate Surcharge- 03/20/2014 $49.54 Plumbing 2 ea Fixture/Sewer Cap 03/20/2014 350 04 0 12%State Surcharge- 03/20/2014 56.00 Plumbing Total $518.40 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 Noti fort-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 dire questions to O)R C b a ng 503 232.1987 or 1 800.332.2344. Is ed By: // ,fC Fermittee 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. Plumbing Permit Annlien Building Fixtures ( 'ri ti Lu FOR OFFICE USE ONI City of Tigard , 2 0 ?' 4 Received L Permit Na. 13125 SW Hall Blvd.,Tigard,OR 97223 Date/B : '/ „ re_ t.�I i r r ,0 .IN ,_--- Plan Review ln�` ■ Phone: 503.718.2439 Fax: 503.98.1960?`, i IukM� Date/By: Other Permit No.: I` 2_��i�j Inspection Line: 503.639.4175 p Date Ready/By: J tl I I 1� \r I t ,1 y/By: furls ® See Page 2 for Internet: www.tigard-or.gov `" Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑New construction ❑Demolition For special information use checklist Description I Qty. I Ea. I Total ❑Addition/alteration/replacement ❑Other: New I-2-family dwellings(includes 100 ft.for each utility correction) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ❑ 1-and 2-family dwelling ❑Commercial/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 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 'L Catch basin or area drain 18.76 n '�/ Drywell,leach line,or trench drain 18.76 City/State/ZIP: Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name: C-t(yL Manufactured home utilities 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 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 D SCRIPTION OF WORK Backwater valve _ 12.51 0_62,0 ��J Clothes washer 25.02 )��� t �X/��` L'Kh��, Dishwasher 25.02 i) L ct-�, 1 (Jn-E.I .( 0-l Drinking fountain 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: Fixture/sewer cap (9%., 25.02 56. 0 / Address: - Floor drain/floor sink/hub tS 25.02 75:4_ Garbage disposal _ 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 ❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name: Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax: :( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 Water closet 25.02 CONTRACTOR p Water heater 37.52 Business name: NI 4 3Z I-t U � I L?/3 l 13 a Water piping/DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal /0/ 7/41 Phone:( ) Fax:( ) _ Minimum permit fee: $72.50 CCB Lic.: Plumbing Lic.no.: Plan review (25%of permit fee) - State surcharge(12%of permit fee) /5:41 Authorized signature: X 7 TOTAL PERMIT FEE ,/ ± %fi . . Print name: f 7,1� 24/p N Date: 3/2-A ..c This permit application expires if a permit is not obtained within ISO days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1,Building\Permits\PLMU-PerrnitApp doe 10/01/09 440-4616T(HNOLCOM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty Fee(ca) Toed 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 Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to Other Inspections or Fees 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 90.00mr and includin $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 S100.00 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 -Drive tall as defined in OAR918-780-0040. Cuspidor/Water-Dr vetor ❑ Medical gas and vacuum systems for health care facilities. Dishwasher Commercial ❑ Any multipurpose fire sprinkler system. Domestic El 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 nun-loud that meet the qualifications above. Disposal: -Domestic food related -Commercial food related -Industrial food related Ice MachJRefrig.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: 1:\Building\Permits\PLMF_PetmitApp.doc 08/04/2011 2 CITY OF TIGARD PLUMBING PERMIT :• • COMMUNITY DEVELOPMENT Permit#: PLM2013-00404 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/13/2013 Parcel: 2S102AB04800 Jurisdiction: Tigard Site address: 12460 SW MAIN ST Project: Jeffery Alan Decor Subdivision: KINGSTON Lot: 2 Project Description: CAP(2)lays and(2)water closets;ADD(1)tub/shower,(1)dishwasher,(4)lays,(2)water closets and(1)urinal. Contractor: MANZHURA PLUMBING Owner: LUONG, PETER&HIEU PO BOX 820429 113 KINGSGATE R VANCOUVER,WA 98682 LAKE OSWEGO, OR 97035 PHONE: 360-772-8145 PHONE: FAX: FEES Quantity Description Date Amount 4 ea Fixture/Sewer Cap 11/13/2013 $100.08 Specifics: 1 ea Ice Maker 11/13/2013 $12.51 4 ea Lavatories 11/13/2013 $100.08 Type of Use: COM 1 ea Tub/Shower/Shower Pan 11/13/2013 $12.51 Class of Work: ALT 1 ea Urinal 11/13/2013 $25.02 Type of Const: 2 ea Water Closet 11/13/2013 $50.04 Occupancy Grp: 1 ea Water Heater 11/13/2013 $37.52 Stories: 1 12%State Surcharge- 11/13/2013 $40.53 Plumbing Total $378.29 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 44. Issued By: / rmittee 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. Plumbing Permit Applica it`tf.CEVED Building Fixtures . FOR OFFICE USE ONLY NOV 1 2 2013 Received City of Tigard Date/By: ��/ ?/�-3 Permit Not -e0 y0 y III n 13125 SW Hall Blvd.,Tigard OR 914 �TII!�fl® Plan Review C Phone: 503.718.2439 Fax: 503.5 .'t OJr l�f i Date/By: Other Permit Nc�(�2/'-jOj9f TIGARD Inspection Line: 503.639.4175 BUILDING DIVISION Date Read B Y Juris: ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE El New construction ❑Demolition For special information use check list Description I Qty. I Ea. I Total e Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 SFR(2)bath 437.78 El I-and 2-family dwelling ig Commercial/industrial l SFR(3)bath 500.32 t ❑Accessory building El Multi-family Each additional bath/kitchen 25.02 El Master builder ❑Other: Fire sprinkler(_sq.ft.) Page 2 Q JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: /� Catch basin or area drain 18.76 City/State/ZIP: (0°A4 c �� Drywell,leach line,or trench drain 18.76 01 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: 1 Project name:fE �y 41-�677U /AWE- Manufactured home utilities 50.03 Cross street/directions to job site: 2Sr€:?!Y-Manholes 18.76 - ,I � Q 41- 4 � Rain drain connector 18.76 Pl 11 6 Ta� Sanitary sewer(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.: Backflow preventer 31.27 DESCRI' ION OF WORK Backwater valve 12.51 .151MW% / li5! Clothes washer 25.02 ii I L _ /� L�:.i Dishwasher 25.02 S )11 6 - Drinking fountain 25.02 Ejectors/sump 25.02 isk PROPERTY OWNER I El TENANT Expansion tank 12.51 Name: Fr---f- Ig Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 1.24,6-D C � �-�h Garbage disposal 25.02 City/State/ZIP: `T7 . d� OG.___ O. Lam/ Hose bib 25.02 Phone:( ) Fax:( ) ~7 Ice maker 12.51 APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name: Medical gas(value:$ ) Page 2 Contact name: 7 a � > Primer 12.51 `- U/lam Roof drain(commercial) _ 12.51 Address: ill/Z` Sink/basin/lavatory 11 25.02 City/State/ZIP: (.1-ra 3' Solar units(potable water) 62.54 Phone:( ) r Fax::( ) Tub/shower/shower pan 1 • 12.51 E-mail: Urinal 1 25.02 CONTRACTOR Water closet /2i 42. 25.02 Water heater I 37.52 Business name: /1/41/2t{/ - /04,tt /3/A/G Water piping/DWV 56.29 Address: ,oQ /sox e- o y2. 9 Other: (4)/e.:J-- /--/*hyt/Z ' / 25.02 ty /457--/V ea u L/it/2, �1- 9���� Subtotal City/State/ZIP: Minimum permit fee: $72.50 Phone:136o) 77v)-cf /9/- Fax:( ) P CCB Lie.: / / Plumbing .no.: ,L 3I/ (] Plan review (25%of permit fee) 7�7�n1 Plumbin Lic no State surcharge(12%of permit fee) Authorized signature: 1,, - yt.t,._„-- .. j TOTAL PERMIT FEE s37f g? Print name: 1,P L.�ltd t n Date: it 1 1) l /] This permit application expires if a permit is not obtained within 180 days rl` 1"1 l7 after it has been accepted as complete. ‘3',i7 r:-55- 1 *Fee methodology set by Tri-County Building Industry Service Board. 1:\BuildingTermits\PENN-PermitApp.doc 10/01/09 440-4616T(10/02/COWWEB) 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 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 I -Jacuzzi/Whirlpool engineer. Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure Drive tall as defined in OAR918-780-0040. Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities. Dishwasher: -Commercial A ❑ 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 ar non-food related $7 4- '7 radley --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 WaterCloset-Toilet , f9`1/ % � plumbing permit can be issued. Urinal Other Fixtures: I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 CITY OF TIGARD . • BUILDING DIVISION PERMIT#: 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 .J..!� I. INSPECTION WORKSHEET FOR, DATE: //-( /5 TIME: PAGE: SISUBDIVISION:D 91{O /41-4 0 Fa" / F 7-1-01-#: CL TYPED OF OUSE: PROJECT NAME: DESCRIPTIO p L goo 3 -co Li oil) OWNER: PHONE #: CONTRACTOR: Pi 141 p9/3 — 0cf—f 0 / PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message 3;20 .B 6- 2G(6-7- Corrections/Comments/Instructions: © /- r^c./7 it i (O I 11A-film,/ G— O Ai V L/V T - 4r/z /204/-7 ' 0 �a.(Qat-'cT AIa r /5 44., iv G- �'Gt4-AvruT a N f ./44,a 3 POVA-i ia/ 0 v� n-- 1 3.5 ' Ch,c-n A-es ® b%1 b--e`r7%t,yr N4 /,- i..,:7"1/0 a I!Sr- 12Le- a 4/Al i r_ ,- I A G / 'N D P /94P-1— Ca 'i ti_ C • r� ie . SAD 1!/41v7 r_� .WA 'T CO ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS `E AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED - Inspector: / �� v Date: Phone. (503) 718- Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 12460 SW MAIN ST, TIGARD, OR, 97223 Commercial - Plumbing 399 Plumbing final FAIL PLM2013-00404 George Heimos 1. Provide approved hard cap on front outside 2" ABS pipe. 101.4.1.1.3 2. Add to existing permit 5-ea hose Bibbs. (4 in rear, 1 in front). 103.4.1 3. Attach water piping for at rear of hose bibbs to structure. 313.3/314.5 4. Attach and caulk all hose Bibbs.313.3/314.5. 5. Provide cleanout on 2" rear rain drain riser. 1101.12.2 6."complete storm sewer at front of building to thru-curb discharge location. 103.5.4 7. Provide test on rear rain drain riser. 1101.4 8. Attach utility sink to structure and caulk. 310.4 9. Caulk 2nd floor bathroom sink. 310.4/407.2 10. Provide approved location for water heater pressure relief discharge tube. 608.5 11. Provide non-absorbent finish on wall where utility sink top meets brick. 401.1 12. Recall inspection when corrections have been completed. Re-inspection required. 103.5.6.1 Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 12460 SW MAIN ST, TIGARD, OR, 97223 Commercial - Plumbing 399 Plumbing final FAIL PLM2013-00404 George Heimos 1. Correction #6 previous inspection not completed. 2. Provide 2-ea overflow drains for new addition. And provide test. Call for conference on how to install drains. 3. Recall when completed. Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 12460 SW MAIN ST, TIGARD, OR, 97223 Commercial - Plumbing 399 Plumbing final FAIL PLM2013-00404 George Heimos 1. Correction #6 previous inspection not completed. 2. Provide 2-ea overflow drains for new addition. And provide test. 3. Recall when completed. Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 12460 SW MAIN ST, TIGARD, OR, 97223 Commercial - Plumbing 399 Plumbing final PASS - No C of O PLM2013-00404 Chip Barnett Violation Summary: Inspector Contractor