Permit CITY OF TIGARD PLUMBING PERMIT
IN >•. COMMUNITY DEVELOPMENT Permit #: PLM2013 00425
T t A R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/09/2013
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Parcel: 1 S 136DCO2504
Jurisdiction: Tigard
Site address: 7301 SW DARTMOUTH ST
Project: Lumber Liquidators Subdivision: HUNTER POLLOCK NO.2 Lot: G
Project Description: Replacing 200 ft. of water service and 25 ft. of sanitary sewer.
Contractor: MODERN PLUMBING Owner: AMERICAN INDUSTRIES INC
11120 SW INDUSTRIAL WAY 1750 NW FRONT AVE STE #106
TUALATIN, OR 97062 PORTLAND, OR 97209
PHONE: 503 - 691 -6166 PHONE:
FAX: 503 - 691 -6771
FEES
Quantity Description Date Amount
25 If Sewer Service 12/09/2013 $62.54
Specifics:, 200 If Water Service 12/09/2013 $100.06
1 12% State Surcharge - 12/09/2013 $19 51
Type of Use: COM Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $182 11
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
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Issued By: Permittee Signature: _
:1 r ....-4 -
.,
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Dec. 5. 2013 8:56AM Modern Plumbing No. 2832 P.
Plumbi K
n Permi A licationn r�I��
Building Fixtures 111 �! volt t>I I It_ L u.i. cl,�l
Cl of Tigard Y 13 R ECW i PerroitNo.: ,p
City Hall 1,�l s 13 4/'•a 013 - OOL II 13125 SW Hell Hlvd., Tigard, OR 9722 C p
Phone; 503.718.2439 Fax: 503.598.1 ` ikR� oatel6 other Permit No.: f : '
Inspection Line: 503. 639.4175 �?G ` r : e Ready /By: limo Bl See • age 2 for c‘V i 11 1 f, Internet: wHw.lignrd or.gov
�,�11 U A `vV S 1 Nolified/MethOd: - Co Suppleasenlal lnformauon
TYPE OF WORK (Tit" FEE* SCHEDULE
6e so liton For specie! blfarmoliou rrse checklist
New construction ❑Demoi Description Qry. Ea. Total
[$AddilionJnhleration/replacemenl ❑ Other: _ New 1- 2- family dwellings (includes 100 ft. for each utility connection) .
CATEGORY OF CONSTRUCTION SFR (I) bath 312.70
SFR (2) bath 437.78
❑ I- and 2- family dwelling 12 Commercial/industrial 500.32
sPR (3) bath -
ID building ❑ Marlti- family Each additional bath/kitchen 25.02
❑ Master builder ❑ Other Fire sprinkler ( sq, IL) Page 2
JOB SITE INFORMATION AND `LOCATION • Site utilities:
Catch basin or area drain 18.76
Job site address: '7 30 , 5 t,,,) ')!r Y1-- 42A`k1.-... Dyed, leach line, or trench drain 18.76
City /State/ZIP: - 1 - ' , to it Ct - 1 . Footing drain (no. linear lt.: _1 Page 2
Suite/bldg./apt. no.: Project name: ._. A. ,+, Manufactured home utilities 50.03
Cross street/directionS to job site: Manholes 18.76
F T - Yu Rain drain connector
r 18.76
SA 11 Sanitary sewer (no. linear ft : S) Page 2 6 T1
A l Stone sewer (no, linear IL: � 1 Page 2
l s S .>t t :r V C. Wate service (no. linear fl.: ?Q ' Page 2 I (1)
k,
f
Subdivision: Lot no.: Fixture or item;
- far map/parcel no.:
DESCRIPTION DP WO • Clothes washer 25.02 -
/ - . r T►yr 1 „ a Dishwasher 25.02
' / ■ r - - _ 00 ` 0O I r' Drinking fountain 25.02
;- 4.,v\.b till rI r W 041!e, 1` A, Ejectors/sump - 25.02
/�� ® 1Y . Expansion tank 12.51
■ ,. a
Fixture/sewer cap 25.02
Floor drain/ floor sink /hub 25.02
Garbage disposal 25.02
Hose bib 25.02
Phone: ( )
lee maker 12.51
25.02
CI APPLICANT • . , . : . ■ t Interceptor /grease trap
Medical gas (value: $ ) Pagc 2
Business name: 12,51
Primer
Contact name: Roof drain (commercial) 12.51
Address: Sink/basin/lavatory 25.02
City /Slate/ZIP: Solar units (potable water) 62.54
Phone: ( ) 'Fax:: ( )
Tub /shower /shower pan 12.51
Urinal 25.02
E -mail: Water closet 25.02
.CONTRA: OR:::: .- . ::::::::::-• ;.; . <:`::• ::. ...:':> `.:•:.> Water healer 3 7.52 • Business name: ' / • , L / V A „I I `• - Water piping/DWV 56.29
Address: O S' 4 • A I i .9'3 Other: , 25.02
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City/Stale/ZIP. Subtotal ��.� i 1' 4
� h'(� =F I' 9 i 6,) Minimum permit f ee: $72.50
Phone: ( lei /�, � n tP � 1 ' °a' (1/1/1 q , (D 1 1
GA _ plan review (25 % of prnnil fee)
CCB Lic.: % 11 D ( ,i Plumbing Lic.no. it • State surcharge (12% of permit fee) _ ly rs 1
Authorized signature: krt..,- c- �-t0 _o TOTAL PERMIT FEE � .,:
I` # a 1.1 $ Dale, • This penult application i s :sir a permit is not obtained wi a Iao days I � ? )1
after ti has been accepted as complete s
'let methodology set by Tri- County Building Industry Service Board,
I \ nuildiaglPermas 'PLMU- PamfrApp.doe 10/01109 410.16167(10.'03,COMM'En)
Dec. 5. 2013 8:56AM Modern Plumbing No. 2832 P. 3
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 (00' 37.52 2,001 to 3,600 $169.69
Sewer - 1st 100' 62.54 3,601 to 7,200 5233.20
Se
C �P ). 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
750 y Valuation: `Pet nit 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 55,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for
Other Tns actions or.Fees Qty. Fee (es) Total each additional $100.00 or fraction thereof, to
A and including 510.000.00.
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
%%inch no fcc 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
Reinspeclion 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 -12 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 * .
ty by Fixture Type
Quanll
.: Re ar k.' aum b ........ allationo .::::::':::::>
Fixture Type for Repto
Plan review is required for any of the following.
Work Performed: Capped Added nelocale
Baptistry/Font Please check all that apply.
Bath -Tub/Shower El Any new commercial building with water service 2" and
lacuzxi/Whirlpool greater, except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thin ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Asdralor 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 OAR91 780 -0040.
Eye Wash
Floor Drain/sink - 2" Submit 2 sets of plans with any of the above.
-3"
Car Wash Drain 5' L4QIAefr lC: Oi lse 'iI�IR[zl'flR1::::::::::5 >::'::'
Garbage Donnestic�,n food ❑ Isometric or riser diagram is required for new buildings
Disposal - Domestic-food related that meet the qualifications above.
-Commercial-food related
- Industrial -food related
Ice MachJRcfrig. Drains
Oil Separator (Gas Station) _ Comments regarding fixture work:
Rec. Vehicle Dwup Station
Shower -Gang 1I1 r .1JLLAC1 -
-Stall
Sink/t.av -Non -food related tyY■ 1✓
- 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:
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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
7301 SW DARTMOUTH ST, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
2014-01-15 00:00:00
PLM2013-00425
FAIL
1. Provide threaded cleanout outside of building with approved thread sealant.
718.3/719.1. 316.1.1
All else ok
Violation Summary:
Inspector Contractor
CITY OF TIGARD
BUILDING DIVISION PERMIT #:' ' .;' - 4 _''. L�_" •i •
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639-4171 ..u,,
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: \ ;' ;),3$,{. TIME: PAGE:
SITE ADDRESS: `! O1 c;. ' ' �' "} CLASS OF WORK:
SUBDIVISION: - LOT#: TYPE OF USE:
PROJECT NAME: -v- ~ <
DESCRIPTION:
•
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: — .= i Pour Time:
Code # Inspection Description Confirm # Contact # Message
.1
Corrections/Comments/Instructions:
�1 1,.4,Y rte, ` ��. ,�� . • �1 ._ 1- . CA k
❑ PASS ❑ PARTIAL APPROVAL CANCEL NO ACCESS
IA FAIL ❑ CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: '' L".' Date: - 10_ } Phone #: (503) 718-
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
7301 SW DARTMOUTH ST, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
2014-01-23 00:00:00
PLM2013-00425
PASS - No C of O
Violation Summary:
Inspector Contractor