Permit CITY OF TIGARD PLUMBING PERMIT
I Permit#: PLM2014-00105
COMMUNITY DEVELOPMENT
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/09/2014
T[('AR.O Parcel: 2S102AB04500
Jurisdiction: Tigard
Site address: 12436 SW MAIN ST
Project: Tigard Wine Crafters Subdivision: KINGSTON Lot: 2
Project Description: Relocating(2)sinks
Contractor: RELIANT PLUMBING&MECHANICAL Owner: CAPISTRANO, NICOLAS N REV LIV TR
11575 SW PACIFIC HWY SUITE 219 CACH, CHRISTOPHER J
TIGARD, OR 97223 6003 4TH AVE NE
SEATTLE,WA 98115
PHONE: 503-246-1201 PHONE:
FAX: 503-246-1205
FEES
Quantity Description Date Amount
2 ea Sink 04/09/2014 $50.04
Specifics:, 1 12%State Surcharge- 04/09/2014 $8.70
Plumbing
Type of Use: COM 22 ea Minimum Fee Adjustment- 04/09/2014 $22.46
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 Notic�ation 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 d(i,....._J
questions , OUNC by calling 503.232.1987 or 1.800.332.2344.
Iss By: /, Permittee Signatu e: w-i
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.
Apr. 8. 2014 10:09AM Relient Plumbing and Mechanical No. 0711 P. 1
Plumbing Permit Application
Site Utilities RECEIVED FOR OFFICE LISP: asax
li,eeelvea
City of Tigard DarerBy: 4 ' / I Penni,No.: pc 1.49.4/ -40105
IN ■ 13125 SW Hall Blvd.,Tigard,OR 9 3 Plan Review
I. Phone: 503.718.2439 Fax: 503A 960 a 2014 Date/By: Other Permit No.:
Inspection Line: 503.639.4175 Date Reidy/By:B Jam: ®See Page 2 for
Trt„Ann dy/ y s
Internet: www.tigard-oLgov 0r t a •'.� Notified/Method: Supplemental Information
l - --- - -
❑New construction ❑Demolition For special information use checklist.
Description Qry. I Ea. I Total
K Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 R.for each utility connection)
r--=_ _ 00-1(irts ` Rip- shit ffisf.;�- T.1 SFR(1)bath 312.70
❑ 1-and 2-family dwelling .t 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
t-_- „,- -ilJ y -8'c 1141 -it V-7(l n�teci 11ij-L ;.. Site 11
Job site address: I�"7 3co a In 3�' Catch basin or area drain 18.76
Drywall,leach line,or trench drain 18.76
City/State/ZIP: I c C 6' r 3
Footing drain(no.linear ft.:,_,__) Page 2
SOi Lc/bid gJapt.no.: Project name:TIC)aIrel (&J int CYA1f4t Manufactured home utihtwa 50.03
Cross street/directions to job ste: 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: Lot no.: Fixture or Item:
Tax map/parcel no.: Backftow prevontcr 31.27
Backwater valve 12,51
"----..-__._ '_ - = Clothes washer 25.02
1 • S 1 Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
°R 92.0.0 .0-fa.if-- H -i d F l is o 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 25.02
Phone:( ) Fax:( ) Ice maker 12.51
t A "iTiti t.1` ��- i)it
1 ;_-- -. �t! Rf�i�,j_trNl7�I;� s Interceptor/grease trap 25.02
lay)-1- t l'e r\I Medical gas(value:$�) Page 2
Business name: M I r X.,e,'
^`y� , '(ir Primer 12.51
Contact name: U1 Roof drain(commercial) 12.51
Address: 11S-7S- PaCI tc wY Sink/basin/lavatory 2 25.02 '513„Oil
City/State/ZIP:I-l a rk 1 c,A2. to-?223 Solar units(potable water) 62.54 I
Phone;( 3) S U_ I Fax:: ) 2/../( - I2 Tub/shower/shower pan 12.51
E-mail: a Sri .A 04 at I a l/ 7i f unn t<JI .r . Oril Urinal 25.02
_ - :-400 f.1 `;r - _ Watercloset 25.02
-_- -= Water heater 37.52
Business name: !A a Si - 11 • .. .t , �.� to waterpiping/DWV 56.29
Address: l Ecls- icr 1c F }-f'4� 3 Other: 25.02
City/State/ZIP: -r pa f� aia 972 -�5 Subtotal
Phone:( j ) Z L4 Co- 126 I Fax:cfj1) yCp-n65" Minimum permit fee: $72.50 ,s-o
CCB Lic.: 0 9(Gl Plumbing Lic. `1 Plan review (25%of permit fee)
State surcharge(12%of permit fee) C$L..70
Authorized signature: ^_____ c ` TOTAL PERMIT FEE 1,2z)
V n t_t Bed s ? f/8,126 I This permit application expires if a permit is not obtained within 180 days
Print name: t r l-1,/' ate:"7 4
✓" erter it lies been accepted as complete.
'Fee methodology set by Tri-County Building industry Service Board.
I:iau nding\Pe+miu\PLMU-Per<n4.pp.doc tOfOV09 4404616T(I0/02/COM/W.B)
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' 37.92 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
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 ❑ Any new commercial building with water service 2"and
greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
-Jacuzzi/Whirlpool engineer.
Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure
v as defined in OAR918-780-0040.
Cuspidor/Water-Drive Thru ❑ 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 Filer increase of sewer EDUs,a sewer permit will be issued and
Washer-Clothes fees assessed for the sewer increase must be aid before the
Water Extractor p
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12436 SW MAIN ST, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
April 28, 2014 at 10:01:12 AM
PLM2014-00105
George Heimos
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12436 SW MAIN ST, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2014-00105
George Heimos
Violation Summary:
Inspector Contractor