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Permit u CITY OF TIGARD PLUMBING PERMIT 114 COMMUNITY DEVELOPMENT Permit#: PLM2014-00099 T t(i A.RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/14/2014 Parcel: 2S112AA00300 Jurisdiction: Tigard Site address: 14200 SW 72ND AVE Project: Gerber Blades Subdivision: MILLMONT PARK Lot: 49 Project Description: Interior plumbing:Installing(1)2"floor sink and(1)water supply. Contractor: ASSOCIATED PLUMBING CO Owner: ASGARD LLC 200NE VICTORY AVE"C" BY GERBER LEGENDARY BLADES GRESHAM, OR 97230 14200 SW 72ND AVE PORTLAND, OR 97223 PHONE: 503-492-1922 PHONE. FAX: 503-492-1923 FEES Quantity Description Date Amount 1 ea Floor Drain/Floor Sink/Hub 04/10/2014 $25.02 Specifics: 35 ea Minimum Fee Adjustment- 04/10/2014 $34.97 Plumbing Type of Use: COM 1 ea Primer 04/10/2014 $12.51 Class of Work: ALT 1 12%State Surcharge- 04/10/2014 $8.70 Type of Const: Plumbing Occupancy Grp: Stories: Total $81.20 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By:C Permittee Signature: / ( /n Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Plumbing Permit Application - l i a i Site Utilities �NV i i i i 1 OC1 RCC@1ved Vennrt Ni' City of Tigard OI�� Downy `�f 74y �__ Pu.-- /1.41.4 <h_eve em 13125 SW Hall blvd_Tigard.(112 97222 1 ` t;Lm Review tlthcr Permit Nn.: Vi Phnne' 51)3.714.2439 Pax: 503.598.1960 Ao )ate 13v -----..... - inspectinn l,inc• 5(13.N19,4179 r`� (([`_� );�I•Iltrn,.h%Itp loci, 1;3 Rae Pace 2 Mr T1GnRD inti rllcl• www.li�,ard-Pr.p(w �c% cdtMethud 1 Supplements'Inrnrmntinn - . TYPE OF WORK C1� 21` _. FEE* SCHEDULE _ ih %\11f" _ For:vein/information Nee rheckln7.� ❑New ctmstntction ' ... - , I)eseriptidn _ I Qty.;_-) Ea. I TO.,al -g 71/4ddition/alteration/replacement ❑Other: New I-2-ramily dwellings(Includes 100 0. for each wilily connection) -- I 1 hash 312 7t) CATEGORY OF CONSTRUCTION SYR( -- -•-- - tifR(2)bath 437.74 ❑ 1-and 2-family dwelling Cmllnlereial/indtlstrial inn,32 .- SFR(3)bath - ❑Accessory building ❑Multi-I;imily Each additional bath/kitehcn 29.(12 ❑Master huildor ❑Other: Fire sprinkler( sq. R.) Page 2 J(1$ SITE INFORMATION AND LOCATION Site tttilitica: .-.• -- C':ateal basin nr area drain _ 18.76 Job she address:/Y-)rr Vp _��' '� - Drywell,leach line.or trench drain 14.76 City/St ate/711': 4/d.m4 v r-. 1??l-'� - Footing tting - drttilt(no.linear ft.: ) Page 2 Suitc/b)dg./apt.no Prr+jcta namc:� . ..gp►�rr, .. Mnnnlaitured home utilities 50.03p - - Manholes 18.76 Cross slreet/dircctiony to job Suet -_-_.,__... _ - , - .-..-. ----•• --.-._._.. IR.76 -"-- Rain drain connector _ _.._.-..... . .._._.__.......,. _._..-_.-... ...._._ San dm sewer{nu.linear I't.:��i ('age 2 •- ..•--• Storm sewer(no.linear Iii,: ) Page 2 ____._ .. _--._. - Water service(nn.linear 0.:-) Page 2....._ Subdivision: I of no.: hate or item, -- -• .._-.-_. .-.. Backllnw prevenicr » 31.27 Tax map/parcel no.: - --.... r Backwater valve 12.51 DESCRIPTION OF WORK ---• ____.. _-- Clothes washer 25.02 `4VltaC..4 e/) A7ao.- S-"...,44- a- (f) t er-ve_. -._ Dishwasher _ O2 - - Drinking.lbuntain 25,02 Ejectors/Pimp 25.02 - Expansion tank 12.51 fv _.._- G PROPERTY OWNER © TENANT 25.02 _ J Fixturc/sel.vcr cap Name- - - - Floor drain/floor sink/hub.- L` 25.02 2rs-°� r Address: ,.. (iarha•e disposal 25.02 _ b R - City/Stole/ZIP! -.. .... _ _ l In+e hih _ 25.02 .. 12.51 - Ice maker Phone:( ) hay:( ) +- Interceptor/grease trap 25.02 ❑ APPLICANT (:()N'I'A(.'(' PER,. _.. ... --- _ . ....._. l _.,... Medical gas(value:C 1 Page 2 Rosiness name, . _Primer -- . - ' i,Z 1 Contact name: t --- - t It,ad'drtttn(commercial) 12.51 Address: _ 1,_I _ Sink/1+asin/lavatnr} 25.02 -- ... ..... ,... _-.._.. ....._--. -- -_-... ....---•- ` Solar units(potable+valet') 62.54 Ott _ ._......---•- J l uh/shuwcY/ghnwcr pan 12.51 _,.‘• Phone:( 1- _ elite: :1 I _ •- 2c - _.. urinal k-mail: • 25.02 _. _-----., Water closet - w CONTRACTOR _. _ Water healer 37.52 Kusincss name: G • - Water pipiiig/DW V 56,29 .__.,. _...- ,, , l)ihCr: 25.02 City/titate/%11': G �, D.. 97 .7 S 37.s �- q Minimum permit toe: A72.5U .A_ Phone: v )..• L-/47,.L Pax:('sil3 ) /4,. '•it -- - ` --- ----- • Plan review 125'Yn of permit icc) C•C'13 1.1c.: Phnnbing I ie,nu.: r6�i/L fe ---" �[� ... .... _ State surcharge(17."/•nl'permil fro) er`' Authorized signature: / TOI AI,PERMIT FF.F I g Print i 1):ttc: 4,...7....#.y l 1'lhi.permit aPPtientinn rrpires irn permit is nft obtained within 19n'days mune: D XAytgiaL,,� I niter it has been accepted as complete. "Fee mcmodiiimiv eu1 tw•ere-Cnanty Rsikling Industry Service B 1. � I,Iluildin1DI'cr...,,+nl.Ml'-nrnnnApp(I'.c +'+^II4.. Jau-10 innr-q'I M.,Wlillt -5 a3 Plumbin Permit A lieation - City of Tigard Page 2 - Supplemental information Fee Schedule: Residential Fire S^ppression Sntem$: ,,,,_ Site Utilities Qty. J Fcc(en) Total ' 9uare Foota7e: Permit Fee: 50.03 O to 2,1100 _ $121.90 Fooling drain-t" Inn' �2.pot to 3.000 5169.69 . Sewer _ .. Fooling drain-each additional 100' 17.52 -3,601 to 7,200 -5233.20 - Scwcr- I st 1011• (,2.54 7,201 and •reeler ._ 11327.54 • Scwcr-each:ulditional 100' 37.52 Water Service-1st 100' 62.54 .� Medical Gas Systems: , Water Service•each additional 1(X)' 37 52 V8{UAtion: _ _ Permit Fee: . Storm&.Rain Drain-1st 100' hL•54 c .n(1,n tiS.O(r1 cis Minimum Ice$72.50 Storm R C Rain Drain•each uddilinnal I00- i .17.52 — -'15.1iiil.01 to$I(1.(00 00 $72.50 irtr the lint$5.001.00 and$1.52 for �r" Fcc(ca) Total each additional$(00.00 nr fraction thereof:to Other Inspections or Fees Qt'' and ineh,dinQ$10.000 i►ll. Inspection nl'exisming plumbing ,i fir $10.0nI oo to$2y-O011 Ofl $148.50 1'or the firs($10,00(1.00 and$1,5.4 for which no fix is specifically indicated 911.00/hr each additional$100.00 or fraction thereof,to (minimum charge-1/2 hoar) _ and including$25_000.00. _ inspections outside annum!hnsincss 90.00/hr $25.001.00 In$50,00(1.00 $.179.50 for the first$25.000.00 and$1.45 for _hours(minimum charge-2 hours) , ._ . - each additional 5100.00 nr fraction thereof,to Rcinspeetinn!-co S 90.00/hr and including$51),000.00. 90.(x)/hr 550.(x11.00 and op $742.00 for the first S50,000.00 and$1.20 for Additional e a r review for revisions ∎ each additional$100.00 or fraction thereof. 1 (minimum charge IT!hour) .. ---.... 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. Quantity b):Fixture l'Ypc , Plan Review for Plumbing Installations Fixture Type for Replace/ Plan review is required for any of the following. Work Performed: lapped \tided Relocate Please cheek all that apply, 13aplisirvnin( - ❑ Any new commercial hUilding with wafer service 2"and Rath 1'uh/Sltmvcr _- -, . .. greater,except systems designed and stamped by licensed -,facu»dWhirlpool __ — engineer. Car Wash -Each Stall •... ❑ New exterior rittr phitnhing site utilities for any complex structure -Drive'lira as defined in()AR9113-780-t)t440,• Di spitlor/Waler Aspirator _ ❑ Medical gas and vacuum systems for health care facilities. Dishwasher -Commercial I _ -iNimestic _ ❑ Any multipurpose lire sprinkler system. Drinking Fountain ❑ Any complex structure AS defined in C)AR918.78O-0040. Lye Wash I — Submit 2 sets of plans with any of the above. Floor Drain/sink •2 - � � -4- _} — Isometric or Riser Diagram - (yrWash Drain ❑ Isometric or riser diezram is required for new buildings (iorhage -Domestic-non-food Disposal -t)nmestic•lood related { -^ — that meet the qualifications above, •COmmcrcinl-foarl related -industrial-food related lee Maeltiltcrri .Drains ----- Oil Separator((las Station) Comments regarding fixture work: Rec.Vehicle Dump Station ,-- -Urn_ _ -Stall Sink/l.:av -Non-food related -Bradley _ -Commercial-food relined — -Service Swimmin!Pool pilfer *Note: if the fixture work under this permit results in an Washer--Clothes increase of sewer EDUs.a sewer permit wilt he issued and Water Closet-i fees assessed for the sewer increase must be paid before the Water Closet-Toilet r _ Urinal plumbing permit can be issued. Other Fixtures! L C:111sers\O wnerl lcsklop\l)ocumcnls\l)octimenta"l't:rmitsATigard PImh.do0 . qia PLUMBING Ca. 200 NE Victory AVE "C" - } Gresham, OR 97030 CCB# 057890 Phone: 503-492-1922 Fax: 503-492-1923 FAX. TRANSMITTAL DATE: April 7, 2014 TO: City of Tigard PROJECT: Gerber Blades .., ATTN: Trade Permits PAGE #INC. COVER: 3 _. ._ SENT BY: Brad Marshall MESSAGE: See the attached permit application. Please call when ready for payment 503-492-1922 Thank. you Commercial " Residential * Industrial * Remodel * Repair * Service