Permit CITY OF TIGARD PLUMBING PERMIT
NI s. COMMUNITY DEVELOPMENT Permit#: PLM2014-00202
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/23/2014
Parcel: 2S102CC00500
Jurisdiction: Tigard
Site address: 13600 SW PACIFIC HWY
Project: Dotty's Subdivision: FREWING'S ORCHARD TRACTS Lot: 15
Project Description: Interior plumbing:Adding(5)2"floor drains,(1)ice maker,(3)lavatories,(1)utility sink,(1)service sink,and(2)
water closets;Capping(1)lavatory and(1)water closet. Other fixtures include(1)backflow preventer,(1)
expansion tank,(2)fixture caps,(1)grease trap,(4)primers,and(1)water heater.
Contractor: WEST LINN PLUMBING Owner: ROIC OREGON LLC
16470 SW BROOKMAN RD 8905 TOWNE CENTRE DR, STE 108
SHERWOOD,OR 97140 SAN DIEGO, CA 92122
PHONE: 503-740-8251 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 06/23/2014 $31.27
Specifics: 1 ea Expansion Tank 06/23/2014 $12.51
2 ea Fixture/Sewer Cap 06/23/2014 $50.04
Type of Use: COM 5 ea Floor Drain/Floor Sink/Hub 06/23/2014 $125.10
Class of Work: ALT 1 ea Ice Maker 06/23/2014 $12.51
Type of Const: 1 ea Interceptor/Grease Trap 06/23/2014 $25.02
Occupancy Grp: 4 ea Primer 06/23/2014 $50.04
Stories: 5 ea Sink 06/23/2014 $125.10
2 ea Water Closet 06/23/2014 $50.04
1 ea Water Heater 06/23/2014 $37.52
1 12%State Surcharge- 06/23/2014 $62.30
Plumbing
Total $581.45
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 day of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Li -•on
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-009' You may obtain a copy of T es
or direct questions to OUNC by calling 503.232.1987 or 1.80
Issued By: Permi ee Signature: ',/ / •
,1111.111W
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,he project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application v.S luJ, o�l 5c1c `!12o?l7tit __ S?e,
Building Fixtures FOR OFFICE USE ONLY
City of Tigard Received permit No.:
g \*\) Date/By: /-7//if GMVtllt(-O
a 13125 SW Hall Blvd.,Tig. l 2
III I Plan Review
Phone: 503.718.2439 Fax. - �'l'. `60 ri `1Q1"1 Date/13y: Other Permit No.:8 436 f 1-
Inspection Line: 501639.41 \\\\�\ '1 Date Read/B 1 la See Page 2 for
I IGARD Internet: www.tigard-or.gov Jv �® Notified/Method: Supplemental Information
TYPE OF WO' . \\ _ FEE* SCHEDULE
❑New construction I� I ?•, On 14 For special information use checklist
0_ !-- Description I Qty. I Ea. I Total
Addition/alteration/replacement a Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
ID , m
1-and 2-family dwelling omercial/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: 1 1-600 St A�- C(c1 C Hw fr/ Catch basin or area drain 18.76
City/State/ZIP: •-r•t a �+`SW- '� ` Drywell,leach line,or trench drain 18.76
y d c Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: v Project name: Do 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 2 31.27 31,17
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Vy 5 : Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER ❑ TENANT Expansion tank •Z 12.51 I2.S1
�/�p� C fit ' �.,o Fixture/sewer cap 25.02 TO O it
Name: (�re(jyp� >f L� Vr�J 11\. �.]�� J\W S
• -"J�" Floor drain/floor sink/hub 25.02 125,10
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 1- 12.51 ( .t-1
❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 1 25.02 2f,02..
Business name: Medical gas(value:$ ) Page 2
Contact name: Primer 4 12.51 50,p(.1
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory ,' 25.02 h)_`a, '
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 A. 25.02 5Q,4 C/-
Water heater Z 37.52 37 s2
Business name: '�esr 1 u n r't (1
r "`� Water piping/DWV 56.29
Address: 16(470 5W ookviiar rd Other: 25.02
City/State/ZIP:Sc'W8od or c17icto Subtotal 57Q l,s'
Phone:(93) 7440-yrLS--f Fax:( ) Minimum permit fee: $72.50
CCB Lic.: 1 cZfC/� ii,/iQ1t5 Plumbing Lic. �JddAQ 7 - Plan review (25%of permit fee)
7/l/, State surcharge(12%of permit fee) (.pa, tD
Authorized signatu �fpi 7 TOTAL PERMIT FE ¶5 IT 6-
Print name: `�,!'`� Date: 67/7//V This permit application expires if a permit is not obtained w hin ISO days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
C\Building\Pennits\PLMU-PermitApp.doc 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-151 100' 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
Storm&Rain Drain-1st 100' 62.54 Valuation: Permit Fee:
$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
Re inspection 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
-Jacuzzi/Whirlpool engineer.
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 ❑ 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" j f
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/Bar non-food related Z 3 ✓
-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 aid before the
Water Extractor p
WaterCloset-Toilet a c/ plumbing permit can be issued.
Urinal
Other Fixtures: Vsl•1.4 Z
&read 1141"? �-
I:\Building\Permits\PLMF_Permit pp.doc 08/04/2011 2
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
13600 SW PACIFIC HWY, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
FAIL
PLM2014-00202
George Heimos
1. Correct leak at dual stop in coffee cabinet. 310.0
2. Disconnect adapter on spout of mop sink faucet. Recommend approved/listed, Side-
kick Wasting Tee from EcoLab for mop/janitorial faucets 301.1 and Chapt.14 Ref. Stds.
3. Water heater pan drain required to go to an approved location. 508.4
4. Provide hot water at women's bathroom sink. 601.3
5. Recall inspection when corrections have been completed. Re-inspection required.
103.5.6.1
1/2" watts model 009M3, serial no. 37761
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
13600 SW PACIFIC HWY, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
FAIL
PLM2014-00202
George Heimos
NOTE: Corrections from previous inspection completed.
1. Correct 3-compartment drainage as per health department requirements, needing an
indirect waste for food prep sink.
2. 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
13600 SW PACIFIC HWY, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2014-00202
George Heimos
Violation Summary:
Inspector Contractor