Permit CITY OF TIGARD PLUMBING PERMIT
a COMMUNITY DEVELOPMENT Fs Permit#: PLM2014-00286
T t c,A It O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 CO Date Issued: 08/28/2014
Parcel: 1 S126DC04700
Jurisdiction: Tigard
Site address: 9575 SW LOCUST ST
Project: Phoenix Inn Subdivision: LEHMANN ACRE TRACT Lot: 5
Project Description: Adding(1)glass washer,(2)floor sinks,(1)floor drain,(1)interceptor/grease trap&(1)hand wash sink. 9/15/14:
Reprinted permit to include(2)water closets and(1)capped Jacuzzi next to pool.
Contractor: PLUMBING CONCEPTS INC Owner: PIH TIGARD LLC
PO BOX 1068 111 CONGRESS AVE#2600
CLACKAMAS, OR 97015 AUSTIN,TX 78701
PHONE: 503-658-5232 PHONE:
FAX: 503-658-5232
FEES
Quantity Description Date Amount
1 ea Dishwasher 08/25/2014 $25.02
Specifics: 3 ea Floor Drain/Floor Sink/Hub 08/25/2014 $75.06
1 ea Interceptor/Grease Trap 08/25/2014 $25.02
Type of Use: COM 1 ea Sink 08/25/2014 $25.02
Class of Work: ALT 1 12%State Surcharge- 08/25/2014 $18.01
Type of Const: Plumbing
Occupancy Grp: 1 ea Fixture/Sewer Cap 09/15/2014 $25.02
Stories: 2 ea Water Closet 09/15/2014 $50.04
g 12%State Surcharge- 09/15/2014 $9.01
Plumbing
Total $252.20
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: Permittee Signature: p z
r G-zs.G-_,n..
Call 503. 9.4175 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 APnlicat'O
Building Fixtures CEIVE� FOR OFFICE I'SF O)NI ,
Rmelvcd
1,1 .. City of Tigard r � y If'ti if -/ Permit No Li+)'r,�f1l T�ily
13125 SW Hall Blvd,Tigard,OR 97i G 2 :) 2014
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960� _4j_`� Date/By Other Permit No.:d(,t:? !!ti// ,
7'I[i A ft 1) Inspection Line• 503.639.4175 CITY Ot j f(. ARD Date Ready/By: runs a See Page 2 for
Internet: www.tigard-or.gov MINIM' NotifiedlMMhod: f Supplemental Information
TYPE OF FEE* SCHEDULE
❑New construction 0 Demolition RECFIV )1 I For special information use checklist '
�t son.lion y. Ea. Thai
,Z]Addition/alteration/replacement ❑Other: New I-2-family dwellings(includes 100 ft.for each utility comedian)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
rst
4411. I ' SFR(2)bath 437 78
❑ I-and 2-family dwelling Cm
ornercial/indu
- ..._._ SFR(3)bath 500.32
❑Accessory building ❑Multi-family -, t 1
• additional bath/kitchen 25.02
❑Master builder ❑Other: ■ t
r r• • f •f 1 , f I, J
� i sprinkler(__sq.ft.) Page 2 .........
JOB SITE INFORMATION AND LOCA • Site utilities:
lob site address: OT�5- S w J <r)(o - .4. Catch basin or area drain 18.76
City/State/ZIP: Drywell,leach line,or trench drain 18 76
y2.1 ��- , 17 2-�3 rooting drain(no linear ft.: ) Page 2
Suite/bldg.lapt.no.: Project name: ,t r�/ , f i iPi IP , ufactured home utilities 50.03
Cross street/directions to job site: 1 ,I , holes 18.76
IIMEt11211, drain connector 18 76
anitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: l Page 2
Subdivision: Lot no.: Fixture or item:
fax map/parcel no.: /5/a`4 aC^ '/ 7D0 Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
'/5/,if ; a4'r t fkj (1) Cif 1*r eke , ,,r9f Dishwasher 25.02
COcq/OtCr-eit' / _ _ Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER-1 ❑ TENANT Expansion tank 12.51
Name:
Fixture/sewer cap 25.02 • S o
Floor drain/floor sink/hub iffell 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 I 25.02
Business name:
Medical gas(value.S ) Page 2
Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 1 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
Urinal 25.02
E-mail: .A •. ♦ 9 . t ,5 5) ,- (.
CO. CTOR Water closet 25.02 So.cy
Water heater 37.52
Business name: (Flu,M 1 ry Cb P' �N Water piping/DWV 56.29
Address: T o 730 x D
Other 25.02
City/State/ZIP: el 4 G 0 1 . <7D(C."- _____ - Subtotal
1111111111 15-.(1
Phone:(5-a3) 1,c3 ,s'-_, 9 Fax:(533) e 5:3 2,s-s-3 Minimum permit fee: $72.50
CCB Lie.: 9 7's g 7 :'16 Plumbing Lic.no.: 3 293 ph Plan review (2S°�of permit fee)
Authorized Sigtlatufx k State surcharge(l2%of permit fee) q.0i
TOTAL.PERMIT FE Illrirnict,,
Print name: +, �� tc: 1 This permit application espirea if a permit is aot obtained with g0 days 'a r 07
✓G"J`'E" �./�c wt l.-�' ■ L) - atar it oaf bees accepted of cowpkte.
*Fee methodology set by Tn-County Building Industry Service Board.
1`9udding■Permigkpt.pnl-PermnApp doe io,oivc 440A616T(10r02KO!WWEB1
p CITY OF TIGARD PLUMBING PERMIT
1 COMMUNITY DEVELOPMENT Permit#: PLM2014-00286
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/28/2014
Parcel: 1 S126DC04700
Jurisdiction: Tigard
Site address: 9575 SW LOCUST ST
Project: Phoenix Inn Subdivision: LEHMANN ACRE TRACT Lot: 5
Project Description: Adding(1)glass washer,(2)floor sinks,(1)floor drain,(1)interceptor/grease trap&(1)hand wash sink.
Contractor: PLUMBING CONCEPTS INC Owner: PIH TIGARD LLC
PO BOX 1068 111 CONGRESS AVE#2600
CLACKAMAS, OR 97015 AUSTIN,TX 78701
PHONE: 503-658-5232 PHONE:
FAX: 503-658-5232
FEES
Quantity Description Date Amount
1 ea Dishwasher 08/25/2014 $25.02
Specifics: 3 ea Floor Drain/Floor Sink/Hub 08/25/2014 $75.06
1 ea Interceptor/Grease Trap 08/25/2014 $25.02
Type of Use: COM 1 ea Sink 08/25/2014 $25.02
Class of Work: ALT 1 12%State Surcharge- 08/25/2014 $18.01
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $168.13
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 • ..t started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the . : adop by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may o.1 a cop • the rules
or direct qu OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By. ,/,. , Permittee Signature:
1 —46—"---- lk
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 ApplicaRECEIVED'
Building Fixtures FOR OFFICE USE ONL1
City of Tigard
rril
q 13125 SW Hall Blvd.,Tigard,OR.597.19G 2 5 2014
Phone: 503.718.2439 Fax: 5039860 Re ceived
Plate/By:
4)i v'` i 1'1
Plan Review
Date/By: ,`� Pernut No 1(may' j. f
-z 9 I i
Other Permit No.:5C04,020fillfre299
T l GARD Inspection Line: 503.639.4175 CITY O-I K3ARD Date Ready/13y: Iuris: H See Page 2 for
Internet: www.tigard-or.gov WIRIO Notified/Method: Supplemental Information
TYPE OF FEE* SCHEDULE Z
❑New construction ['Demolition For special information use checklist ��
Description I Qty. I Ea. I Total
, J Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) ^r\
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ I-and 2-family dwelling grCommerciaUindustrial 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: .0675- 5 W l - v 54- �,..� ' Catch basin or area drain 18.76
J Drywell,leach line,or trench drain 18.76
City/State/ZIP:e i ci��� OR- • 17 2- 3
} Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name: ThO��1 y (/JN 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.: /9 -ip 1 4/ -zoo Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Dishwasher t 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 sink/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 I 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: pLt,trnb n5 C,,,,jc Pf'S I( m C(rv,4 I,�cy Urinal 25.02
J Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: (T to 4.,_4(.-)-1 N „!)(I-cam?+ .IN C Water piping/DWV 56.29
Address: 6 -Bo , i cD iA Other: 25.02
City/State/ZIP: L/4G14 , �'7D(1/4C---Q Subtotal `5(7.,3-
Phone:(S-a3) to54 S-.9 2 Fax:(533) 4s3 3 3 Minimum permit fee: $72.50 =
CCB Lic.: 9 7'5 7 a 'IL Plumbing Lic.no.: 3 4293 p,. Plan review (25/°of permit fee)
State surcharge(12%of permit fee) /4.4
Authorized signat TOTAL PERMIT FEE 1 (��,/5
Print name: --)666" 2 no"-, t,� ( T ate:
This permit application expires if a permit is not obtained within 180 days
CvJ after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Pennits\PLMU-PermitApp.doc 10/01/09 440-46167(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- 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
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
ID 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 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 1 ❑ 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
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 /
-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 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
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
9575 SW LOCUST ST, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
FAIL
PLM2014-00286
George Heimos
1. Provide 1/2" Backflow device test results (RP). 603.3.2
2. Provide a minimum of 1" clearance for both 3/4" and 1 1/2ice machine drains to floor
sink. 801.1
3. Expose/uncover P trap primer. 103.5.1.4/103.5.1.3/315.3
4. Recall inspection when corrections have been completed. Re-inspection required.
103.5.6.1
Violation Summary:
Inspector Contractor