Permit CITY OF TIGARD PLUMBING PERMIT
11111 Permit#: PLM2014-00367
3 COMMUNITY DEVELOPMENT
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/06/2014
TIGARD Parcel: 1 S135BD00100
Jurisdiction: TIGARD
Site address: 9600 SW OAK ST
Project: Plaza West Subdivision: ASHBROOK FARM Lot: 5
Project Description: Replacement only of fixtures for bathroom remodel: (4)lays,(5)water closets and(2)urinals.
Contractor: JAMES ROOD PLUMBING INC Owner: SUN LIFE ASSURANCE CO OF CANADA
125 S 1ST AVE#542 BY NORRIS BEGGS&SIMPSON
HILLSBORO, OR 97123 121 SW MORRISON ST#200
PORTLAND, OR 97204
PHONE: 503-547-0491 PHONE:
FAX: 503-547-0492
FEES
Quantity Description Date Amount
4 ea Lavatories 11/06/2014 $100.08
Specifics: 2 ea Urinal 11/06/2014 $50.04
5 ea Water Closet 11/06/2014 $125.10
Type of Use: COM 1 12%State Surcharge- 11/06/2014 $33.03
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $308.25
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: AN
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
Building Fixtures i FOR OFFICE I_.S' O:NL1 n I c r)
City of Tigard ! W Date/By. lr 6//y "f Permit rro/ou�v7,o/` --eV o 7
r■ 13125 SW Hall Blvd.,Tigard,CR�l Plan Review
Iii = Phone; 503.718.2439 Fax.
503.59 Q 2 C Date/B y: Other Permit N2tP�/ O
D� C3
r s c,n t<n In ectin Line: 503.639.4175 Date Ready/By: s: gi See 2 for
Internet www.tigard-or.gov - NotifedRvtetbod: $upplequaaral Information
❑New construction • III 1 'lion For special information use checklist
- Description Qty. Ea. Total
DI Addition/alteration/replacement ❑Other. New 1-2-fatal dwell",:a includes 100 it for each util' connection)
SFR(1)bath 312.70
❑ 1-and 2-family dwelling ❑Cammacialf idustfiai SFR(2)bath 437.78
- - SFR(3)bath 500.32
❑Accessory building ❑Multi-family Each additional batti/latchen 25.02
❑Master builder ❑Other. _ Fire sprinkler( sq.ft.) Page 2
4 FLT :-. .._.. w:.. Site utilities:
lob site address: 2(00 cy L f cf 5--- -
Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: , V/-' Footing drain(no.linear ft.: ) Page 2
Suite/bldgjapt.no.: w Project name:3,,.r( ,_,letiOttlkk kehtr Manufactured home utilities 50.03
Cross stir-et/directions to job site: ,_..s Manholes 18.76
Rain drain connector 18.76
'" Sanitary sewer(no.linear ft.:__) Page 2
- - Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: ( Lot 00_: `Fixture or item:-
Tax map/parcel no.: _.__ Backflow preventer 31.27
,s- - Backwater vale 12.51
e
: i .:---- -- ... ... ,:_ Clothes washer 25-02
CA-C eW Rx7 '‘)/ VS Dishwasher 25.02 -
O! 6ts- ,-A.,ed /Lr) 1224,1 + - t1MS Drinking fountain 25.02
op‘''''' acteit // 1 • Ejectors/sump 25.02
s r f; `"" - - Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: Garbage disposal 25,02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice makes 12.51
WI wT .„_.-- .. . _. tnterceptor/grease trap 25.02
Business name: Medical gas(value:$ ) 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: Urinal a- 25.02 -
Water closet 5' 25.02
1?jia ° i '_...._...,, .. ..... ....�_.... .._. ,....,_........ Water heater 37.52
Business name: �
�" / -�../(��� � L1'►�I kJ �1�.�, Water pipittg/DWV 56.29
Address: /a-S S' /51- tip/" .0(e--5-y2_ Other: 25.02
City/State/ZIP: Ai r/ls 9 CM 0 jra 7 / Subtotal
Phone:( o ) S _ b ea Fax:(3-63) f ' - 1-- Minimum permit the: $72.50
CCB Lic.: /7.2:70 I ., 7q1 I 10 Plumbing Lic.no.: 45-5- Plan review (25%of permit fee)
.' State surcharge(12%of permit fee)
Authorized signatur i . TOTAL PERMIT FEE see,ca.si
/ q�_� This permit application expires if a permit is ant obtained within 180 days
Print Hartle: a Date(//5//20/Y after it has beau accepted as complete,
//// !
'Fee methodology set by In-County Bcdldingg Industry Service Board.I:\Builcinerermits\Ptan3-Parn,itArp.doc 10/01/09 4A au6TbnrovcOM+Waa) oici ,/ ON LI /E L /SS-t.e l/yA/L
Plumbing Permit Application- City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Su■ ,ression S stems:
111.7‘'-';:77",:_:'_7-7--7;::".7.-:,.:2!;-::!2, i 7777 .: y r _„i S - ..t. '�,;. l t t ;!t a T'%:767
1.;•-,,'..,:,i1,..,-, .:.. � �: r _._.__,_.. ,..yr i -�1 .:.. _1 LL .. d•m .rtYr-,�.•.1(-;1 ;:d....0. .,. .•:., -,�'F.HN1M: Ynh�n.r:i`C h,[�1'�ail�
Footing drain-1'100' 50.03 Oto 001 0 co 0.600 $129.90
Footing drain-each additional 100' 37.52
3 601 to 7,200 $233.20
Sewer-1st 100' _ 62.54 7 01 and: ater $327.54
Sewer-each additional 100' _®�
Water Service-1st 100' NM 62.54
Medical Gas S stems:
Water Service each additional 100' 37.52 W
WI 4,u , {. " , ''" _ `.:• "•
Storm&Rain Drain-1st 100' 62.54
_ $1.00 to$S 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
,. . , , r y fr each additional$100.00 or fraction thereof,to
` 't i{.,,,,. t '' ' !` and includin:$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 char:e-1/2 hour and includin:$25 000.00.
Inspections outside of normal business NI 90.00/hr - $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours minimum char:e-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and includin:$50 000.00.
Additional plan review fbr revisions MI 90.00/hr - $50,001.00 and up 5742,00 for the first$50,000.00 and$1.20 for
minimum char:e-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*.
IAt'iI+ '4Wrnma ^,; �'�'r,. ,u7,VT,+t.,T'7,�.-7^^rc ei,(A �S f,•� k .'nr:-,1-_;:,.:7,:....._-.1-,.;;s:,-„,,i
' i r.A i •- t t't" n ' i;'I R i t -1u5'i. i•',;' ,.-' 1...,r r :S ? .,,i•1 5,,, , 15 I , .,r -
Gre +a��, '� ri � ,fi sf- W S ,w r w�,n� .0»-:' .;'..r;- t....,t•c,.,t..!_..:. ...., .. L:.,,..
f-. 1;tr(f., ,. x ,F} 1 r��; i A «g t 1, y i,, Plan review is required for any of the following.
:Ix,,.fin .. ,. �..x.A it L 1 a.., 24..aiSI :�_.AK .. 1 . Please check all that l
Baptistry/Font �p Y
Bath -Tub/Shower ❑ Any new commercial building with water service 2"and
-
-Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru 0 New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR9 I 8-780-0040.
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 OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
-3"
,1 ....»- ,- a
- . .r,:u X r.� z r.... T ; .._ �
Car Wash Drain
Garbage -Domestio-non food ❑ Isometric or riser diagram is required for new buildings
Disposal -Domestic--food related that meet the •ualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) _ Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang AP ' s-
Stall _ ; _ ,f �C./ l �/ Q i^
Sink/Lav -Non-food related q ��
-Bradley !j�S
-Commercial-food related -.
Service .___________
Swimming Pool Filter *Note: lithe 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 5 fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixanes:
C_1Usersljim\Down loads\PLMF-PermitApp(14).doc 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
9600 SW OAK ST, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2014-00367
George Heimos
Violation Summary:
Inspector Contractor