Permit CITY OF TIGARD PLUMBING PERMIT
''1111 • • COMMUNITY DEVELOPMENT Permit#: PLM2014-00369
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11!13/2014
TIGARD Parcel: 2S102AC00700
Jurisdiction: TIGARD
Site address: 12550 SW MAIN ST 120
Project: All Tech Subdivision: BURNHAM TRACT Lot: 1
Project Description: TI for new tenant adding(2)bathrooms and a breakroom to include(2)water closets, (2)lays,(1)breakroom sink
and(1)water heater.
Contractor: JAMES ROOD PLUMBING INC Owner: DOLAN & CO LLC
125 S 1ST AVE#542 BY FLORENCE T DOLAN
HILLSBORO, OR 97123 4523 NE DAVIS ST
PORTLAND, OR 97213
PHONE: 503-547-0491 PHONE.
FAX: 503-547-0492
FEES
Quantity Description Date Amount
1 ea Sink 11/13/2014 $25.02
Specifics: 2 ea Lavatories 11/13/2014 $50.04
2 ea Water Closet 11/13/2014 $50.04
Type of Use: COM 1 ea Water Heater 11/13/2014 $37.52
Class of Work: ALT 1 12%State Surcharge- 11/13/2014 $19.51
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $182.13
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 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 OU_NC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: ,'/ W(Pr9--770 A /
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 r.r( oral(r l -0
City of Tigard DaRfteiv'd
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1,, .. 13125 SW Hall Blvd.,Tigard,OR plan Review
Phone: 503.718.2434 Fax 503. 6 2014 Davy. Other Permit Na37//j2,0/y 040/,20
. u�, Inspection Line: 503.639.4175 pate Ready/Br hair Ed See Page 2 for
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Internet www.tigard-or.gov . ' ,. y .a l Notified/Metbod: Su., . information•"r'''''''li Ig. ,+,.era e:.a E,t..1.'24'";:'...-.4%.;114;,' ti rh., ... - .., .....t...L t... .,........%.11_'',L . .:... .... _1 - ? -....
❑New construction ❑Den3Olitiola For special information use checklist
Description I Qty. 1 Ea. I Total
Addition/alteration/replacement ❑Other New 1-2-family dwellings(includes 100 R.for each utility connection) N.
,T,Vi a�- n.,. r j�i,. s t
SFR(1)bath 312,70
1.r1 .:, .i,w...r dbh..`.?.i: ..._ ., - , :.,....._ .. _. . at,i d,.. ..... 1
❑ 1-and 2-family dwelling Si Comm SFR(2)bath 437.78 Q
SFR(3)bath 500.32
❑Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 .".
-1 :ISM f J 4 ,y '' _ '+'il7. , :�
i. i ! 1! ∎ ! � '.) r...; !o. Site utilities:
Job site address: )a,S 5O ,W t,6.- S Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:
Footing drain(no.linear It.: ) Page 2
Suite/bldg./apt.no.: /AC I Project name:ALL 1c.-rEcttt 2 Manufactured home utilities 50,03
Cross street/directions to job site: Manholes 18.76
r
Rain drain connector 18.76
Sanitary sewer(no-linear ft.: , ) Page 2
Storm sewer(no.linear ft.: 1 Page 2
Water service(no.linear ft.:) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
Tax
i. ft
Backwater valve 12.51
1&1>!$ 7,i. ;c:. ;,.w:r _,a .::_ f....:u. . ,tni:+ ;n, ,,., 4e Clothe was-her 25.02
au__ rvr its a1• !cis �, bp-�il00Ue•- �1 Dishwasher 25.02
` ,1I.. i.ityvcl..- k t exti>" Drinking fountain 25.02
Ejectors/sump 25.02
fy8t 1- y..1 )T+ t-yr,�m r r^m Tim-5G�,rt 1131
W am ytt,: ,v . ' _ .. ,., !-. .,. ...-, i ` bt Expanstontank 12,51
�.i . : ; ,fit i .,ea`,.r}... �,7,y„4),�p):. r--
Name: Fixture/sewer cap M 25.02
Floor drain/floor sink/hub 25.02
Address: Garbage disposal 25.02
City/State/ZIP: 7 Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
i P 1 ' ,rt '7' '" 'r ' : ` i ,, interceptor/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 ._r 3 25.02 )3_04
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
ir.: err: -' ', . Water closet iZ„ 2102 So.0y
... . ... ... Watu heater i 37.52
Business name. S &c PIk'1�t i Water P�P Sro 1 in WV 56.29 -
Address: i 4,,$ 5", 43, ave. $( Other. 25.02
City/State/ZIP: /7114 bo+f-0 4 0 I.'. 9 7/ 7 Subtotal _/6g,6A
Phone:(St)3 ) sls 7.- 0 4/9/ Fax:($'p3 ) s.9 2-691 Z Minimum permit fee: $72.50
CCB Lie_: r Stan`'31f 4 Plumbing Lie.no.:pes C}
Plan review (25%of permit fee)
` ---w - State surcharge(12%of permit fee) /9.5/
Authorized signature: . ---#"",.......,....• - / TOTAL PERMIT FEE ff,,Z
Print name: i._r i Dom- ♦ 'This permit application expires it permit is not obtained within 180 dart
after it has been accepted as complete.
l 'Fee methodology set by Tri-County Building industry Service Board.
Rik ilding\Permits\P'LMU-PermitApp.doc 10/01/09 440.¢616T(10/02/COI+r/wEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information .
Fee_Schedule: Residential Fire Su i r ression S stems:
?,-4,* r,r.,Fc.�- '...-.-_ .' ?.m 1 . :t'. .,- 3: ,.} G rir.''., d i,ain,. .r„ ..ta, '.,',.t'.{.. __..,. ...:
Footing drain-I"100' 50.03 0 to 2000 $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 01 and treater $327.54 _
Sewer-each additional 100' ®IONII
Water Service-1st 100' 62.54 Medical Gas S stems:
water Service-each additional 100' 37.52 r ; .'cr i- e7.. ; !,' A' '.'. iF„ . ,.ray i'i lrf?t{T r±1
Storm fit 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
each additional$100.00 or fraction thereof,to
. r:F.rr..,,l 1 y�...!' i..,.' l',", and inoludi :$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 includin,$25 000.00.
Inspections outside of normal business 11111 90.00/hr - $25,001.00 to 550,000.00 $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 for revisions - 90.00/hr - $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
minimum char ,12 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 re'ort fixtures could result in increased sewer fees*.
t. � K' ey t ,•big +4? >1Q Stew -t. (at�.' ...r '+ �31. v,,;,4,-, .,--,.-‘,..,,,-.,• t- .....'.,.-• ; , ,..... •4N � �' ` _w.l V �, ri 1 i it
i':' . r r1 ' ,' x, t �- f.;'.<a� {' Plan review is required for any of the following. '~•5...', t,,.. .r o .i 'nr 7L-?; ,. f.i"k. ti..._.w.',...... ,....... .4., ..=.. Please check all that apply.
Baptistry/Font
Tub/Shower ❑ Any new commercial building with water service 2"and
Bath -
- b/S i/Whirlpool • greater,except systems designed and stamped by licensed
-Car Wash -Each Stall engineer. ,
-Drive Thru ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR-918.780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain Q 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"
-4„ i °r tf ' E i . i ti r,i7.:jnlJ:`'e.:4,kj9
Car Wash rain w,: ra _ :, .., ,t .
2c:;',,,
Garbage Domestirrnon food ❑ Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the i ualificattons above.
-Commercial-food related
-Industrial-food related _
ice Mach./Refrig.Drains
Oil Se1arator(Gas Station) C9wTnents regarding fixture worli:
Rec.Vehicle Dump Station . , l -'fio►!'t _ /ty_
Shower -Gang
Stall . i4 o i vi !
Sink/Lay -Nonfood related ,
-Bradley _
-Commercial-food related
-Service
Swimming fool Filter *Note: If the 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 1, fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
C:\Users\jim\Downloads\PLMP-PermitApp(5).doc 2
James Rood Plumbing Inc. 11/6/14
Office 503-547-0491 fax 503-547-0492
Jroodplumbing @gmail.com
Forwarding plumbing application,please let me know plumbing permit fee's&sewer fee's
Thanks,Jim
7111 Accumulative Sewer Tally
■
Tenant Name: All Tech SWR# 2014-00120
r G n k D Site Address: 12550 SW Main St.,Ste. 120 PLM# 2014-00369
Parcel#: 2S 1 02AC 00700
Fixture Value Previous Previous Credits Capped Fixture I Fixture New New
# value count capped#s value count added# added value total#s total values
Baptisery/Font 4 0 0 0 0 0
Bath: -Tub/Shower 4 0 0 0 0 0
-Jacuzzi/Whirlpool 4 0 0 0 0 0
Car Wash: -Each Stall 6 0 0 0 0 0
-Drive through 16 0 0 0 0 0
Cuspidor/Water Aspirator 1 0 0 0 0 0
Dishwasher. -Commercial 4 0 0 0 0 0
-Domestic 2 0 0 0 0 0
Drinking Fountain 1 0 0 0 0 0
Eye Wash 1 0 0 0 0 0
Floor Drain/Sink: -2 inch 2 0 0 0 0 0
-3 inch 5 0 0 0 0 0
-4inch 6 0 0 0 0 0
-Car Wash 6 0 0 0 0 0
Garbage Disposal:
-Domestic(to 3/4 HP) 16 0 0 0 0 0
-Commercial(to 5 HP) 32 0 0 0 0 0
-Industrial(over 5 HP) 42 0 0 0 0 0
Ice Machine/Refrigerator Drain 1 0 0 0 0 0
Living Unit 16 0 0 0 0 0
Oil Sep(Gas Station) 6 0 0 0 0 0
Rec.Vehicle Dump station 16 0 0 0 0 0
Shower. -Gang(per head) 1 0 0 0 0 0
-Stall 2 0 0 0 0 0
Sink:
-Lav/Bar-Non-Food Related 2 0 0 3 6 3 6
-Bradley 5 0 0 0 0 0
-Com/Serv/Util-Food Related 3 0 0 0 0 0
Swimming Pool Filter 1 0 0 0 0 0
Washer-Clothes 6 0 0 0 0 0
Water Extractor 6 0 0 0 0 0
Water Closet-Toilet 6 I) 0 2 12 2 12
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS _ 0 0 0 0 5 18 5 18
Current Fixture Value 18 divided by 16= 1.125 Current EDU 1 EDU= $4,900.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change 18 divided by 16= 1.125 over (under) $ 5,537.00
Enter EDU Change Here 1.130
Notes:
Authorized Name/Signature: Dianna Howse Date: 11/10/2014
Building Division
ote: The property owner shall retain the ORIGINAL sewer tally record. If credits exist,this document will serve as a voucher which must be
ubmitted to the City of Tigard Building Division to redeem credits towards future system development charges.
r
I:\Building\Sewer Tally\SewerTallySheet_4900._070114.xlsx
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
12550 SW MAIN ST 120, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2014-00369
George Heimos
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
12550 SW MAIN ST 120, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
FAIL
PLM2014-00369
George Heimos
1. Lock box code 9123 does not work, provide access for inspection, no inspection
made. Recall when ready. 103.5.4
2. Re-inspection fee will be assessed if previous correction(s) are not approved on next
inspection 103.5.6
3. Recall inspection.
mhvac
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
12550 SW MAIN ST 120, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
FAIL
PLM2014-00369
George Heimos
1. Work not completed, no inspection made. Recall when ready. 103.5.4
2. Recall inspection when corrections have been completed. Re-inspection required.
103.5.6.1
Violation Summary:
Inspector Contractor