Permit CITY OF TIGARD PLUMBING PERMIT
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COMMUNITY DEVELOPMENT Permit#: PLM2015-00265
I WARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/11/2015
Parcel: 2S112AA00600
Jurisdiction: Tigard
Site address: 6777 SW BONITA RD 110
Project: Spec Space Subdivision: MILLMONT PARK Lot: 49
Project Description: Capping(1)sink,(1)water closet&(1)bidet. Adding(1)sink.
Contractor: K&C PLUMBING INC Owner: ICON OWNER POOL 1 WEST LLC
PO BOX 2124 BY RYAN
OREGON CITY, OR 97045 PO BOX 460169
HOUSTON,TX 77056
PHONE: 503-518-0234 PHONE:
FAX: 503-518-1100
FEES
Quantity Description Date Amount
3 ea Fixture/Sewer Cap 08/11/2015 $75.06
Specifics: 1 ea Sink 08/11/2015 $25.02
1 12%State Surcharge- 08/11/2015 $12.01
Type of Use: COM Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $112.09
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 N. • enter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-11.0. You may obtain a copy of the rules
or dir- questions to •► C by calling 503.232.1987 or 1.800.332.2344.
Iss -d By: j 4 / Permittee Si.nature: '/
Call 503.639.4175 by 7:00 a.m.for the next available i .ection 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 RECEIVED
Building Fixtures AUG 10 2015 , I,F: "1 t It 1 , ,1 „\, , r
City of Tigard R lit IS / Permit No.: •Ur/e(S'60A10
• 13125 SW Hall Blvd.,Tigard,OR 972 ' TY OF f I(�ARD Plan Review
•' Phone: 503.'1182439 Fax: 503.598 1 .. _,y: • Other Permit No.:
T,c . ,,
Inspection Line: 503.639.4175 LDING DI tl ISIO . ■ Ready/By: iuis pJ Ste Page 2 for
Internet: www.hgard-or.gov N� Su,. -. oral bibrntatioo
0 New construction ❑Demolition For special information use checklist
Aescriution Ea. I Total
't AdditioU/alteration/replacement ❑Other: New 1-2-Family dwellings(includes 100 ft.for each utility connection)
--- SFR(1)bath 312.70
❑land
2-family dwelling t ommerciaUuadustrial SFR(2)bath 437.78
SFR(3)bath 500.32
0 Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other:
Fire sprinkler( sq.ft, Page 2
1:, " Site utilities;
', ,:.. ties:
Job site address: ( 7 7 72 c5 4) !a L �'T Catch basin or area drain, 18.76
r
City/State/ZIP: -7- 1 Drywall,leach line,or trench drain - 18.76
1 G ( 0 v` n - Footing drain(no.linear fi.:,___) Page 2
Suite/bldg./apt no.: 1.1 2, f..
Project name: M c c pple.. 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: Lot no.: Fixb re or Item:
Tax map/parcel no.: 6425 i I a 0-60�
m0 Backfl ow preventer 31.27
- Backwater valve 12.51
'' Clothes washer 25.02
3 - mi • e a- r� - Dishwasher 25.02 -
1)1 i,.t.1fvL �_ •l? ri VA.,.K..� Drinking fountain 25.02
Ejectors/sump 25.02
Expansion wait 12.51
Name: Fixtaae/sewer cap «3 25.02 Jr.O fjs
Floor drain/floor sink/hub 25.02
Address: Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02 µ�
Phone.( ) Fax:( ) Ice maker 12.51•. - r , _ interceptor/grease trap 25.02
Business name: Medical gas(value:$ ) Page 2
-Contact name:
Primer 12.51
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 1 25.02 a S O2
./.: City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
-
E-mail Urinal 25.02
---- -,- _..T r= "o,,_ .,. - water closet 25.
02
! _ . Water eater
_-..._..,_.: �.'..`.'..:, h 37.52
Business name: L. q ' i0 VIA. ml fl I_kZ _ Water tin WV 56.29
pp t�
Address: P - 0 l Other: µ 25.02
City/State/ZIP: Y^ . ,p I.-. 0 l 0 ez 7 ols -Subtotal
i CO.
Phon :6753) 7 a Z--° 3 y H Fax: 3-1�_ (f p O Minimum permit fee $72.50
CCB Lie.: ((� w(v 4,9 9 Plumbing Lie.no.: p e5 Plan review (25%of permit fee)
State surcharge(12%of permit fee) /.2 A O
Authorized sign
TOTAL PERMIT FBE //2 e 63;
Print name`- Rct.c.5 Ce�f2 icA Date: 3-7-l This permit application expires if a permit is not obtained within la0 days
�-�y/� after it bas been accepted as complete.
YY *Fee methodology set by-Fri-County Building Industry Service Board.
1:\Buil&nePatmitslPLMU,PermitApp.doc 10/01/09 440-4616T(10102/COWwEb)
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Plumbing Permit Application - City of Tigard
Page 2-Supplemental Information
• Fee Schedule: Residential Fire Su t cession S stems:
• Footing dram-la 100' 50.03 0 to 2000 5121.90
Footing drain-each additional 100' 37.52 2001 to 3600 $169.69
3 601 to 7 200 $233.20
Sewer 1st 100' 62.54 r 7 01 and •eater $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 84 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
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 a-1/2 hour and includin:$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 ch :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 fbr the first$50,000.00 and$1,20 for
minimum ch :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
ii n i increased Csewnc,-1 e r fees*.
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... . -_....." ,..._..._... ice
i"777 o q7 ��-
1c y Plan review is required for any of the following-
. �• ..t.„w.k...»(..4......... t •....., t.f Il.f.6t-.!t l^l^'" :Mfl.t{R:M. Cfin..,
Da.ti • /Font Please check all that apply,
Bath -Tub/Shower El Any new commercial building with water service 2”and
-Jacuzzi/Whirl••01 —=MI— greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
• -Drive Thm New exterior plumbing site utilities for any complex structure
C •idor/Water •:,irator as defined in OAR918-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic ❑ Any multipurpose fire sprinkler system.
Drimkin:Fountain ❑ Any complex structure as defined in OAR918-780-0040.
E e Wash
Floor Drain/sink -3" Submit 2 sets of plans with any of the above.
-3"
-4„
Car Wash Drain ��� .
Garbage -Domestic-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./Refri .Drains N
°tor as teflon �� Comments regarding fixture work:
Rec.Vehicle Dorn.Station
Shower Gang m ,i I ' .
'Sink/Lay -Non-food related IMRE-_� -t i t 1]E.r f(`
-Bradley ��MN=
_
-Commercial-food related
-Service
Swi uniun:Pool Filter
Washer-Cloches
*Note: If the fixture work under this permit results in an
• Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet WAM fees assessed for the sewer increase must be paid before the
urinal • plumbing permit can be issued.
Other Fixtures: . - -��-
Maciniosh HD:Users:blkcmb2:Downloads:PLMF_PennitApp-2.doc 2
atie Sewer Tally
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Tenant Name: Spec Space ***ACREDITS ccumul*** SWR# N/A
Site Address: 6777 SW Bonita Rd PLM# 2015-00265
Parcel#: 2S112AA00600
Fixture Value Previous Previous Credits Capped Fixture Fixture New New
# .due 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 r 0 0 0 0 0
-Domestic 2 0 0 0 0 0
Drinking Fountain 1 0 0 0 0 II
Eye Wash 1 0 0 0 0 0
Floor Drain/Sink: -2 inch 2 0 0 0 0 Il
-3 inch 5 0 0 0 0 0
-4 inch 6 0 0 0 0 0
-Car Wash 6 0 0 0 0 Il
Garbage Disposal:
-Domestic(to 3/4 I IP) 16 0 0 0 0 0
-Commercial(to 5 I IP) 32 0 0 0 0 0
-Industrial(over 5 I IP) 42 0 0 0 0 0
Ice Machine/Refrigerator Drain 1 0 0 0 0 0
Living Unit 16 0 0 0 0 Il
Oil Sep(Gas Station) 6 0 0 0 0 Il
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:
-Lay/Bar-Non-Food Related 2 0 1 2 0 -1 -2
-Bradley 5 0 0 0 0 0
-Com/Serv/Util-Food Related 3 0 0 0 0 0
Swimming Pool Filter I 0 0 0 0 0
Washer-Clothes 6 0 0 0 0 0
Water Extractor 0 0 0 0 0 0
Water Closet-Toilet 6 0 2 12 0 -2 -12
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 3 14 0 0 -3 -14
Current Fixture Value -14 divided by 16= -0.875 Current EDU 1 EDU= $5,100.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change -14 divided by 16= -0.875 over (under) $ (4,488.00)
Enter EDU Change Here -0.880 *
*Round EDUs to the nearest 1/100th: a count ending in.005 shall be rounded up to.01,and a count ending in.014 or less shall be rounded down to.01.
Notes: ***CREDITS*** Per Becky,CWS,count the bidet as a toilet.
Authorized Name/Signature: Debbie Adamski Date: 8/11/2015
Building Division
Note: The property owner shall retain the ORIGINAL sewer tally record. If credits exist,this document will serve as a voucher which must be
submitted to the City of"Tigard Building Division to redeem credits towards future system development charges.
1:\Building\Sewer Tally\Sewer TallySheet_5110_070115.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
6777 SW BONITA RD 110, TIGARD, OR, 97224
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2015-00265
George Heimos
Violation Summary:
Inspector Contractor