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Permit (45) CITY OF TIGARD PLUMBING PERMIT * ; COMMUNITY DEVELOPMENT Permit#: PLM2016 00183 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/05/2016 T[C Akt D Parcel: 1 S 1260000300 Jurisdiction: Tigard Site address: 9779 SW WASHINGTON SQUARE RD D11 Project: Champs Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: S Project Description: Relocate and replace(2)floor drains,(2)lays,(2)water closets&(1)water heater. Contractor: CASCADE PLUMBING CO Owner: PPR WASHINGTON SQUARE LLC 15765 SW 74TH AVE#110-A PO BOX 847 TIGARD, OR 97224 CARLSBAD, CA 92018 PHONE: 971-312-1174 PHONE: FAX: FEES Quantity Description Date Amount 2 ea Floor Drain/Floor Sink/Hub 04/05/2016 $50.04 Specifics: 2 ea Lavatories 04/05/2016 $50.04 2 ea Water Closet 04/05/2016 $50.04 Type of Use: COM 1 ea Water Heater 04/05/2016 $37.52 Class of Work: ALT1 12%State Surcharge- 04/05/2016 $22.52 Type of Const: Plumbing Occupancy Grp: Stories: Total $210.16 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 No - enter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or dir- t questions to Ob C • • ing 503.232.1987 or 1.800.332.2344. IsOed By: A/ LO Permittee Signature: &/akki 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. UserrIID: Cascade Main, Date/Time: 4/5/2016 3:08 PM, Document Name: Microsoft Word-Tigard.doc riumning rermu application Building Fixtures RECEIVED FOR OFFICE USE ONLY Received City of Tigard / Permit No.: 13125 SW Hall Blvd.,Tigard,OR 9722 Date/By: ��p (,�Fl2o((� l t R 0 1� 2016 Plan Review Phone: 503.718.2439 Fax: 503.598.1 Date/By: Other Permit No.:4.,1/614/� 3�! Inspection Line: 503.639.4175 ��l�Plilfl Date Read iB funs ® See Page 2 for 7 TIGARDTIGARD y y g Internet: www.tigard-or.gov CITY OF h Notified Method: Supplemental Information TYPE OF DING DIVISION FEE* SCHEDULE ❑ New construction 111 Demolition For special information use checklist. Description I Qty. I Ea. 1 Total ❑ Addition/alteration/replacement ❑ Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) - CATEGORY OF CONSTRUCTION SFR(I)bath 312.70 ~❑ I-and 2-family dwelling ElCommercial/industrial SFR(2)bath _ 437.78 El Accessory buildingSFR(3)bath 500.32 ❑ Multi-family Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler( sq.ft.) Page 2 x'79 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: $S SW Washington Sq.Rd Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard,OR Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: Project name:Champs Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 • Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: Lot no.: Fixture or item: Tax map/parcel no.: Backtlow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 relocate and replace existing fixtures Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 0 PROPERTY OWNER I 0 TENANT Expansion tank 12.51 Fixture/sewer cap 25.02 Name: Floor drain/floor sink/hub 2 25.02 50.04 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 2 25.02 50.04 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax: :( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 Water closet 2 25.02 50.04 CONTRACTOR Water heater 1 37.52 37.52 Business name:Cascade Plumbing Co WaterP1P g m /DWV 56.29 Address: 15765 SW 74th Ave#110-A Other: 25.02 City/State/ZIP:Tigard,OR 97224 Subtotal 187.64 Phone:(503)289-7095 Fax:(503)283-9514 Minimum permit fee: $72.50 Plan review (25%of permit fee) CCB Lic.:204392 Plumbing Lic.no.:PB1528 0 �; � State surcharge(12%of permit fee) 22.52 Authorized signature' TOTAL PERMIT FEE 210.16 This permit application expires if a permit is not obtained within 180 days Print name:Crystal Jones Date.04/05/2016 PP P after it has been accepted as complete. "Fee methodology set by Tri-County Building Industry Service Board. I:Building Permits PLMU-PetmitApp.doe 1001 09 440-4616T)10 02 COM WEB) r 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-1'1100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 S169.69 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 Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to Other Inspections or Fees 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 S50,000.00 $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*. Quantity by Fixture Type Plan Review for Plumbing Installations Fixture Type for Replace/ Work Performed: Capped Added Relocate Plan review is required for any of the following. Baptistry/Font Please check all that apply. 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 ❑ New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918-780-0040. 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" 2 Submit 2 sets of plans with any of the above. 3" 4.. Isometric or Riser Diagram Car Wash Drain sd f ❑ Isometric or riser diagram is required new buildings Garbage -Domestic-non-food g q g Disposal -Domestic-food related that meet the qualifications 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 -Stall Sink/Lay -Non-food related 2 -Bradley -Commercial-food related -Service Swimming Pool 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 2 fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: C:\Users\Cascade Main\Desktop\PERMITS\Tigard.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 9779 SW WASHINGTON SQUARE RD D11, TIGARD, OR, 97223 Commercial - Plumbing 399 Plumbing ﬁnal PASS - No C of O PLM2016-00183 Don Sylvester 1. Corrections are complete, plumbing ﬁnal approved. Violation Summary: Inspector Contractor