Permit CITY OF TIGARD PLUMBING PERMIT
"! 2 COMMUNITY DEVELOPMENT Permit#: PLM2016 00297
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/14/2016
Parcel: 1 S135BD00100
Jurisdiction: Tigard
Site address: 9600 SW OAK ST 400
Project: Everest Institute Subdivision: ASHBROOK FARM Lot: 5
Project Description: Replace(1)existing sink and add(1)new sink for break room.
Contractor: BEAVERTON PLUMBING INC Owner: PLAZA WEST OWNER LLC
13980 SW TV HWY BY CHIEF FINANCIAL OFFICER
BEAVERTON, OR 97005 680 FIFTH AVE 20TH FL
NEW YORK, NY 10019
PHONE: 503-643-7619 PHONE:
FAX: 503-643-7620
FEES
Quantity Description Date Amount
2 ea Sink 06/14/2016 $50.04
Specifics: 1 12%State Surcharge- 06/14/2016 $8.70
Plumbing
22 ea Minimum Fee Adjustment- 06/14/2016 $22.46
Type of Use: COM Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
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 503.232.1988 or 1.800.332.2344.
Issued By: / Permittee Signature: •
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.
From:Beaverton Plumbing 5036437620 06/07/2016 10:56 4,177 P.001/001
Plumbing Permit ApplicaHECEIVED
Building Fixtures FOR orrice iisr ONLY
City of Tigard JUN 7 2016 ! ieil'/'4'
13125 SW Hall Blv .,Tigard,0 (�. 6OF TIGARD Other Permit ,�alik.�O/
Datr'Ry
if
Inspection Line. 503.639.4171 LING DIVISION _ i
1 1( 41:D Date keadye By: /�j/_ htns See Page 2 for
Internet: www.tigard-or gov Notified Method V lv Supplemental Information
TYPE OF WORK FEE* SCREDULE
0 New construction ❑Demolition For special information use checklisx
Description I Qty. I Fa 1 Total
( ddition/alteration/replacement 0 Other: New I-2-family dwellings(includes 100 ft.for each utility connection I
CATEGORY OF CONSTRLJCTION" ' SFR(I)bath 312.70_
0 I•and 2-familyt -dwelling ommerciai/industrial SFR(2)bath 437.78
SFR(31 bath 500.32
❑Accessory building ❑Multi-family -- -
- - Each additional bath/kitchen 25.02 I
❑Master builder 0 Other:
Fire sprinkler( sq-ft.) Pagc 2
JOB SITE INFORMATION ANA LOCATION Site utilities:
Job site address: C C.C1/ c e Catch basin or area drain 18 76
+ f3(.,..1,--- t`� (C � Drvwell,leach line,or trench drain 18.76
City/State/ZIP: Footing drain(no.linear ft.. 1 Page 2
Suite/bldg./apt.no.: I Project name: I.UC'a((.-+`5t `_i.-),O. i
k`,`ttManufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
jRain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
- `- - Stone sewer(no.linear ft.:_) Page 2
--- Water service(nolinear ft.: ) Page 2
Subdivision: Lot no.: Fixture oritent: _
Tax map/parcel no.: - Backflow preventer -' 31.27
DESCRIPTION OF„WORK Backwater valve - 12.51
Clothes washer 25.02IL
C'at ams?\�ti v Y11�1..•w Dishwasher i 25.02
1.2,-;.Q-e-t p-I 4..p_ M $'I A) Drinking fountain 25.02
Ejectors sump - - 25.02
:g PROPERTY-OVYNE3t ' " [}fag-Ai Expansion tank 12.51
Name: Fixture/sewer cap 25.02
- - Fkxxdrain!ttoorsinkhub 25.02
Address: Garbage disposal 25.02
City/State/ZIP: Hose bib 25 02
Phone:( ) Fax ( ) Ice maker 12.51
Q, , ,,, .,Cr1NT b ;Cuu*'A ''PERsO i Interceptor/grease trap 25.02
Business name: Medical gas(value:S_) Page 2
Primer _ 12.51
Contact name: - f -
- Roof drain(commercial) 12.51
Address: Sinkbasinlavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) I Fax::( ) Tub/showershowerpan 12.51 �-
E-mail: V q�J t r l J b�-i\ _'C'\-C'�t'� 25.02
Uc�� � m Urinal
Water closet 25.02
itCONTRACI'ORr [i
. .. PEAV�l�.UMt NO !NUI Water heater 37.52
Business name: I --
Address:
13980 S.W.Tualatin Valley Hwy. Water pipingiDW V s6.29
Beaverton,Oregon 97005 - othn: 2s.o2�
City/State/TIP: ( )643-7619 Subtotal i-I
Phone:617 )`-f O.to5)C( Fax:(!_:C.3 1 0-I 3_7(D0 Q Minimum permit fee. 572.50 7 ,;JC
` B Lie.: )a ci i q f . Plumbing Lic.no.: -,-1 p® ;
Plan review (25°0 of permit fee)
SL State surcharge(12%of permit fee) `�7G
Authorized signature: R+"t�A _ TOTAL PERMIT FEE "5, ( 15 Y
�/QYIR( \ t Tinsipermit application expires if a permit is not obtained within 180 dais
Print Y '`�-�t� l Date: (L17��Cr after it has been accepted as complete.
*Fee methodology set by Tri-County Building Inductn Scn ice Board.
I hulldtug Pcnrots Pl.Ml;-Pern nApp so: 11:01Sc 44o-45151(10 02 COM WPM
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 400, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2016-00297
Don Sylvester
Violation Summary:
Inspector Contractor