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Permit (47) Ilk CITY OF TIGARD PLUMBING PERMIT 31 . . COMMUNITY DEVELOPMENT Permit#: PLM2016 00376 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/12/2016 Parcel: 2S 112 DA00700 Jurisdiction: Tigard Site address: 15353 SW SEQUOIA PKWY 100 Project: Inspired Results Subdivision: PACIFIC CORPORATE CENTER Lot: 3 Project Description: Adding(2)2"floor drains,(1)break room sink,(4)lays,(1)urinal,(5)water closets&(1)water heater. Contractor: CASCADE PLUMBING CO Owner: PACIFIC REALTY ASSOCIATES LP 15765 SW 74TH AVE#110-A ATTN: N PIVEN TIGARD, OR 97224 15350 SW SEQUOIA PKWY#300 PORTLAND, OR 97224 PHONE: 971-312-1174 PHONE: FAX: FEES Quantity Description Date Amount 2 ea Floor Drain/Floor Sink/Hub 07/12/2016 $50.04 Specifics: 1 ea Sink 07/12/2016 $25.02 4 ea Lavatories 07/12/2016 $100.08 Type of Use: COM 1 ea Urinal 07/12/2016 $25.02 Class of Work: ALT 5 ea Water Closet 07/12/2016 $125.10 Type of Const: 1 ea Water Heater 07/12/2016 $37.52 Occupancy Grp: 1 12%State Surcharge- 07/12/2016 $43.53 Stories: Plumbing Total $406.31 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or dire questions to c NC by calling 503.232.1987 or 1.800.332.2344. Iss ed By: Ais / / Permittee Signature J0� ` /17624 ,r,.- ....., Call 503.639.4175 by 7:00 a.m,for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Plumbing Permit Application , BuildingFixtures ` , , ' I FOR OFFICE USF: O1l.1 City of Tigard Received 7 / Date/By: 14, / Permit No.: �)i 1 10**0037 IIII 13125 S W Hall Blvd.,Tigard,OR 97,223 l , i- pv I Phone: 503.718.2439 Fax: 503.59$:1966 ' Plan Review Other Permit No 4)-0e,a5-a Inspection Line: 503.639.4175 Date/By: I I G A R D Date Ready/By: Juris: See Page 2 for Internet: www.tigard-or.gov I. Notified/Method:7. s' , _ Supplemental upplemental Information ' '''.-* 4''''' -,Y% -,,,,. ,,-,. tizik'sicwou' tr - : 0 -16 -: .?, ❑New construction 0 Demolition For special information use checklist. Description Qty. Ea. Total ddition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) ~ 6A Y e'I y i CQN Rt1(T 6N z. " f , SFR(1)bath 312.70 1 1 ❑ I-and 2-family dwelling Commercial/industrial SFR(2)bath 437.78 O ❑Accessory building 0 Multi-family SFR(3)bath 500.32 ❑Master builderEach additional bath/kitchen 25.02 0 Other: Fire sprinkler( sq.ft.) Page 2 , _' 4;JOE SIMANFcluviAti9N 4.0 ATI 1 ,`>A" *4; Site utilities: Job site address: 5; 5\M 5e ctuatiG 'Q k, I Catch basin or area drain J 18.76 City/State/ZIP: Drywell,leach line,or trench drain 18.76 �„�� Footing drain(no.linear ft.:_) Page 2 Suite id /app'•: 4 j 6, I Project name: 11\'3piced � f Z� > 1v 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: I Lot no.: Fixture or item: Tax map/parcel no.: / i v1 :D c)c) Backflow preventer 31.27 ,DES IP„ON OF R > � Backwater valve 12.51 Clothes washer 25.02 W \ of (5 �,,��,, � ; � V1c�Vi,.51�11L.} Dishwasher 25.02 0))q2.o� �U� w t-t'N (i( ) 1 nes (2)f oo r Drinking fountain 25.02 "t'Cti 4` ( I ) tptkirA4Ejectors/sump 25.02 0 PROPERTYOWNER I 07'i'E ANt °, -" Expansion tank 12.51 Name: Fixture/sewer cap 25.02 Address: Floor drain/floor sink/hub 25.02 Z. Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 C) Phone:( ) Fax:( ) Ice maker 12.51 N AP;PLICAN"1 ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name: Iti.C_ PO t Medical gas(value:$ ) Page 2 �` Primer 0", Contact name: CilA--k-e fe-th- .1/,`/1,n 12.51 Address: �1 4-n V �1��FF�' Roof drain(commercial) 12.51 a} M Sink/basin/lavato V S .131 25.02 5 ,n City/State/ZIP: �� ) 0- 1 011 4 Solar units(potable water) 612.541 I" Phone:( �'), Fax: : �i Tub/shower/shower an � �`..7 � ��J (��)��., "' ��1� P 12.51 E-mail: C(sf�i it (; ptw�et) ry - rte^ Urinal 25.02 1� CONTRACT W'. 1 Water closet 25.02 5 Business name: e0��r`pt /�n �i' ' ,r� ) Water heater 37.52 i 1,�' Vim"" `V�' R J Water piping/DWV 56.29 Address: 1`j 5 \ •�q.`1.. A�� r ail.- Other: 25.02 �� City/State/ZIP: Ti C-6Z 1 ©e_ 91 a c�"'1 Subtotal 3(Ovt.A Phone:(503) a8t 7.3083 Fax:(ed?) 8-3-cis(4 Minimum pennit fee: $72.50 CCB Lic.: 1,9,c43C1 Plumbing Lic.no.: pa 15,2 Plan review (25%of permit fee) �4 J State surcharge(12%of permit fee) 43- Authorized signature: • I,to TOTAL PERMIT FEE 1 ,, Print name s t 'ili Z. 0`6 h je&,)\ Date: 7 I 7 02C, i This permit application expires if a permit is not obtained within 180 days / �F after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1 Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) � a Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: ite U r t'tiek 14, ` qty: 'eO at S . , "g_ , l t F t rte, Footing drain-1"100' 50.03 0 to 2,000 $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 7,201 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 'aluation: £ Permit 'ee 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 Other Ili pectlon3 orF (ea> y Toth' ' each additional$100.00 or fraction thereof,to 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$50,000.00 $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*. tity b Fixture PlanTReview for Plumbing*foliations Fixture Type for - { eaa� Plan review is required for anyof the following. Work Performed: CapAdded Relocate 9 Baptistry/Font Please check all that apply. Bath -Tub/Shower 0 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 OAR918-780-0040. Dishwasher -Commercial 0 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" Isometric or Riser Diagram Car Wash Drain Garbage Domestic-non-food 0 Isometric or riser diagram is required for new buildings 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/Lav -Non-food related 5 -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 . fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: C:\Users\Cascade Main\Downloads\PLMF PetmitApp.doc