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Permit (90) CITY OF TIGARD PLUMBING PERMIT ,111 111 COMMUNITY DEVELOPMENT Permit#: PLM2016-00432 T[GA RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/11/2016 Parcel: 2S103 DD00850 Jurisdiction: Tigard Site address: 13815 SW PACIFIC HWY 110 Project: Blazing Gyros Subdivision: None Lot: None Project Description: Adding(2)2"floor sinks,relocating(2)sinks&(1)water closet Contractor: ALPHA OMEGA PLUMBING LLC Owner: D W SIVERS CO 201 ARDUS DR 4730 SW MACADAM AVE#101 NEWBERG, OR 97132 PORTLAND, OR 97239 PHONE: 503-538-7848 PHONE: FAX: FEES Quantity Description Date Amount 2 ea Floor Drain/Floor Sink/Hub 08/11/2016 $50.04 Specifics: 1 ea Sink 08/11/2016 $25.02 1 ea Lavatories 08/11/2016 $25.02 Type of Use: COM 1 ea Water Closet 08/11/2016 $25.02 Class of Work: ALT 1 12%State Surcharge- 08/11/2016 $15.01 Type of Const: Plumbing Occupancy Grp: Stories: Total $140.11 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, he rul- .-.. . Oregon Utility • '. enter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. .. ay obtain a copy of th- rules or d' -ct questions to O. C by 'ng 503.232.1987 or 1.800.332.2344. Is- ed By: k 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. Plumbing Permit Application Building Fixtures �`Ieo City of Tigard ` Received �/ �°/y (� GG Date/By: /i//ir PermitNo.: PL°l ,2`x`6-00 13125 SW Hall Blvd.,Tigard,OR 3 w _ { 2 Plan Review Phone: 503.718.2439 Fax: 503.598.196Q�G 1 Date/By: Other Permit No.: 6„- rg 7)32 T I G A R U Inspection Line: 503.639.4175 IN' G f` ,� �nl Date Read/B t x Internet: www.tigard-or.gov l,_)1.-^^y. i S !ryt\ Ready/By: Jam: ® See Page 2 for ,\AS\ Notified/Method: ' Supplemental Information TYPE OF VAC"1... FEE* SCHEDULE ❑New construction !!eemolition For special information use checklist Description Qty. Ea. I Total [Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTR CTION SFR(1)bath 312.70 ❑ 1-and 2-family dwelling ice]Commercial/industrial SFR(2)bath 437.78 ❑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 ' ` JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: " rw 7 /.`, Catch basin or area drain 18.76 !�3 gfs Se,J c r' :c } Drywell,leach line,or trench drain 18.76 City/State/ZIP: I i c:N d t V.s e Ci--r Z ii Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: 1 1 f5 I Project name: ALA xl 0,spec C Y S. Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 C;/� Rain drain connector 18.76 7 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.: Backflow preventer 31.27 DESCRIrtION OI;iiv t t Backwater valve 12.51 7 '- Clothes washer 25.02 Q Ubu V, y f\C)-5 "/ l r('t rte, Dishwasher 25.02 v® �' 1( $` "� Drinkingfountain 25.02 Ejectors/sump 25.02 O PROPESTY OWNER NA -' < I _ ',4,„,„ r Expansion tank 12.51 Name: ASI;'<� t/1 ) .3--,-,01 I Fixture/sewer cap 25.02 i t ,4 - Floor drain/floor sink/hub • 25.02 Address: t) e 7 c 17-ii,,,,., LJ!'"f1 S/- Garbage disposal 25.02 City/State/ZIP: ��k y /el 92 . Hose bib 25.02 Phone:( ) V Fax:( ) Ice maker 12.51 .; Er APPI CANT_ ' ❑ .CONTA i' tso Interceptor/ ease trap25.02 Business name: , // Medical gas(value:$ ) Page 2 �N .,. l.l,.-L l L Ci Primer 12.51 Contact name: . J ' �5 't f' Roof drain(commercial) 12.51 Address: fg,) / 4 f).45 �, Sink/basin/lavatory , 25.02 S City/State/ZIP: A), ,t ro q /3 Solar units(potable water)� 7 � 62.54 Phone:(5' ) 5-3 g- 7 X Fax::( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 Water closet . CONTRACTOR 25.02 g ©'Z Water heater 37.52 Business name: `//1 } N ice' u �t C L C/ Water piping/DW V 56.29 Address: 2 o )`7 1 /f`` I ,.� 25.02 A C�i S LJ Other: / 1 /J lU��:,u� vL V✓`( � �/J(� Subtotal 425.1/0City/State/ZIP: Phone:('f) 2-7.✓ / / Fax:( ) Minimum permit fee: $72.50 CCB Lic.: �(/)C) ?110(1 a1,1 gic.no.: // tL Plan review (25%of permit fee) �' �� / T State surcharge(12%of permit fee) /5:0/ Authorized signature: TOTAL PERMIT FEE /110,it Print name: �� /��-Ey 4 Date j ' )ofe This permit application expires if a permit is not obtained within 180 days 1 f after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. :\Building\Pennits\PLMU-PerntitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: + Qty. Fee(ea) Total Square Footag e: Permit Fee: Site�Utilltlesg Footing drain-l'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 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 Fee(ea Total each additional$100.00 or fraction thereof,to Other Inspections or Fees Qty ). 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 each additional$100.00 or fraction thereof. (minimum charge-1/2 hour) Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to x, accurately report fixtures could result in increased sewer fees*. Plan Review`for Plumbing Installations Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replace/ Please check all that apply. Work Performed: Capped Added Relocate ❑ Any new commercial building with water service 2"and Baptistry/Font greater,except systems designed and stamped by licensed Bath: -Tub/Shower ...- engineer. -Jacuzzi/Whirlpool 0 New exterior plumbing site utilities for any complex structure Car Wash: -Each Stall as defined in OAR918-780-0040. -Drive Tluu 0 Medical gas and vacuum systems for health care facilities. Cuspidor/Water Aspirator 0 Any multipurpose fire sprinkler system. Dishwasher: -Commercial - om ❑ Any complex structure as defined in OAR918-780-0040. Drinking Fountain Submit 2 sets of plans with any of the above. Eye Wash Floor Drain/sink: -2>' ; 3„ isometric or.Ris+ Diagram 4" 0 Isometric or riser diagram is required for new buildings -Car Wash Drain that meet the qualifications above. Garbage -Domestic non-food Disposal: -Domestic food related -Commercial food related -Industrial food related Ice Mach./Refrig.Drains Comments regarding fixture work: Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: -Gang -Stall _ Sink: -Lav/Bar non-food related _ -- -Bradley -Com/Serv/Util food related -Service *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer EDU5,a sewer permit will be issued and Washer-Clothes fees assessed for the sewer increase must be paid before the Water Extractor plumbing permit can be issued. Water Closet-Toileti Urinal Other Fixtures: I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 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 13815 SW PACIFIC HWY 110, TIGARD, OR, 97223 Commercial - Plumbing 399 Plumbing ﬁnal PASS - No C of O October 27, 2016 at 10:13:48 AM PLM2016-00432 Don Sylvester Corrections complete . 1/2" RP device Watts model if009qt serial#13248 approved with test report. Violation Summary: Inspector Contractor