Permit (73) 1411 CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2016-00460
T f e
q D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/12/2016
Parcel: 1 S135BD00100
Jurisdiction: Tigard
Site address: 9600 SW OAK ST 400
Project: Everest Institute Subdivision: ASHBROOK FARM Lot: 5
Project Description: Add(8)sinks and(2)2"floor drains,(3)hose bibs,(1)primer&(1)water heater.
Contractor: COLUMBIA CONSTRUCTION INC Owner: PLAZA WEST OWNER LLC
28170 BOBERG RD BY CHIEF FINANCIAL OFFICER
WILSONVILLE, OR 97070 680 FIFTH AVE 20TH FL
NEW YORK, NY 10019
PHONE: 503-427-0304 PHONE:
FAX:
FEES
Quantity Description Date Amount
2 ea Floor Drain/Floor Sink/Hub 09/12/2016 $50.04
Specifics: 3 ea Hose Bib 09/12/2016 $75.06
1 ea Primer 09/12/2016 $12.51
Type of Use: COM 8 ea Sink 09/12/2016 $200.16
Class of Work: ALT
1 ea Water Heater 09/12/2016 $37.52
Type of Const: 1 12%State Surcharge- 09/12/2016 $45.03
Occupancy Grp: Plumbing
Stories:
Total $420.32
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 co of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.:l e 32.2344.
Issued By: Permittee Signature: (-)q ,,+ A,
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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 FixturesREC�+ FOR OFFICE USE ONL
v' City of Tigard ��� Y
Received 0 �
Permit No.: N�Q QQ�66
" - v 13125 SW Hall Blvd.,Tigard,0Wcti 1 2016 Plan Review
Phone: 503.718.2439 Fax: 50 1 0 U Date/By: Other Permit No.: /‘-expd9?
Inspection Line: 503.639.4175,TIGARD ( Y V ARL Date Read/B
Juris 0 See Page 2 for www tigard or gov� Notified/Method:
,,. i. TP1 � � �. � NOMI,� *' FEE* SCHE 0 n
Supplemental Information
��UL �.
krNewconstruction ❑Demolition For special information use checklist. ._
Description 1 Qty. Ea. Total �J
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION4 SFR(1)bath 312.70
❑ 1-and 2-family dwelling N Commercial/industrial SFR(2)bath 437.78
ID Accessory building ElMulti-familySFR(3)bath 500.32 k
El Master builder Each additional bath/kitchen 25.02 1
❑Other: Fire sprinkler( sq.ft.) Page 2
J,OB SITE INFORMATION AND LOCATION Site utilities: Q
CI
Job site address: �d S�, Oak Catch basin or area drain 18.76
City/State/ZIP: -r} Drywell,leach line,or trench drain 18.76 NJ
�� Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name: „OtT° Manufactured home utilities 50.03
Cross street/directions to job site: FSE r�7�V e•j/SIJ j j..t7 - 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.: /5/ 3S /7)CO l De) Backflow preventer 31.27
DESCRIPTION SCRIPTION OF WORK Backwater valve 12.51
"'' •
Clothes washer 25.02
�IC 4� - � � Y` Dishwasher
//�� p,,� I f 25.02
JL1.�,t` �< Ut( ,ti drOdh 4- VC tufrkq,. (/ Drinking fountain 25.02
Ki-70S LC-1 f €2. c �4- - .-- l�{t j Ejectors/sump 25.02
❑ PROPERTY`OWNER 1;, ' ❑ TENANT Expansion tank 12.51
-tee
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hubp� 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 3 25.02
Phone:( ) Fax:( ) Ice maker 12.51
APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name: -•• • _: ::,: Page 2
Primer
I 12.51
Contact name:
Roof drain(commercial) 12.51
Address:
Sink/basin/lavatory $7 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax: :( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
'CONTRACTOR. .. j,-,:i.,:-,:::,,f,..,
Water closet 25.02
Water heater
37.52 name: Cb(U kI PC��s Water piping/DWV .
56.29
Address: n 0 S W a o6 Q Other: 25.02
City/State/ZIP: (A)/1s o vv; f4 G( q7 6'70 Subtotal
Phone:(S18 ) 2'7 _ d.6 I1 1 Fax:( ) Minimum permit fee: $72.50
CCB Lic.: (�R Plumbing Lic.no.: pe L1 00 Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: Qe, J,. ` TOTAL PERMIT FEE ��ap.32-
Print name: laare,eAA. pA I t Date: r(/ 1.‘ This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
-Yee Schedule: Residential Fire Suppression Systems:
w- � ... .. . .
le ties Qty:- ��e fea)-- Total >: Square Footage` , "E Periiut Fee � ,
Footing drain-151 100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
Sewer-1st 100' 62.54 3,601 to 7,200 $233.20
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 e R
Storm&Rain Drain-1st 100' 62.54 valuation Permit Fee
$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
or Fees Qty= Fee(ea) Total each additional$100.00 or fraction thereof,to
Otheir Inspections
Inspection of existing plumbing or for and including$10,000.00.
$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*.
Quantity by Fixture Type
Plan Review for PlumbInstallations
Fixture Type for ' Replace/ Plumbing
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" Submit 2 sets of plans with any of the above.
-3"
Car Wash Drain Isonietric Or Riser Diagram •
Garbage Domestic-non-food ❑ 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
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter
Washer-Clothes *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 fees assessed for the sewer increase must be paid before the
Urinal
Other Fixtures: p g permit can be issued.
C:\Users\Darren\AppData\Local\Temp\PLMF_PermitApp.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
9600 SW OAK ST 400, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2016-00460
Don Sylvester
Corrections complete
Violation Summary:
Inspector Contractor