Permit (42) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2016-00515
TEGA RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/12/2016
Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 6650 SW REDWOOD LN 105
Project: Middlegate Subdivision: 1996-048 PARTITION PLAT Lot: 2
Project Description: Interior Plumbing:Relocating(1)breakroom sink;Replacing(1)water heater.
Contractor: DEAN WARREN PLUMBING&REMODELING INC Owner: PACIFIC REALTY ASSOCIATES
PO BOX 14701 ATTN: N PIVEN
PORTLAND, OR 97293 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-236-4152 PHONE:
FAX: 503-296-2218
FEES
Quantity Description Date Amount
1 ea Sink 10/12/2016 $25.02
Specifics: 1 ea Water Heater 10/12/2016 $37.52
1 12%State Surcharge- 10/12/2016 $8.70
Type of Use: COM Plumbing
Class of Work: ALT 10 ea Minimum Fee Adjustment- 10/12/2016 $9.96
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utilit • . .• enter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
o o irect questions to • N •y calling 503.232.1987 or 1.800.332.2344.
Issued By:
14t-- Permittee Signature: Oie
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application
Building Fixtures ' �'`
P �'
City of Tigard Received l /_ y�
t,.. Date/By: l L/ /)_ err PermitNo.:i nn Of& tV5f
III
13125 SW Hall Blvd.,Tigard OR'87223 // C/,j
')0,* teBeviewC Phone: 503.718.2439 Fax 503.598.190 ,
Other Permit No.: r�"ta7rDaY Inspection Line: 503.639.4175 � 1'T[GAR D
Date Ready/By: Jurist. I ® See Page 2 for
Internet: www.tigard-or.gov -7��
A�
Notified/Method: •liCi Supplemental Information
TYPE OF W1 [$tt `•41,1 V''-' FEE* SCHEDULE
❑New constructionr. ,17tiolilic n For special information use checklist
s _-
-
Description
S.Addition/alterAion/replacement ❑Other: Qh Ea. Total
New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder ❑Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMA ON AND LOCATION Site utilities:
Job site address: ‘ GJ..L'L )/ Catch basin or area drain 18.76
City/State/ZIP: rf.0 taw B ` 7-`, Drywell,leach line,or trench drain 18.76
'` Footing drain(no.linear ft.:
Suite/bldg./apt.no.: 10 I Project name:,) //' ,o , ) Page 2
r a 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.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
4c 7;74,9_ Clothes washer 25.02
�J-wy/7 Si`4/�(
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Name: �,��7--r,,-5-9--
Fixture/sewer cap 25.02
Address: t �� S S C e.,....., CJ �, fro r� ,r Floor drain/floor sink/hub 25.02
/t � Garbage disposal 25.02
City/State/ZIP: 7---I,J )7cL 0,7_ 3 j) ;--Lf Hose bib
02
Phone:(,ter`)) �fi J 0.4g Fax:( ) Ice maker 25.
12.5151
0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name: /9,,,:,/...,42,44.m.,____"1-5 tf- -0�T� Medical gas(value:$ ) Page 2
Contact name: l-,.._€ Primer 12.51
Address: a � Roof drain(commercial) 12.51
�`2or� /ed.3'4.t Sink/basin/lavatory / 25.02 2 y,G Z_
City/State/ZIP: / .4.vim 41,462 ^
a_ $ 1 Solar units(potable water) 62.54
Phone:(.-...7075. ) 7',IC-C I(d C I Fax::( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
CONTRACTOR Water closet 25.02
Business name: Water heater
56.29 %yam
G r or") ��eY Water piping/DWV 56.29
Address:
Other: 25.02
City/State/ZIP:
Subtotal f y.5'`i
Minimum permit fee: $72.50 72,'C�
Phone:( ) Fax:( )
CCB Lic.: l r"ri e Plumbing Lic.no.:j‘ );C.,/5 Plan review (25%of permit fee) I
State surcharge(12%ofpermit fee) K. 3)
Authorized signature �� C/ r
TOTAL PERMIT FEE l et
Print name: _ �i° I Date:f G!1 .,.e I This permit application expires if a permit is not obtained wit n 180 days
sQ after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I\Building\Permits\PLMU-PermitApp.doe 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:
Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee:
Footing drain-15`100' 50.03 0 to 2,000 $121.90
37.52 2,001 to 3,600 $169.69
Footing drain-each additional 100' 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
each additional$100.00 or fraction thereof,to
Other Inspections or Fees Qty. Fee(ea) Total 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.
$50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
90.00/hr
Additional plan review for revisions 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
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 0 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 Thru 0 Medical gas and vacuum systems for health care facilities.
Cuspidor/Water Aspirator 0 Any multipurpose fire sprinkler system.
Dishwasher: -Commercial 0 Any complex structure as defined in OAR918-780-0040.
-Domestic
Drinking Fountain Submit 2 sets of plans with any of the above.
Eye Wash
Floor Drain/sink: -2"
-3" Isometric or Riser 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 Comments regarding fixture work:
Ice Mach./Refrig.Drains
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 Filler increase of sewer EDUs,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-Toilet
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
6650 SW REDWOOD LN 105, TIGARD, OR,
97224
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
November 2, 2016 at 9:37:30
AM
PLM2016-00515
Chip Barnett
Violation Summary:
Inspector Contractor