Permit (17) " CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2016-00539
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/26/2016
Parcel: 2S 112 DB00400
Jurisdiction: Tigard
Site address: 7337 SW KABLE LN
Project: Consolidated Supply Subdivision:'HERN PACIFIC TIGARD INDUSTRIAL I Lot: 4
Project Description: Relocate(1)drinking fountain,(1)non-food related sink,and(1)water heater for existing tenant improvement.
Contractor: POWER PLUMBING CO Owner: TILLAMOOK LIGHT LLC
PO BOX 19418 ATTN: BOB BRUCE
PORTLAND, OR 97280 7337 SW KABLE LN
TIGARD, OR 97224
PHONE: 503-244-1900 PHONE:
FAX: 503-244-8825
FEES
Quantity Description Date Amount
1 ea Drinking Fountain 10/26/2016 $25.02
Specifics: 1 ea Sink 10/26/2016 $25.02
1 ea Water Heater 10/26/2016 $37.52
Type of Use: COM 1 12%State Surcharge- 10/26/2016 $10.51
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $98.07
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 503.232.1987 or 1.800.332.2344.
Issued By: / -. Permittee Signature: D�
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.
OCT-21-2016 01:32 From: To:5035981960 Page:1'2
Plumbing Permit A 1� CEIVE
Building Fixtures FoR OFFICE USE. ()NIA"
City of Tigard OCT T 2 4 2 01 Doctor '�// Penult No
et 13125 SW Halt Blvd.,Tigard.OR 97223 Plan Review o�fG%/�" /C�TFL/`9 ���'"r lJ 1
' 2 Phone: 503.7182439 1 � 5� 86?' Date/By: Other Permit N20/104/( ,02'77
Inspection Lane: 503.639.3311 5
� lnsp • Date Resdy/By: ruris: ®See Pae 2 for
C A P.L Internet: www.tigard •r> T: i .1* 7 Notified/Method!
Supplemental Information
rm w ;WP1 7rwO — a�1A9::ca J `�fhpw�-aY� �°�I ``7:.F0, 5+, "1., .b. t..,-+... -- 5- G2.v*
fy, "y,;.
New construction ❑Demolition For s ecial in orrnation use checklist
Demi,tion 04• Ea. Total
Addition/alteration/replaccment 1::I • New 1.2-family dwellings(includes 100 ft.for each utility connection)
VittE5,LVOIRM:451.E6§1..f3K<Winittritagig5griali SFR(1"3th 312.70
SFR(2)bath 437.78
lj 1-and 2-family dwelling A Commercial/industrial
0 Accessory building ■
Each additional hath/Ititchen 25,02
■ Master builder ■ • Fire sprinlder( sq.ft) Page 2
1. I :AfiFT .• 1 t 1 Site utilities:
3� Eel 18.76
brywell.leach line,or trench drain 18,76
Job site address: /�a r fL
City/State/ZIP: -7 j j / 0 e 97?z_t/ Footing drain(no.linear ft.:_____) Page 2
Suite/bldgJapt.no.: Project name: On ) s c ♦/
Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
,caht'thatir caincLua 143.76-
Sanitary sewer(no.linear ft.:, ) Page 2
Storm sewer(no.linear ft: ) Page 2
Water service(no.linear ft.:�) Page 2
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.:
gt/I\ . ^'fi +R2 ;�"'" g �� . .IifteT6Backwater
Clothesvalve 12.51
25.02
.
,.:..a,. . - A / GDishwasher
in, 25.02
Drinking � 5,0 2..
Ejectors/sump 25"02
SLMI t trw •,,maq gyi�+,�47N81133116°1"u* 12.51
Fixture/sewer cap 1
Address:Namc: Floor drain/floor sink/hub 25.02
Garbage disposal 1
City/StatetZTP: Hose bib 25.02
Phone: Fax:( ) Ice maker 12.51
® • ;,04j5:747 • i' 25.02
/ Page 2 NMI
Primer 1111 1251
Contact name. ` • l 1, if wt Roof drain(conuriercial) Ill 12.51
Address: f 0 J ' / , r. /
City/StaterZJP: 'L ��d p/c 972 gf7 Solar (potable62.54 —
Phone:( ) - l✓
Fax::(5'03) �CI Ll- Tub/shcnver/shower pan 12.51
Urinal 25.02
E-mail:$e.6(1 [,:, - 10142_f b _ AL A 'A r 6'4. Cr
Water closet`_-2 " i 7k° J4 "rCO T„..CTR17 ,,' ♦ rE ,k % ( ,�” ? 25.02
Business name. / /AMA Phi fn h/'n .' Id . Water piping/DWV
• ,
Address: , w LAiggrAJZLIWAII • . 25.02 IIIIIIIIII
City/Statd'GIP: 'Q14/17_14.0( OK 77 2 Subtotal
EIRMI
Minimum permit fee: $72.50
Phone:(5157j) a cp./- r Fax:(raj) al"t,/_ '$_ Plan review (25%ofpermitfee)
CCB Lie.: 5z. 3 7 if" Plumbing Lic,no.;34/-/s73/'� r ""11 /�i
State surcharge(12%of permit fee)
Authorized signature: ,m_.L /2-•tS TOTAL PERMIT FEE ' '
Print name: Date: j pThis permit apptieatlem expires if a permit isnot obtained within 180 days
/pp This
it has been accepted as complete. 91'' '' r
*Fee medtodobgy set by Tri-County Building Industry Service Board
1:11kildtneftrmits1PLMU-PowJ1App.doc 10i011139 440-4616T(I0197.COM/wf:n)
OCT-21-2016 01:32 From: To:5035981960 Pase:2'2
Plumbing Permit Application - City of Tigard
Page 2-Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
a i��y ,n, w m:wwr holt",,,. r ,�,awa•r •r•.4, h;yr!'�r+,z,, r (int.v,
�x roc„ !;1 1:17,A r,s i.i. .Qty:�. Fee".-.4 a 1,0.-"Otat..' �, a.K.C1E. ut Fee, c i, ,y i Y'4.41x.ti
1;►S�[.e Utlilt..Stat^i,. a. .t..,:* w uC �.bi. asrc t� 4 S .rx:~' i S�Qllalte: �1Q ,E:.,.,a.�
Footing drain-1'100' 50.03 0 to 2,000 $121.90
2,001 to 3,600 $169.69
Footing drain-each additional 100' 3752 3 601 to 7,200 $233.20
Sewer-lit 100' 6254 7,201 andDeater $327.54
Sewer-each additional 100' — 3732
Water Service-1st 100' • 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52 yy3Vao AwraCVm.yr eeis1 T e
4n'l �4K..7Y!
Storm&Rain Drain 1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$7250
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$152 for
each additional$100.00 or fraction thereof,to
i r;' v�gra•au rr� 4 cv "•,an.y,;�s,,•,:u` Qty; tIgita)'"' zTu' each and including$10.000.00.
f�.0tei�specao�°is,.or�Fees.�.,..,�.�,.�� ,a.�,��� �r;�.: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 hours2 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)
.. .-,. Sebtotnl.
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 increasedsewerr��,a e, fo' P l `niallX► RstaaXlonSi,`:
�'
Qtiantlty by 1tt1XhIre Tiii ril,� r ';r lIM t tl �I
rctur"r,,Type for ` ' 'Rc�laai+. Plan review is required for any of the following-
, ';,
',WOK , .r . ciiPfd,:; . Added', r Ac:loogre,
Work Performed Please check all that apply.
- a�tistry/Font (] Any new commercial building with water service 2"and
Bath -Tub/Shower greater,except systems designed and stamped by licensed
-Jacuzzi/Whirlpool engineer.
• Car Wash -Each Scall
-Drive Thru ❑ New exterior plumbing site utilities for any complex structure
as defined in OAR918-780-0040.
Dishwasher
o ❑ Medical gas and vacuum systems for health care facilities.
...Cuspidor/Water
-Commercial
-Domestic 0 Any multipurpose fire sprinkler system.
D Fountain ) 0 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.K
trtiMilligarlit
Car Wash Drain 0 Isometric or riser diagram is required for new buildings
Garbage -Domestic-nond relatedood that meet the qualifications above.
Disposal -Domestic-food
-Commercial-food related
-Industrial-food related
lee MachJRefrig.Drains
Mil Separator(Gas Station) Com ents regarding fixture work: n
Rec.Vehicle Dump Station / Idcet 7
Shower -Gang
-Stall _
Sink/Lay. -Non-food related /
-Bradley ..
-Commercial-food related
-Service
Swimtnin_Fool Filter *Note: If the fixture work under this permit results in an
Washer-clothes Cloincrease of sewer EDUs,a sewer permit will be issued and
Water Extractorfees assessed for the sewer increase must be paid before the
Water Closeet t--Toilet
Urinal I plumbing permit can be issued.
Oth�Fixtures: IA 1 ykir �l G r
http://www.tigard-or,gov/document_center/Bu ilding/PLMP_PermitApp.dS