Permit (34) CITY OF TIGARD PLUMBING PERMIT
Ill COMMUNITY DEVELOPMENT Permit#: PLM2016-00554
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/09/2016
TIGARD 9 Parcel: 2S101 DB00100
Jurisdiction: Tigard
Site address: 7320 SW HUNZIKER RD 208
Project: CleanNet Subdivision: None Lot: None
Project Description: Interior plumbing for TI:Relocating(1)sink.
Contractor: WESTERN PLUMBING Owner: HILLTOP BUSINESS CENTER LLC
9460 SW TIGARD AVE SUITE 101 HUNZIKER LLC
TIGARD, OR 97223 9430 NW KAISER RD
PORTLAND, OR 97231
PHONE: 503-639-5296 PHONE:
FAX: 503-684-9015
FEES
Quantity Description Date Amount
1 ea Sink 11/09/2016 $25.02
Specifics: 1 12%State Surcharge- 11/09/2016 $8.70
Plumbing
Type of Use: COM 47 ea Minimum Fee Adjustment- 11/09/2016 $47.48
Class of Work: ALT Plumbing
Type of Const:
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
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 .;i;. 2.2344.
Issued By: Permittee Signature: \\
VVV
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.
11/03/2016 06:00 5036849015 WESTERN PLUMBING INC PAGE 01/02
dumbing Permit Application
Building Fixtures i OR (erl it 1. l til. ()�1.1
City of Tigardlk-N
ltecetred / r - PermitNo.: ' 02 16 0_ 4,1„..,
0t : /0i� ,.�..�
• is w 13125 phone:S503.718.2439 Tigard,
03. 598-1960 1 '� Review Other
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Permit
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Inspection Line: 503 639 4175 suds 0 Sea Pegc 2 for
T!tr•,51 � Su lemeobl information
Internet www.tigard-or.gov � d% Not,fed/MmhQd ,,.7-77,,v,,..7 ,, r 7-1 i 7V r;ggi,'a
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For •dal in Dimon use checklist
0 New construction 0 i.'4,14 km .- peseri.ion MN Ea, Total
V Addition/alteration/replacement rev., is,1-2-family dwellings(includes 100 ft,
1,,,,.,.„..,,,„( i
for each utility
connection)
,, ,, - T w I.r s�4{f „ ,nil r SFR(1)bah 312.70
bw FK ) P. , ,, -7 , ,iS4t r�Y7ri,r , ., ti5•I _
,sLV/,"hk=.r ?,; V; . '.'' ••,� r�/.-_1 ,. ,,,, r,_.,.-•',••'. . �, ,, �
SFIt(2)bath 437.78
0 1-and 2-family dwelling iN Commercial/industrial SFR(3)bath - 500.32
0 Accessory building 0 Multi-family ).ech additional bath/kitchen 25.02 •
__,
Master builder ❑Other: Fire sprinkler( _ sq.ft.) W Page 2
rr^7r -1 '71',rr 1''N'''7',r , 'f9`� T�,d y r w" 1; 7 i y' C _._
y , / 3,41,1 ,, ,uf�i' y w , Y 4- --i^! �r lR'i' i 1'' - -UEEhnee:
�,r. ` 1't <..-c � .k,.{t,t>f , 18.76
� )� ,. �.F.i a.s.....u.t „r ,. `. Catch basin or area drain
Job site address:
O. `, 1\ } ��MJ., - Drywell,leach line,or trench drain 18.76
City/State/ZIP: \ 6` fit .- ...� Footing drain(n0-linear ft.:-_) Page 2
..1, 03
Suite/bldg./apt.no.; ♦M. Project name: Olt(1A\,‘,.4 Manufactured home utilities 50.18.03
_
Cross street/directions to job site: Manholes
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: Lot no.: Fixture or Item:
r Backflow preventer 31.27
Tax map/parcel no.:
x ..hd ,{1 '.
--, -.:i,,.:•.“•%!,,,,,,,:. ''71i,!:pl�l, 9 �,� Backwater valve
hi.' �rr ` nS,7, ' rHarr .f1, r iiii,it�LGe./11'c; Clothes washer
25.02
_ ,
, Dishwasher . 25.02
T
Drinking fountain 25.02
itis " \ i _ 25.02
�' w�I�i t�l11•.i�r< Ejectors/sump.
} '1: it1 V7° Y01 ', ' c , :r rix d' ' r*7 d d' Ex anion tanlc 12.51
� a N fi •-.7',,,,..,,,,,!-' '`"�,�•,�„�f+,a,,,iow, n�C;, ..Y�aY iJCli ,.3*.,i;ar,1,t�...rr�7tC 25,02
i tis+ ;w,a.iim,•,,.,r„,-,m,r,-,c* Fixture/sewor capa
Name: - Floor drain/floor sink/hub `. 25,02 ,
Address: Garbage disposal _ 25.E
City/State/ZIP: . �_ Hose bib 25.02
Phone
( ) Fax ( ) Ice maker 12.51
•,•••'',,4"'°'1''''''''''''''-'..-''''''''''-''''''''''''
' ... .1''''''''''''• n. re',I , +,+ ' Jam,, ,i interceptor/groase trap
� r. 0,‘,04;,44•3-•,
w! r m^ ,r ' rryn, y 'lrc4r : , , e'Y1 + r�trn aer ,,a+/ 25.02
ix���ala m`4>,,�n1HnTr,:nn.Mrl7x� sss.'r4t' „„:Mr.f�,a . d ' ., ,n,ti ,'Yrt..w�,, .„..' . .
Page 2
Medical gas(value:$ )
Business name: , f r , ii . , * �,� Primer _ _ 12.51
412.51
(
Contact name: y�pp i ��� v 1 A {� Roof drain(commercial)
Address: t'f�-i' t,1�� \\' 1•-• (,)� 1C.„ . ".C- Sink/basin/lavatory - 1 25.02 o Y `�
1. Solar units(potable water) 62.54
City/State/Z11': 12.51
Tub/shower/shower pan
Phone:( 1i� •/ .till ... Fax::( ,� ) / . Urinal - - 25.02
��
LL „ Water closet 25,02
)te i;l $ ,r.-:•:•"-'... . ,r ' sl„ , ,1 {1 �
i14M , 1i,;,tyr•l';',.,,'',i,•••':',:,,..',.,---,;,,,„,-7,,,, _,. i'',,,,•;•;, ,f�dRn', ,hiyr rcue a,,f.,RJ"M+» - ,. _Water Beate
37.52
Business name:Western Plumbing.Inc.nc. w Water piping/DWV 56.29
-
Other. 25.02
Address:9460 SW Tigard Street,Shite 101 _ _
Subtotal * ►�
City/State/ZIP:Tigard,OR 97223
Minimum permit the: $72.50
Phone:(503)639-5794 Fax:(503)684-9015 Plan review (25%of permit fee)
CCB Lia:2439 Plumbing Lie.no.:3429PB ' State surcharge(12%of permit the)V
Authorized signature: , • -
%w . !1 TOTAL PERMIT FEE �\. -
•it This permit application expires it*permit Is not obtained within PM days
WA Bate. after it has been accepted 48 complete.
Print name: � , ;
Fee methodology set by Tri-County Building Industry Service Board.
440-0616T(10/02)COM/ B)
1lauiiding\PttmitslPLMU-PmRitApp.doc 10/01/09
w
11/03/2016 06:00 5036849015 WESTERN PLUMBING INC PAGE 02/02
1
- Plumbin! Permit Application - City of Tigard
Pa -2 -Supplemental Information
Fee Schedule: Residential Fire Su i i ression S stems:
NT:7; �r�',y,, "17,7;',„;,.:',,.'.e5 a . r r wa 9 lE i .% r l' 6 r y'., t ' ' VM k'4 e<tur�r�y'e',9�5�T''4p"
d.+iG. m; „d.. ,r,.,. . .�+S,S, ,:t7E. u�i ; ,,+ ,i ,, r . . rS...' C[,rr .:>7ll
Footing drain-I. 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 7,20Q . $23320
0, = 7201 and greater $327.54
Sewer-each additional 100'
water Service-1st 100' 62.54 Medical Gas S stems:
Water Service-each additional 100' 37.52 r
Storm&Rain Drain-1st 100' 111111 62.54
$1.00 to$5,000.00 Minimum foe$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
'P ils i�h r, 6W; each additional$100.00 or fraction thereof,to
,41
�*� ,:,-;.4 .;M .. n, w,... r.,.,. J ,? ..
,aiG.w. �,E, ..i-.t;,r:?tf' 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 char:--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 ch- _c-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees ME 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 charLe-1/2 hour) each additional$100.00 or fraction thereof.
Sitbtotal:
111.1111111111111111
Commercial Future Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accuratel re.ort fixtures could result in increased sewer fees`.
':',':),-1-',."
)1:: r':44.%,' lxF,141 UQ�i%yg 14111 t, x�r "l�,.2,7 t ',.` �+l S y'.+ >I f t, r r T 1' f{+71CFl
4 Ili F, r7 "'y1" 'rrh ik r...L rL � a,w:y,eai!'� f an ' I��r;r ' t tA17!.3
2n ' ' ry 4"r 2iiCl<'`i:��•}'Val m,�P�IC R v�y ti x � '�4^'�rrr�;-.. 1 ..Ti .,.+,�, �.r. i.�. ,,.:.,, ..�. :;, �,. I,�„... {,a„.,:;,r.. .. Z.•,, s�.r,i,thAcr3u7
, .0 , ,,' ;• �t1 P 's';,I n, '. 'r I ",',...'•1'
wr° ', Plan review is required for any of the following_
li . ."34,4;.0ln ttlIdi.1' .,tatto7 r rittteItMt,a,•k . Please check all that apply.
13aptistry/Font
Bath -Tub/Shower ❑ Any new commercial building with water service 2"and
-Jacuzzi/WhirIkool greater,except systems designed and stamped by licensed
. Car Wash -Each Stallengineer.
-Drive Thru _ . D New exterior plumbing site utilities for any complex structure
-Cuspidar/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial 0 Medical gas and vacuum systems for health care facilities.
-Dome_stic 0 My multipurpose fire sprinkler system.
Drinking 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.
3„
-4" ,71rf�?eip°4,-,i-li r •� 14 ,---:I y9r.,.
, .. I., 4..?4,.. ���7iiwg, ti
Car Wash Drain rdb>; :,i i',+. .m„S,/.. .,.c „,r'c-? it .Y'Srt"i`e, r.li`i1.7, }')�t 1'.404
Garbage [7omestie-tion food • Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the •ualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach.JRefrig_Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall Sink/Lay -Non-food-Non-food related
-Bradley m
-Commercial-food related - 'i
-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 W fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
-
Other Fixtures:
http://www.tigard-or.gov/city hall/departments/cd/docs/PLMF-PermitAptdoc