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Permit (150) CITY OF TIGARD PLUMBING PERMIT ■ COMMUNITY DEVELOPMENT Permit#: PLM2017-00054 T r C;;k It D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/01/2017 Parcel: 2S112DC00701 Jurisdiction: Tigard Site address: 15955 SW 72ND AVE Project: Doorway Mortgage Subdivision: FANNO CREEK ACRE TRACTS Lot: 39 Project Description: Install(1)break room sink Contractor: WATERWAYS INC Owner: PACIFIC REALTY ASSOCIATES 2118 SE 12TH AVE#101 ATTN: N PIVEN BATTLE GROUND,WA 98604 15350 SE SEQUOIA PKWY#300 PORTLAND, OR 97224 PHONE: 360-687-1304 PHONE: 503-624-6300 FAX: FEES Quantity Description Date Amount 1 ea Sink 02/28/2017 $25.02 Specifics: 1 12%State Surcharge- 02/28/2017 $8.70 Plumbing Type of Use: COM 47 ea Minimum Fee Adjustment- 02/28/2017 $47.48 Class of Work: ALT Plumbing Type of Const: Occupancy Grp: Stories: Total $81.20 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility No" _-nter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or dir= ' questions to O C b - in. ,03.232.1987 or 1.800.332.2344. Iss ed By: 1 i- Permittee Sig ature: Call 503.639.4175 by 7:00 a.m.for the next available ins.- tion date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Plumbing Permit Application Building Fixtures City of Tigard . ' -'°'i Receives 11,1 a 13125 SW Hall Blvd.,Tigard,OR 97223Y 02-o�3 / 7 Penait No.: Phone: 503.718.2439 Fax: Plan Review �y/�/7-�©57` Inspection Line: 503.639 4175 f �Y Other permit No.: /7„ 4 77 Internet: www.tigard or 11 a Ready/By: 1�s: 113 See Page 2 far .. i , , r c N Notified/Method: Supplemental Iafotxaatioa T# # >$ ORK ;4;-7,,N. ( FEE* SCHEDULE 0 New construction 0 Demolition For special tq onnation use checklist ®Addition/alteration/replacement Description 0 Other: i Qty. I Ea. l Total New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 0 1-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78 0 Accessory building 0 Multi-family SFR(3)bath 500.32 ❑Master builder Each additional bath/kitchen 25.02 ❑Other: JOB SITE INFORMATION AND LOCATION Fire sprinkler( sq.ft) Page 2 Site utilities: Job site address:15955 SW 72"Ave. Catch basin or area drain 18.76 City/State/ZIP:Portland,OR 97224 Drywall,leach line,or trench drain 18.76 Suite/bldgJapt.no.: .I Project name:DoorwayMo Footing drain(no.linear ft.: ) Page 2 J age Manufactured home utilities Cross street/directions to job site: 8.76 1 Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service ) Page 2 Subdivision: I Lot no.: {no.linear ft.: Fixture or item: Tax map/parcel no.: ,29-S 1/a- / !'••(.%140 7c / Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Rough-in and finish one breakroom sink Clothes washer 25 02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 0 PROPERTY OWNER J ® TENANT Expansion tank 12.51 Name:Doorway Mortgage-Jay Jaffee Fixture/sewer cap 25.02 Address:15955 SW 72"Ave Floor drain/floor sink/hub 25.02 City/State/ZIP:Portland,OR 97224 Garbage disposal 25.02 Phone:(503)575.1279 Hose bib 25.02 Fax'( ) Ice maker ® APPLICANT 12.51 v._. _. _ _ lnrereelWerenn ie trap 25.02 Business name:Waterways,Inc. Medical gas(value:$ ) Page 2 Contact name:Sabrina Matson Primer 12.51 Address:2118 SE 12t°Ave#10I Roof drain(commercial) 12.51 City/State/ZIP:Battle Ground,WA 98604 S 'asrn/lav atOD 1 25.02 25.02 Solar units(potable water) 62.54 Phone:(360)687.1304 I Fax::(360)666.9743 Tub/shower/shower pan 12.51 E-mail:sabrina@waterwaysplumbing.com Urinal 25.02 CONTRACTORWater closet 25.02 Business name:Waterways,Inc. Water heater 37.52 Address:2118 SE 12"Ave#101 Water piping/DWV 56.29 Other: 25.02 City/State/ZIP:Battle Ground,WA 98604 Subtotal 25.02 Phone:(360)687.1304 Fax:(360)666.9743 Minimum permit fee: $72.50 72.50 CCB Lie.:163323 Plumbing Lic.no.;37-5601111 Plan review (25%of permit fee) Authorized signature: `JCt�✓u 'inState surcharge(12%of permit fee) 8.70 z TOTAL PERMIT FEE Print name: (n 81.20 ' . t x�i) i h Lt 11 I ll �.,n I Date: ,t I This permit application expires if a permit isnot obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:Vdoilding\Permits\PLMU-PamitApp.doe 10/01!09 aaaaelar(laozicoMrwEa) • / 3 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: 0 to 2,000 $121.90 Footing drain-1°100' 50.03 2,001 to 3,600 $169.69 Footing drain-each additional 100' 37.52 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: 62.54 Minimum fee$72.50 Storm&Rain Drain-1st 100' $1.00 to$5,000.00 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 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 and including$25,000.00. (minimum chargetsiof2 Inspections outside of normal business 90.00lhr $25,001.00 to$50,000.00 each additional$100.00 or fraction thereof to e first$25,000.00 and$1.45 for s m charge-2 hours) and including$50,000.00. Reinspection Fees 90.00/hr 550,001.00 and up $742.00 for the first$50,000.00 and$1.20 for Additional plan review for revisions 90.00/hr 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*. Quantity by Fixture Type Plan Review for Plumbing Installations Fixture Type for Replace/ Plan review is required for any of the following. Work Performed: Capped Added Relocate Please check all that apply. Baptistry/Font 0 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 Stall ❑ New exterior plumbing site utilities for any complex structure -Drive Thru as defined in OAR918-780-0040. Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities. Dishwasher -Commercial 0 Any multipurpose fire sprinkler system. -Domestic 0 Any complex structure as defined in OAR918-780-0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink -2" -3" 4=> Isometric or Riser Diagram Car Wash Drain 0 Isometric or riser diagram is required for new buildings Garbage -Domestic-non-food that meet the qualifications above. 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 -Non-food related 1 -Bradley -Commercial-food related -Service Swimming Pool Filter "Note: If the fixture work under this permit results in an Washer-Clothes increase of sewer EDUs,a sewer permit will be issued and Water Extractor fees assessed for the sewer increase must be paid before the WaCloset-Toiletfees permit can be issued. Urinnag l Other Fixtures: C:1Users1sabrina\Downloads\PLMF PermitApp(5).doc 2 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15955 SW 72ND AVE, TIGARD, OR, 97224 Record Type: Record ID: Commercial - Plumbing PLM2017-00054 Inspection Type: Inspector: 399 Plumbing final Don Sylvester Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor