Permit (55) CITY OF TIGARD PLUMBING PERMIT
2`- COMMUNITY DEVELOPMENT Permit#: PLM2017-00201
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/23/2017
T t dR g Parcel: 2S112DD01601
Jurisdiction: Tigard
Site address: 15755 SW SEQUOIA PKWY
Project: Orthopedics Northwest Subdivision: PACIFIC CORPORATE CENTER Lot: 4
Project Description: Adding(1)shower stall,(1)lay&(1)water closet. Replacing/relocating(2)2"floor drains and(6)sinks.
Contractor: PARFITT PLUMBING Owner: PACIFIC REALTY ASSOCIATES LP
12172 SE 222ND DR ATTN: N PIVEN
DAMASCUS, OR 97089 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-658-5068 PHONE: 503 324-6300
FAX: 503-658-2497
FEES
Quantity Description Date Amount
2 ea Floor Drain/Floor Sink/Hub 05/22/2017 $50.04
Specifics: 6 ea Sink 05/22/2017 $150.12
1 ea Lavatories 05/22/2017 $25.02
Type of Use: COM 1 ea Tub/Shower/Shower Pan 05/22/2017 $12.51
Class of Work: ALT 1 ea Water Closet 05/22/2017 $25.02
Type of Const: 1 12%State Surcharge- 05/22/2017 $31.53
Occupancy Grp: Plumbing
Stories:
Total $294.24
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.
Issue By: 4—.....'411.--d— a_....4.46,_
/ Permittee Sig,ature:
- /
ALL✓ L _4 — jr _.L/.// % '
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Call 503.639.4175 by 7:00 a.m.for the next available i .ection 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 F E E1VED IOR ()FEI(- E: t SE ()NEN
City of Tigard 6t a 7ipli
Permit No.: 4 �/7-0oj
13125114 ill 7 Received SW Hall Blvd.,Tigard,OR 972 Date/By:Y 2 2 2017f
C Phone: 503.718.2439 Fax: 503.598.1960 Plan Review DateB 6.^J /7� 60
Other Permit No. (�O
Inspection Line: 503.639.4175 CITY OF TIGARD y
TIGARD Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov BUILDING ItVIt S ON Notified/Method: Supplemental Information
'P +IIS WOE `, 1' * SCHEDULE .
■ New construction ■ Demolition For special information use checklist
Description I Qty. I Ea. I Total
' ' ' "ent ■ New 1-2-family dwellings(includes 100 ft.for each utility connection)
t�A tt,VO)F +lvf}I!) t cT o SFR(1)bath 312.70
, dwelling , SFR(2)bath 437.78 F
■
SFR(3)bath p�
■ building tvm
500.32Each additional bath/kitchen 25.02
Master builder 8 Fire sprinkler( sq.ft.) Page2t ' ; l t ' o t t Site utilities
Job
- , , , , Catch basin or area drain 18.76 site
Drywell,leach line,or trench drain 18.76
Portland oR
Footing drain(no.linear ft.: ) Page 2 lJ
Suite/bld_ 'e:Orthopedics NVVManufactured home utilities 50.03
Cross street/directions 'job 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: 1 Lot no.: Fixture or item:
Tax map/parcel no.: pZ 5 I 1?DDp 1 1,,ij i Backflow preventer 31.27
OBackwater valve 12.51N4W WOR
Clothes washer 25.02
Remodel of existing space adding sinks,ADA shower&bathroom
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
':.. 4.4i ' C) E11 t(-.T NAN Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub 2 25.02 3d,d5t
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker
12.51
® Interceptor/grease trap 25.02
Business na
„• Medical gas(value:$ ) Page 2
Contact name:
Primer 12.51
Roof drain(commercial) 12.51
1' Sink/basin/lavatory 7 25.02 175/54
Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 1 12.51 l.. Sl
TUrinal 25.02 JOI{M e_ QN(,( i1 QI..0/-fit !sow, , GOD Water closet 1 25.02
a� G 7�mAo
Water heater 37.52
Business name:Parfitt Plumbing Inc WaterPitin
P g/DWV 56.29
Address:12172 SE 222nd Dr Other: 25.02
City/State/ZIP:Damascus,OR 97089 Subtotal (pa, 7
Phone:(503)658-5068 / Fax:(503)658-2497 Minimum permit fee: $72.50 �_
CCB Lic.:85121 +I/ 1 Plan review (25%of permit fee)
j ale (� ,�j bing .no.:3 B State surcharge(12%of permit fee) 3/.5.3
Authorized signature: 'r TOTAL PERMIT FEE age • !
Print name:John Parfi Date:5/22/2017 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-PemitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
1
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-1"100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
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
V41000111: e t snit dee;
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
Other Inspectionqr.Fees ` ( ) T6 each additional$100.00 or fraction thereof,to
, • 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
(minimum charge-1/2 hour) each additional$100.00 or fraction thereof,to
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
F �
accurately report fixtures could result in increased sewer fees*. ; k F �, $ rs' la ,
4uartia iky 1Fr Tylsa Plan review is required for any of the following.
Frxtue Thoe
for tetft Please check all that apply.
Worlc1erforned _ .._ _., .. Calipeil.. ' +9l fe
Baptistry/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 Stall
0 New exterior plumbing site utilities for any complex structure
Drive tall as defined in OAR918-780-0040.
Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities.
Dishwasher: -Commercial 0 Any multipurpose fire sprinkler system.
Domestic ❑ 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" Z
-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 for y
Sink: -Lav/Bar non-food related 114 . b
-Bradley
-Com/Serv/Util food related
-Service *Note: If the fixture work under thisermit results in an
Swimming Pool Filter p
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
Water Closet-Toilet y plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15755 SW SEQUOIA PKWY, LAKE April 3, 2018 at 11 :02:27 AM
OSWEGO, OR
Record Type: Record ID:
Commercial - Plumbing PLM2017-00201
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Corrections completed
Violation Summary:
Inspector Contractor