Permit (41) illCITY OF TIGARD PLUMBING PERMIT
8 ' " COMMUNITY DEVELOPMENT Permit#: PLM2017-00216
Tf GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/12/2017
Parcel: 2S113AA00500
Jurisdiction: Tigard
Site address: 16100 SW 72ND AVE B18
Project: Jevo Subdivision: ROSEWOOD ACRE TRACTS Lot: PT A&F
Project Description: Interior plumbing for TI:Adding(1)2"floor drain;Replacing(1)commercial dishwasher,(1)drinking fountain,(5)2"
floor drains,(2)ice machines,(13)sinks,(9)water closets,(2)urinals;Installing(1)backflow preventer.
Contractor: WESTERN PLUMBING Owner: PACIFIC REALTY ASSOCIATES
9460 SW TIGARD AVE SUITE 101 ATTN: N PIVEN
TIGARD, OR 97223 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-639-5296 PHONE:
FAX: 503-684-9015
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 06/06/2017 $31.27
Specifics: 1 ea Dishwasher 06/06/2017 $25.02
1 ea Drinking Fountain 06/06/2017 $25.02
Type of Use: COM 6 ea Floor Drain/Floor Sink/Hub 06/06/2017 $150.12
Class of Work: ALT 2 ea Ice Maker 06/06/2017 $25.02
Type of Const: 13 ea Sink 06/06/2017 $325.26
Occupancy Grp: 2 ea Urinal 06/06/2017 $50.04
Stories:
g ea Water Closet 06/06/2017 $225.18
1 12%State Surcharge- 06/06/2017 $102.83
Plumbing
Total $959.76
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:
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.
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Plumbing Permit Application ,_ I �.0 s
Building Fixtures ' = :t
RECEIVED 1 OR 1)1 I It I I til ONI
City of Tigard Permit No.: ,�1 7- 1
1UN 1 2017 Dae/By: f t7 - ocA
13125 SW Hall Blvd.,Tigard,OR 972 Plan Review ether Permit No.:�il 7`tC-lS,
Phone: 503 inn: 43. Fax: 503.5 Datem
3
Inspection Line: 503.639.4175 OF TIGA � Date Ready/By: Sent: ® See Page 2 for
ii„,,A, Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method:
Su emenalInformation„.:3,4,1/4,1/4
, . �s�r���; �...,.'.>;: -...,i'k«ti�.�.,,W �..4��'is_<t.=��jc.:'�� ri;'„*A4.r?� `.
Demolition0 For special information use checklist
New construction 0 Description I Qty. I Ea. I Total
►G Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
5 s ,..-.',..,v, "`' 1`)4� r � 4. SFR(1)bath ( 312.70
:',44"'^i'3..z.+ TA'4x..14-..-4. .0,t�3vzv.n.,:', _.,.,;r.... ..,.. :.,._,.¢ t. r:, to .,5''.T.::'
SFR(2)bath 437.78
❑ 1 and 2-family dwelling 14 Commercial/industrialSFR(3)bath 500.32
❑Accessory building ❑Multi-family Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 I
,,,,....,,;.7.-1,1,--4,-,,,,, j Z -" „,,. Site utilities:
_ _ sa; ._.. r .,s3 .n � �. om_ _ 18.76
'" �' Catch basin or area drain
-Job site address:\\ �'� VI 1,(IL Drywell,leach line,or trench drain 18.76
City/State/Z11q\ '_xj cC (�`' DOy Footing drain(no.linear ft.:___,) Page 2
Suite/bldg./apt.no.: I Project name: (y 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.:„__,_) 1 Page 2
Water service(no.linear ft.:.,,,---) Page 2
Subdivision: 1 Lot no.: Fixture or Item:
Backflow preventer ✓ f, 31.27 a,Q- .
Tax map/parcel no.: --:--f:-. -wis Backwater valve 12.51
Clothes washer 25.02
Dishwasher r, 1 25.02 05.02
WAPJCV-1- CZOINf A.LL Drinking fountain ✓ V 25.02 (y
Ejectors/sump 25.02
:�w 4 r ",,v4,!:-.--.s r. , . ,re, 7 ... } X-& Expander tank 12.51.
:ter:. ''3's `r"a Freer-F.,.r...:e.1.,r:,.r, ,'il .w1,c1 5151�>: e1,•Ca�.'%'N::.s .id.,�#^ 4+�>`*r 25.02
Fixture/sewer cap /i
NameC-7 } Floor drain/floor sink/hub `p 25.02 ,C:1:-AgZ
Address: Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02'
Phone:( ) Fax ( ) Ice maker O t 12.51 J.0').-
.e"'' }ej,.w.,4,' s .-a SR.,,..,41,t.,;,,,,,,,.14,, `;.-,.311.-:,:-....,v,,,-., _ �,•;': " , ,5;7^ ,, ]nterceptor/grease trap 25.U2
'V''':: 4.54'.9, 'warm it x& -,. ;7:4,;; a+6b 4:.' 'i.P..m.Whrt:v's^� .. .`'.N H�� .'° ieay.7,..N`...,EG I.
Medical gas(value:$ ) Page 2
Business name:
Primer 12.51
Contact name: Roof drain(commercial) 12.51
Address: Sink/basin/lavatory Z. 0 24.02 &T- ,0(p
City/State/ZIP: Solar units(potable water) 62.E
Phone:( ) I Fax::( ) 'Cub/shower/shower pan 12.51
I Urinal 25.02 a),04.
E malt 0 p p 6 t 1 I. 4 I �,r 4 ' in 25.02 ,
t ,! Waterc-met ✓ � �r0J v6.
_.. �' K° x+�v,.`,*':�'. _ p--- .. <. ......- ,,C ,,,Q„-,,,,.�r,,.A,1a?�kss ,•_,. . „,,?,,.;� Water heater 37.52
Business name:Western Plumbing,Inc. Water piping/DWV 56.29
Address:9460 SW Tigard Street,Suite 101 Other: 25.02,
Subtotal
City/State/ZIP:Tigard,OR 97223 � q 684-9015 Minimum permit fee: $72.50 0:3„
Phone:(503)639-5296 Fax:(503) Plan review (25%of permit fee) .
CCB Lic.:2439 1 Plumbing Lic.no.:3429PB State surcharge(12%of permit fee) i(c?,
Authorized signature: .,Lt( 1 �,� tib,
'I TOTAL PERMIT FEE Clect p /"�- 2'` - This permit application expires ita permit is not obtained within 180 days
Print name: `' \r\ Dater I �I�. l after it has been accepted as complete.
.. *Fee methodology set by Tri-County Building Industry Service Board.
r'
1:\Building\Permits\PLMU-PemdtApp.doe IO/01/09 440.4616T(IOro21COM/WEB)
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Plumbing Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Su• i ression S stems:
' L'K 4 a s 'v c _ ,: ':'-r,;',..,:::-.,1�
ya
_ W..t, #.1 -a:: �Zffiab 4,,�A..,z.�'�# rte..a,,.i��. 4,.<ry %3 �-�e,>».w».a ar.... ... -,,.....k.-..,.,. ,e.:.r.� .zn,z.....*, o--.x:c - a,.
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
Sewer-1st 100' 62.54 3 201 andt7 00 $23320
7,201 y • r $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas S stems:
Water Service•each additional 100' I= 37.52 ;,;
Storm&Rain Drain-1st 100' 62.54
$1.00 to$5 000.00 Minimum fee$72.500.
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
n ` 4, r i' f -, , x . - iw each additional$100.00 or fraction thereof,to
..L.%.1;;.-...wa ,,: ,.=:„.,..s ,.•k, z•:- _x}L�;?,ms'
andincludin•$10000.00.
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 S100.00 or fraction thereof,to
minimum ch :e 1/2 hour and includin:$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 char:e-2 hours each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and includin:$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 eh :e-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
accurately report fixtures could result in increased sewer fees*.
;< 7 [ filmr� } ! x y --,,,1,4,„ ,, ,°+'sem { -' . ! s-,'-•"1 -t:#.4
ntih 'l z Cv +�� k�� > � x�F�n. x?'€
_ t,` " 'l` '�x ..:..-f,:: Plan review is required for any of the following.
brkloroone+dt= ,- :1 . ,. ,M ,. ', ,. . A. Please check all that1
BapBaptistry/Font apply.
y
Bath -Tub/Shower 0 Any new commercial building with water service 2"and
-Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thm 0 New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator y as defined in OAR918-780.0040.
Dishwasher -Commercial +i_ ✓ 0 Medical gas and vacuum systems for health care facilities.
-Domestic 0 Any multipurpose fire sprinkler system.
Drinking Fountain - %. . ✓ 0 Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" % S _ . ✓ Submit 2 sets of plans with any of the above.
-3"
Car Wash Drain +.1r..,, w ,,- .r., „ ' , - a's; «M ,As .�t,�, �'..
Garbage -Domestic-non-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./Refrig.Drains a .7-
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related 'r{S _r✓
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes
Water Extractorincrease of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet 1 -✓ fees assessed for the sewer increase must be paid before the
Urinal :/ plumbing permit can be issued.
Other Fixtures:ilsicK401.13l f
http://www.tigard-or.gov/city_hall/departments/cd/docs/PLMF-PermitAppQdoc
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16100 SW 72ND AVE B18, TIGARD, OR, 97224
Record Type: Record ID:
Commercial - Plumbing PLM2017-00216
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
1 . Corrections are complete, plumbing final approved.
Violation Summary:
Inspector Contractor