Permit (59) CITY OF TIGARD PLUMBING PERMIT
is
11111
COMMUNITY DEVELOPMENT Permit#: PLM2017-00414
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/10/2017
Parcel: 2S 101 DB00100
Jurisdiction: Tigard
Site address: 7320 SW HUNZIKER RD 201
Project: Medical Evaluation Specialists Subdivision: None Lot: None
Project Description: Replace existing fixtures: (1)dishwasher,(1)garbage disposal and(1)break room sink.
Contractor: WESTERN PLUMBING Owner: HILLTOP BUSINESS CENTER LLC
9460 SW TIGARD AVE SUITE 101 9430 NW KAISER RD
TIGARD, OR 97223 PORTLAND, OR 97231
PHONE: 503-639-5296 PHONE:
FAX: 503-684-9015
FEES
Quantity Description Date Amount
1 ea Dishwasher 10/10/2017 $25.02
Specifics:, 1 ea Garbage Disposal 10/10/2017 $25.02
1 ea Sink 10/10/2017 $25.02
Type of Use: 1 12%State Surcharge- 10/10/2017 $9.01
Class of Work: Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $84.07
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: /
p �'ZG r.� ew /9",c..../('q%7v/'j/
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.
Plumbing Permit Applicant i,- ki
Building Fixtures „y 1. : ,, 1 „ I , ,,1
RI
City of Tigard 0 1 O 1 Raxived
13125 SW Hall Blvd.,Ti Permit N
Tigard, 972��� ,i�.. � a� , i,tx -� Pl�att�Review /8�/7 �4'���%,'L'JG7 %V
Phone: 503.718.2439 Fax 50339k-1960' , ,f.,, �,, Due/ ; Other Permit c
Inspection Line: 503.639.4175 3,1!l t �91- �° 1114,a "r: e e� for
o ���� %
Internet: www.tigard�tgov i Date Ready/By:
hair 0 See Page 2 for
Notified/Method:
¢Y rw a� Sea, taltaformatlon
'� _ .... s : ...fix_..�-�'S;tsx 2>av4..Wry •>r, ..�fYz-„ : ..--;� r.;: � b„�`
New construction 0 Demolition For speciallgfomsadoa use checklist
Description Qty. I Ea I Total
►1 Addition/alteration/replacement 0 Other: New I-2-family dwellings(includes 100 ft.for each utility connection)
.. �., � � .. • �}.0 `...._.,P SFR(1)bath 312.70
❑ I-and 2-family dwelling vi4Commerciafrndustrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
Each
*. -
additional bath/kt tch
en 25.02 502❑Master builder ❑Other: Fi
Fire ( sq,ft.) Page 2
i .
-' site amides:
Job site address:`1 ) ) ��i V( C�i Catch basin or area drain 18.76
City/State/ZIP: / ►+ >/ dwell,leach line,or trench drain 18.76
C C ,S(2
1Footing drain(no.linear ft.:_,_,) Page2
Suite/bldg./apt.no.:, -41,',410/. / ` name:MQOli O EXl a Manufactured home utilities 50.03
Cross street/directions to job : Qin'( S,AS Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_J Page 2
Storm sewer(no.linear ft.:__) Page 2
Water service(no.linear ft.:_„-) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
';'''7,4-•-" ,' ._ r 4 ,,,---r.",:. Backwater valve 12.51
.,
r, ::gyp. r,_-,,,,c.:•,,';‘..-_k Clothes washer 25.02
cccco A 1 Dishwasher 25.02 , ....1,c),-1..
y,` �'� S1��L- Drinking fountain 25.02
Ejectors/sump 25.02
..k�: �_ - x Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Address: Floor drain/floor sink/hub 25.02
City/State/ZIP: Garbage disposal ‘ 25.02 p`),
Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
f.x �.t ti� Intercepts/grease trap 25.02
Business name: Q • ►/YY1 bi % , Medical gas(value:S ) Page 2
Contact name t jack_ 1 rl 12.51
L1 Roof drain(commercial) 12.51
Address:
Sink/basin/lavatory ‘ 25.02
City/State/ZIP: Sjytk 2
Q GS Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
I, L i t . Urinal 25.02
E-mail:
NIL Ad A . AI.• t i , Weber closet
25.02
4.:4:: ::' - ' ... ..__ -_ • :_ >_,. , -- Water heater
37.52
Business name:Western Plumbing,Inc. WaterPiP g/D m WV
56.29
Address:9460 SW Tigard Street,Suite 101 Other: 25.02
City/State/ZIP:Tigard,OR 97223 Subtotal 45OkQ
Phone:(503)639-5296 Fax:OD keels, Minimum permit fee: S72.50
CCB Lic.:2439 Plumbing Lic.no.:3429PB Plan review (25%of permit fee)
State surcharge(12%of permit fee) 494/
Authorized Signature' TOTAL PERMIT FEE 5t(4,6-4. It/.
Print name: L,r $ 4 Mr Date: JO)(D/1'1. This Permit application aspires tf a permit b not obtained widen 180 days
1 after it baa been moped as complete.
'Tee methodology set by Tri-County Building Industry Service Board.
hauildineermiu\PLMU-PemftApp.doe 10/01/09 440-4616T(10102JCOM/WEB)
Plumbins Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Su ression S stems:
Footing drain-I"100' 50.03 0 to 2 000 $121.90
Footing drain-each additional 100' � � 2 001 to 3 600 $169.69
3 601 to 7 I I $233.20
Sewer-1st 100' �SIM�� 7,201 and_,- Cr $327.54
Sewer-each additional 100'
Water Service-1st 100' 62.54
� � Medical Gas S stems:
Water Service-each additional 100'
Storm&Rain Drain-1st 100' 62•
_ $1.00 to$S 000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 r $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
each additional S100.00 or fraction thereof,to
and includi _$10 000.00.
Inspection of existing plumbing or for S10,001.00 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 • -1/2 hour and includin $25 000.00.
Inspections outside of normal business - 90.00/hrr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 end$1.45 for
hours minimum ch -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
each additional S100.00 or fraction thereof.
minimum
-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*.
L
.
.. ., .. 1 ^ ..., e......
,
xa ,, t« . ` Plan review is required for any of the following.
. „ s Please check all that apply.
Baptistry/Font 0 Any new commercial building with water service 2"and
Bath -Tub/Shower/hi greater,except systems designed and stamped by licensed
-Jacuui/Whiripool
Car Wash -Each Stall engineer.
-Drive Thur 0 New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial 0 Medical gas and vacuum systems for health care facilities.
-Domestic t 0 Any multipurpose fire sprinkler system.
Drinking Fountain 0 Any complex structure as defined in 0AR918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
-3"
.4" a
Car Wash Drain { ,
Garbage -Domestio-own-food 1 • 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 MachfRefrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station rww/w-ES l'14.)67° S'7.46 1,
Shower -Gang w 6-6- /9 4'1)/7/8/7/7
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial-food related
-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 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-PermitApadoc
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
7320 SW HUNZIKER RD 201 , TIGARD, November 28, 2017 at
OR, 97223 2:04:26 PM
Record Type: Record ID:
Commercial - Plumbing PLM2017-00414
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor