Permit (89) 114
CITY OF TIGARD
PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2017-00409
D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/09/2017
ff` g Parcel: 2S113AA00500
Jurisdiction: Tigard
Site address: 16100 SW 72ND AVE B18
Project: Jevo Subdivision: ROSEWOOD ACRE TRACTS Lot: PTA&f
Project Description: ADD(2)2"hub drains and(2)primers for tenant improvement.
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
2 ea Floor Drain/Floor Sink/Hub 10/09/2017 $50.04
Specifics: 2 ea Primer 10/09/2017 $25.02
1 12%State Surcharge- 10/09/2017 $9.01
Type of Use: COM Plumbing
Class of Work: ALT
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: /i Permittee Signature: Ara
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 Auplicati94;3 } -- ,- <-,
Building Fixtures , ,,,, ,., , ), . ; ,i ., , ,
El
City of Turd `7 ("d`f Received
13125 SW Hall Blvd.,Tigard,OR '�1-7 t
Phone: 503.718.2439 Fax: 503. " ` Plan e/By:w
5
Inspection Line: 503.639.4I75 Date Ready/By:
Internet: www.tigard-or.gov newsy: /C���/.�Notified/Method:
Julie. E See Pap 2 for
sr . saw information
0 New construction 0 Demolition For, emotion use checklist ‘1,.'
bescript► Qty. Ea. Total ,
V' Addition/alteration/replacement ❑Other fi
New 1-2-thmily dwell' _. includes 100 ft.for each utili connection)
s: It 70
iy SFR 312.�
■ ,.... XCommercial/industrialSFR 437.78 cS
32
■ Accessory building ❑Multi-familySFR(3)bafti v
Each additional bathAdtchen e
0 Master � [3 Other:
Job site address: 1Lo\ c��7)'_ aiiii 110 Catch basin or area drain / t)
City/Suete/ZIPgag Ihywell,leach lute,or trench drain 18.76
1 Footing drain(no.linear ft.:._4J '
Suite/bldg./0M.no.: )it Project name: j V
Cross street/directions to job site: Manufactured
es 18.76Rain drain comrector 18.76
Sanitary sewer(no.linear ft.:___„) Page 2
Storm sewer ,
Water service(no.linear ft.:____) Page 2
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
WrC
,.; Bae.kwater valve 12.51
ic,*�,.w.,. .. ., Clothes washer25.02
Dishwasher .02
`��'`cLYQ trI� t)iit �(Upj �l
YYID Y� Drinking fountain ®�
Ejectors/sump �
`,..' a r ' _ Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub e ¶byAddress:
Garbage disposal 25.02
City/State/ZIP: Hose bib
25.02
Phone:( ) Fax:( ) Ice maker 12.51
FIZre :. .... . .. r� , Interce11111 25.02
Business name: " +` Medical gas(value:S )
Co1111�Mill
Contact name: ��a` 1 Q h
Address:
Roof
City,'StateJZIP: C v Q`� 0Q'`Q""` '
ry
Solar units(potable water) 62.54
Tub/shower/shower pan 12.51 IIII
. !it/ ► t_11 A.. 'J4 L_e r
Die.gt • MIN
urinal e
`-3 _ _.� 2. water elmet 25.02
weer hater 37.52
Business name:Western Plumbing,Inc.
Water
Address:9460 SW Tigard Street,Suite 101 •
er: 25.02
City/State/ZIP:Tigard,OR 97223 Subtotal 5:(l0
Phone:(503)639-5296 Fax:(503)684-9015 '
Plan review (25%CCB Lic.:2439 Plumbing Lic.no.:3429PBit State surcharge(12%of permit fee) (-3,0'
Authorized sigma., di/Ltit TOTAL PERMIT FEE ti 4.
Print name: . 1 NIP t Date:/0)6,/t 1. This permit application expires if a permit h not obtained within 1 I days
after t has
*Fee methodology setby Tnuneen ity Building Industry Service Board.
1:\BuildirglPermstAPLMU-PermitApp.doc 10!01109 440.4616T(1Q102/COMMWEB)
Plumbing Permit Application - City of Tigard
Page 2-Supplemental Information
Fee Schedule: Residential Fire Su+ +ression stems:
Footing drain-1 100' 50.03 0 to 2000 $121.90
Footingdrain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer-1st 100' - 62.54 MI7,201 and greater $327.54
Sewer-each additional 100' 37,52 MIN
Water Service-1st 100' NM 62.54 Medical Gas S stems:
Water Service-each additional 100'
Storm&Rain Drain-1st 100' w 62.54 $1.00 to$5,00000 Minimum fee$72.50
Stonn&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
each including 50,000.00$ fraction thereof,to
and i
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 ch _. -1t2 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 oh : -2 hours each additional$100.00 or fraction thereof,to
Reinspection Fees Ell "'Mu. _ and including$50,000.00.
Additional plan review for revisions 11111 90.00/hr ( $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
each additional$100.00 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*,
.,,' `'' X' tr° ' _ ' • .,,,...s,-1,-;-,A4,;,-,4-4Plan review is required for any of the following.
r •s Ar M Please check all that apply.
Bat hstry/Font 0 Any new commercial building with water service 2"and
Bath -Tub/Shower u lAVhr greater,except systems designed and stamped by licensed
-Jacuzzi/Whirlpool
Car Wash -Each Stall engineer.
-Drive Thm 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 0 Any multipurpose fire sprinkler system.
Drinking Fountain 0 Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" p Submit 1 sets of plans with any of the above.
-3"
Cor Wash Drain a.. . ;.:... . , a:
'Garbage -Domestic-non-food d Isometric or riser diagram is required for new buildings
Disposal -Domestic-food relatedthat meet the •ualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-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
W -Clothes increase of sewer EDUs,a sewer permit will be issued and
Water
Extractor
Water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
_Other FixtureslNf v0-Y „Q
http://www.tigard-or.gov/city hall/departmentsted/docs/PLMF-PermitApp2doc
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 PLM2017-00409
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor