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Permit (100) CITY OF TIGARD PLUMBING PERMIT IIII '' COMMUNITY DEVELOPMENT Permit#: PLM2017 00459 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/07/2017 T1a'Ae 9 Parcel: 2S112DD00300 Jurisdiction: Tigard Site address: 15900 SW 72ND AVE Project: 76 Gas Station Subdivision: None Lot: None Project Description: Interior plumbing. Replacing water lines for the following fixtures:(1)hose bib,(1)primer,(5)sinks,(1)water closet,and(1)water heater. SDC fees do not apply. Contractor: PLUMBING CONCEPTS INC Owner: PACIFIC REALTY ASSOCIATES LP PO BOX 1068 BY APRO LLC CLACKAMAS, OR 97015 17311 S MAIN ST GARDENA, CA 90248 PHONE: 503-658-5232 PHONE: FAX: 503-658-5232 FEES Quantity Description Date Amount 1 ea Hose Bib 11/07/2017 $25.02 Specifics: 1 ea Primer 11/07/2017 $12.51 5 ea Sink 11/07/2017 $125.10 Type of Use: COM 1 ea Water Closet 11/07/2017 $25.02 Class of Work: ALT 1 ea Water Heater 11/07/2017 $37.52 Type of Const: 1 12%State Surcharge- 11/07/2017 $27.02 Occupancy Grp: Plumbing Stories: Total $252.19 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 mayobt 'n a y of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. / G/ �C_. Issued By: /" 444 _‘ •- i ittee 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. Plumbing Permit Application Building Fixtures ' FOR OFFICE t SE o 1.1 City of Tigard Received �' Date/By: / �7 I Permit No �A�/�/7.Wj G/ Ill 41 13125 SW Hall Blvd.,Tigard,OR 97223 NOV 7 2017 6 / / L^"r��l/ �/0 L _ Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.: Inspection Line: 503.639.4175 11 G A R D Date Ready/By: Juris. ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information :<t ""_ TYPE OF WORK FEE* SCHEDULE ' 0 New construction 0 Demolition For special information use checklist Description I Qty. I Ea. Total Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ❑ 1-and 2-family dwelling yCommercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 1" Catch basin or area drain 18.76 /5 00 5-lV w//7a/ ire City/State/ZIP:���, , Drywell,leach line,or trench drain 18.76 1/1 c2c + 02 I L _J r Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: J I Project name: 1/121 i 6✓/(1c) J 7415b Manufactured home utilities 50.03 Cross street/directions to job site: 7(, ,-:.z� CManholes 18.76 l o/�/`5,_ 1 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: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 A- rBackwater valve 12.51 _ DESCRIPTION.;QF WORK -464,- /� /� j) lr' /' � Clothes washer 25.02 / (g I f/ E t.( / i J Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ❑ P tWPERT OWNER ,,." td,,„ NANT Expansion tank 12.51 Name: Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: / Garbage disposal 25.02 City/State/ZIP: Hose bib / 25.02 Phone:( ) Fax:( ) Ice maker 12.51 10 APPLICANT " CONTACT PERSON= Interceptor/grease trap 25.02Business name: Medical gas(value:$ ) Page 2 Primer / 12.51 Contact name: Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 5 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan 12.51 Urinal E-mail: / -, .. _ ; 25.02 I/? C �]�h//9)Ij1/?Cs (r, /? • (,� - Water closet / 25.02 //21-,.,„,b ,,1,,CONTRA ,R Water heater / 37.52 Business name: �i/ia/1),6I/7 - ("re- , i/70._ Waterpiping/DWV 56.29 Address: / Cj r5 v /0/f Other: 25.02 City/State/ZIP:6 /aC kaiv 4-3_5 i O) 976/5 Subtotal Phone: Fax: Minimum permit fee: $72.50 (l 75s,7 /-r / umbing Lic.no. G�J R� Plan review (25%of permit fee) CCB Lic.: - ---,.------.-' Pr State surcharge(12%of permit fee) Authorized sign e____--- TOTAL TOTAL PERMIT FEE Print name: - Date://,_/ /7 This permit application expires if a permit is not obtained within 180 days L% yN U 1/ 7 / after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Qty. Fee, Total uaree-Foo e: Permit Fee: Site Utilitres . �q Footing drain-151 100'cM 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 Valuation: Permit Fee: '- 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 Qty. Fee(ea) Total " each additional$100.00 or fraction thereof,to Other Inspections or Fees 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 (minimum charge-1/2 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 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 i accurately report fixtures could result in increased sewer •es*. '.Flat#Review for Plumbing Installatio Quantity by Fixture Typ= Plan review is required for any of the following. Fixture Type for R ' aeel Please check all that apply. Work Performed: Capped Added •elocate ❑ Any new commercial building with water service 2"and Baptistry/Font greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool Car Wash: -Each Stall 0 New exterior plumbing site utilities for any complex structure as defined in OAR918-780-0040. -Drive Thru Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities. ❑ Any multipurpose fire sprinkler system. Dishwasher: -Commercialirator 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" -3" Isomeric or tisgr.Diagram 4" 0 Isometric or riser diagram is required for new buildings -Car Wash Drain that meet the qualifications above. Garbage -Domestic non-food 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/Bar non-foe• related -Bradley -Com/Sery it food related -Service *Note: If the fixture work under this permit results in an Swimming Pool F.ter increase of sewer EDUs,a sewer permit will be issued and Washer-Cloth:: fees assessed for the sewer increase must be paid before the Water Extract', Water Closes -Toilet plumbing permit can be issued. Urinal Other F. tures: 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: 15900 SW 72ND AVE, TIGARD, OR, 97224 Record Type: Record ID: Commercial - Plumbing PLM2017-00459 Inspection Type: Inspector: 399 Plumbing final Don Sylvester Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor