Permit (19) CITY OF TIGARD PLUMBING PERMIT
m Permit#: PLM2018-00289
a - COMMUNITY DEVELOPMENT
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/13/2018
T I + L g Parcel: 2S101 DB00103
Jurisdiction: Tigard
Site address: 7360 SW HUNZIKER RD 203
Project: Body in Balance Subdivision: None Lot: None
Project Description: ADD(1)new 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 Sink 06/13/2018 $25.02
Specifics: 1 12%State Surcharge- 06/13/2018 $8.70
Plumbing
Type of Use: COM 47 ea Minimum Fee Adjustment- 06/13/2018 $47.48
Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
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: �'r= 7,2 Permittee Signature: /f� /n4—/c -- "7e"/
77 Call 503.639.4175 by 7:00 a.m.for the next available inspectiontidate.
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 Permjt Application , I
Building Fixtures I tilt I>11 It l I si o\1 't
City of Tigard JUN 11 2018 Received W// /9 4./7(/_ Permit I i. y ee-ea 9 1
11 13125 SW HO Blvd..Tigard,OR 9 Y I C�F� + Pit"'Revcew i i s
Pircrttr. 503.718.2439 Fax: 503.598. t� r Pit"'Ry Other Permit Nc�. e4ezit et9 f
Inspection Line: 5Q3.639,4116 BUILDING P> It ',Date Ready/By//� ,,��� ,,((j�� Jun 611 See Page 2 for
r t +' Internet: www.tigard-or.gov Notitied'Meti i,3//,e- !‹4-i Supplententat Information
TYPE:OF WORK e FEE{ scitzliutt ,
For special leorntatlon use checklist
0 Ne construction I 0 DemolitionFor
I Qty, ] Ea. ( Total,
IX Addition/alteration/replacement I 0
Other: New I-2-family dwellings(includes 100 ft.tar each utility connection)
SFR(I)bath 312.70
CATEGORY OFCOIYIRUGTrON 437.78
Commercial/industrial
SFR(2)bath
0 I-and 2-family dwelling ' SFR(3)bath 500.32
0 Accessory building0 Multi-family 25.02
Each additional bath/kitchen
o Master builder 0 Other: Fire sprinkler( sq.Il.) Page 2
JOB s1T1;'INFORMA t ION AND LOCATION Site utilities:
L1 `,,•' ,,�(,� Catch basin or area drain
18.76
Job site address:.1106 Fl i Al MINI CSA Drywell.leach line,or trench drain 18.76
City/State/ZIP: `\ Ot `'��a03 Footing drain(no.linear ft,: -) Page 2
Suite/bldg./apt.no.: �1 Project name: �, Manufactured home utilities 50.03 ;
Cross stn�ct/directians to job site: Manholes 18.76 1
Rain drain connector 18.76
i Sanitary sewer(no.linear ft.: ) Page 2
- Storm sewer(no.linear ft.: ) Page 2
. . Water service(no.linear ft.:�,,,,,-) Page 2
r Subdivision:
Lot no.: . Fixture or item:
_ .. _ I Backflow prevcnter 31.27
Tax map/parcel no.: }2,5)
Backwater valve
DleKCRIPT'ION OF WORK 25.02
Clothes washer
Dishwasher 25.02
-Ar‘` Y\'ii C'� \Y\ I Drinking fountain I 25.02
Ejectors/sump 25.02
PROPERTY OWNER TENANT- _Expansion
tar cap 25.02
Name: &fhYZVWx. Floor drain/floor sink/hub 25.02
Address: . . .. . Garbage disposal 25.02
CitylState/L1P: ; tiosebib 25.02
Ice maker 12.51
!'terns:( ) Fax:( ) 4
} APPLICANT 0 CONTACT P1F;11~SCON Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name: 01 , 12:51
I-- Primer
Contact name: �) v n + Roof drain(commercial) 12.51
Address: QLl(0 'l� 1%.xi1 5fr I .SI,„-{ IO1 Sink/basin/lavatory \ 25.02 c,09 1
C°it /State/1.1P:� 4110‘...,1._ Solar units(potable water) _ 62.54
�y
Phone:611 tp j0Cf(iO Fax::( ) Tub/shower/shower pan 12.31
Urinal 25,02
I-mail: CID
,,,,, eKY1LYl/ } �d 25.02
CONTRACTOR ,
IIID CA- L0.12� , . �'`, Wafer closet
Water heater 37.52
Business name:Western Plumbing,Inc. Water piping/DW V 56.29
Address:9460 SW Tigard Street,Suite 101 Other: 25.02
Subtotal cc,r,-)(]12,,.
1
City/State/ZIP:Tigard,OR 9/223 ‘10,C:-.0
Phone:(503)639-5296 I Fax:( )
Minimum permit fee: $72.50
Plan review (25%of permit fee)
C'C'[i 1_ic.:2439 Plumbing Lie.no.:3429PB State surcharge(12%of permit fee) , 1
Authorized signature: ) o // TOTAL PERMIT FEE A,a j
ichis permit application expires if a permit is not obtained within 180 days
Print name: ' ' \i x-\ Date: �j after it has been accepted as complete.
*Fee methodology set by 'ri-County Btulding Indastn Service Board.
I`.Budding!Permits\PL'.MU-PermitApp.dee 10/01/09 440-46115T(I0102fCOMAVE13)
Plumbing Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilttiea QtY• pr*. TotalSqum. E` get P mit Fee:
Footing drain-l'"100' 50.03 y } 0 to 2.000 5121.90 ,
Footing drain-each additional 100' 37.52 I2.001 to 3.600 5169.69
3.601 to 7,200 $233.20
Sewer-1st 100' 62.54 1 7,201 and greater 5327.54
Sewer-each additional 100' 37.52
Water Service-1st IQO' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52
Villi Dt11011.« Permit i' .
t Storm&Rain Drain-1st 100' 62.54 $1.00 to 55,000 00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.521 $5,001.00 to 510.000.00 $72.50 for the first$5,000.00 and$1.52 liar
Other Inspections or Fees QV irea_(e$) Total I 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 each additional 5100.00 or fraction thereof.to
(minimum charge-1/2 hour) {{ and including 525,000.00.
Inspections outside cifnormat business 90 00/hr I $25.001.00 to 550,000.00 1 5379.50 for the first$25.000.00 and$1.45 for
hours(minimum charge 2 hours) Jeach additional$100.00 or fraction thereof,to
Reinspection Fees 90.00Ar ` and including 550.000.00.
IAdditional 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
accurately report fixtures could result in increased sewer fees*.
Quantity by Fixtu a Type Pi&H'Re few'` flu"PUtnitaikilt InitallOttions, 1
Fixture Type for Replace/ Plan review is required for anyof the following.
Performed: Capped Added Relocate9
Baptism/FontPlease check all that apply.
Bath Tub/Shower 11
❑ 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 Thru 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" Submit J sets of plans with any of the above.
I •
.. •
Car Wash Drain i90111etric-Or er grstni;
Garbage Domestic-non-food
0 isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above,
-Commercial-food related
-Industrial-food related
lee Mach./Refrig..Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rey.Vehicle Dump Station
Shower -Gang
�ra � �
14- �
I -Stall
1 Sink/l.av -Non-food related
1 -Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer Extractor Clothespermit increase of sewer EDUs,a sewer 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:f/www,tigard-or.gov/document_centeriBu i ldingfPLM F_Perm i tApp.dcg:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
7360 SW HUNZIKER RD 203, TIGARD,
OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2018-00289
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
1 . Plumbing final for break room sink- approved
2. Note: remove test equipment at tie in on first floor.
Violation Summary:
Inspector Contractor