Permit (3) ph y!1
CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2012 -00324
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/01/2012
Parcel: 2S 101 AB90000
• Jurisdiction: TIGARD
Site address: 12011 SW 70TH AVE
Project: CH Physical Therapy Subdivision: 2012 -009 PARTITION PLAT Lot: 1
Project Description: Plumbing TI
Contractor: SHARPE PLUMBING Owner: RED ROCK CREEK CONDOMINIUM
PO BOX 23984 - OWNERS OF ALL UNITS
TIGARD, OR 97281 00000
PHONE: 503 - 590 -7050 PHONE:
FAX: 503 - 400 -6714
• FEES
Quantity Description Date Amount
1 ea Clothes Washer 11/01/2012 $25.02
Specifics: 1 ea Sink 11/01/2012 $25.02
1 ea Lavatories 11/01/2012 $25.02
Type of Use: COM 1 ea Tub /Shower /Shower Pan 11/01/2012 $12.51
• Class of Work: ALT 1 ea Water Closet 11/01/2012 $25.02
Type of Const: 1 ea Water Heater 11/01/2012 $37.52
-. Occupancy Grp: 1 12% State Surcharge - 11/01/2012 $18.01
Stories: Plumbing
•
Total $168.12
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 ru - adopted by the Oregon
Utility Notificat • - liter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You m. •,btain a .py of the rules •
or direct • - stions to OU • • - ing 503.232.1987 or 1.800.332.2344.
•
Issued =y: /A� ` / Permittee Signature: v �-
Call 503.639.4175 by 7:00 a.m. for the next available inspec , on 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.
e
From: Rebecca Sharpe Fax: (503) 400 -6714 To: +15035981960 Fax: +15035981960 Page 2 of 2 11/1/2012 3:06
11/01/2012 15:42 5035981960 CITY OF TIGARD PAGE 01/02
Plumbiaa Permit Application ,
Building Fixtures 1.,,,„. a i s i I t r a ti F t t\I.\
City of Tigard Aecri.a 9. EMEILM
• 13125 SW Hell Blvd., Tigard, OR 97223 Area Review Other permit Nal _ i , 4,7.-de) r /
I ■ - Phone" 503.718.2439 Fax 503.598.1960 fratelD.:
- inspecti®u Line: 503.639.4175 Date Read kHz y/8y: "r fB Sa>'� 2 Wormed=
1 i ' i' a , Internet www.tigaad- or.gov Notifed/MOM& SaBP to .
Fea spedatinfonnatIon we check/L%1
0 Now construction 0 Demolition _ - U • Ea Total
❑ Addition/alteration/replacement ❑ Other: New 1 -2- family dwellings (includes 100 ft. far each u tI1tt)cormection)
,.�e . ma) bah 31/70
1L'AY OF OI`ILIOlIT.. _
SFR (2) bath 43738
❑ 1- and 2- family dwelling _ ❑ Commercial/industrial S 500.32
El Accessory building ❑ Mufti- family — Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: Fite sprinkler L sq. it) Page 2 U
• AO ark •IWVO 8M 'IG ANfl 1 AVON Site mow j � � � Catch basin of area drain 15 -76 \ T
Job site addresx O / 0 well, leach line, or trendy drain 18.76 W
City/State_ ____ /ZIP: 7i Z Footing drain (rm. linear R: _) Page 2 l.)
`
Suite/bldg./apt. no.: Project name: Mmaithauied home utilities 50.03
Cross street/directions to job site: Manholes 1 &76
Rain drain connector 18.76
Strltery sewer Ono, linear it: r Page 2 ________
Storm sewer (no. linear ft.: _.J Page 2
Water salvia (no. linear IL: _._) Page 2
Subdivision- I Lot no.: Marc to item:
8adtflow Invent= 31.27
Tax map/parcel no.: _ 1251
- Backvratcr valve
. AF. WOW - — Clothes washer 25.02 J
W ' • )v _ 0 Dishwasher 25.02
prinking fountain 25.02
Ejectors/saran 25 -02
0 PRQpE111Y OWNER I ❑' TENANT Expansion tank 12.51
Fixture/sewer cap 25.02
Name: — Floor dsainAloar sirt/hub - 25.02
Address: a &mad 25.02
City/State/ZI Hose Crib 25.02
Phone: ( ) Fax ( ) ice maker 12.51
.❑ Ati'P1dCAPIt • .❑ CORrACT pgRSON Interceptor /grease Imp 25.02
Medical gets (value: $_) Page 1
Business names: 12.51
_ Prialet
Contact name: Roof drain (cantmerciai) 1251
Address: _ _ _ Sitdt/basin/lava 25.02 2,
City/State/a: Solar mks (potable wade) 62.54
Tub/showy/Shower pan 12.51 1
Phone:( } Fax::{ ) T — 25 Urinal 25
E -mail_ 25.02 t
Water closet
• CosivActos • ` • '
Water heats 37.52
Business seater l4 (� L' �. l•t YJ t /) t _ Water piping/Dwv ' 56_29
Address: )" 39 . 4 Other: 25.02
City/State/22P; - I Q a( d f (_ C Z Sebtotol /S •��
Phone: (5CJ 590 -- -1 OS'0 Fax ( 3 WOO - 107 I W Minimum permit fix: 57250 T
Flan review (25% of wand fee)
CC8 Lie.: 1 i 2 g FS Plumbing Lie. no.: 4 7j P6 state smdtat'ge (12% ofperrnit fee) /$.O /
Authorirrd signature: 74.--- /� n t c v im` JA TOTAL PRRZMIr FEE /Did,.
Print trams: k 1� v i {� S 1 - I t- 1 ` - r � E Date i) 1 u i Thin Punts arnahatiaa epZnu it a pent* is not bh
ontd wititra 110 days
after It has bow re mptate•
"Fee mealodalom set by Tri- County Bu8dmA r°bstry Service Boast.
RVwadlslPmeibNPLMC - CP•l0° l ilbUGY 44.4e15T(i0/07/CO.wWxla)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty: Fee (ea) Total Square Footage: Permit Fee:
Footing drain - I 100' 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
Other Inspections or Fees Qty. Fee (ea) Total each additional $100.00 or fraction thereof, to
h 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
accurately report fixtures could result in increased sewer fees Plan Review for Plumbing Installations
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate
❑ 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 ❑ New exterior plumbing site utilities for any complex structure
Car Wash: -Each Stall
Drive Thru as defined in OAR918- 780 -0040.
Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system.
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"
Isometric or Riser Diagram
4., ❑ Isometric or riser diagram is required for new buildings
- Car Wash Drain
Garbage Domestic non - food that meet the qualifications above.
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: -Lay/Bar non -food related
- Bradley
- Com/Serv/Util food related
- Service *Note: If the fixture work under this permit results in an
Swimming Pool Filter increase of sewer EDUs, a sewer permit will be issued and
Washer - Clothes fees assessed for the sewer increase must be paid before the
Water Extractor
Water Closet Toilet / plumbing permit can be issued.
Urinal
Other Fixtures:
I:\ Building \Permits\PLMF- PermitApp.doc 08/04/2011 2
From Rebecca Sharpe Fax: (503) 400 -6714 To +15035981960 Fax: +15035981960 Page 1 of 2 11/1/2012 3:06
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a a,
FAX Date: 11/1/2012
Pages including cover sheet: 12
To: +15035981960 From: Rebecca Sharpe
Sharpe Plumbing
•
PO Box 23335
Tigard
OR 97281
Phone Phone (503) 400-6714
Fax Number +15035981960 Fax Number (503) 400 -6794
NO -TEc` ".
plumbingapplication
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