Permit (275) p CITY OF TIGARD PLUMBING PERMIT
1111 • COMMUNITY DEVELOPMENT Permit#: PLM2014-00254
T t(,A RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/06/2014
Parcel: 2S115BA02500
Jurisdiction: TIGARD
Site address: 16200 SW PACIFIC HWY Z3
Project: Home Street Bank Subdivision: 2004-015 PARTITION PLAT Lot: 1
Project Description: Add(1)dishwasher and replace(3)sinks and(1)water closet.
Contractor: POWER PLUMBING CO Owner: SN PROPERTIES PARTNERSHIP
PO BOX 19418 1121 SW SALMON ST
PORTLAND, OR 97280 PORTLAND, OR 97205
PHONE: 503-244-1900 PHONE:
FAX: 503-244-8825
FEES
Quantity Description Date Amount
1 ea Dishwasher 08/06/2014 $25.02
Specifics: 3 ea Sink 08/06/2014 $75.06
1 ea Water Closet 08/06/2014 $25.02
Type of Use: COM 1 12%State Surcharge- 08/06/2014 $15.01
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $140.11
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 q tions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued B : G^\\��G Gr Permittee Signature:
rf7, r
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.
JUL/31/2014/THU 09:45 AM P. 001
RECEIVE!)
Plumbin Permit Application
Building Mures JUL 31 2014 FOR OFFICE USE °NIA'
City of Tigard RJ00"'°d $ Permit No.: �M�/ -On) Jr
1312SSW11e1IBlvd,Tigard, ;t 1FTIGARI� p Permit lio. / 1
Phone: 503.X&2439 Parc� DIVISION - '_' Oa IS
lnspraion Line: 503.639.4116 Date ttndy/By, �' >orc id Sea Page 2 for i A
T "t I) lutefnet: www.tigord-or.tov Noose +mod g� sgpkalamat Information V •
_ 3
New construction 0 Demolition ,,a U.) Fors. dal in ormdrrlon use checklist
[] • cri.lion 'MN Ea. Total
Additionhdteranon/replacemcnt ❑Cikrer' 6 t",` !. - ewe 1-2-family dwellings(includes 100 R.for each utility connection)
ria s. , . -F',41-! r -3 0-71pr SFR(1)bath 312.70
i)tlYru a n u1..,s, , ru"-, . 'rte ..: .' a," r',
SFR(2)bath 43738
❑1-and 2-fmaily dwelling P: Com mercial/industrial SFR(3)bath 500.32
❑Accessory f building ❑Multi-family_ Each additional bath/kitchen 25.02
❑Master builder ❑Other' Fire sprinkler( sq.R.) Page 2 0,
;, i;3ojil-(ti,4fi01 dkt1/�'a a v l 'Cfu i rt u"rt Site utilities: V
r r:.. area drain 18.76
-_' �j�� Catch basin or W
Job site address: �(1�✓ SW C � „,L fi(i(� Drywall,leach line,ortrcnch drain 18.76
City/State/ZIP: 11\14/1,1 O` /-]Z.2 7 Footing drain(no.linear f: ) Page 2 �.
SuitelbldgJapt no. Z 3 v I Prcliect name: WAAL Si/{if 1j6(.4 Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:„) Page 2
Storm sewer(no.linear it: ) Page 2
Water service(no_linear ft.:) Page 2
Subdivision: 1 Lot no.: Fixture or item:
fax map/parcel no.:
S//SI A 0 2.5-00 p0 Baclkfow preventer 31.27
_ . _ a Barkwatel'valve 12.51
° ';Ili ; t si u ' '
, _ s • ' '. '" . �e •,.,_ =l Clothes washer 25.02
4 I. LAL. i VO Dishwasher II- 25.02 25.(3-Z.
Drinking fountain 25.02
Ejectors/sump 25.02
F .4;1 Expansion tank
Tr �(�i'1�7�4}1 J)�t\5°`7n�4�' ��� l..��"����. �Y.l `5 s�4,�•I,Ua",�� -1c '6�..- I2.$1
_ - SJ Ficturel6ewer cap 111 25.02
Name:
-_ _ _ Floor drain/floor sink/hub 25.02
Address: , Garbage disposal 25.02
City/State/ZIP: hose bib II 25.02
[
Phone:( ) I Fax:( ) Ice maker 12.51
L '_ �,-, -; M-° w:-yr.•• a. ,�o"` as+ ' ".= Inter for/grease trap 25.02
_! x 7.-.. ti0 L• x k r. 0 7b• T x- 0 Tl �D
Medical gas(value;S ) Page 2
Iluitness rime: f / r Primer 12.51
Contact name; " AL 1 G11 ' Roof drain(commercial) 12.51
I
Address: i , / L /'/�A// • d AG-/C-- Ay ( Sink/basin/lavatory 3 25.02 g.ot„
Ci /State/ZIP: .14. ' Z Solar units(potable water) 62.54
ty �Q ,r. L /
�
Phone: ) 22/41- --
''j2/41 # Fax::(9)3) -z Tub/shower/shower pan 12.51
Urinal 25.02
E-mail: ,-- ![rr∎- i {-L-,T,17.7,7,7-''."',,,,,5.^-�cr z?^x f,i Water closet ( 25.02 Z5 O
_�., __ . ;-,"_,:-..12-! Water heater 37.52
Businessnumae /Q(.(�(j4 /p t -i94 • Water piping/DWV II 5629
Address: PO A /%Lfl e Other 25.02
City/State/ZIP: ,e Air____.„. 1 /)( / Zced Subtotal 725,10
EZE Fax:
- 1/ k12- Minimum permit fee: 572.50
Plan review (25%of permit fee)W
CCS Lie,: rj 2 �j�S' Plumbing Lie.no.: ('_/�� State surcharge(12%of permit fee) 5-,D 1
Authorized signature:
TOTAL PERMIT FEE 1 /
This permit appbcadon expires if a permit is not obtained within 180 days
tltmve: to-R.44-Vyt /��O S Date. _3J'/y ■fterit Nu beta accepted as complete.
"Fee methodology eet by Tn-County Building Industry Service Board.
I:1Hu31din ptnaitaL.MII.Paad1App-dot 10/01/09 ..440461srt1OAVCOMWEB)
AUG/04/2014/M0N 11 :09 AM RECEIVEII P. 003
Plumbing Permit Application - City of Tigard AUG 4 2014
Page 2-Supplemental Information
•
(ATV F IGARU
Fee Schedule: Rest ;;,:r.- ?,. • .: :4s= 1 n stems_ :
Footing drain-1'100' _ 50.03 0 to2.000 $121.90
Footing drain-each additional 100' 37.52 _ 2,001 to 3,600 $169.69
Sewer 6234 3,601 to 7,200 $233.20
ewer-1st 100'
_ 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 1.1111111=11111111 Medical Gas S stems:
Water Service-each additional 100' 37.52 -
Storm&Rain Drain-1st 100' 6234 e
_ $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 $7230 for the first$5,000.00 and$1.52 for
l 1 c r; r 1 each additional$100.00 or fraction thereof;to
- L . � .-... and includ'..$10,000.00_
Inspection of existing plumbing or for $10,001.00 to$25,000.00 5148.50 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 char:e-1/2 hour -_._._ .. _- . _ __ - -.---- .. .- and includ'r..$25,000.00- - - -----
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$75.000.00 and$1.45 for
hours(minimum ch i:e-2 homes each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and induct' :$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 ch -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*.
1<I p
'..,�, [?•1�"f (l : 1 1 � _ I ' r T r 777 ;-,--.,-r- r I I-f Y IY' , z
>r r l fthefol o
PIan review is required for any of following.
JI J:.� " ,., :.: Y�r ....•..,. .,r.,. .r.:,�
B; ti . /Font Pltasc check all that apply.
Beth -Tub/Shower ❑ Any new commercial building with water service 2"and
-7ac1>t/Whirl,,•1 -_- greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-eve Thru --- ❑ New exterior plumbing site utilities for any complex structure
Cu-.idor/Water • •irator -11.11111111.1..1 as defined in OAR918-780-0040.
Dishwasher -commercial -- ❑ Medical gas and vacuum systems for health care facilities.
-Domestic -ME11- 0 Any multipurpose fire sprinkler system.
Drinldn:Fountain 0 Any complex structure as defined in OAR918-780-0040.
E e Wash ini
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
3" 1.111.1111111111.1 .
• -4" --- c • m 1 i:±c 1 r. r c 'r t
Car wash Drain MIME • Isometric or riser diagram is required for new buildings
Garbage -Domestic-non-food -_-
Disposal -Domestic-food related MIME that meet the•uahfications above.
-Commercial-food related --
-Industrial-food related 1111111111111
Ice MachJRefri:,Drains
Oil -..: ,or Gas Station) Comments regarding fixture work:
Rec.Vehicle Dum•Station --_
Shower -Gang -11111111.
-Stall --
Sink/Lav -Non-food related
-Cy
-Commercial-food ercia]-food related
-Service
Swimm :Pool Filter . *Note: If the fixture work under this permit results in nu
Washer-Clothes
Water Extractor I/IIII. increase of sewer)EDUs,a sewer permit will be issued and
-
water Closet-Toilet --MEM 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-PemvtApedoc
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
16200 SW PACIFIC HWY Z3, TIGARD, OR,
97224
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2014-00254
George Heimos
Violation Summary:
Inspector Contractor