Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2018-00357
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/24/2018
T I c;;'E 1<I) g Parcel: 2S101 DB00100
Jurisdiction: Tigard
Site address: 7340 SW HUNZIKER RD 215
Project: TKG Subdivision: None Lot: None
Project Description: Relocating(1)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: 503-639-5296
FAX: 503-684-9015
FEES
Quantity Description Date Amount
1 ea Sink 07/24/2018 $25.02
Specifics: 1 12%State Surcharge- 07/24/2018 $8.70
Plumbing
Type of Use: COM 47 ea Minimum Fee Adjustment- 07/24/2018 $47.48
Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: ,
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
CEIYEI)
Plumbing Permit A nnlicntio► E
Building Fixtures JUL g Z018 t t)l (>► ► u I i t_,1) 1
City of Tigard I Received c r f//1 Permit N- s
IIIat 13125 SW flail Blvd.,Tigard,OR 97 . OF TIC na;e/$ : ! Q i0p�01/p Qv��
: R rlah Review
Phone: 50:1.718,2439 Fax: 503.59F,. Other Permit No.:
1r ` C a(c/13v.
I 1 r, Inspection Line: 503.639.4175 III yy��,�era1��T`e_xaa I ' '
u E LIA.T 61;l� 5IV I S I~ die Rtadyrpy: J ri ® See Page 2 for
Internet: www.tigard-or gov Notifi d/method: r• Supplemental Information
E TYPE'OF WORKrEE. SCHEDULE
I New construction I'0 Demolition For special information use checklist
iDescription Qty. Ea. Total I
Addition/alteration/Ir piaceinent ❑Other: � New 1-2-family dwellings(includes 100ft.for each utility connection)
���"'iii CATEGORY OF CONSTRUCTION ' SFR(1)bath 312.70
I 0 1-and 2-family dwelling ]Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
�0 Accessory building 0 Multi-family
- Each additional bath/kitchen. I j 25.02
0 Master builder [0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION I Site utilities: ,I
'\ \ Catch basin or area drain „ 18.76
Job site address:` m�1�` SI,JJ X- (
C ttvlSlate/!11'. V.A. Drywall-leach line,or trench drain 18.76
Footing drain(no.linear 11::_) Page 2
Suite/bldg./apt.no.: Project name: "" jam I Manufactured home utilities 50.03
Cross street/directions to job site: I Manholes 18.76
Rain drain connector1 8.76
v Sanitary sewer(no.linear R.: ) Page 2 .
Storm sewer(no.linear ft.; ) Page 2
Subdivision: Lot no.: Water service(no.linear ft.:_�) Page 2
1 Fixture or item; i
Tax map/parcel no.: Backflow preventer 31.27 I
Backwater valve 12.51
DESCA "' 25.02
' Clothes washer
�,_:Ow!Alb. �A��.RIP'ITC]N'OF WORKrhshwasher 25.02
t b{ Q-, .S\r\� 1 11)rinking fountain t 25.02
IEjectors/sump
1 25.02
0 PROPERTY OWNER t it TENANT Expansion tank 12.51 I
Fixture/sewer cap 25.02
manic: -'
Floor drain/floor sink/hub 25.02
Address: Carbage disposal 25.02
City/State/ZiP: !lose bib25.02
Phone:( ) . Fax:( ) Ice maker 12.51
APPLICANT I' 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name: ` `,,` Medical gas(value:$ ) Page 2
`,,. ,* 1 11(Y�`,a, \1\C_W
1----• i I Primer � 12.51
Contact name: ,L • �,' �n
1 ., • Roof drain(commercial) 12.51
Address: C r, vi„ 1S1.0 JOi Sink/basin/lavatory ` 25.02 /per
City/State/ZIP: /l ,IXC(, Oi ... �[ ..,90J Solar units(potable water) 62.54
Phone: )1p ,.60(4(0 Fax::( ) Tub/shower/shower pan 12.51
fi-mail: . Urinal 25.02
t,ag*,, r1 i. nin)Pl ftC i 11C .C�Yn
Water closet 25.02
CO1Nt CTOR , L."
Water heater 37.52
Business name:Western Plumbing,Inc. Water piping/DWV 56.29
Address:9460 SW Tigard Street,Suite 101 Other: 25.02.
Subtotal _
! City/State%IIP:Tigard,OR 97223 Oa ,00).
Phone:(503)639-5296 Fax:( ) al-,29 PB 7//70 Minimum permit fee: $72.50 `40 a
CC'll Lie.:2439 Plumbing Lie.no.:3429PB Plan review (25%of permit fee)
State surcharge(12%of permit fee) ,V)
Authorized signature: 41)
Ati4 t S�J) TOTAL PERMIT FEE lat) j
I C/►vJ- y C-i This permit application expires ifa permit is not obtained within 180 days
Print name:�k , ;lir Date: ` IC4(g after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I`.Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4610T(10/02/COMAVEB)
Plumbing.Permit Application City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilitie8 (0Y. Fge{ea) Total Sqturre Fo e: i fit `ee:
it Footing drain-l"100' 50.03 0 to 2.000 $121.90
I Footing drain-each additional 100' 37.52 2.901 to 3.600 $169.69
3.601 to 7.200 $233.20
Sewer-1st 100' 62.54 f 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& Drain 1st 100' a 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
Total each additional$100.00 or fraction thereof,to
Other Inspections or Fees 1 and including$10,000.00.
Imp:talon of existing plumbing or for i 510.001.00 to$25.000.00 i $148.50 for the first S10,000.00 and$1.54 for
which no lee is specifically indicated 90.00/hr I 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 I $25,001,00 to$50,000.00 1 $379.50 for the first$25,000.00 and$1.45 Ibr
hours minimum charge-2 hours! each additional$100.00 or fraction thereof.to
1 Reinspection Fees 90.00/hr and including$50.000.00.
Additional plan review for revisions 90.t10/i r $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*. •
Oualttity by FixtureTY Piall'itefie .)".Plumbing Installations
Fixture Type for Rrptaeef Plan reviewis required for artyof the following.Performed: Capped Added Relocate t 9
flartisiry/font 1 lease check all that apply. 1
Bath -Tub/Shower 0 Any new commercial building with water service 2"and
Jacuzzi/Whirlpoolgreater,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 Aspiratorass defined in OAR9I8-7X0-0040.
Dishwasher -Commercial ' ; 0 Medical gas and vacuum systems for health care facilities.
-Domestic i 0 Any multipurpose fire sprinkler system.
Drinking Fountain 0 Any complex structure as defined in OAR91 X-7€30-0040.
Eye Wash i
IFloor Drain/sink Submit a sets of plans with any of the above.
-4.. Isometric of Aber Diagram
Car Wash Drain I 0 isometric or riser diagram is required for new buildings
Garbage -Domestic-non-food
Disposal -Domestic-food related I that meet the qualifications above.
-Commercial-food related
-industrial-food related
lee Mach./Refrig.Drains ,
Oil Separator(Gas Station) W Comments regarding fixture work:
Rue.Vehicle Dump Station
Shower -Gang
-Stall
Sink/t.av -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes increase of sewer EDUs,a sewer permit will be issued and
Water Extractor
Water Closet-Toiletfees assessed for the sewer increase must be paid before the
1.1rinal plumbing permit can be issued.
Other Fixtures: _
http://www.tigard-or.gov/document_center/Building/PLM P_PermitApp.dcp: