Permit (194) CITY OF TIGARD PLUMBING PERMIT
.111 COMMUNITY DEVELOPMENT Permit#: PLM2018-00422
Date Issued: 09/10/2018
r I GAFt D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1S134AA01800
Jurisdiction: Tigard
Site address: 10110 SW NIMBUS AVE B11
Project: Spec Space Subdivision: IKOLL BUSINESS CENTER,TIGARD Lot: 2
Project Description: Interior plumbing:Adding(1)sink.
Contractor: BEAVERTON PLUMBING INC Owner: KYLE LATTA
13980 SW TV HWY 10240 SW NIMBUS AVENUE, L-3
BEAVERTON, OR 97005 PORTLAND, OR 97223
PHONE: 503-643-7619 PHONE: 503-598-9980
FAX: 503-643-7620
FEES
Quantity Description Date Amount
1 ea Sink 09/10/2018 $25.02
Specifics: 1 12%State Surcharge- 09/10/2018 $8.70
Plumbing
Type of Use: COM 47 ea Minimum Fee Adjustment- 09/10/2018 $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.
From:Beaverton Plumbing 5036437620 09/07/2018 13:08 #424 P.002/003
Plumbing Permit Application -
Building Fixtures
ed
City of Tigard Received
/ t., 1,i• ,� f - Permit No.. �p ,a `r3r_ .
• 13125 SW Hall Blvd..Tigard,OR 97223 Date/By:g Plan Review ��)
• Phone: 503.718.2439 Fax: 503.598.1960 Other Permit No.: `t�P�,� j/
Date/By. i?. `t'r[/02/e
Inspection Line: 503.639.4175
IICiANu Date Ready/By: Anis: See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑New construction ❑Demolition For special information use checklist
Description i Qty. I Ea. l Total
®Addition/alteration/replacement ❑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 ®Commercial/industrial SFR(2)bath 437.78
0 Accessory building ❑Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
0 Master builder 0 Other: Fire sprinkler( sq.11.) Page 2
/�y�j�./ SITE INFORMATION AND LOCATION Site utilities:
Job site addrdss:f V NIMBUS AVENUE Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:TIGARD OREGON
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.:B-Il Project name: J I 3nv%(Q 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 ft.:_) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: 1 Lot n�no.: Fixture or item:
Tax map/parcel no.: /5�r. /'f/ / ' ! Backflow preventer 31.27
"e/ - • Backwater valve 12.51
„DESCRIPTION OF WORK
Clothes washer 25.02
REMOVE AND REPLACE 1 UTILITY SINK AND FAUCET
i
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
PROPERTY OWNER ❑ TENANT ` 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
® APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:BEAVERTON PLUMBING INC Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:JACKIE STEWART
Roof drain(commercial) 12.51
Address:13980 SW TUALATIN VALLEY HWY Sink/basin/lavatory 1 25.02 23,V'L
City/State/ZIP:BEAVERTON,OREGON 97005 Solar units(potable water) 62.54
Phone:(503)643-7619 Fax::(503)643-7620 Tub/shower/shower pan 12.51
E-mail:Jackie@beavertonplumbing.com Urinal 25.02
1 Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:BEAVERTON PLUMBING INC Water piping/DWV 56.29
-
Address: 13980 SW TUALATIN VALLEY HWY Other: 25.02
City/State/ZIP:BEAVERTON,OREGON 97005 Subtotal )(5'cs .,
Phone:(503)643-7619 Fax:(503-)643-7620 Minimum permit fee: $72.50 J.)_67)
CCB Lie.: 12889 Plumbing Lic.no.:34-4PB Plan review (25%of permit fee)
State surcharge(I2%of permit fee) 76
Authorized signature- t:E j f-(.-L.(4"..d.-e. ZL' ,E,:`L , ( TOTAL PERMIT FEE ,,f7,y7 ch
Print name:JAC ;'LINE STEWART Date:09/07/2018 •Fbis permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I\Building\Permits\PLMC-PermitApp.doc 10/01/09 440-4616T(10/02/COMJWEB)
From:Beaverton Plumbing 5036437620 09/07/2018 13:08 #424 P.003/003
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-1"l00' 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 Qt3'' ��(ea) Total each additional$100.00 or fraction thereof,to
P 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*.
Quantity by Fixture Type .Plan Review for Plumbing Installations
Fixture Type for Replace/ Plan review is required for anyof the following.Performed: Capped Added Relocateq
Baptistry/FontPlease check all that apply.
Bath -Tub/Shower 0 Any new commercial building with water service 2"and
Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer. 1
-Drive Thru 0 New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspiratoras 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 2 sets of plans with any of the above.
-3"
4" Isometric or Riser Diagram
Car Wash Drain
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
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
-Rec.Vehicle Dump Station Le. s r(.. C ( /f C // -`
Shower -Gang
iffe.
Stall . /Z.:,_e‘ 1
Sink/Lav -Non-food related
-Bradley '`"--..`
-Commercial-food related y/j
-Service /V✓` 6l Ake-4-4) 1-•ww�OG'- �r >,- ,- `7/9
Swimming Pool Filter *Note: If the future work under this permit results in an
Washer-Clothes �.
Water Extractor increase of sewer EDUs,a sewer permit 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://cros4.revize.com/revize/tigard/document_center/Building/PLMF_Pe, iitApp.doc
From:B eaver ton Plumbing 6036437620 09/07/2018 13:07 4424 P.001/003
SEE
13980 SW Tualatin Valley Hwy.
Beaverton OR 97005
503.643.7619
Fax 503.643.7620
CCB# 012889
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City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10110 SW NIMBUS AVE B11 , TIGARD, October 1 , 2018 at
OR, 97223 11 :39:35 AM
Record Type: Record ID:
Commercial - Plumbing PLM2018-00422
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor