Permit (81) CITY OF TIGARD PLUMBING PERMIT
8^ COMMUNITY DEVELOPMENT Permit#: PLM2019 00234
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/13/2019
Parcel: 2S 101 AA02900
Jurisdiction: Tigard
Site address: 12123 SW 69TH AVE
Project: Compass Oncology Subdivision: WEST PORTLAND HEIGHTS Lot: B
Project Description: Interioro plumbing: Adding(1)2"floor drain and(1)sink.
Contractor: AMERICAN HEATING INC Owner: SDC TIGARD CORPORATE CENTER INC
5035 SE 24TH AVE ATTN:ANDREW HARPER
PORTLAND, OR 97202-4765 101 CALIFORNIA ST, 26TH FLOOR
SAN FRANCISCO, CA 94111
PHONE: 503-239-4600 PHONE:
FAX: 503-239-7038
FEES
Quantity Description Date Amount
1 ea Floor Drain/Floor Sink/Hub 06/13/2019 $25.02
Specifics: 1 ea Sink 06/13/2019 $25.02
1 12%State Surcharge- 06/13/2019 $8.70
Type of Use: COM Plumbing
Class of Work: ALT 22 ea Minimum Fee Adjustment- 06/13/2019 $22.46
Type of Const: Plumbing
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 503.232.1*: or .:Se. -.- 44.
Issued By: 7 _ •: •.',•e Signature: _.y
—
arzt 6470.—.
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.
Plumbing Permit Application ,1 c,, 't1)t ,
Building Fixtures � y, FOR OFFICE USE ONLY
City of Tigard J FOR
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,.< Date/BY: G7/6//1 , ,- PermitNo.; /0i4/v0 t/et-r;r0 l/
41 13125 SW Hall Blvd,,Tigard OR Plan Review
illh z: Phone: 503.718.2439 Fax: 503,5'': '''.+ i u Date/By: /v//4
OV,, Other Permit No.: � 1l 1
Inspection Line: 503.639.4175 r t,-) Date Read/B / ions &i Sedage 2 for
riCrARr) V,, Y x $
Internet www tigard-or goy i @1bdfed/Method: h Supplemental Information
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0 New construction
0 I fJon For s eclat in ormaton use checklist
Description Qty. Ea. l Total
el Addition/alteration/replacement�+]+/5 �( /rt}y 70 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
L 11:5 x F 4[J.■+�1x3O O 61'4 1 ,a r'a k SFR(1)bath 312.70
❑ 1-and 2-family dwelling ►14 Commercial/industrial SFR(2)bath 437.78 -
❑Accessory buildingMulti-family SFR(3)bath 500.32
0
Each additional bath/kitchen 25.02
❑Master builder 0 Other: .
Fire sprinkler( sq.ft) Page 2
Pr 4$(B* . oR IoT1DT A-iii01 Site utilities:
Job site address:12123 SW 69th Ave Catch basin or area drain 18.76
City/State/ZIP:Tigard OR 97223 Drywall,leach line,or trench drain 18.76
Footing drain(no.linear ft.:`) Page 2
Suite/bldg./apt.no.: , Project name:Compass Oncology 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: )5 is i ` 'G1?l.{.) I Lot no.: Fixture or item: i
Tax map/parcel no.: Backflow preventer 31.27
'"f"�"ca-�xrni b't'C{ft 41 O{`33'O h ' ~ .N t Backwater valve 12.51
' Clothes washer 25.02
add one sink and one drain Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
' yy ,i i ' u N a Expansion tank 12.51
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Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub 1 25.02 -`(5)._
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
t0At gk ��, J� Interceptor/grease trap 25.02
rJs.. .,. .�"�'".w. §:...x lr �-,3ry -li�,��� .,��iR.��i�.s,�15,`c"`'sy
Business name:American Heating Inc. Medical gas(value:S ) Page 2
Primer 12.51
Contact name:Brad Manchester
Roof drain(commercial) 12.51
Address:5035 SE 24th Ave Sink/basin/lavatory 1 25.02
City/State/ZIP:Portland,OR.,97202 Solar units(potable water) 62.54
Phone:(503)239-4600 Fax::(503)239-7038 Tub/shower/shower pan 12.51
TaxUrinal 25.02E-mail:brad@americanheating.net
ti `ti , g ` t6,11a L sr . f gk Water closet 25.02
."- .A-r,; 14r ,ii z. . _r• ... , .t5 )4 :` , ,i 'vkg,,.I"
Water heater 37.52
Business name:American heating Inc. Water piping/DWV 56.29
Address:5035 SE 24th Ave. Other: 25.02
City/State/ZIP:Portland,OR.,97202 Subtotal •z z1
Phone:(503)239-4600 Fax:(503)239-7038 Minimum permit fee: $72.50 .74_5
Plan review (25%of permit fee)
CCB Lie.:33135 Plumbing Lic.no.:PB982 State surcharge(12%of permit fee) "70
Authorized signator : C TOTAL PERMIT FEE y j,A
Print name:Brad Manchester Date: This 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.
1:1Building\Pmmits1PLMU-P*nnhApp.dac 10/01/09 440-46161(10/02/COM1WEB)
"Plumbing Permit Application - City of Tigard
•
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Fe ea) `l utal >, ►tllZ#1<'` , .r. ...
Footing drain-1"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
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
each additional$100,00 or fraction thereof,to
0 1e' Sp ttoosf+p1";.��eek. ,_ 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*.
uanh by Fixture e ..t-3`,;111 .� bin i
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Plan review is required for any of the following.
Woi-kPerformed -Capped, . ,Added. ;Relocate,.
Baptistry/FontPlease check all that apply.
Bath -Tub/Shower ❑ Any new commercial budding 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 2 sets of plans with any of the above.
3"
Car Wash Drain
Garbage -Domestic-non-food Li 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
Shower -Gang
-Stall
Sink/Lay -Non-food related /
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture 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:
S:\_Pemfits\Permits\City of Tigard\Tigard Plumbing Application(BuildinaFixtures).doc
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12123 SW 69TH AVE, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2019-00234
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor