Permit (134) 1,1 q
CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2019-00353
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/04/2019
Parcel: 1 S 136 D D05300
Jurisdiction: Tigard
Site address: 11850 SW 67TH AVE, STE# 100
Project: The Partners Group Subdivision: WEST PORTLAND HEIGHTS Lot: 9
Project Description: Interior plumbing for TI:Adding(5)sinks.
Contractor: MCKINSTRY COMPANY LLC Owner: PNWP LLC#2
16790 NE MASON STREET SUITE 100 PNWP LLC
PORTLAND, OR 97230 6600 SW 105TH AVE#175
BEAVERTON, OR 97008
PHONE: 503-331-0234 PHONE:
FAX: 503-331-6907
FEES
Quantity Description Date Amount
5 ea Sink 09/04/2019 $125.10
Specifics: 1 12%State Surcharge- 09/04/2019 $15.01
Plumbing
Type of Use: COM
Class of Work: ALT
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 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.
Plumbing Permit Application , ,
Building Fixtures FOR OFFICE USE ONLY
Received / Permit No.:
City of Tigard y: q�5/!`j ' /G 244.f-CV ?Z3
- Plan 1
II
d 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Other Permit No.: <._
• Phone: 503.718.2439 Fax: 503.598 1960 i.�, ,, 2019
DateBy: �j 4/ ax 6.,i
TIGARD Inspection Line: 503.639.4175 Date Ready/By: Juris: BI See age 2 for
Internet WWW tigard oC gov ' t Notified/Method: Supplemental Information
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0 New construction 0 Demolition For special information use checklist.
Description I Qty. I Ea. I Total
®Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
niN ° i ' , i,1, "7 (OicI gbai , ' ca °0@wi
SFR(1)bath 312.70
IuHhOlIIIlIihIJii h , ,0, 3 _
El1-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ❑Multi-family Each additional bath/kitchen 25.02
❑Master builder ❑Other:
Fire sprinkler( sq.ft.) Page 2
!-,o(ida,aori4omAITE F9ATO . h -I25A ONuai. r�i� r , Site utilities:
Job site address:11850 SW 67th Ave Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97223 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Page 2 ,
Suite/bldg./apt.no.: 100 1 Project name:The Partners Group 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: Lot no.: Fixture or item:
Tax map/parcel no.: / _/- . i r- Backflow preventer 31.27
,,,,,,,i; 1, p^w >> ° , T' " n ;i, h v, � xi I �
Backwater valve 12.51
Illf:1 1 jf1I� „ t_v a lg Y�' i' QI ; N � �„i dl
. ;
Clothes washer 25.02
Rough in and installation of equipment with water and draining connections Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
';',61;10,41,,,,,,S ,,' c gR, OWNER I - ❑ TEIYANfi Expansion tank 12.51
Biu„i, o .. *,,, _ .
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
il1Iil i N APPLICANT
❑ ONTAT PERSON Interceptor/grease trap 25.02
Business name:McKinstry LLC Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Russell Smale
Roof drain(commercial) 12.51
Address:16790 NE Mason St Sink/basin/lavatory5 25.02
- j-'5-1
City/State/ZIP:Portland,OR 97230 Solar units(potable water) 62.54
=plrbYig'-(503r2��ZZ3� _--- - . .__MC.T------)----- _ _ tom --------------_ - =--1-2:5-1--- --=
E-mail:RussellS@Mckinstry.com Urinal 25.02
-;r CnO. 3 aiti. NoNi,Uiicu 6� ...;:�,• d..iryun Water closet
25.02
NTRACTO t", s.
Water heater 37.52
Business name:McKinstry WaterPin 1P g/DWV 56.29
Address: 16790 NE Mason St Other: 25.02
City/State/ZIP:Portland,OR 97230 Subtotal /e&5 /t)
Phone:(503)262 2301 Fax:( )
Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lic.:172811 Plumbing Lic.no.:37-22B State surcharge(12%of permit fee) . %j,0 j
Authorized signature: 14_0 2 4 TOTAL PERMIT FEE e ilOW
Print name:Russell Smale Date:8/14/19 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.
I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential
Fire Supression Systems:
Q eaTotal � reir
,{ ,
F
Footing drain-1s`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 07rt .1nI��i' PW r ��T�INiN��y
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
OfifOi,inspaalais- teeblp('iiii, Qty �J'I ):. Total each additional$100.00 or fraction thereof,to
(ioi 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:
Other Fixtures:
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
,FlxtnreTypef1►ro"-,Fixture .rn.;s:r. w 4" ae 671% !,',1A11) gCapped Added Relocate Performed:
Plan review is required for anyof the following.
Baptistry/Font q
Bath Tub/Shower Please check all that apply.
Jacuzzi/Whirlpool 0 Any new commercial building with water service 2"and
Car Wash -Each Stall greater,except systems designed and stamped by licensed
-Drive Thru engineer.
Cuspidor/Water Aspirator ❑ New exterior plumbing site utilities for any complex structure
Dishwasher -Commercial as defined in OAR918-780-0040.
-Domestic ❑ Medical gas and vacuum systems for health care facilities.
Drinking Fountain ❑ Any multipurpose fire sprinkler system.
Eye Wash ❑ Any complex structure as defined in OAR918-780-0040.
Floor Drain/sink -2"
3" Submit 2 sets of plans with any of the above.
-4"
Car Wash Drain Nr " 0 iiih��
Garbage -Domestic-non-food 1 Isome�6 ar iSer°.D 4, ....." ' 1 .,
�= ry
Disposal -Domestic-food related ❑ Isometric or riser diagram is required for new buildings
-Commercial-food relatedthat meet the 9ualifications above.
Triddstna-ood related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station)
Rec.Vehicle Dump Station Comments regarding fixture work:
Shower -Gang (1)Mop Sink
-Stall (1)Break Room Sink
Sink/Lav -Non-food related 5 ,l
-Bradley (1)Living Area Sink
-Commercial-food related (1)Mother's Room Sink
-Service I (1)Pantry Sink
Swimming Pool Filter
Washer-Clothes
Water Extractor *Note: If the fixture work under this permit results in an
Water Closet-Toilet increase of sewer EDUs,a sewer permit will be issued and
Urinal fees assessed for the sewer increase must be paid before the
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