Permit (2) CITY OF TIGARD PLUMBING PERMIT
I
. COMMUNITY DEVELOPMENT Perm
COMMUNITY PLM2020-00189
Date Issued: 8/4/2020
TIGA It.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S136CD01700
Jurisdiction: Tigard
Site address: 11686 SW PACIFIC HWY
Project: Chase Bank Subdivision: None Lot: None
Project Description: Interior plumbing: Capping(1)2"floor drain/sink,(1)3"floor drain/sink,(1)ice machine,(4)sinks,and(1)water
closet;Adding(1)drinking fountain,(3)2"floor drains/sinks,(4)sinks,and(2)water closets; Installing(1)
expansion tank,(3)primers,(1)water heater,(1)coffee maker,and (1)water purifier.
Contractor: PMSI LLC Owner: NTN PACIFIC LLC
8295 NW EVERGREEN PKWY#204 19830 NW DIXIE MOUNTAIN RD
HILLSBORO, OR 97124 NORTH PLAINS, OR 97133
PHONE:
PHONE: 503-466-2222
FAX: 503-466-2211
FEES
Quantity Description Date Amount
1 ea Drinking Fountain 07/28/2020 $25.02
Specifics: 1 ea Expansion Tank 07/28/2020 $12.51
8 ea Fixture/Sewer Cap 07/28/2020 $200.16
Type of Use: COM 3 ea Floor Drain/Floor Sink/Hub 07/28/2020 $75.06
Class of Work: ALT 3 ea Primer 07/28/2020 $37.53
Type of Const: 4 ea Sink 07/28/2020 $100.08
Occupancy Grp: 2 ea Water Closet 07/28/2020 $50.04
Stories: 1 ea Water Heater 07/28/2020 $37.52
50 Misc Other Fee 07/28/2020 $50.04
1 Plan Review 07/28/2020 $146.99
1 12%State Surcharge- 07/28/2020 $70.56
Plumbing
Total $805.51
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: e,?. .- ,;(4 )-:
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
'Builaing Fixtures t FOR OFFICE USE ONLY ,yam„
City of Tigard RECEIVE Puma No.: '
■ 13125 SW Hall Blvd.,Tigard,OR 97223 y / '�/ � ��l ,
Plan Review n„- Other Permit No.: v ./
5 Phone: 503.718.2439 Fax: 503.598.1960 APR 2 2 202Q Date/By: _I �0,70 k/W G.
T I GARD Inspection Line: 503.639.4175 Date Ready/By / n W.tans: RI See Page 2 for
f
Internet: www.tigard-or.gov __�,,ma�ys T (3' Noiit d/Mcthed:, t` '-- ' Supplemental Information
TYPE OF WORx';1LJI , itqt, i-r"tit, 1 v .,.w FEE* SCHEDULE
For special information use checklist.
❑New construction El Demolition
Description I QtY. I Ea. I Total
®Addition/alteration/replacement El Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
h CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ I-and 2-family dwelling LEICommercial/industrial
SFR(2)bath 437.78
SFR(3)bath 500.32
0 Accessory building 0 Multi-family Each additional bath/kitchen 25.02
0 Master builder El Other: Fire sprinkler(_sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 11686 SW Pacific Highway Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: Ti ard, OR 97223
V g Footing drain(no.linear ft.: ) Page 2
�Suite/bldg./apt.no.: I Project name: Chase Bank Tenant Improvement Manufactured home utilities 50.03
+1 Cross street/directions to job site: Pacific Hwy and SW 78th Ave Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
XWater service(no.linear ft.:_) Page 2
Subdivision: I Lot no.: Fixture or item:
_ Tax map/parcel no.: 1 S136CD01700 Backflow preventer 31.27
\ Backwater valve 12.51
RT 11PN`OF VOW( Clothes washer 25.02
N DESG
. Interior tenant improvement to accommodate(2)new restrooms with associated Dishwasher 25.02
plumbing fixtures,Lounge hand sink,floor drains,mop sink and water heater. Drinking fountain 1 25.02 25.02
C Ejectors/sump 25.02
\, 0 PROPERTY OWNER ® 'TENANT
Expansion tank 1 12.51 12.51
Fixture/sewer cap 25.02
Name. Joe Hernandez,VP-Chase Bank Floor drain/floor sink/hub 3 25.02 75.06
° Address: 24085 El Toro Road, Floor 2 Garbage disposal 25.02
,� City/State/ZIP: Laguna Hills,CA 92653 Hose bib 25.02
Phone:(602 )703-3816 Fax:( ) Ice maker 12.51
1 ® APPLICANT ® CONTACT PERSON Interceptor/grease trap 25.02
14, Business name: PM Design Group Medical gas(value:$ ) Page 2
Primer 12.51
Contact name: Arlan Sanders 12.51
(,y Roof drain(commercial)
' Address: 3860 Broadway,Suite 110 Sink/basin/lavatory 4 25.02 100.08
City/State/ZIP:American Canyon,CA 94503 Solar units(potable water) 62.54
IPhone:( 707) 731-7394 1Fax: :( ) Tub/shower/shower pan 12.51
E-mail: asanders@pmdginc.com Urinal 25.02
Water closet 2 25.02 25.02
CONTRACTOR Water heater 1 37.52 37.52
Business name: ��,si Water piping/DWV 1 56.29 56.29
Address: Fo2g5- ,44.,} tg'�j. �� t r Other: 25.02
City/State/ZIP: ..64 NJ�--,vo dk. 9) j of Subtotal $331.50
`, ) ! / Fax:( ) Minimum permit fee: $72.50
Phone:
4Si!3 `76G'pNv Plan review (25%of permit fee) $82.88
CCB Lic.: 15-75-02$70 Plumbing Lic.no.: 31-y37
/
�� J State surcharge(12%of permit fee) $39.78
Authorized signature: dZ• - --'t`"' TOTAL PERMIT FEE $454.16
Print name: Arian Sanders Date: 4/22/20 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:\Building`Permits/PLMU-PermitApp.doe 10/01/09 440-4616T(I 11/02/COM/WEB) 0 BOG/ /1_,`
Phunpbin;: Permit Application - City of Tigard
•
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Q • Fee(ea) Total Square Footage: Permit Fee:
Footing drain-1"100' 50.03 0 to 2,000 5121.90
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 Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
11 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*. Plan Review for Plumbing Installations
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate
❑ Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower engineer.
-Jacuzzi/Whirlpool
Car Wash: -Each Stall 0 New exterior plumbing site utilities for any complex structure
as defined in OAR918-780-0040.
-Drive Thru
0 Medical gas and vacuum systems for health care facilities.
Cuspidor/Water Aspirator
Dishwasher: -Commercial El Any multipurpose fire sprinkler system.
-Domestic 0 Any complex structure as defined in OAR918-780-0040.
Drinking Fountain 1
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink: -2" 1 3
3" 1 Isometric or Riser Diagram
4" ❑ Isometric or riser diagram is required for new buildings
-Car Wash Drain
Garbage Domestic non-food that meet the qualifications above.
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
Ice Mach./Refrig.Drains 1 Comments regarding fixture work:
Oil Separator(Gas Station) Existing sink types: (1) 3-compartment sink,
Rec.Vehicle Dump Station (1) lavatory, (1) bar sink, (1) mop sink
Shower: -Gang New sink types: (2) lavatories, (1) break room
-Stall sink, (1) mop sink
Sink: -fav/Bar non-food related 2 3
-Bradley
-Com/Serv/Util food related 1
-Service 1 1 *Note: If the fixture work under this permit results in an
Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and
Washer-Clothes fees assessed for the sewer increase must be paid before the
Water Extractor
Water Closet-Toilet 1 2 plumbing permit can be issued.
Urinal
Other Fixtures:
I:1Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
Plumbing Permit Application
Building Fixtures FOR OFFICE USE ONLY
Received /
City of Tigard Date/By -j 7/� �!/��.j�_ Permit No.: pLM logo•-ao leg
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Other Permit No.: ]'
Date/By: 5 I t;f'c�pU $W� Gb1
T 1 G A R D Inspection Line: 503.639.4175 Date Ready/By: ` funs: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method:/ � Supplemental Information
TYPE OF WORK `1(-r0� J� FEE* SCHEDULE
0 New construction ❑Demolition �v� For special information use checklist.
Description I Qty. I Ea. I Total
.Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ 1-and 2-family dwelling Al-Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building 0 Multi-family
Each additional bath/latchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: t L Catch basin or area drain 18.76
ii�Sb 5.( .!, de�,�r tlicike,,,a
City/State/ZIP: ;L R. . v Drywell,leach line,or trench drain 18.76
`� l i Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name: C h24.P 13& .k -rI Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
/.e-noxt 1 r"t(?VL Ue..44.ki t . )r iV$w 13C v Dishwasher 25.02
Drinking fountain / 25.02 :2 5,0„
Ejectors/sump 25.02
❑ PROPERTY OWNER I ❑ TENANT Expansion tank r 12.51 /ot•5 i
Name: Fixture/sewer cap 8 25.02 a 00.16
Floor drain/floor sink/hub 3 25.02 175,0c
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
0 APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name: Medical gas(value:$ ) Page 2
Primer 3 12.51 37,53
Contact name:
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 4/ 25.02 OQQ,()
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
CONTRACTOR Water closet d 25.02 50.oy
Water heater / 37.52 3r],Sal
Business name: Water piping/DWV 56.29
Address: Other:LatfK Male e l a, 25.02 50,6 q
City/State/ZIP: t.. sktt PurPitt = , Subtotal 589, 9'
Minimum permit fee: $72.50
Phone:( ) Fax:( )
CCB Lic.: Plumbing Lie.no.: Plan review (25%of permit fee) 1y6,y9
State surcharge(12%of permit fee) 9Q,56
Authorized signature: TOTAL PERMIT FEE peg,5/
Print name: 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.
l:msildtng1PemitsTLMU-PermtApp.doc 10/01/09 440-4616T(10/02/COM/WEB) �‘.-e't`V c 2.
.5t mk.s= 2
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"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 S327.54
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 Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
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
(minimum charge-1/2 hour) and i l 0 or fraction thereof,to
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*. Plan Review for Plumbing Installations
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate
❑ Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
-Jacuzzi/Whirlpool engineer.
Car Wash: Each Stall 0 New exterior plumbing site utilities for any complex structure
Drive Thru as defined in OAR918-780-0040.
Cuspidor/Water Aspirator ElMedical gas and vacuum systems for health care facilities.
Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system.
Domestic ID Any complex structure as defined in OAR918-780-0040.
Drinking Fountain
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink: -2" r j
Isometric or Riser Diagram
4 ❑ Isometric or riser diagram is required for new buildings
-Car Wash Drain
Garbage Domestic non-food that meet the qualifications above.
Disposal: -Domestic food related
-Commercial food related
-Industrial food related Ice Mach./Refrig.Drains f Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -lavBar non-food related
-Bradley
-Com/Serv/Util food related
-Service i I *Note: If the fixture work under this permit results in an
Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and
Washer-Clothes fees assessed for the sewer increase must be paid before the
Water Extractor
Water Closet-Toilet I ,,9, plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF_PelmitApp.doc 08/04/2011 2
Branden Taggart
From: Branden Taggart
Sent: Friday, June 5, 2020 12:22 PM
To: asanders@pmdginc.com
Subject: Chase Bank Plumbing Permit: PLM2020-00189 - 11686 SW Pacific Hwy
Attachments: Branden Taggart2.vcf; Chase Bank Invoices & Sewer Tally.pdf
Hi Ariane,
The plumbing and sewer permits for the Chase Bank, located at 11686 SW Pacific Highway, are ready to issue now. I
have attached invoices above for you to reference, and the fees due are as follows:
Chase Bank
Permit# Fees Due
PLM2020-00189 $ 805.51
SWR2020-00120 $ 1,450.00
Total: $ 2,255.51
You can pay the above fee online through our website: https://aca.accela.com/TIGARD/Default.aspx. From there, click
on the Building tab, enter the permit numbers in the Record Number field, and click Search. If paid online, please notify
us at tigardbuildingpermits@tigard-or.gov, and I will issue these permits and place them in our open conference room
adjacent to our outer Permit Center lobby to be picked up between the hours of 8:00 a.m. and 5:00 p.m., Monday
through Thursday. We are closed on Fridays. Furthermore,the permit fees for both permits will need to be paid before
we can issue either of them, and we will also need the plumbing contractor's license information prior to
issuance. Please let me know if you have questions.
Thanks,
!I Branden Taggart
City of Tigard
Senior Permit Technician
Community Development
13125 SW Hall Blvd
Tigard, OR 97223
(503)718-2449
brandent@tigard-or.gov
1
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
q Transmittal Letter
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: 5' DATE RECEIVED:``�DEPT: BUILDING DIVISION " e m. I— L.
MAY 14 ZOZO
FROM: ,4-fri;of„i /3')Oref CITY OF TIGARD
3UILDING DIVISION
COMPANY: Q � ' a
PHONE: �5��� �( 7'6a
By: l
RE: 1k9 /46I c eLar "C7'"J rogd--ct)i
(Site Address) (Permit Number)
(A
(Project name o subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s) of plans. Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS: /✓a d (1i-w7/5
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: Initials:
Fees Due: ❑ Yes ❑ No Fee Description: Amount Due:
Special
Instructions:
Reprint Permit(per PE): ❑ Yes ❑ No El Done
Applicant Notified: Date: Initials:
I:\Building Worms\TransmittalLetter-Revisions_061316.doc
PM Design Group, Inc.
6930 Destiny Drive, Suite 100
Rocklin, CA. 95677
DESIGN P: 916.303.4412
Arch to c tor.11
`rnlut[sns Granp
Transmittal
Iv1AY 14 2020
CITY OF l SGA D
IJIL,DlNia DIVISION
Date ; 05/11/20
To: Building Permit Tech From: Adrian Mora
City of Tigard—Building Department RE: Chase Tenant Improvement
13125 SW Hall Blvd 11686 SW Pacific Hwy
Tigard,OR 97223 Tigard, OR
Phone: 503-718-2439
Project JPM19015.0
Number:
Sent Via:
r Fax E US Mail E For Your Use E For Comment
Fax Po-Overnight E As Requested For Revision
Number
Number
of Pages Electronic rosr For Approval F High Priority
Quantity Date Description
2 - P2.2 sheet
Comments
Enclosed is the above listed item per plan checker request.
If you have any questions, please contact myself of Ariane Sanders.
Thank you
Adrian Mora
Assistant Project Manager
562-477-6281
Office Locations
Sacramento a Portland s Phoenix g Dallas a San Francisco 0 Denver m Los Angeles
www.pmdginc.com