Permit t
CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2020-00279
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 9/11l2020
Parcel: 2S 112AD01000
Jurisdiction: Tigard
Site address: 7007 SW CARDINAL LN 135
Project: PacStar Subdivision: PACIFIC CORPORATE CENTER Lot: 1
Project Description: CAP(1)break room sink and(2)water closets for existing tenant expanding into adjacent space.
Contractor: ALWAYS FAITHFUL PLUMBING LLC Owner: PACIFIC REALTY ASSOCIATES LP
PO BOX 757 ATTN: N PIVEN
WILSONVILLE, OR 97070 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-780-9486 PHONE:
FAX:
FEES
Quantity Description Date Amount
3 ea Fixture/Sewer Cap 09/11/2020 $75.06
Specifics: 1 12%State Surcharge- 09/11/2020 $9.01
Plumbing
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $84.07
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: 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 ApplicationRECEIVED Jpd
Building Fixtures JUL.01142020 FOR OFFICE USE ONLY
City of Tigard CITY OF TIGARD Date/By: 2-VW sea Permit NA.141,21,„To -2‘7,2.79
lilt • 13125 SW Hall Blvd.,Tigard,OR 972a d PlDateBy:an Revie
I Phone: 503.718.2439 Fax: 503.598. LDING DIVISION Other Permit No..
TIGARD Inspection Line: 503.639.4175 Date Ready/By: ,/� Jens. ® See Page 2 for
Internet www,tigard-or.goy Notified/Method:7/Zt la .4e Supplemental Information
TYPE OF WORK 'a x t 1Trr-
�. ` ?�§g? FEE* SCHEDULE
❑New construction ❑Demolition For special information use checklist.
Description I Qty. I Ea. I Total
®Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 fl.for each utility connection)
tag.,it TECORY OF CONSTRUCTION SFR(1)bath , 312.70
❑ 1-and 2-family dwelling g Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
0 Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 7007 SW CARDINAL LN Catch basin or area drain 18.76
City/State/ZIP: TIGARD OR 97224 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: 135 Project name: PACSTAR 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.: Backflow preventer 31.27
Backwater valve 12.51
DESCRIPTION OF WORK,
Clothes washer 25.02
DEMO AND CAP 1 BREAK SINK AND 2 WATER CLOSETS
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER ❑ TENANT Expansion tank 12.51
Name: Pacific Realty Fixture/sewer cap 3 25.02
Floor drain/floor sink/hub 25.02
Address: 6650 SW Redwood Ln Ste 290
Garbage disposal 25.02
City/State/ZIP: Portland/ OR/ 97224 Hose bib 25.02
Phone:( 503) 624-6300 Fax:( ) Ice maker 12.51
® APPLICANT 0 CONTACT PERSON •4 1.1 Interceptor/grease trap 25.02
Medical gas(value:$_) Page 2
Business name:Always Faithful Plrtmhing
Primer 12.51
Contact name: Corey Chamberlain
Roof drain(commercial) 12.51
Address: PO Box 757 Sink/basin/lavatory 25.02
City/State/ZIP:Wilsonville OR 97070 Solar units(potable water) 62.54
Phone:(503)780-9486 Fax: :( ) Tub/shower/shower pan 12.51
E-mail: alwaysfaithfulplumbing@yahoo.com Urinal 25.02
Water closet 25.02
CONTR CTOR `ry
Water heater 37.52
Business name: Always Faithful Plumbing Water piping/DWV 56.29
Address: PO Box 757 Other: 25.02
City/State/ZIP: Wilsonville, OR 97070 Subtotal
Phone:( 503)780-9486 Fax:( ) Minimum permit fee: $72.50
CCB Lie.: 217284 Plumbing Lic.no.:PB1940 Plan review (25%of permit fee)
/ State surcharge(12%of permit fee)
Authorized signature: C • TOTAL PERMIT FEE (eq.; 07
Print name:Corey Chamberlain Date: 7/10/202 D 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\PLMt-PermitApp doe 10/01/09 440-4616T(10/02/COM/WEB)
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 ,;1,;"
Footing drain-I'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 Valuation: Permit Fee. f3
Storm&Rain Drain-1st 100' 62.54 $1 00 to$5,000.00 Minimum fee$7250
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 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
-Jacuzzi/Whirlpoolengineer.
❑
Car Wash: Each Stall New exterior plumbing site utilities for any complex structure
Drive 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 ❑ 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"
3" Isometric or Riser Diagram
❑ Isometric or riser diagram is required for new buildings
-Car Wash Drain that meet the qualifications above.
Garbage -Domestic non-food _
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
Ice Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -Lav/Bar non-food related 1
-Bradley
-Com/Serv/Util food related
-Service *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 2 plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
Accumulative Sewer Tally
• . 'Tenant Name: PacStar SWR# N/A
r c;ntil) Site Address: 7007 SW Cardinal Ln,Suite 135 PLM# PLM2020-00279
Parcel#: 2S112AD01000
Fixture Value Previous Previous Credits Capped fixture Fixture New New
# value count capped#s value count added# added value total#s total values
Baptisery/Font 4 0 0 0 0 0
Bath: -Tub/Shower 4 0 0 0 0 0
-Jacuzzi/Whirlpool 4 0 0 0 0 0
Car Wash: -Each Stall 6 0 0 0 0 0
-Drive through 16 0 0 0 0 0
Cuspidor/Water Aspirator 1 0 0 0 0 0
Dishwasher: -Commercial 4 0 0 0 0 0
-Domestic 2 0 0 0 0 0
Drinking Fountain 1 0 0 0 0 0
Eye Wash 1 0 0 0 0 0
Floor Drain/Sink: -2 inch 2 0 0 0 0 0
-3 inch 5 0 0 0 0 0
-4 inch 6 0 0 0 0 0
-Car Wash 6 0 0 0 0 0
Garbage Disposal:
-Domestic(to 3/4 HP) 16 0 0 0 0 0
-Commercial(to 5 HP) 32 0 0 0 0 0
-Industrial(over 5 HP) 42 0 0 0 0 0
Ice Machine/Refrigerator Drain 1 0 0 0 0 0
Living Unit 16 0 0 0 0 0
Oil Sep(Gas Station) 6 0 0 0 0 0
Rec.Vehicle Dump station 16 0 0 0 0 0
Shower: -Gang(per head) 1 0 0 0 0 0
-Stall 2 0 0 0 0 0
Sink:
-Lav/Bar-Non-Food Related 2 0 1 2 0 -1 -2
-Bradley 5 0 0 0 0 0
-Com/Serv/Util-Food Related 3 0 0 0 0 0
Swimming Pool Filter 1 0 0 0 0 0
Washer-Clothes 6 0 0 0 0 0
Water Extractor 6 0 0 0 0 0
Water Closet-Toilet 6 0 2 12 0 -2 -12
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 3 14 0 0 -3 -14
Current Fixture Value -14 divided by 16= -0.875 Current EDU 1 EDU= $5,800.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change -14 divided by 16= -0.875 over (under) $ (5,104.00)
Enter EDU Change Here -0.880 *
*Round EDUs to the nearest 1/100th: a count ending in.005 shall be rounded up to.01,and a count ending in.014 or less shall be rounded down to.01.
Notes: EDU CREDI'1S that can be applied towards future added plumbing fixtures.
Authorized Name/Signature: Dianna Omelas Date: 7/21/2020
Building Division
Note: The property owner shall retain the ORIGINAL sewer tally record. If credits exist,this document will serve as a voucher which must be
submitted to the City of Tigard Building Division to redeem credits towards future system development charges.
I:A Building\Sewer Tally ASeweiTallySheet_5800_070119.xlsx