Permit CITY OF TIGARD PLUMBING PERMIT
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COMMUNITY DEVELOPMENT COMMUNITY
PLM2020-00514
Date Issued: 12/29/2020
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S101DA00100
Jurisdiction: Tigard
Site address: 13010 SW 68TH PKWY 100
Project: Triangle Corporate Park Subdivision: VARNS ACRES Lot: 9
Project Description: 350 ft.of water service,
Contractor: WESTERN PLUMBING Owner: PACIFIC NW PROPERTIES LIMITED PA
9460 SW TIGARD AVE SUITE 101 STERN FAMILY LIMITED PARTNERSHIP
TIGARD, OR 97223 STERN FAMILY LLC
6600 SW 105TH AVE#175
BEAVERTON, OR 97008
PHONE: 503-639-5296 PHONE:
FAX: 503-684-9015
FEES
Quantity Description Date Amount
350 If Water Service 12/29/2020 $175.10
Specifics: 1 12%State Surcharge- 12/29/2020 $21.01
Plumbing
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $196.11
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 too 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 Applicaf4ECEIVED - (2115 20
Site Utilities
City of Tigard DEC 1 5 20Z0 Received y
g Date/By: �✓/i/I) 7-r. Permit No.: /44 '],fi _.v 1�
III 13125 SW Hall Blvd..Tigard.OR 97Z4� Plan Review 0-1 e'r t0I (��•'A
■ Phone. 503.718.2439 Fax: 503.5061196I)OF TIGARD Date/By: Other Permit No.:
l ,:rlr Inspection Line: 503.639.4175 BUILDING DIVISION Dale Ready/By: 'Tr" _ I 0 See Page 2for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑New construction ❑Demolition For speciallnformaton use checklist.
Description I Qty. I Ea. I Total
lill Addition/alteration/replacement ❑Other: New I-2-family dwellings(includes 100 I) for each utility connection)
CATEGORY OF CONSTRICTION SFR(1)bath 312.70
❑ I-and 2-family dwelling 1Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building 0 Multi-family
Each additional hath/kitchen 25.02
D Master builder 0 Other: Fire sprinkler(_sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:\�\p Si) kDM�es ' Catch basin or area drain 18.76
Dr� , � Cr Footing
drinhline,n trench drain 18.76e
City/State/ZIP: Footing drain(no.linear ft.:_) Page 2
Suitc/bldg./apt.no.:/U' ) Project name: 1 6,,N. ),I / vl', 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 N. Page 2 \"a(o.C�Y I7 16
Subdivision: I Lot no.: Fixture or item: "
Tax map/parcel no.: Backtlow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
� � (��(n� 1^ Clothes washer 25.02
`o1 ]r 6` SQ� � .jest....
� .. Dishwasher 25.02
V Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER I 0 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
0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:\Nes\er� kiM� \s�c x Medical gas(value:$_) Page 2
Primer 12.51
Contact name ,��`\Qc‘ r.‘ Roof drain(commercial) 12.51
Address:(( j) k kikud. Sk e)c, 101 Sink/basin/lavatory 25.02
City/State/ZIP7T��1+'rµ. ` a22 Solar units(potable water) 62.54
Phone( I 14 _50t(p Fax::( ) Tub/shower/shower pan 12.51
E-mail:d d etc\ \) .ntn .C.D' Urinal 25.02
Water closet 25.02
CONTRACTOR Water heater 37.52
Business name: Kt(\ �t�Y\�)� V ► , Water pi ping/DWV 56.29
Address:q(ij tVf,Sl� ,irh �..�t ,‘e 101 Other. 25.02
City/State/ZIP:`-3--,*,( -CrIDO3 Subtotal \Az, 1;5.t0
Phone:en) 4 /W Fax:( ) Minimum permit fee. 572.50
/�,[ a� Plan review (25%of permit fee)
C'C•B Lie.: t.0 3-q I Plumbing Lic.no.: 34 .�
State surcharge(12%or permit fee)Y!]�,":5 ✓A ,
Authorized signature: ei 1. TOTAL PERMIT FER
¢ays if
Print name:
��� /j��� Date: /�f! I w This permit applicationtorexpires if a permit is not obtained wi n Teo days
s.../� W ( after it has been accepted as complete.
•fee methodology set by Tri-County Building Industry Service Board.
I Bu,Idmy\PermnsIPLMe-PermnApp dot ItV01;0I 444Nol1•TI I un6'COM:WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee tea) Total Square Footage: Permit Fee:
Footing drain-I"100' 50.03 0to2.000 $121.90
Footing drain-each additional 100' 37.52 2.001 to 3.600 8169.69
3.601 to 7200 $233.20
Sewer-I st 100' 62.54 7.201 and greater $327.54
Sewer-each additional 100- 37.52
Water Service-1st IOU' \ 62.54 Medical Gas Systems:
Water Service-each additional 100' ,, 37.52 Mt, 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 $5001.00 to$10 000.00 $72.50 for the first$5.000.00 and$1 52 for
Qty. Fee(ea) Total each additional$100.00 or fraction thereof.to
Other Inspections or Fees and including$10,000.00
Inspection of existing plumbing or for S 10.001.00 to$25.000.00 $148.50 for the first S10.000.00 and$154 for
which no fee is specifically indicated 9(1.00/hr each additional$100.00 or fraction thereof.to
(minimum charge-1/2 hour) and including S25.000.00.
Inspections outside of normal business 90.00/hr $25 DOL(x)to S50.000.00 $379.50 for the first 825.000.00 and SI 45 for
hours(minimum charee-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including S5000000.
Additional plan review for revisions 90 00/hr $50.001 00 and up S742.00 for the first$50.000.00 and$1.20 for
each additional$100.00 or fraction thereof.
(minimum charge-1/2 hour)
Subtotal: VV
i7> • !J
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*.
Quaadty by Fixture Type Plan Review for Plumbing Installations
Fixture Type for Capped Added Repine/tee Plan review is required for any of the following.
Work Performed: Please check all that apply.
Baptistry/Font 0 Any new commercial building with water service 2"and
Bath -Tub/Shower greater.except systems designed and stamped by licensed
-Jacuzzi/Whirlpool engineer.
Car Wash -Each Stall
-Drive Thru ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems For health care facilities.
Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040.
Eve Wash
Floor Drain/sink -2- Submit 2 sets of plans with any of the above.
-3
4.. Isometric-or.Riser Diagram
Car Wash Drain 0 Isometric or riser diagram is required for new buildings
Garbage -Domestic-non-food
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/Law -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 increase of sewer EDUs,a sewer permit will be issued and
Extractor
-t-
Water Closet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures.
I:\Building\Permits 1PLMU_PermitApp.doc 2
Branden Taggart
From: Branden Taggart
Sent: Monday, December 28, 2020 5:46 PM
To: 'Dana@westernplumbinginc.com'
Subject: Triangle Corporate Park Permit: PLM2020-00514 - 13010 SW 68th Pkwy Suite 100
Attachments: Invoice.pdf
Hi Dana,
The Plumbing permit for Triangle Corporate Park is ready to issue now. The balance due is$196.11, and I have attached
an invoice above for you to reference. The permit fees can be paid online through our
website: https://aca.accela.com/tigard/Default.aspx. From there, click on the Building tab, enter the permit number
(PLM2020-00514) in the Record Number field, and click Search. Once paid, please notify us at
TigardBuildingPermits(a)tigard-or.gov, and we will email the permit paperwork to you.
Thank you,
Branden Taggart
11114 r City of Tigard
R. Senior Permit Technician
Community Development
13125 SW Hall Blvd
Tigard, OR 97223
(503)718-2449
bra.ndent@tigard-or.gov
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