Permit CITY OF TIGARD PLUMBING PERMIT
$11 = COMMUNITY DEVELOPMENT Permit#: PLM2020-00502
R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 1/19/2021
Parcel: 1 S 134BC00100
Jurisdiction: Tigard
Site address: 12100 SW SCHOLLS FERRY RD
Project: Chase Bank Subdivision: None Lot: None
Project Description: Site utilities: 52 ft.of sanitary sewer to tie-in infiltration planter overflow into existing private storm drain.
Contractor: JRD EXCAVATION LLC Owner: ATLAS GREENWAY LLC
PO BOX 2440 808 SW ALDER ST STE 200
CLACKAMAS, OR 97015 PORTLAND, OR 97205
PHONE: 503-422-9830 PHONE:
FAX: 503-658-698
FEES
Quantity Description Date Amount
52 If Storm Sewer 01/14/2021 $62.54
Specifics: 1 Plan Review 01/14/2021 $18.13
1 12%State Surcharge- 01/14/2021 $8.70
Type of Use: COM Plumbing
Class of Work: ALT 10 ea Minimum Fee Adjustment- 01/14/2021 $9.96
Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $99.33
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: \ \\ \ 1 CV \ �� Permittee Signature: O� ape 1` �L o
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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 ApplicatiofEC
EIVE 1 zo
Site Utilities 11 L�
City of Tigard DEC 1 5 MO Received e mNo.:
III_ • 13125 SW Hall Blvd.,Tigard,OR 97223 Dale/BY: /2/t 7 fr 'Or- Permit
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Plan Review ether Perini[No.• _ } 7.2
Phone: 503.718.2439 Fax 503.598.190I OF TIGARD Date/By: f-tl-,24A I aid" ��t
Inspection Line: 503.639.4175 WING3U� DIVISION DaceRead B inn H S ePage2fot
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Internet www.tlga[d-OL gOV NotifiLIadcTod f//y�0, Supplemental Information
TYPE OF WORK t j' ` l //// (' .,; , . SCHEDULE
❑New construction ❑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)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
El1-and 2-family dwelling IXCommercial/industrial SFR(2)bath 437.78
El Accessory building SFR(3)bath 500.32
CI
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: 12100 SW Scholls Ferry Rd 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.: I Project name: Chase Bank Tenant Improvement Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Corner of SW Scholls Ferry Rd&SW 121st Ave. Rain drain connector 18.76
Sanitary sewer(no.linear ft:_) Page 2
Storm sewer(no.linear ft.:,52 ) 1 Page 2 62.54
Water service(no.linear ft.:_) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no... 1 S134B000100 Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Tie-in infiltration planter overflow into existing private storm-drain Dishwasher zs.oz
Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER I 1K] TENANT Expansion tank 12.51
Name: Joe Hernandez,VP-Chase Bank Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
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
❑ APPLICANT ® CONTACT PERSON Interceptor/greasetrap 25.02
Business name: PM Design Group Medical gas(value:$_) Page 2
Contact name: Elizabeth Cole Primer 12.51
Roof drain(commercial) 12.51
Address: 19120 SE 34 St.,Suite 115 Sink/basin/lavatory 25.02
City/State/ZIP: Vancouver,WA 98683 Solar units(potable water) 62.54
Phone:( 614 )212-4330 Fax: : ( ) Tub/shower/shower pan 12.51
E-mail: ecole@pmdginc.com Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: JRD Excavation, LLC Water piping/DWV 56.29
Address: PO Box 2669 Other: ' 25.02
City/State/'ZIP: Estacada, OR 97023 subtotal 62.54
Minimum permit fee: $72.50 72.50
Phone:(503 ) 422-9831 Fax:( )
Plan review (25%of permit fee) 18.13
CCB Lic.: 174641 Plumbing Lic.no.: pg1225
State surcharge(12%of permit fee) 8.70
Authorized signature: 456.14% l C.e TOTAL PERMIT FEE 99.33-)
Print name:
Elizabeth Cole Date: 12/15/2020 This permit application expires if a permit is not obtained within ays
after it has been accepted as complete.
°Fee methodology set by Tri-County Building Industry Service Board.
I:1BuildingiPermits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/CAM/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:
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
�q Valuation: Permit Fee:
Storm&Rain Drain-1st 100' j 62.54 49 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 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: 6a,SLf
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 Plan Review for Plumbing Installations
Fixture Type for Replace/
Work Performed: Capped Added Relocate Plan review is required for any of the following.
Baptistiy/Font Please check all that apply.
Bath Tub/Showe ❑ Any new commercial building with water service 2"and
-Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-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.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
-3"
Isometric or Riser Diagram
Car Wash Drain
Garbage Domestic-non-food ❑ 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/Lav -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter
Washer-Clothes *Note: If the fixture work under this permit results in an
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:
I:\Building\Permits\PLMUPermitApp.doc 2
Branden Taggart
From: Branden Taggart
Sent: Thursday, January 14, 2021 8:03 AM
To: ecole@pmdginc.com
Subject: Chase Bank Plumbing Permit: PLM2020-00502 - 12100 SW Scholls Ferry Rd.
Attachments: Invoice.pdf
Hi Elizabeth,
The Plumbing permit for the Chase Bank, located at 12100 SW Scholls Ferry Road, is ready to issue now. The balance
due is$99.33, 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(PLM2020-00502) in the Record Number field, and click Search. Once paid, please notify us at
TigardBuildingPermits@tigard-or.gov, and we will place this permit and the approved site copy set of plans in our open
Permit Center conference room for you to pick up between the hours of 8:00 a.m. and 5:00 p.m., Monday through
Thursday. We are closed on Fridays. No appointment is necessary to pick up.
Thank you,
Branden Taggart
., City of Tigard
Senior Permit Technician
w '' Community Development
13125 SW Hall Blvd
Tigard, OR 97223
(503)718-2449
brandent@tigard-or.gov
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