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Permit CITY OF TIGARD PLUMBING PERMIT . ' COMMUNITY DEVELOPMENT Permit#: PLM2020-00492 Date Issued: 3/25/2021 T[GAR t 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S135DD03301 Jurisdiction: Tigard Site address: 11945 SW PACIFIC HWY 209 Project: Qiu Yun Wetness Spa Subdivision: METZGER ACRE TRACTS Lot: 9 Project Description: TI for new tenant:ADA restroom remodel. Contractor: BLAKELY PLUMBING INC Owner: COMMERCIAL ENTERPRISES LLC 1833 PARK AVE NE 8320 NW HWY 99 SALEM, OR 97301 VANCOUVER,WA 98665 PHONE: 503-399-9348 PHONE: FAX: FEES Quantity Description Date Amount ea Clothes Washer 03/17/2021 $25.02 Specifics: 1 ea Sink 03/17/2021 $25.02 1 ea Tub/Shower/Shower Pan 03/17/2021 $12.51 Type of Use: COM 1 ea Water Heater 03/17/2021 $37.52 Class of Work: ALT 1 12%State Surcharge- 03/17/2021 $12.01 Type of Const: Plumbing Occupancy Grp: Stories: Total S112.08 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 u I_ �,,� - ; ,v G-- 12/3 /2o Building Fixtures FUI: i)1.1 ICE USE 1 ivl 1 E ./171\E , Received City tyOB Yd DEC Z�2� Dale/BY: it2iiii?7, Permit No.:P`iy1 i-��Cl� 1iU IIHd Ii A� rfm � LE� F ����!"x�aV �" � M . Y„OU urNIS1DCsoleutew lift` bc, i c Phone: 503.718.2439 Fax: 5(11..J .3 tl 1N DateBy: Otto.PemtitNo.: 1 R P. Inspection Line: 503.639.4175 Date Ready/By; 1 ® See Page 2 for ,,,: , G Internet: WN44.ligard-Or.gOV Notified Method Fc �9✓� xT Supplemental Information TYPE OF WORK t ",',."4 .t d,,'. FEE* SCHEDULE D New construction ❑Demolition For special information use checklist. Description I Qty. Ea. Total 14 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ❑I-and 2-family dwelling Iist Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 El Accessorybuilding El Multi-family Bach additional bath/ldtchen 25.02 ❑Master builder El Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: N qqs .& .Ir L ,4Cu y Catch basin or area drain 18.76 d�,y�/. n Drywall,leach line,or trench drain 18.76 City/State/ZIP: " 'r J e/C, ,/_�L�'� Footing drain(no.linear ft.: ) Page 2 Suite/btdg./apt no.: ? I Project name: ri1 �U/1/ vl J3 Jbxi Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear It:_J 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.: 2 5/3 o n 7?U) Backflow preventer 31.27 �La DESCRIPTION OF WORKCl Backwater valve 12.51 es CCP.4.4.+1Lo/At • itet.0 S'W"�"- - Dishwasher 25.02 I 25.02 25.02 lJoU� 51 F klia.s4s3 MAiasie 4. 44,4- Atecie^ Drinking fountain 25.02 Ejectors/sump 25.02 0 PROPERTY OWNER ❑ 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 4 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 _ Medical gas(value:$ Page 2 Business name: ePnot,..e.e. )Contact name: /Za.n /2Yk/e �� Primer 12.51 Roof drain(commercial) 12.51 Address: f?Ur I5o 79 V Sink/basin/lavatory / 25.02 ?5• City/State/ZIP: Te..q,1 D/. 17223 Solar units(potable water) 62.54 Phone: D3) Fax:: Tub/shower/shower pan12.51 (S 3g9-FS�a ( ) / la_s i E-mail:464.to y f l c.rl 41141 &4 /1.Q4 /Corp') Urinal 25.02 CONT OR Water closet 25.02 Water heater / 37.52 3 i;5� Business name: .5"-c.,.rh Water p i pi WV 56.29 Address: Other: 25.02 City/State/ZIP: ' Subtotal (U0:G'7 Phone:( ) Fax:( ) Minimum permit fee: $72.50 Cat Lie.: /7$'Z Plumbing Lie.no.:p,J y/7 _ Plan review (25%ofpetmit fee) slate surcharge(12%of penult Pt) /d,01 Authorizedsignaattuuree: c��/ „ TOTAL PERMIT FEE (/i,p� /�.. jSi ti 4. I /2-Z-2c I , This permit application expires if permit is not obtained eitbin lib days Print name: a n Date: liner it boa hens arreintsa.a....mum 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- 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 7201 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$103.00 or fraction thereof,to and including$10,000.00. Inspection of existing plumbing or for • $I0,001.00 to S25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional S100.00 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 Reinspoction 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 S100.00 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 Qooutiy by Fixture Type Plan review is required for any of the following. Fixture Type fur Replace/ Please check all that apply. Work Performed: tapped Added Relocate ❑ Any new commercial building with water service 2"and Baptistry;rout greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -lacuzzi/Whirlpool Car Wash: -Each Stall ❑ New exterior plumbing site utilities for any complex structure as defined in OAR918-780-0040. -Drive Thru Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities. Dishwasher: -Commercial ❑ Any multipurpose fire sprinkler system. -Domestic 0 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 4" 0 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 tee Mach./Refrig.Drains Comments regarding fixture work: Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: -Gang -Stall / Sink: -lav/Bar non-food related / -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 washe Clothoe / fees assessed for the sewer increase must be paid before the Water Extractor • Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: I:1BuildinglPermitskP1.MF_PermitApp.doc 08/04/2011 2 Branden Taggart From: #Building Permit Technicians Sent: Friday, December 11, 2020 6:41 PM To: 'blakelyplumbing@gmail.com' Subject: RE: Plumbing Permit Application for 11945 Pacific HWY Suite 209: PLM2020-00492 & SWR2020-00189 Attachments: Tigard Permit.pdf; Invoices & Sewer Tally.pdf Hello Brian, The Plumbing and Sewer permits for Qiu Yun Wellness Spa are ready to issue now. I have attached invoices above for you to reference,and the fees due are as follows: Qiu Yun Wellness Spa Permit# Fees Due PLM2020-00492 $ 112.08 SWR2020-00189 $ 3,654.00 Total: $ 3,766.08 You can pay the above fees 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. Once paid online, please notify us at tigardbuildingpermits@tigard-or.gov, and I will email the permit paperwork to you. Furthermore,the permit fees for both permits will need to be paid before we can issue either of them. Please let me know if you have questions. Thank you, Branden Taggart a City of Tigard ■• Sentor Permit Technician Community Development TutAto 13125 SW Hall Blvd Tigard,OR 97223 (503)718-2449' brandent©tigard-or.gov Original Message From: Brian Blakely<blakelyplumbing@gmail.com> Sent: Wednesday, December 2, 2020 9:53 AM To:#Building Permit Technicians <TigardBuildingPermits@tigard-or.gov> Subject: Plumbing Permit Application for 11945 Pacific HWY Suite 209 My name is Brian Blakely with Blakely Plumbing. I am sending in this Plumbing Permit Application that is attached. Could some one please call me at 503-510-4462 to let me know that it has been received. 1