Permit CITY OF TIGARD PLUMBING PERMIT
1 COMMUNITY DEVELOPMENT Permit#: P LM2021-00294
Date Issued: 7/28/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S102AB04100
Jurisdiction: Tigard
Site address: 12386 SW MAIN ST
Project: Live Edge Eco Salon Subdivision: None Lot: None
Project Description: Plumbing for new tenant: CAP(1)dishwasher,(1)2"floor drain, (1)ice machine,(1)sink&(1)urinal;ADD(2)
sinks&(1)clothes washer;RELOCATE(2)2"floor drains and(2)service sinks.
Contractor: MY PLUMBING SERVICES Owner: WINE, ROBERT S
17416 SE BROOKLYN ST 11837 BLANCHET DR
PORTLAND, OR 97236 OREGON CITY, OR 97045
PHONE: 971-413-0302 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Clothes Washer 07/20/2021 $25.02
Specifics: 5 ea Fixture/Sewer Cap 07/20/2021 $125.10
2 ea Floor Drain/Floor Sink/Hub 07/20/2021 $50.04
Type of Use: COM 4 ea Sink 07/20/2021 $100.08
Class of Work: ALT 1 ea Water Heater 07/20/2021 $37.52
Type of Const: 1 12%State Surcharge- 07/20/2021 $40.53
Occupancy Grp: Plumbing
Stories:
Total $378.29
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
Issued By: Permittee Signature: OwAppl�ca�w-�
ffnUy VcrAvDeiWefye
Call 503.639.4176 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.
e
Plumbing Permit Anulicatio
2
EC IVE®
Building Fixtures 1 (11; (11 I It I t ,1 ,rti 1
City of Tigard JN , 2027 R . _7��.2/� is/ PermitNo. f`�Zd2( !'9Q 1it
III Pam e
�, • 13125 SW Hall Blvd.,Tigard,OR 97223 ,-.1, OF fiIG/af3G Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 1 Other Permit No.:
petelRy:
Inspection Lino. 503.639.4175 )I���1!�I�IISioNi lurk B See Page 2for
11' Atit Deem edfMetho _ f1 . ; entat Information
lntemel: www.ugprdor.gov Notified/Mctiwdf/!�i f L� j� � S'WP�
TYPE OF WORK 1 (11+.11.-- N16 L FEE' SCHEDULE
0 Demolition: For special information use checklist
❑New constructionDescription I Qty. I Ea. I Total
[13 Addition/alteration/replacement ❑Other: New l-2-family dweNinga(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
SFR(2)bath 437.78
❑ 1-and 2-family dweUing afornmercialftndustrial SFR(3)bath 500.32
❑Accessory building 0 Multi-fatniy Each additional bath/kitchen 25.02
❑Master builder _ ❑Other: Fire sprinkler(_sq.ft) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
l r
Catch basin or area drain 18.76
Job site address: /', ` ,7 l Al ll,.' 4z it p } y a Drywell leach line,or trench drain 18.76
City/State/ZlP: r L Al..) Y ( t G G Footing drain(no.linear ft. _) Page 2
Suite/bldg/apt.no.: 1 Project name: l.1 V C-- 1 € E Ct<. Manufactured home utilities 50.03
Cross street/directions to job site: S.41-0 di Manholes 18.76
Arl_ Tvt -{)• l• 44 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 Meta
Backflow preventer 31.27
Tax map/parcel no.: _
Backwater valve 12.51
DESCRIPTION OF WORK Clothes washer it "
25.U2 01.,
terV)i"t,-y,; .s"t}tkira"G' AI t'4{` rt` Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
TENANT Expansion tank 12.51
0 PROPERTY OWNER 25.02 f(
Fixttnc/sewercap
Name. ( ( t to el � ' ' Floor drain/floor sink/hub ! y . 25.02 0 (
Address: 6j/,3 hsf ),�140 `0 Garbage disposal 25.02
�?
City/State/ZIP: 7401,1 �.c.- y` O& c't j(� Ct .) Hose bib , 25.02
( Ice maker 12.51
Phone:( ) Fax:( )
APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name: Ak11.40442.14- c„ , 4. I r,*(,,,, /A, . Primer 12.51
Contact name: /0 14-6(, `?,O?( Roof drain(commercial) 12.51
£ICif'
Address: d box 1g34 ''L Sink/basin/lavatory / 25.02 J lJ .
City/State/ZIIP: 6-f- 64 ct4-/ (�f/" q tO c 5 Solar units(potable water)�': 62.54
Phone:
(93 ) 't d Igo I Fax: (7 Tub/shower/shower pan 12.51 Urinal 25.02
E-mail:C(t3e(b! 4�Ig4i Q� arl•� Water closet 25.02
( edNTRACTOR '''
Water heater i j ,� 37.52 -11 .
Business name: J1 - A 1 0a- Water piping/DWV 56.29
Address:
Other: 25.02
Subtotal
City/State/Z1P:
Minimum permit fee: S72.50
(
Phone:( ) Fax: )
1 _ Plan review (25%of permit fee)
CCB Lic.: f l �' ;‘,..'2,--Plumbing Lies� OS Slate surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE -?/f Fs;ct
_t - YY This permit appheetdon esPirea if a permit b not obtained o 180 days
�Prittt name. Ailf (' Date: 2.I after it lifer been accepted as complete.
`
'Fee methodology act by Tri-County Building Industry Service Board. L'-`t
I:tBuiIda ' UP.N U-PenitApp m 10/01i09 440-616T(ta02000M+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:
50.03 0 to 2,000 S 121.90
Footing drain-1'100' _ --- 2,001 to 3,600 $169.69
Footing drain-each additional 100' 37.52 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 t00' 37.52 $5,001.00 to S 10,000.00 $72.50 for the first$5,000.00 and$1.52 for
each additional$100.00 or fraction thereof,to
Other Inspecions Fees
Qty. Fee(ea) Total and including S10,000.00.
Inspection of existingt plumbing or for $10,001.00 to$25,000.00 5148.50for the first$10,000.00 and$L54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
and including$25,000.00.
(minimum charge- 1/2 hour) '
Inspections outside of normal business 90.0011v i $25,001.00 to 550,000.00 $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
�_00/hr { and including$50,000.00.
Additional
Reinspectionl Fees S50,001.00 and up $742.00'for the first S50,000.00 and$1.20 for
Additional plan review for revisions 90.00/hr each additional S 100.00 or fraction thereof.
(minimum charge- 1/2 hour) f
Subtotal:
1
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If'tyes",
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.
Replace/ Please check all that apply.
Work Perforead: Cappedotr o for Added ReloRelocate ❑ Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower engineer.
-Jacu2zi/WKvtpeol 0 New exterior plumbing site utilities for any complex structure
Car Wash' -Each Stall _ as defined in OAR918-780-0040.
-Drive Thin 0 Medical gas and vacuum systems for health care facilities.
Cuspidor/Water Aspirator 0 Any multipurpose fire sprinkler system.
Dishwasher: -Commercial 1 0 Any complex structure as defined in OAR918-780.0040.
-Domestic
DrinkingFountain
EvWsSubmit 2 sets of plans with any of the above-
Eve Wash ,.� •
Floor Drain/sink: -2" I Isometric or Riser Diagram
4•• — 0 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 Comments regarding fixture work:
Ice Mach.lRefrig.Drains 1
Oil Separator(Gas Station) -
Rec.Vehicle Dump Station —
Shower: -Gang - f
-Stall
Sink: -Lav/Bar non-food related 1 I le-
-Bradley
1
-Com/Serv/tJtil food related _
-Service -T • "Note: If the fixture work.nder 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 plumbing permit can be issued.
WaterCloset-Toilet -
Urinal /
Other Fixtures: •
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
Dianna Ornelas
From: Nigel Bray <nigelbray@liveedgeoc.com>
Sent: Monday, June 28, 2021 2:45 PM
To: #Building Permit Technicians
Subject: Re: BUP2021-00139: Live Edge Eco Salon - 12386 SW Main St.
Attachments: img024.jpg; img023.jpg
Categories: Dianna
Warning!This message was sent from outside your organization and we are unable to verify the sender.
Here you go. Sorry about that.
Nigel
On Mon,Jun 28, 2021 at 9:59 AM #Building Permit Technicians<TigardBuildingPermits@tigard-or.gov>wrote:
Hi Nigel,
Thank you for submitting the commercial Plumbing Permit Application for processing. However, we will need you to
make the following changes before we can process this permit:
• All of the capped fixtures will need to be entered on the first page of the application in the "fixture/sewer cap"
field.
• The relocated fixtures listed on the second page of the application will need to be included on the first page of
the application. For instance, the (2) relocated fixtures will need to be included with the (2) new sinks for a
total of(4) sinks on the first page of the application.
• Please enter the (2) relocated floor drains/sinks on the first page of the application.
if you have questions, please let me know.
Thank you,
1
Branden Taggart
1114 City at Tigard
r rx Senior Permit Technician
Community Development
T WARD
13125 SW Hail Blvd
Tigard,OR 97223
(503)718-2449
brandent@tiga.rd-or.g ov
From: Nigel Bray<nigelbray@liveedgeoc.com>
Sent: Sunday,June 27, 2021 5:11 PM
To:#Building Permit Technicians<TigardBuildingPermits@tgard-or.gov>
Subject: BUP2021-00139
Please see attached forms.
Thank You
Nigel Bray
NCI
5033480146
DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-
mail may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are
retained by the City of Tigard in compliance with the Oregon Administrative Rules "City General Records Retention
Schedule."
2
Dianna Ornelas
From: #Building Permit Technicians
Sent: Monday,July 12, 2021 4:57 PM
To: 'nigelbray@ncioregon.com'
Subject: RE: PLM2021-00294 - Live Edge Eco Salon - 12386 SW Main St
Importance: High
Hello Nigel,
I want to also mention that we need a valid plumbing license for the plumbing contractor listed on the application
before we can issue the permit.
Thank you.
Dianna L. Ornelas
Building Division Services Supervisor
City of Tigard I Community Development
13125 SW Hall Blvd I Tigard, OR 97223
503-718-2430 Direct 1503-718-2439 Permits
From:#Building Permit Technicians
Sent: Monday,July 12, 2021 4:53 PM
To: nigelbray@ncioregon.com
Subject: PLM2021-00294- Live Edge Eco Salon - 12386 SW Main St
Hello Nigel,
This permit is ready to issue and the balance due is$378.29 (see attached invoice).
The fees can be paid online at https://aca-prod.accela.com/TIGARD/Welcome.aspx by searching for the permit record
number PLM2021-00294 under the Building tab. Payment can be made by 'card' for a 3%service fee or select the
'check' payment option and there is no service fee.
Please email the permit technicians at TigardBuildingPermits(atigard-or.gov once the fees are paid so that we can
issue the permit and email a copy.
Thank you.
Dianna L. Ornelas
Building Division Services Supervisor
City of Tigard I Community Development
13125 SW Hall Blvd I Tigard, OR 97223
503-718-2430 Direct 1503-718-2439 Permits
1
Accumulative Sewer Tally
Tenant Name: hive Edge Eco Salon SWR# N/A
Site Address: 12386 SW Main St PLM# 2021-00294
TIGARD
Parcel#: 2S102AB04100
Fixture Value Previous Previous Credits Capped Fixture Fixture New New
# value count capped#s value count added# added value total#s total values
Baptisery/Pont 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 1 4 0 -1 -4
-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 1 2 0 -1 -2
-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 I IP) 42 0 0 0 0 0
Ice Machine/Refrigerator Drain 1 0 1 1 0 -1 -1.
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 2 4 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 1 6 1 6
Water Extractor 6 0 0 0 0 0
Water Closet-Toilet 6 0 0 0 0 0
Urinal 6 0 1 6 0 -1 -6
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 5 15 3 10 -2 -5
Current Fixture Value -5 divided by 16= -0.313 Current EDU 1 EDU= $5,800.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change -5 divided by 16= -0.313 over (under) $ (1,798.00)
Enter EDU Change Here -0.310 *
*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: **CREDITS**
Authorized Name/Signature: Dianna Ornelas Date: 7/12/2021
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\Sewerl'allyShect_5800_070119.xlsx