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Permit CITY OF TIGARD PLUMBING PERMIT 111 ' ' COMMUNITY DEVELOPMENT Permit#: PLM2020-00503 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 6/16/2021 T f::;A f?.i.7 g Parcel: 2S113AB00701 Jurisdiction: Tigard Site address: 16145 SW UPPER BOONES FERRY RD Project: Kiddie Academy Subdivision: CIRCUIT PARTITION Lot: 2 Project Description: Site utilities for a new daycare facility. Contractor: EK PLUMBING Owner: PO BOX 1898 BATTLEGROUND,WA 98604 PHONE: 360-687-4648 PHONE: FAX: 360-687-6473 FEES Quantity Description Date Amount 7 ea Catch Basin or Area Drain 02/06/2021 $131.32 Specifics: 2 ea Manholes 02/06/2021 $37.52 75 If Sanitary Sewer 02/06/2021 $62.54 Type of Use: COM 1641 If Storm Sewer 02/06/2021 $662.86 Class of Work: ALT 80 If Water Service 02/06/2021 $62.54 Type of Const: 2 ea Backflow Preventer 02/06/2021 $62.54 Occupancy Grp: 6 ea Rain Drain-Single Family 02/06/2021 $75.06 Stories: Dwelling 1 Plan Review 02/06/2021 $273.59 1 12%State Surcharge- 02/06/2021 $131.33 Plumbing Total $1,499.30 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: oily Vary OwAppLicattton 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 ApplieR CEIVED -B- 12I121120 Site Utilities DEC 14 2020 IIIIIIIIIEIIIIIMZIZIIIIIIIIIIIIII City of Tigard Received {/� >, t J Permit No..,P 'fi'v l n �`'�' • 13125 SW Hall Blvd.,Tigard,ORGITY OF TIGARD Date/By:nv f�/�' -- oV,! (�(6.( I Plan Review ( Phone 503.71 R.2439 Fax: 5 `� �`6q Date/By: f,� Cj .2,C3 o� ©,�Other Permit No.: Inspection Line: 503.639.4175 Dui a MG DIVISION TIGARD Date Rd/Met o: „ /14i ,Ipse ®SeePentafnr Internet vnvw ti and-or. ov ' ` g g Notificd/Mcthod: / e Suppkmcn[allntormation .ilrl, , 'TYPE OF WORK FEE* SCHFD H ;: it (XI New construction ❑Demolition For special information use checklist. -._.._. Description I Qty. I Ea. I Total 0 Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 6.for each utility connection) CATEGORY OF CONSTRUCTION SFR(l)bath 312.70 ❑ 1-and 2-family dwelling NJ Comercial/industrial SFR(2)bath 437.78 m ❑Accessory building ID Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler( sq.11.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 16145 SW Upper Boones Ferry Rd Catch basin or area drain 18.76 )3L 32 Drywell,leach line,or trench drain 18.76 City/State/ZIP: Tigard/OR/97224 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name: Kiddie Academy-Tigard Manufactured home utilities 50.03 Cross street/directions to job site: SW Upper Boones Ferry Rd Manholes _2 18.76 373Z Rain drain connector 18.76 Sanitary sewer(no.linear ft.:75r) Page 2 , Storm sewer(no.linear ft.:10 2A, Page 2 37. Li Water service(no.linear f1.:I31 ) Page 2 I��{p Subdivision: Lot no. 00701 Fixture or item: Tax n:ap/parcel no.: 2S1 13AB00701 Backflow preventcr 2- 31.27 6,Z.54 Backwater valve 12.51 DESCRIPTION OF WORK Clothes washer 25.02 Site utilities for new daycare facility. Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 PROPERTY OWNER ❑ TENANT Expansion tank 12.51 Name: Kalvi LLC Fixture/sewer cap 25.02 Address: 8821 NW Savoy Ln. Floor drain/floor sink hub 25.02 Garbage disposal '25.02 City/state/ZIP: Portland/OR/97229 Hose bib 25.02 Phone:(503)577-3822 Fax:( ) Ice maker 12.51 ❑ APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: Medical gas(value:$ ) ~ Page 2 CIDA Inc. "- -" Primer 12.51 Contact name: Gavin Russell Roof drain(commercial) 12.51 75t0ti60 Address: 15895 SW 72nd Ave., Suite 200 Sink/basin/lavatory 25.02 City/State/ZIP: Portland/OR/97224 Solar units(potable water) 62.54 Phone:(503)226-1285 Fax: :( ) Tub/shower/shower pan 12.51 E-mail:gavinr@cidainc.com Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 37.52 Business name: TBD Water piping/DWV - 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal Phone:( ) Fax:( ) Minimum permit fee: $72.50 Plan review (25%of permit fee) CCB Lie.: Plumbing Lic.no.: fe , - State surcharge of PERMIT FEE ee) Authorized signature: / yW,,1�/ TOTAL PERMIT FEE Print name: Gavin Russell Date:/a--//---?dZP This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. ',Fee methodology set by'I Building Industry Service Board i\Building5Pcnniusl'LMU-PermitApp.duc 10/01/09 440-76t6T(10/02/COM/WE➢) 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 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 each additional$100.00 or fraction thereof,to Other Inspections or Fees Qty. Fee(ea) Total 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: Arc 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/ Plan review is required for anyof the following. Work Performed: Capped Added Relocate 4 g- Baptistry/Font Please check all that apply. Bath Tub/Shower CI 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 OAR91 8-780-0040. Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities. -Domestic ❑ Any multipurpose fire sprinkler system. Drinking Fountain El 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 SinklLav -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 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\PLMU_PermitApp.doc 2 Plumbing Permit Application Site Utilities FOR mulct.: I Si. O,AL' City of Tigard Received ;1LM;IN°-605-0 . ll Permit No.: 1' pl 111 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By:Review j 1C Plan Phone: 503.718.2439 Fax: 503.598.1960 Date/By: hot(3-o-C 1 f[c-J Other Permit No.: T I G A R D Inspection Line: 503.639.4175 Date Ready/By: kris' ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE %New construction ❑Demolition For special information use checklist Description Qty. Ea. I Total ❑Addition/alteration/replacement El Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ElI-and 2-family dwelling Commercial/industrial SFR(2)bath 437.78 buildingSFR(3)bath 500.32 ❑Accessory 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Catch basin or area drain 18.76 f J1,`3a Job site address: ' j 14 5 S.I.C.). dpp Lr 0ilis V S FeYY/ lZti. Drywell,leach line,or trench drain 18.76 City/State/ZIP: r , a l Cg 1 1u7 a Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name: Ki Ltt:.t� A c a et.W%i. Manufactured home utilities 50.03 Cross street/directions to job site: 1 Manholes a. 18.76 391 52 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:41s) I Page 2 6 a,Sy Storm sewer(no.linear ft.:Q.of I) /ri Page 2 63..84 Water service(no.linear ft.: R&l / Page 2 62.S4 Subdivision: Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer a 31.27 d e)i 541 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 .S:+'12 « i l L t i z$ .f c Vla.rt(.c) CI Al C i:Pfk. Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER ❑ TENANT Expansion tank 12.51 Fixture/sewer cap 25.02 Name: 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 Medical gas(value:$ ) Page 2 Business name: Contact name: Primer 12.51 Roof drain(commercial) 6 12.51 t)5 06, Address: Sink/basin/lavatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax: :( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 CONTRACTOR Water closet 25.02 Water heater 37.52 Business name: Water piping/DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal 4Q1K38 Phone:( ) Fax:( ) Minimum permit fee: $72.50 Plan review (25%of permit fee) 2')3,46 CCB Lic.: Plumbing Lic.no.: State surcharge(12%of permit fee) /3/.3�' Authorized signature: TOTAL PERMIT FEE /lin 3D Print name: Date: 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\PLMU-PermitApp.doc 10/01/09 440-46 16T(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: 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 1 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 0,54 Medical Gas Systems: Water Service-each additional 100' 37.52 Valuation: Permit Fee: Storm&Rain Drain-1st 100' f 62.54 6a Sy $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' i 6 37.52 60c),'j). $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) n each additional$100.00 or fraction thereof. Subtotal: !S I.VII 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. Baptistry/Font Please check all that apply. Bath Tub/Shower ❑ 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 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/Lav -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter *Note: If the fixture work under this permit results in an Washer-Clothes increase of sewer EDUs,a sewer permit will be issued and Water Extractor Water Closet-Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: l:\Building\Permits\PLMU_PermitApp.doc 2 • Site Utilities — Plumbing Permit Application Plan Submittal Requirements TIGARD A plumbing permit for site utility plumbing work is required for sanitary sewer, storm sewer and potable water systems on private property. 1. SITE PLAN and vicinity map showing the geographic location (fully dimensional, drawn to scale) labeled with: A. ❑ map&tax lot# ❑ project name ❑ site address ❑ suite number ❑ zoning ❑ applicant name ❑ phone number B. North arrow. C. Scale (architectural or engineering only). D. Street names. E. Building pads with project location. 2. PLUMBING PLANS -Two (2) complete sets, civil only. All details listed below shall be incorporated into the plumbing plans: A. Storm drainage plan showing: 1) Finish elevations throughout the developed site. 2) Grade breaks determining area serving each catch basin. 3) Location of catch basins. 4) Pipe size. 5) Type of material. 6) Slope of piping. 7) Manholes and field drains. 8) Cleanouts provided for each 100 feet or fraction thereof. 9) Roof drain laterals specifying cleanouts at each upper terminal. 10) Location of existing or proposed connection to a public sewer line. B. Utilities plan showing: 1) Sanitary sewer line location,pipe size, type of material, slope of piping,manholes and cleanouts provided as required for storm. 2) Size and location of domestic water piping and drainage. 3) Proposed location of connection to a public water or sanitary sewer line. 1:\Building\Permits\PLMF-PermitApp.doc 12/30/05 Branden Taggart From: Branden Taggart Sent: Tuesday, February 2, 2021 5:19 PM To: gavinr@cidainc.com Subject: Kiddie Academy Site Utilities Permit: PLM2020-00503 - 16145 SW Upper Boones Ferry Rd. Attachments: Invoice.pdf Hi Gavin, The Site Utilities Plumbing permit for Kiddie Academy is ready to issue now. The balance due is$1,499.30, and I have attached an invoice above for you to reference. The fees can be paid online now at https://aca- prod.accela.com/TIGARD/Welcome.aspx by searching for the permit record number PLM2020-00503 under the Building tab. There is a 3%service fee for credit cards, but e-checks do not have a service fee. Once the fees are paid, please email the Permit Technicians at TigardBuildingPermits@tigard-or.gov so that we may issue this permit and make it available for pick up. We will send you another email when this permit has been issued. Please note that the contractor's CCB license information is required prior to permit issuance. Thanks, Branden Taggart oh, s City of Tigard .x Senior Permit Technician Community Development TIGA .D 13125 SW Hall Blvd Tigard, OR 97223 (503)718-2449' brandent©tigard-o r,gov 1