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Permit
CITY OF TIGARD PLUMBING PERMIT '. '' COMMUNITY DEVELOPMENT Permit#: PLM2022-00057 Date Issued: 3/3/2022 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S135BD00100 Jurisdiction: Tigard Site address: 9600 SW OAK ST 540 Project: Allure Total Body Sculpt Subdivision: ASHBROOK FARM Lot: 5 Project Description: Interior plumbing for TI:CAPPING(1)shower and(1)sink;ADDING(1)break room sink,(1)hub drain,(1)primer, and(1)water heater. Contractor: CASCADE PLUMBING SERVICES CO Owner: KING CAPITAL INVESTMENTS LLC PO BOX 112 ATTN KING,THOM WOODLAND,WA 98674 19250 NE PORTAL WAY PORTLAND, OR 97230 PHONE: 503 -544-7454 PHONE: FAX: 503-283-9514 FEES Quantity Description Date Amount 1 ea Floor Drain/Floor Sink/Hub 02/22/2022 $25.02 Specifics: 1 ea Primer 02/22/2022 $12.51 1 ea Sink 02/22/2022 $25.02 Type of Use: COM 1 ea Water Heater 02/22/2022 $37.52 Class of Work: ALT 1 12%State Surcharge- 02/22/2022 $12.01 Type of Const: Plumbing Occupancy Grp: Stories: Total $112.08 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 Issued By: �_ Permutes Signature: ��S Call 503.639.4175 by 7:00 a.m.for the next available inspection date. /�G� 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®ECEIVE � d Site Utilities +� C FOR OFFICE USE ONL1' City of Tigard 9 2022 Riceivcd iliAl 13125 SW Hall Blvd.,Tigard,OR 97223 FEB Date'B). i7/Z2 A i- / dO R Phone: 503718.2439 Fax: 503.59R.1960 Il 3- PlanRevmw _/ Livl 1 ICAO In;pecnon 1 me 503639-4175 �,fYOF I����V D./By: ".,. Internet u Srlir and or gov I n A'(� (� Dal<Read rB r_ A.Lr — -- - --- I `I'v`� J!V I I I Notifrcd! y chy (f — loos: ® See Page 2 for _ _ TYPE OF WORK /�� �� Supplementaltn[ormation E New eonnnu.non � I�+A� df/. FEE` SCIiEDUhE ❑Demolition Fors cea/rn arraafian use cher:Alia Deter,,lion -- - ❑Other MN 1 a. Total Addition/alteration/replacement New I-2-family dwellin_s(includes 100 ft for each unlit connection) ---_ CATEGORY OF CONSTRUCTION 1 - SFR(I)bath 312.70 ❑ I-and 2-family dwelling Commercial industrial SFR(2)baUl - 437.78 ❑Accessory building ❑Multi-familySFR(3)bath 500.32 0 Master builderFach additional bath/kitchen 25.02 ❑Other. JOB SITE INFORMATION Fire sprinkler( sq.ft.) MAI'IOK AND Page 2 Job site address: oo '�X"A13UN: . C Site utilities: Catch basin or area drain City/StatelZlP: T /111.11111 — -- -- Drywall,leach line,or trench drain . _ IR,76 Suite/bidg.lapt.no.: Project name' ' c^ Footing drain(no.linear ft.: ) Page 2 AN4 Manufactured home utilities Cross street/directions to Job site. 50 03 Manholes _ 18.76 Rain dram connector 18.76 --__. Sanitary sewer(no.linear R.: ) ..- Storm sewer(no.linear ft.: ) .. -- Water service(no.linear R.: ) Page 2 Subdivision: - ------ Lot no.: Fixture or item: fax map/parcel no.. _ -.. ------- fa -- _ Reckllow preventer _ .DF, ON __ — 31.27 1)1,7 r am - Backwater valve 12.51 l _ _ ,Ck.. la Diothesshw asher 25.02 - 25.02 0 PROPERTY OWNER _` c.♦ -�v0r.TTEENNANT Expansion tank Name: ----- -- 12.51 Fixture/sewer cap 25.02 Address: --- - Floor drain/floor sirdc/ub ' City/State/ZIP: _.. 25.02 Garbage disposal 25.02 Phone:( ) . Hose bib 25.02 fax ( ) Ice maker - APPLICANT - - - - 12.51 Sr" _ CONTACT ___ -, !j, interceptor/grease trap 25.02 Business name. -, it,_ • � �/1 �°W``'—'� Medical gas(value:$ 'a I L i+ 'lmO"--f �/+c --, ) Page 2 s r' � Primer �. •/I A /, �4 _ f 12.51 ��, C I►. _ Roo drain(commercial) 12.51 Sink/basin/lavatory 1 2502-- --City/State/ZIP. L/ IAci UI_lrt I 4 • 6— i Phone Solar units(potable water) r ) . — Fax:.( ) Tub/shower/shower pan T 62 54 25.02 r x:;p(+ 4 J ; _! 1/� ✓1'sr„ / Urinal. "q .... .r i. CO OR r it�[J! -CC-a- Water closer _ 25.02 .It iti C i Water heater _ 37.52 rr �a -...�� —�- - ' ,I0Waterpiping/DWV 56.29 Clly/ tatdV41 ' ', ,l!'�' Other: total �i.A A I j/7, / L Phone:(err1 q Subtotal �- .... Fax:( ) Minimum permit fee: $72.50 CCB Lie.: I . / rA Plan review (25%of pc fee) Plumbing Lie no.: dTbrnut _ Authorized signature: r State surcharge(12%of permit ice) Print name: t7►- 1iL�iT TOTAL PERMIT FEE � L s I . 1. I © This permit application expires it a permit Is not obtained within ISO days ( after It has been accepted as complete. •Fcc methodology set by TO-County Balding Industry Service Board. taBnklinrl'crmialPLMU-Permnnpp.doc I0,01/09 440-4616T 110,02 CU M:W EE) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Site Utilities Residential Fire Su ression Systems: Qty. :Fee(ea) Total r---- Fooling drain- I"100' care FOOt.$_�e, Permit FCC: 50.01 0 to 2,000 Footing drain-each addmonal 100' 5121.90 3— 2 2001 to3,ti00 - -- 69.69 $1 Sewer- 1st I00' 3,601 to 7,200 62.54 $233.20 Sewer-each additional 100' 7,201 and ter Water Service- 37.52 __.. $327.54 _ 1st 100' Water Service-each additional 100' 62.54 37.52 Medical Gas Systems: Storm&Rain Drain-1st 100' �alUdtlt)n Storm ersa - PermitFee:" __-- Rain n-eachadgtional100' 375? $1OGto__ r100-00 II M__i let.5�2Sfi Othat �S _ $5.001.00 to S 10,000.00 $72.50 for the first$5,000.00 and$1.52 for pections or Fees '• Fee tom) Tate! each additional$I00 00 or fraction thereof,to Ins ccnon of existing plumbin or for which no fee is specifically indicated S 10,001.00 to$25,OOD.00 and includin $10,0(i0.00. minimum charge hourl 90.Wrhr $14R.50 for the fire$I0,000.00 and$1.54 for inspections outside of normal business each additional$100.00 or fraction thereof,to hours(minimum char e— 90.00/hr 525,0p1.00 to$SO,DOOIX7 and includin $25.000.00. R 2 ours) Remspection Fees ---_._ $379.50 for the first$25,00p_0p and$1.45 for 90.ODihr each additional$100.00 or fraction thereof to Additional plan review for revisions 90.00Por $50,0p1.00 and u and includin S50,000.00. (minimum charge—1/2 hour) p 0 for the first$50,000.00 and$1.20 for each additional each additional$100.00 or fraction thereof. Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately re urt fixtures could result in increased sewer fees*. �v� ts . aoeu, b Firitu'e Ta _._ ' �` ,« — Replace/ Plan Review for,Plumbint Installations B.it's. wont } +, AdrIM Reior4te Plait review is required for arty of the following. Bath Please check all that apply. -Tub/Shower ❑ Any new commercial building with water service 2"and lacuui/Wltirl.°°I greater,except systems designed and stamped by licensed Car Wash -Each Stall -Drive Thru engineer. Cus.idocRt7ater As.irator ❑ New exterior plumbing site utilities for any complex structure a as defined in OAR918-780-0040. Dishwasher -Commercial Domestic 0 Medical gas and vacuum systems for health care facilities. CIDr nkin_Fountain Any multipurpose fire sprinkler system. E e wash 0 Any complex structure as defined in OAR918-780-0040. Floor Drain/sink -2" Submit 2 sets of plans with any of the above. -a•' Car Wash Drain ----- Garbage -Domestic-non-food '� �Of`IlaSei'..: ram. Disposal -Domestic-food related Isometric or riser diagram is required for new buildings •Commercial-food related that meet the qualifications above. -Industrial-food related Ice Mach./Refn•.Drains Oil Set arator Gas Station) Rec.Vehicle Dum.Station CcAnments r garding fixture work: Shower -Gang _ Stall Sink/Lav -Non-food related -Bradley -Commercial-food related -Service Swimmin• 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 Othe Fixtures; i plumbing permit can be issued. 1:U3u i Iding\Perm i tatPLM U_P ermitApp.doc 2 Accumulative Sewer Tally INS 'Tenant Name: ALLURE BODY SCULPT SWR# N/A TIGARD Site Address: 9600 SW OAK,SUITE 540 PLM# PI.M2021-00057 Parcel#: 1 S 135BD00100 Fixture Previous Previous Credits Capped Fixture Fixture New New # value count capped#s value count added# added value total#s total values Baptisery/Font 4 0 0 0 0 0 Bath: -Tub/Shower 4 0 1 4 0 -1 -4 -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 0 0 0 0 -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 0 0 0 0 -3inch 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(o 3/4 HP) 16 0 0 0 0 0 -Commercial(to 5 HP) 32 0 (1 0 0 0 -Industrial(over 5 HP) 42 0 0 0 0 0 Ice Machine/Refrigerator Drain 1 0 0 0 0 0 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 0 0 0 0 -Bradley 5 0 0 0 0 0 -Cum/Scrv/Util-Food Related 3 0 0 0 0 0 Swimming Pool Filter 1 0 0 0 0 0 Washer-Clothes 6 0 0 0 0 0 Water Extractor 6 0 0 0 0 0 Water Closet-Toilet 6 0 0 0 0 0 Urinal 6 0 0 0 0 0 Previous EDU Count 0 0 Capped EDU Credit 0 TOTALS 0 0 1 4 0 0 -1 -4 Current Fixture Value -4 divided by 16= -0.250 Current EDU 1 EDU- $6,085.00 Previous Fixture Value 0 divided by 16= 0.000 Previous EDU Change -4 divided by 16= -0.250 over (under) $ (1,521.25) Enter EDU Change Here -0.250 * *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: ***CREDIT*** Authorized Name/Signature: JULIE DRINKWATER X2804 Date: 2/9/2022 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:\Building\Sewer Tally\S ewe rTallyShee t_6085_070121.xl sx