Permit CITY OF TIGARD PLUMBING PERMIT
I I. COMMUNITY DEVELOPMENT Permit#: PLM2022-00034
Date Issued: 2/24/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S112DA00700
Jurisdiction: Tigard
Site address: 15333 SW SEQUOIA PKWY, STE# 100
Project: Bridgetown ER and Veterinary Subdivision: PACIFIC CORPORATE CENTER Lot: 3
Project Description: Interior plumbing for a new pet clinic and trench drains:Adding(2)dishwashers,(15)sinks,(3)clothes washers,
(2)water closets;Replacing(1)sink; Installing(1)backflow preventer,(3)garbage disposals,(2)hose bibs.(2)
ice makers,medical gas,(1)water heater,(8)wet tables,(1)distiller,and(9)trench drains.
Contractor: LOCAL PLUMBING COMPANY Owner: PACIFIC REALTY ASSOCIATES LP
20833 SW OLDS PL ATTN: N PIVEN
SHERWOOD, OR 97140 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-642-2067 PHONE:
FAX: 503-642-5954
FEES
Quantity Description Date Amount
g ea Drywell,Leach Line or Trench 02/15/2022 $168.84
Specifics: Drain
1 ea Backflow Preventer 02/15/2022 $31.27
Type of Use: COM 3 ea Clothes Washer 02/15/2022 $75.06
Class of Work: ALT 2 ea Dishwasher 02/15/2022 $50.04
Type of Const: 3 ea Garbage Disposal 02/15/2022 $75.06
Occupancy Grp: 2 ea Hose Bib 02/15/2022 $50.04
Stories: 2 ea Ice Maker 02/15/2022 $25.02
1 ea Medical Gas 02/15/2022 $72.50
16 ea Sink 02/15/2022 $400.32
2 ea Water Closet 02/15/2022 $50.04
1 ea Water Heater 02/15/2022 $37.52
225 Misc Other Fee 02/15/2022 $225.18
1 Plan Review 02/15/2022 $315.22
1 12%State Surcharge- 02/15/2022 $151.31
Plumbing
Total $1,727.42
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: l (1y Vaw t7e,Wege. Permittee Signature:
Ow A
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 * ��„ 0. _ ki �,_
Building Fixtures RECEIVE '"''' FOR OFFICE USE ONLY
Cityof Tigard "eceived
ll Date/By: Permit No.:P�n� L]a"-C
11 III 13125 SW Hall Blvd.,Tigard,OR 97223 f3/27va
i > 4IIJDv VC �
e 1 Zert Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 FEBLB �uLG Other Permit No.: /_
Date/By: �-I�`22 � �p1_CldS1
Inspection Line: 503.639.4175
t 1 G A 1:D Date Ready/By: / 7 61 See Page 2 for
Internet: www.tigard-or.gov TIGARD Notified/Method: rc` /3� J'� V 1e( Supplemental Information
CIlYOF
TYPE OF WORK t3UILDING DIVISION , +1 L.d ,�EE* SCHEDULE
New construction Fors cial information use checklist.
❑ ID l
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
1-and 2-familydwellingSFR(2)bath 437.78
❑ ®Commercial/industrial
SFR(3)bath 500.32
❑Accessory building ❑Multi-family
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:15333 SW Sequoia Pkwy., Ste. 100 Catch basin or area drain 18.76
Drywell,leach line,or trench drain 3 18.76 56.28
City/State/ZIP:Tigard, OR 97224 Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.:100 I Project name:Bridgetown ER&Veterinary Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
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
w> Subdivision: I Lot no.: Fixture or item:
NTax map/parcel no.: s)t,'. ,KA&Ot•) 7(2,, Backflow preventer 1 31.27 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 2 25.02 50.04
Plumbing for TI41 Dishwasher 2 25.02 50.04
T,� _ Drinking fountain 25.02
_\�1 Ejectors/sump 25.02
k4 ❑ PROPERTY OWNER ❑ TENANT Expansion tank 12.51
(' Name: Fixture/sewer cap 25.02
1+ Floor drain/floor sink/hub 25.02
$ Address:
t Garbage disposal 25.02
City/State/ZIP:
Hose bib 2 25.02 50.04
Phone:( ) Fax:( ) Ice maker 2 12.51 25.02
® APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:Local Plumbing Co.
Medical gas(value:$ 4.000) 1 Page 2 72.50
Primer 12.51
Contact name:Brandy Solano Roof drain(commercial) 12.51
Address:20833 SW Olds Place sink/basin/lavatory 22 25.02 550.44
City/State/ZIP:Sherwood, OR 97140 Solar units(potable water) 62.54
Phone:( 503)462-2067 Fax::(503 )642-5954 Tub/shower/shower pan 12.51
E-mail: brandys@localplumbingco.com Urinal 25.02
Water closet 2 25.02 50.04
CONTRACTOR
Water heater 1 37.52 37.52
Business name:Local Plumbing Co. Water piping/DWV 56.29
Address:20833 SW Olds Place Other: 25.02
City/State/ZIP:Sherwood, OR 97140 Subtotal 973.19
Phone:( ) Fax:( Minimum permit fee: $72.50
503 642-2067 503)642-5954 -
Plan review (25%of permit fee)
CCB Lie.: 72253 Plumbing Lie.no.:34 197PB
State surcharge(12%of permit fee) 116.78
Authorized signature: TOTAL PERMIT FEE 1089.97
Print name:Brandy Solano Date:12/16/21 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I.Building.Pei mils:PI MU-PermitApp.doe 10'01.09 440-4616T(l0/02/COM/WEB)
I 4 •c) . L$G1 -�_,' . 2/43f.0
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- I'`100' 50.03 0 to 2,000 $I21.90
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
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:
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
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate
Baptistry/Font 0 Any new commercial building with water service 2"and
greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
engineer.
-Jacuzzi/Whirlpool
Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure
Drive Thru as defined in OAR918-780-0040.
Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system.
Domestic 2 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
ElIsometric or riser diagram is required for new buildings
-Car Wash Drain g
Garbage Domestic non-food that meet the qualifications above.
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
ice Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -Lav/Bar non-food related 20 1
-Bradley
-Com/Serv/Util food related
-Service t *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
Washer-Clothes
Water Extractor fees assessed for the sewer increase must be paid before the
Water Closet-Toilet 2 plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
,Plumbing Permit Application
Building Fixtures FOR OFFICE USE ONLY
City of Tigard Received
11 Date/By: a/3/��- /ylti Permit No.: P�/H �°O�1�1._�yyS�[!
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ! ) �•+ 21 C co 7
S Phone: 503.718.2439 Fax: 503.598.1960 Date/By: a-if'10/1 CA Other PernttNo.:64p 4-cW,I
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Janis: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
0 New construction ❑ Demolition For special information use checklist.
Description Qty. Ea. Total
XAddttion/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
0, y. 44`` CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
El1-and 2-family dwelling ,Commercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
❑Master builder Each additional bath/kitchen 25.02
❑Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address t Catch basin or area drain 18.76
►S333 SA). ce$uoio, i'1,(41 So,ft... (
Drywell,leach line,or trench drain °I 18.76 l 4,8,8Y
City/State/ZIP: T iixexd OR /"q,$)e)
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: too 1 Project name:R E7r e`{-
oW41 E R 4- Manufactured home utilities 50.03
Cross street/directions to job site: kiejet i N0.Ft j Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer / 31.27 '3 i t a ri
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 3 25.02 75 06
Dishwasher a. 25.02 5-0.0/i
Drinking fountain 25.02 7
.
Ejectors/sump 25.02
0 PROPERTY OWNER ❑ TENANT Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 3 25.02 /)5.(36
City/State/ZIP: Hose bib A 25.02 v.5-0,oq
Phone:( ) Fax:( ) Ice maker a 12.51 5,02
❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name: Medical gas(value:$Vf �Page 2 � 50
Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory /6 25.02 400.32
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
Water closet a 25.02 J�U,a u
CONTRACTOR
Water heater ' 37.52 31,s2
Business name:
Water piping/DWV 56.29
Address: Other:Loa we,bk:$ 9 25.02 a15.i8
City/State/ZIP: Dist i(Heir: J Subtotal I.2&D,sq
Phone:( ) Fax:( ) Minimum permit fee: $72.50
CCB Lie.: Plumbing Lic.no.:
Plan review (25%of permit fee) 3I5,y,2.
State surcharge(12%of permit fee) 01.1 1
Authorized signature: TOTAL PERMIT FEE 172?,yZ
Print name: Date: This permit application expires if a permit is not obtained withint180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:\Building\Permits\PLMU-PennitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
CtOii.0C a-opt. - c yr. A/thi
Plumbing Permit Application - City of Tigard IV it
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee:
Footing drain-1't 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 S5,000.00 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 S100.00 or fraction thereof,to
p and including$10,000.00.
Inspection of existing plumbing or lin. $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:
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
Quantity by Fixture Type Plan re%ieo is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate
0 Any new commercial building with water service 2"and
Baptistry Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower engineer.
-Jacuzzi/Whirlpool
Car Wash: -Each Stall 0 New exterior plumbing site utilities for any complex structure
as defined in OAR918-780-0040.
-Drive Thru
0 Medical gas and vacuum systems for health care facilities.
Cuspidor/Water Aspirator Elal Any multipurpose fire sprinkler system.
Dishwasher: -Commercial
-Domestic a 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 / that meet the qualifications above.
Garbage -Domestic non-food
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
Ice Mach./Refrig.Drains Comments regarding fixture work: - ,
Oil Separator(Gas Station) 6,✓66+7,t tt fA :j A44 -eidzvj if�j,'_&i
Rec.Vehicle Dump Station R Oc4 1 --f h S,k i)'v t/(t,l Zy..01 *3101I 0 7
Shower: -Gang
-Stall
Sink: -Lav/Bar non-food related /Y
-Bradley
-Com/Serv/Util food related
-Service i *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
Washer-Clothes 3 fees assessed for the sewer increase must be paid before the
Water Extractor
Water Closet-Toilet fa plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2
Branden Taggart
From: #Building Permit Technicians
Sent: Sunday, February 13, 2022 3:50 PM
To: 'Brandy Solano'
Subject: Bridgetown ER &Veterinary Plumbing and Sewer Permits: PLM2022-00034 &
SWR2022-00015 - 15333 SW Sequoia Pkwy Suite 100
Attachments: Invoices & Sewer Tally.pdf
Hi Brandy,
The Plumbing and Sewer permits for Bridgetown ER &Veterinary are ready to issue now. I have attached invoices above
for you to reference, and the fees due are as follows:
Bridgetown ER &Veterinary
Permit# Fees Due
PLM2022-00034 $ 1,727.42
SWR2022-00015 $ 24,705.10
Total: $ 26,432.52
The above fees can be paid online now 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. There is a 3%service
fee for credit cards, but e-checks do not have a service fee. Once paid, 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
114 a City of Tigard
Senior Permit Technician
Community Development
13125 SW Hall Blvd
Tigard,, OR 97223
(503)718-2449
brandent@tigard-or,gov
1
w,
Accumulative Sewer Tally
t ll Tenant Name: BRIDGETOWN ER&VETERINARY SWR# 2022-00015
i T l G A R D Site Address: 15333 SW SEQUOIA PKWY SUITE 100 PLM# 2022-00034
Parcel#: 2S112DA00700
4 F- ixture Value Previous Previous Credits Capped Fixture Fixture New New
74 # value count capped#s value count added# added value total#s total values
B- aptisery/Font 4 0 0 0 0 0
B- ath: -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
D- ishwasher: -Commercial 4 0 0 0 0 0
-Domestic 2 0 0 2 4 2 4
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
f -3 inch 5 0 0 0 0 0
-4inch 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 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:
-Lay/Bar-Non-Food Related 2 0 0 14 28 14 28
-Bradley 5 0 0 0 0 0
-Com/Serv/Util-Food Related 3 0 0 1 3 1 3
Swimming Pool Filter 1 0 0 0 0 0
Washer-Clothes 6 0 0 3 18 3 18
Water Extractor 6 0 0 0 0 0
Water Closet-Toilet 6 0 0 2 12 2 12
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 0 0 22 65 22 65
Current Fixture Value 65 divided by 16= 4.063 Current EDU 1 EDU= $6,085.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change 65 divided by 16= 4.063 over (under) $ 24,705.10
Enter EDU Change Here 4.060 *
*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:
Authorized Name/Signature: BRANDEN TAGGART X2449 Date: 2/13/2022
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\SewerTallySheet_6085_070121.xlsx
I: