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Permit • CITY OF TIGARD PLUMBING PERMIT ''1iiCOMMUNITY DEVELOPMENT Permit#: PLM2021-00512 Date Issued: 4/14/2022 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S1136000600 Jurisdiction: Tigard Site address: 16580 SW 85TH AVE Project: Clean Water Services Subdivision: None Lot: None Project Description: 0&M Building interior plumbing for locker room remodel with associated sanitary sewer and water service alterations: Capping(1)shower stall: Replacing(3)shower stalls, (3)sinks,(3)water closets,(1)water piping/DWV,40 ft.of sanitary sewer,and 40 ft.of water service. Contractor: PORTLAND MECHANICAL Owner: CLEAN WATER SERVICES 2000 SW HANNA HARVESTER DRIVE 2550 SW HILLSBORO HWY MILWAUKIE, OR 97222 HILLSBORO, OR 97123 PHONE: 503-656-7400 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Fixture/Sewer Cap 02/10/2022 $25.02 Specifics: 3 ea Sink 02/10/2022 $75.06 3 ea Tub/Shower/Shower Pan 02/10/2022 $37.53 Type of Use: COM 1 ea Water Piping/DWV 02/10/2022 $56.29 Class of Work: ALT 3 ea Water Closet 02/10/2022 $75.06 Type of Const: 40 If Sanitary Sewer 02/10/2022 $62.54 Occupancy Grp: 40 If Water Service 02/10/2022 $62.54 Stories: 1 Plan Review 02/10/2022 $98.51 1 12%State Surcharge- 02/10/2022 $47.28 Plumbing Total $539.83 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: Ct— roc 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. 4 numbing Permit Application 1, Building Fixtures FOR OFFICE USE ONLY City of Tigard Received g �I Permit No.: tell � III g 13125 SW Hall Blvd.,Tigard,OR 9722 E Ct E I V ate By: 4,y11.14 / TT `' "/ I 6A.6�r�L ■ Plan Review '�,�t� Phone: 503.718.2439 Fax: 503.598.1960 Date/By: A C 6, Other Permit No.:..WAA i /n� Inspection Line: 503.639.4175 t, �n ? 71 q� in- ® See Page 2 for ��r TtGARD I, 1 , NoteRd/d / 1u - Internet: www.tigard-or.gov �• _ Notified/Method: ///j(j412rl jam. Supplemental Information TYPE OF WORK Ol I'Y't OF[yIAt .,,,Il..t/11444 ' FEE* SCHEDULE ❑New construction ❑Demolition ' ``f I`'N For special information use checklist Description I Qty. I Ea. Total ©Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(I)bath 312.70 ❑ 1-and 2-family dwelling IDCommercial/industrial SFR(2)bath 437.78 ID Accessory buildingSFR(3)bath 500.32 ❑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: 16580 SW 85th Ave Catch basin or area drain 18.76 City/State/ZIP: Tigard, Oregon, 97224 � ) Drywell,leach line,or trench drain 18.76 C4c-A. L 1 A*- SC,✓V Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name: Women's Locker Manufactured home utilities 50.03 Cross street/directions to job site: Room Remodel r9� Manholes 18.76 Durham Rd and 85th Ave (J Rain drain connector 18.76 Sanitary sewer(no.linear ft.: 40) 1 Page 2 62.54 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.: 40) 1 Page 2 62.54 Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: (2-�7/ e ;`ealiA Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Remodel an existing locker room and replace existing shower valves Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ❑x PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: Clean Water Services Fixture/sewer cap I 25.02 -w-A Floor drain/floor sink/hub 25.02 Address: 2550 SW Hillsboro Hwy Garbage disposal 25.02 City/State/ZIP: Hillsboro, Oregon 97123 Hose bib 25.02 Phone:(503) 681-3600 Fax:( ) Ice maker 12.51 i © APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Clean Water Services Medical gas(value:$ ) Page 2 Business name: g Contact name: Michael Idehara Primer 12.51 Roof drain(commercial) 12.51 Address: 16060 85th Ave Sink/basin/lavatory 3 25.02 75.06 City/State/ZIP: Tigard, Oregon 97224 Solar units(potable water) 62.54 Phone:(503) 547-8152 Fax::( ) Tub/shower/shower pan 3 12.51 37.53 E-mail: ideharam@cleanwaterservices.org Urinal 25.02 Water closet 3 25.02 75.06 CONTRACTOR Water heater 37.52 Business name:- .&El f tf` ,4 $6 ee4 J Water piping/DWV 1 56.29 56.29 Address: C2r�i/0 S �'U/.e��j € t 7 Vf i s7k,' d/ Other: �. 1 25.0- 25-02 City/State/ZIP: Subtotal /lily �t'L lid cJ7 P Phone:(9 R1 L' -Noe) Fax:( ) 7/32-5 Minimum permit fee: $72.50 " /+/7 c7 =1 f _ g 377 Plan review (25%of permit fee) �,yf�f, CCB Lic.: ` L/ 47 Plumbin Lic.no.: Imo"' :, / State surcharge(12%of permit fee) �7 Authorized signature: ..„.....--.2f------ TOTAL PERMIT FEE �14�� Print name: `��Ai r�` // /f This permit application expires if a permit is not obtained within 180' days ��`jA 'l Date: �/ after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry ,$Servicaertf-'-' l!'/ ��9 I:\Buildi g,Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) ' ' Plumbing Permit Application Building Fixtures FOR OFFICE USE 0\I.1 City of Tigard Received permit No.: QL fyf 1- Date/By: r O O 512 lig13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review _ Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.:13Ur�'L21 ID 0 i2e T t G AR D Inspection Line: 503.639.4175 Date Ready/By: Juris ® 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. 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 ❑ I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building 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: Job site address: /6 s-ii v S' 1 ci 3 e- Ali Catch basin or area drain 18.76 City/State/ZIP: Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: Project name:our hArn WAX;Qua• Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:410) I Page 2 42,S Y ? Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.: 1-/0) / Page 2 &2.59 7 Subdivision: 1 Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 0 PROPERTY OWNER I 0 TENANT Expansion tank 12.51 Name: Fixture/sewer cap / 25.02 25 o2 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 ❑ APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 3 25.02 75. 06 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan 3 12.51 774 j 3 E-mail: Urinal 25.02 Water closet 3 25.02 7f.0(1 CONTRACTOR Water heater 37.52 Business name: Water piping/DW V + 56.29 56 ,?9 Address: Other: 25.02 City/State/ZIP: Subtotal Phone:( ) Fax:( ) Minimum permit fee: $72.50 CCB Lic.: Plumbing Lic.no.: Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE 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 1:\BuildingTermits\PLMU-PermitApp.doc I0/0t/09 440-4616T(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 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 ❑ Any new commercial building with water service 2"and greater,except systems designed and stamped by licensed Bath: -Tub/Shower -Jacuzzi/Whirlpool engineer. Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure Drive tall 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 ❑ 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 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 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 -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 Washer-Clothes 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:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 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' 1 62.54 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 1 62.54 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Storm&Rain Drain-1st 100' 62.54 Valuation: Permit Fee: $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 -Jacuzzi/Whirlpool engineer. Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure Drive as defined in OAR918-780-0040. Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities. Dishwasher: Commercial El 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" Isometric or Riser Diagram 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 Ice Mach./Refrig.Drains Comments regarding fixture work: Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: -Gang -Stall 1 3 Sink: -Lay/Bar non-food related 3 -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 Washer-Clothes fees assessed for the sewer increase must be paid before the Water Extractor Water Closet-Toilet 3 plumbing permit can be issued. Urinal / Other Fixtures: A " '64,i) l vt-3 zt reAl r/p/ht 0.T I:\Building\Pernuts\PLMF_PermitApp.doc 08/04/2011 2 /�� Accumulative Sewer Tally INa w Tenant Name: CLEAN WATER SERVICES SWR# N/A Site Address: 16580 SW 85TH AVE PLM# 2021-00512 1 tuARI) Parcel#: 2S113B000600 Fixture Value I'vevious Previous Credits Capped I 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 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 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 -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 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 1 2 0 -1 -2 Sink: -Lay/Bar-Non-Food Related 2 0 0 0 0 0 -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 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 2 0 0 -1 -2 Current Fixture Value -2 divided by 16= -0.125 Current EDU 1 EDU= $6,085.00 Previous Fixture Value 0 divided by 16= 0.000 Previous EDU Change -2 divided by 16= -0.125 over (under) $ (791.05) Enter EDU Change Here -0.130 * *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: BRANDEN TAGGART X2449 Date: 2/10/2022 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 ..................... .. ......................... .„ ,.....,. .... ..,.,,.. .,..,......,.�..........,.....«.N....,,...... r,.r.. ,N,.,., r,u au.r«.re.r u„ar eruarraa,:,wrxaraaruaaudururxawiueuuaaN.w.rurunuru<uuru.. ,.. Branden Taggart From: Branden Taggart Sent: Sunday, February 6, 2022 11:53 AM To: Aaron Cillo Gobel Subject: Clean Water Services Plan Review - 16580 SW 85th Ave. Importance: High Hey Aaron, I have a couple of questions regarding the locker room remodel plan review for Clean Water Services: • They say that they are replacing (8) other fixtures in the Commercial Fixture Work section. However, on the front page of the application they list (1). Don usually provides us with a list of other fixtures. Can you please confirm the quantity and what they are? This would be helpful so that we can note them in the permit. • The (1) other fixture listed on the application could possibly be the (1) shower cap,just misplaced in the fee schedule. Is the shower cap correct? • We normally have a separate Site Utilities Plumbing permit submittal for commercial sanitary sewer and water service. Are you okay with keeping the site utilities scope of work together with the interior plumbing for this permit? Thank you, Branden Taggart q City of Tigard Senior Permit AAR Technician � Community Development ���. 13125 SW Hall Blvd Tigard, OR 97223 (503)718-2449 brandent@tigard-or,gov 1