Permit CITY OF TIGARD PLUMBING PERMIT
: COMMUNITY DEVELOPMENT Permit#: PLM2022-00274
Date Issued: 7/20/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S 1260000300
Jurisdiction: Tigard
Site address: 9669 SW WASHINGTON SQUARE RD CO3
Project: The North Face Subdivision: None Lot: None
Project Description: Interior plumbing for TI: Capping(3)3"floor drains,(2)sinks,and(3)water closets;Adding(1)drinking fountain,
(2)sinks,and(1)water closet; Installing(1)expansion tank and(1)water heater.
Contractor: LOCAL PLUMBING COMPANY Owner: PPR WASHINGTON SQUARE LLC
20833 SW OLDS PL BY MACERICH RET
SHERWOOD, OR 97140 PO BOX 4085
SANTA MONICA, CA 90411
PHONE: 503-642-2067 PHONE:
FAX: 503-642-5954
FEES
Quantity Description Date Amount
1 ea Drinking Fountain 07/20/2022 $25.02
Specifics: 1 ea Expansion Tank 07/20/2022 $12.51
1 ea Fixture/Sewer Cap 07/20/2022 $25.02
Type of Use: COM 1 ea Floor Drain/Floor Sink/Hub 07/20/2022 $25.02
Class of Work: ALT 2 ea Sink 07/20/2022 $50.04
Type of Const: 1 ea Water Closet 07/20/2022 $25.02
Occupancy Grp: 1 ea Water Heater 07/20/2022 $37.52
Stories: 1 12%State Surcharge- 07/20/2022 $24.02
Plumbing
Total $224.17
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
Issued By: "(2..... 4fiele
Permittee Crre°-
4`
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
r .. -
Plumbing Permit Application
Building Fixtures RECEIVE City
of Tigard eceived
gan Date gy: 7/ h ,j7-'- Permit No.: f lt` �l
IT
771,1
111 • 13125 SW Hall Blvd.,Tigard,OR 97223 J{i L
' J U L 2 0 2022 Plan Review
Phone: 503.718.2439 Fax: 503.598 1960 DateBy: Other Permit
No.: p J1T ,'
Inspection Line: 503.639.4175TIGAKD Date Ready/By: )u s ®See Page t for
Internet: www.tigard-or.gov !I'm!' r)C 1-1^A f Notified/Method: Supplemental Information
TYPE OF WOR$t„p i_,_,, I‘ ,)' FEE* SCHEDULE
0 New construction 0 Demolition For special information use checklist
Description ] Qty. 1 Ea. 1 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
ElI-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ❑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:9669 SW Washington Square Road Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard, OR 97223
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.:CO3 I Project name:The North Face#536 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
Subdivision: %3/We 0000, I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Plumbing for TI Dishwasher 25.02
Drinking fountain 1 25.02 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER J ❑ TENANT Expansion tank 1 12.51 12.51
Name: Fixture/sewer cap 1 25.02 d j`X 1}-.
Floor drain/floor sink/hub 1 25.02 25.02
Address:
--------- - Garbage disposal 25.02
City/State/ZIP: _^__ _ Hose bib 25.02
Phone:( 1 Fax:( ) Ice maker 12.51
® APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:Local Plumbing Co. Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Brandy Solano Roof drain(commercial) 12.51
Address:20833 SW Olds Place Sink/basin/lavatory 2 25.02 50.04
City/State/ZIP:Sherwood, OR 97140 Solar units(potable water) T 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 1 25.02 25.02
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 13.815--..1:/. i)
Phone:(503)642-2067 Fax:(503)642-5954 Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lie.: 72253 111 y Plumbing Lie,no.:34 197PB
-/� State surcharge(12%of permit fee) .02
✓
Authorized signature: `^ '� TOTAL PERMIT FEE .15 ,/ 11
Print name:Brandy Solano Date:6/13/22 This permit application expires i(a permit is not obtained within ISO days ii
after it has been accepted as complete.
`Fee methodology set by Tri-County Building Industry Service Board.
I Building Permits PI..MU-PermitApp.doe 100109 440-46161110/02/COMM'EB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
1
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 $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-let 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52 Valuation: Permit Fee:
Storm&Rain Drain-Ist 100' 62.54
$1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 S5,001.00 to$10.000.00 $72.50 for the first$5,000.00 and$1.52 far
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 S25,001.00 to$50,000.00 S379.50 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/Whirlpoolengineer.
Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure
Drive as defined in OAR918-780-0040.
Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher -Commercial ElAny multipurpose fire sprinkler system.
Domestic ❑ Any complex structure as defined in OAR918-780-0040.
Drinking Fountain t
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink: -2'
Isometric or Riser Diagram
4 - ❑ 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 MachJRelirig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -fav/Bar non-food related a
-Bradley
-ComiServ%tltil 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 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:
I:\Building\Permits\PLMF_PermitApp.doc 08/04/20II 2
c
71 6Tenant Name: THE NORTH AFACEcumulative Sewer Tally SWR# N/A I
TIGARD Site Address: 9669 SW WASI IINGTON SQI I:1RI?RI) PLM# 2022-00274
Parcel#: 1S1260000300
Fixture Value 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 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 1 1 1 1
Eye Wash 1 0 0 0 0 0
Floor Drain/Sink: -2 inch 2 0 0 0 0 0
-3 inch 5 0 3 15 1 5 -2 -10
-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:
-Lav/Bar-Non-Food Related 2 0 2 4 1 2 -1 -2
-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 0 0 0
Water Extractor 6 0 0 0 0 0
Water Closet-Toilet 6 0 3 18 1 6 -2 -12
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 8 37 5 17 -3 -20
Current Fixture Value -20 divided by 16= -1.250 Current EDU 1 EDU= $6,625.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change -20 divided by 16= -1.250 over (under) $ (8,281.25)
Enter EDU Change Here -1.250 *
*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: BRANDEN TAGGART X2449 Date: 7/20/2022
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