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Permit
CITY OF TIGARD PLUMBING PERMIT s . COMMUNITY DEVELOPMENT Permit#: PLM2021-00500 TIC.;A R T) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 5/17/2022 Parcel: 1 S 126CA01100 Jurisdiction: Tigard Site address: 9009 SW HALL BLVD 100 Project: Target Subdivision: None Lot: None Project Description: Interior plumbing for TI:Adding(2)2"floor drains/sinks and(1)3"floor drain/sink;Replacing(5)sinks and(2) water closets. Contractor: PMSI LLC Owner: DAYTON HUDSON CORPORATION 8295 NW EVERGREEN PKWY#204 BY TARGET CORP T-0345 HILLSBORO, OR 97124 PROPERTY TAX DEPT/TPN-0950 PO BOX 9456 MINNEAPOLIS, MN 55440 PHONE: 503-466-2222 PHONE: FAX: 503-466-2211 FEES Quantity Description Date Amount 3 ea Floor Drain/Floor Sink/Hub 05/05/2022 $75.06 Specifics: 3 ea Sink 05/05/2022 $75.06 2 ea Lavatories 05/05/2022 $50.04 Type of Use: COM 2 ea Water Closet 05/05/2022 $50.04 Class of Work: ALT 1 12%State Surcharge- 05/05/2022 $30.02 Type of Const: Plumbing Occupancy Grp: Stories: Total $280.22 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: A f �j JJ Permittee Signature: '/ v ) r,Kl/VI - 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 , �� _ ///- j - r Building Fixtures FOR OFFICE ESE oNI.l' ��"''�`� Received City of Tigard C f V C 1 Date/B 1 / f�, Permit No )cov/,D-05� . • 13125 SW Hall Blvd.,Tigard,ORREC L"/ Y I Phone: 503.718.2439 Fax: 503.598.1960 Plan Review Date/By: Ail- Other PermitNo.�,A,4 r�Gal_C,✓-Slg Inspection Line: 503 639.4175 1 2071 Date Read/B ® See Page 2^Ifor TIGARD Ni1t� Y Y �j > Internet www.tigard-or.gov Notified/Method L / /�1 /`� supplemental Information illy "i1 .'' TYPE':OF WORIri # r+ E r ' FEE* SORE'llYTLP- 7 ❑New construction IlEllt91 DIVISION, For special information use checklist. Description I Qty. 1 Ea. I Total ®Addition/alteration/replacement ❑Other New 1-2-family dwellings(includes 100 ft.for each utility connection) , SFR(1)bath 312.70 � C/-�TROORY,OF CONSTRUCTION` .. 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 0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 i r _ri i,ri l,,i, ;r, JOB SITE INFORMATION'AND LOCATION ,, Site utilities: Job site address:9009 SW Hall Blvd 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.: /da Project name:2022 TARGET REMODEL 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: Lot no.: Fixture or item: Tax map/parcel no.: t5/ V/' 0 a o Back flow preventer 31.27 p tf dia Backwater valve 12.51 '' l}BSCRIPTION cr W{-Rk' ,$ r Clothes washer 25.02 PLUMBING MODIFICATIONS Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 1°�1' dllvllll'�. +=LPIIOPBRTY OWNER, © TENANT Expansion tank 12.51 Name: TARGET CORPORATION Fixture/sewer cap 25.02 Floor drain/floor sink/hub 3 25.02 75.06 Address: 50 S 10TH STREET SUITE 400 TP3-11 Garbage disposal 25.02 City/State/ZIP: M I N N EAPO L I S, MN 55403 Hose bib 25.02 Phone:( 612.761.5722 Fax:( ) Ice maker 12.51 0 APPLICANT El rCOr i ACT PERSON Interceptor/grease trap 25.02 Medical gas(value:$ ) Page 2 Business name:Lampert Group LLC Primer 12.51 Contact name:Alexander Lampert Roof drain(commercial) 12.51 Address:10061 Riverside Dr. #760 Sink/basin/lavatory 5 25.02 125.10 City/State/ZIP:Toluca Lake, CA 91602 Solar units(potable water) 62.54 Phone:( 312) 522-5835 Fax: :( ) Tub/shower/shower pan 12.51 Email aml@lampertgroup.build Urinal 25.02 p Water closet 2 25.02 50.04 r li ?s CONTRACTOR tF; ")art,„ r ,- Water heater 37.52 Business name: Q)' s k LI-C_ Water piping/DWV 56.29 Address: 8' c 5 OW Ev cceert R}'I,,-- di j.c,ti Other: 25.02 City/State/ZIP: 4.\\S ,(.3,1-0 4R c i t)ii Subtotal 250.20 Phone:(si;- ) 9("9L0• ) Fax:( ) Minimum permit fee: $72.50 CCB Lic.: � PlumbingLic.no.: L Plan review (25%of permit fee) t� � 3� 3 State surcharge(12%of permit fee) 30. t1, Authorized signature: ,R 4/,y Q/L L. TOTAL PERMIT FEE z?.Q�i�//� Print name:Alexander Lampert Date:1 1/18/21 This permit application expires if a permit is not obtained within IS0 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1:\Btu!ding\Permits\PLMU-PermitApp.doc 10/01/09 440.4616T(10/02/COM/WEB) ,,..---6 T'De-t- c =11,is 7 4 Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities: Q Fee(ca) 4 :=Total Square Footage: Permit Fee: Footing drain-Pt 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 �, e�il; Storm&Rain Drain-1st 100' 62.54 alttat�Qn ( Permit') ee; . �l`:4` $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 Inspe, Lions oz-.Fees Q ;, 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 accuratelyreport fixtures could result in increased sewer fees p Plan RevaevS for P16.41ling' stallatlOns 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 ❑ Any new commercial building with water service 2"and Baptistry/Font greater,except systems designed and stamped by licensed Bath: -Tub/Shower -Jacuzzi/Whirlpool engineer. Car Wash: Each Stall 0 New exterior plumbing site utilities for any complex structure Drive tallThr as defined in OAR918-780-0040. Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities. Dishwasher: Commercial 0 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" 2 3" 1Isometric or�Riser-Diagram;_'`° 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) Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -Lav/Bar non-food related 2 -Bradley -Com/Serv/Util food related 3 -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 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_PetmitApp.doc 08/04/2011 2 Accumulative Sewer Tally 111 o Tenant Name: '1'ARG1:1' SWR# 2021-00318 Site Address: 9009 SW I L\1.1,BI,VD PLM# 2021-00500 IIGARI) Parcel#: 1 S 126CA01100 Fixture Value Previous Previous Credits Capped Fixture 1 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 2 4 2 4 -3 inch 5 0 0 1 5 1 5 -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 0 0 0 0 Sink: -I,av/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 0 0 3 9 3 9 Current Fixture Value 9 divided by 16= 0.563 Current 1?DU 1 EDU= $6,085.00 Previous Fixture Value 0 divided by 16= 0.000 Previous EDU Change 9 divided by 16= 0.563 over (under) $ 3,407.60 Enter EDU Change Here 0.560 *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: 12/8/2021 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. 1 I:\Building\Sewer Tally\SewerTallySheet_6085_070121.xlsx