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Permit CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit#: PLM2022-00278 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 7/26/2022Parcel: 1 S134AA01800 Jurisdiction: Tigard Site address: 10110 SW NIMBUS AVE B6 Project: Grove Cookie Company Subdivision: IKOLL BUSINESS CENTER,TIGARD Lot: 2 Project Description: Interior plumbing for TI: Contractor: LOCAL PLUMBING COMPANY Owner: DIETRICH, NANCY BISHOP 20833 SW OLDS PL ROBINSON,JERRY CHRISTOPHER TRUST SHERWOOD, OR 97140 ROBINSON, LYNN ET AL 9701 SE MCLOUGHLIN BLVD MILWAUKIE, OR 97222 PHONE: 503-642-2067 PHONE: FAX: 503-642-5954 FEES Quantity Description Date Amount 2 ea Floor Drain/Floor Sink/Hub 07/26/2022 $50.04 Specifics: 1 ea Interceptor/Grease Trap 07/26/2022 $25.02 2 ea Sink 07/26/2022 $50.04 Type of Use: COM 1 ea Lavatories 07/26/2022 $25.02 Class of Work: ALT 1 ea Water Heater 07/26/2022 $37.52 Type of Const: 1 Plan Review 07/26/2022 $46.91 Occupancy Grp: 1 12%State Surcharge- 07/26/2022 $22.52 Stories: Plumbing Total $257.07 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: 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 Perndt Applicat ! 4/ E Building Fixtures +J� `,UN 1I� `v"'`) Received City of Tigard Received Permit No.: 13125 SW Hall Blvd.,Tigard,OR 97A OF TIGARD Plan Review Phone: 503.718.2439 Fax: 503.59����p' DawBy: , �TJ'Z2 Other Permit No.l tj 74a), Inspection Line: 503.639.4175 WILDING DIVISION DateRBeady/By: lwis: ® See Page2for Internet: www.tigard-or.gov Notified/Method:7 Supplemental Information TYPE OF WORK (,C�.. E'SCHEDULE ❑New construction ❑Demolition For fecial in ormadon use checklist Description Fa. 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 ❑Accessory building ❑Multi-family SFR(3)bath 500.32 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:10110 SW Nimbus Ave. Bldg. B, Ste 6 Catch basin or area drain 18.76 city/state/zip:Tigard, OR 97223 Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no. Project name:Grove Cookie Company Manufactured home utilities 50.03 Cross street/directions to rw we: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: Page 2 Storm sewer(no.linear ft.:___j Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: Lot no.: Fixture or item: Tax map/parcel no.: 3 l�VD Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Plumbing for TI Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER ❑ TENANT Expansion tank 12.51 Name: Fixture/sewer cap 25.02 Address: Floor drain/floor sink/hub 1 25.02 25.02 Garbage disposal 25.02 City/State/ZIP: Hosc bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 0 APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 1 25.02 25.02 Business name:Local Plumbing Co. Medical gas(value:S_) Page 2 Primer 12.51 Contact name:Brandy Solano Roof drain(commercial) 12.51 Address:20833 SW Olds Place Sink/basin/lavatory 3 25.02 75.06 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@Iocalpfumbingco.com Urinal 25.02 CONTRACTOR water closet 25.02 Water heater 1 37.52 37.52 Business name:Local Plumbing Co. WaterP�i m DWv 56.29 P P Address:20833 SW Olds Place Other: 25.02 City!State/ZIP:Sherwood, OR 97140 subtotal 1 Phone:(503)642-2067 Fax:(503)642-5954 Minimum permit fee: $72.50 Plan review (25%of permit fee) CCB Lic.: 72253 Plumbing Lic.no.:34-197PB State surcharge(12%of permit fee) Authorized signature TOTAL.PERMIT FEF1 4, L , This permit application expires if a permit Is not obtained within 180 days Print name:Brandy Solano Date:6/10/22 after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Sen ice Board. 1:Building P-u,P1..MU-P-itApp doc 10 01'09 440-46161110 02 COM NkM (03 064 Plumbinp, Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea) Total Square Foota e: Permit Fee: Footing drain-I" 100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 31600 $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-Ist 100' 62.54 Medical Gas S stems• Water Service-each additional 100' 37.52 Valuation: Permit Fee: Storm&Rain Drain-1 st 100' 62.54 $1.00 to 55,000.00 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 525,000.00 $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 minimtun charge-2 hours) each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/hr and including 550,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and 51.20 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 accurate!y report fixtures could result in increased sewer fees*. Plan Review for Plumbing Installations uantity 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 ❑ Anv new commercial building with water service 2"and greater,except systems designed and stamped by licensed Bath: -Tub/Shower -Jacuui/Whirl 1 engineer. Stall ❑ New exterior plumbing site utilities for any complex structure Car Wash: -Each S Drive tall as defined in OAR918-780-0040. Cus /dor,Water AspiratorveT ❑ 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: 3- Isometric or Riser Diagram 4 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./Refri .Drains Comments regarding fixture work: Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -Lav/Bar non-food related _ r -Bradley -Com/Sere/1Jul 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 Water Extractor fees assessed for the sewer increase must be paid before the Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: 1:ABuilding\Pennits\PLMF_PermitApp.doc 08/04/2011 2 Plumbing Permit Application Building Fixtures FOR OFFICE USE ONLN' City of Tigard Received Permit No.: . p `� g Date/By: N 1 ����_���8 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ^ = Phone: 503.718.2439 Fax: 503.598.1960 Date/By: r)-25-7,W" 1-2 5-7,W" Other Permit No.: Inspection Line: 503.639.4175 Date Ready/By: Juris: See Pagefor Internet: www.tigard-or.gov NotiSed/Method: Supplemental Information rmation iY.1'E d1F WORK FEE* SCIEDCt ❑New construction ❑Demolition For special information use checklist Description I Qty- I Ea. Total Addition/alteration/replacement ❑Other: New l-2-family dwellings(includes 100 ft.for each utility connection) A� Ry OF Cp1VSltRJCT;( - SFR(1)bath 312.70 ❑ 1-and 2-family dwelling Commercial/industrial SFR(2)bath 437.78 ❑Accessory g buildin Multi-family SFR(3)bath 500.32 ❑ Each additional bath/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 -JOB"STCE.INFORMA►1 ION A ACA ItfN° Site utilities: Job site address: jb11O 5 w. N ib4 s A.x. 346 six Catch basin or area drain 18.76 City/State/ZIP: Drywell,leach line,or trench drain 18.76 MA00ra pR. CI 1223 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: Project name: V2 Cxx.)K',,- Co• 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.: Backflow preventer 31.27 Backwater valve 12.51 DESCRIPTION OF Clothes washer 25.02 ��Ka►b"' 'T1- Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 © 'PROPERTY OWNER Expansion tank 12.51 Name: Fixture/sewer cap 25.02 Address: Floor drain/floor sink/hub 25.02 Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 `❑ APPLICANT ❑ CONT ACT Interceptor/grease trap 25.02 ,QZ_ Business name: Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 3 25.02 75.66 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax: :( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 37.52 37,57- Business name: Water piping/DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal r Phone:( ) Fax:( ) Minimum permit fee: $72.50 CCB Lic.: Plumbing Lic.no.: Plan review (25%of permit fee) 1/6-91 State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE 2517. 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. 1:ABuildingAPermits\PLMU-PermitApp.doc 10,01/09 440-4616T(10/02/C0M/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: its iJtllitie5 (2tY:' Fee ei+} Total" uare I'OOta i:,_ 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-1 st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1 st 100' 62.54 Medical Gas S stems' Water Service-each additional 100' 37.52 Storm&Rain Drain-1st 100' 62.54 Valuation. „ $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 A Total each additional$100.00 or fraction thereof,to Other 1 ` � 0ee5 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*. Plaln RevirzW fOr if`� I ,;, 1 'tiU #ions uantitv by Fixture T e 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 Ba tist /Font greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool Car Wash: -Each Stall El New exterior plumbing site utilities for any complex structure as defined in OAR918-780-0040. -Drive Thru Cus idor/Water Aspirator El Medical gas and vacuum systems for health care facilities. ❑ Any multipurpose fire sprinkler system. Dishwasher: -Commercial -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„ IsometrlC6.1 oe"r ►" gft 01",,- 4" o,4" ❑ 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./Refri .Drains Comments regarding fixture work: Oil Separator Gas Station) UJOLS4= I -{'loot 5;"k a, er Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -Lav/Bar non-food related t -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: 1:ABuilding\Permits\PLMF_PermitApp.doc 08/04/2011 2 Accumulative Sewer Tally 1:9 'Tenant Name: GROVE COOKIE COMPANY SWR# 2022-00102 Site Address: 10110 SW NIMBUS AVE B6 PLM# 2022-00278 Parcel#: 1 S 134AA01800 Fixture Value Previous Previous Credits Capped Fixture Fixture New New # value count capped#s value count added# added value total#s total values Ba tine /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 1 2 1 2 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 Se 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 1 2 1 2 Bradley 5 0 0 0 0 0 -Com/Scry/Util-Food Related 3 0 0 2 6 2 6 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 4 10 4 10 Current Fixture Value 10 divided by 16= 0.625 Current F'DU 1 EDU= $6,625.00 Previous Fixture Value 0 divided by 16= 0.000 Previous EDU Change 10 divided by 16= 0.625 over (under) $ 4,173.75 Enter EDU Change Here 0.630 *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: (1)FLOOR SINK NOT ASSI_?SSED FEES AS IT IS INDIRECT WASTE TO'I'I IRBI?-COMPAR'I'MI?NT SINK Authorized Name/Signature: BRANDEN TAGGART X2449 Date: 7/26/2022 Building Division ote: I"he 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. L•\Building\Sewer'I'ally\Sewer 1'allySheet_6625_070122.xlsx Branden Taggart From: Branden Taggart Sent: Thursday,July 21, 2022 11:45 AM To: Don Sylvester;Aaron Cillo Gobel Subject: Greast Trap Plan Review for Grove Cookie Company: PLM2022-00278 - 10110 SW Nimbus Ave 66 Importance: High Hey guys, It appears someone did not route the grease trap submittal for plan review when it was received on June 10. Since we have had the permit for five weeks already, is it possible for one of you guys to complete an expedited plan review for this one (I know you guys are busy)? If so,we would appreciate it. I am going to place the submittal on Don's desk. Thanks, Branden Taggart A City of Tigard ■ Senior Permit Technician Community Development f 13125 SW HailBlvd Tigard, OR 97223 (503)718-2449 brandent@tigard-or.gov 1