Permit t CITY OF TIGARD PLUMBING PERMIT
'91 COMMUNITY DEVELOPMENT Permit#: PLM2022-00522
Date Issued: 12/28/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 1S1266C01500
Jurisdiction: Tigard
Site address: 9000 SW WASHINGTON SQUARE RD
Project: Embassy Suites Hotel Subdivision: None Lot: None
Project Description: Replacing 50 ft.of sanitary sewer in maintenance/housekeeping area.
Contractor: LOVETT INC Owner: WASHINGTON SQUARE PROP INVESTMENT LLI
6920 NE 42ND AVE BY SLK GLOBAL SOLUTIONS AMERICA
PORTLAND, OR 97218 2727 LBJ FREEWAY STE 806
DALLAS, TX 75234
PHONE: 503-737-8423 PHONE:
FAX: 503-288-1630
FEES
Quantity Description Date Amount
50 If Sanitary Sewer 12/23/2022 $62.54
Specifics: 1 12%State Surcharge- 12/23/2022 $8.70
Plumbing
Type of Use: COM 10 ea Minimum Fee Adjustment- 12/23/2022 $9.96
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
Issued By: Permittee Signature:
G M
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application Building Fixtures RECEIVED
V012 OI I ICE USE ONLY
City of Tigard Received
=..111 a : /t n_ Permit No. � �''
:
13L25 SW Hall Blvd.,Tigard,OR 97223 DEC a 2022 Date/By ��3//^t�" p/J /� y )'�
Plan Review
Phone: 503.718.2439 Fax 503 598 1960 Date/By /^�� Other Permit Na
TIGARU Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By ]q� runs HI See Page 2for
[ntcinct• wwlv.trgard of gov rtU1i;P)N(, iVISt Noufiaimeibud I/ iir. q?. �r 7;,7SupplementallafarmaBon
TYPE O F: /oli ' 30 . f, 4 trkt, ' qk *x.$ .Ir ED i-KN fi
❑New construction ❑Demolition For special information use checklist
--- ----- -- Description j Qty. I Ea. I Total
1t Addition/alteration/replacement ❑Other: 1
t*tNew 1-2-family dwellings(includes 100 R.forcach utility connection)
CATEGORY OF CO]aS�• , r .. ^t...,�' a , ,,„}.tax; SFR(1)bath 312.7t1 $
❑ t-and 2-family dwelling ❑Cmnmeacial/instrial SFR(2)bath 437.78
du
building SFR(3)bath 500.32
❑Accessory g ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder `®.Other ��� Firc sprinkler( sq.It) Page 2
g Y- P.k.'3 Y.`.✓[" ^k' .:.�y{7�,r C A SYJ> cry'. Lary
.1,l Nf.irshd° 1 ;•`W- ffiti�v. ' � ?**36 >t,4 r' ':-P'kSt 'n't y Site utilities:
Job site address: C 000 SIrJ W f1.3 i s 1 1f(�-., .501 lJ01. e Catch basin or area drain 18.76
)1 1 Drywell,leach line,of trench drain 18.76
City/State/ZIP:
�I 9�Ck l 4 R.l 111' Footing drain(no.linear ft: ) Page 2 1
Suite/bldg./apt.no.: Project name: . 10 )�� �� +t e' 3 Manufactured home utilities 50.03
Cross street/directions to job site: �=M Manholes 18.76
. Rain drain connector 18.76
Sanitary sewer(no.linear ft.:,'5 V) / Page 2 f_gS I
Storm sower(no.linear ft.: ) Page 2 �r
Water service(no.linear ft.: ) Page 2
Subdivision: I Lot no.: Fixture or Item:
Tax map/parcel no.: Backflow preventer 31.27
t` 'r '�-t ratin
o n}0/,'* opt r0p WO`_' �u ; ' ? Backwater valve 12.51
x�$ ' ? .K` r? r5-'4xtY nr, �.,� ? ro �
Ptate. o ppro' So' 44• iy}(riot d},r-adngq> Dishwasher
25.02
,y I�, Jti Dishwasher 25.02
I'A mQ+ `1{.t/t( e-e../�a`15( Ts,{.P i n(3 Of e.A. Drinking fountain 25.02
Ejectors/sump 25.02
_ 'D 1 TY OWNER 2 iiir'g �L ' 4 p z Exparision tank 12.51
Name: Fixture/sewer cap 25.02 j''
- - 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
AMPLICANT `1 O IT;r#.6fivE0151I, t ; Interceptor/grease trap 25.02
Business name: r��'t, ( Medical gas(value:$ ) Page 2
Contact name: LAnce 6,,,, at,o Primer 12.51
,,(�r�l! Roof drain(commercial) 12.51
Address:(lV O NIL Lt �' � Sink/basin/lavatory 25.02 J
City/State/ZIP: POr i d 09 9e nig Solar units(potable water) 62.54
Phone:( )-f3' -A Fax::( ) Tub/shower/shower pan 12.51
E-mail: y�.l� (� IO�G1-{-5erv( s,(�an Urinal 25.02
f<r
may, 3:: p t:= „ Wafer closet 25.02
II C. Walca heater 37.52
`
Business name: l (jV2TI[' II, WaterpipingiDWV 56.29
�C
Address: O ksje, 42J t1't1'e., Other: 25.02
City/State/ZIP: o.fiio,v k (0Q,/11-Irct? Subtotal St/
Minimum permit fee: $72.50 ') To(,Sa )�+,�1..-��t 2) Fax:( ) Plan review (25%of permit fec) l
CCB Lie.: I'�S•S h2.Plumbing Lie.no.: `'�-}'3 pig„T��))t „"^^ � State surcharge(12%of permit fee) �^�,J
Authorized signature: TOTAL PERMIT FEE cyj Iv
Tltis permit application expires if a permit is not obtained within 180 days
Print name: �� ( Iv) Date: (Z�+S 2Z after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Hoard.
r:lnaildineemiesWi.MU-PennitApp.doc I0/01/09 440-0616T(10/02/COM/WEH)
Plumbing Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Uhlittgs{ V . . .. 3. : (?) K !i, 1^fi i s OdZi .4% a1 re qr *.3S. x.r.'
dr aCe A � .' . ,
Footing drain-1'100' 50.03 -0 to 2,000 $121.90
Fooling drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer-1st 100' v\ er 'pft,ir,,y( Sty. 62.54 (0.1, 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas Systems:
a%- WCs
Water Service-each additional 100' 37.52 if a'�ir:41Gv'"�"44 4 0
Storm&Rain Drain-1st 100' 62.54 a
$I.OD 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
Qty. 'Fee(ea) Total` each additional$100.00 or fraction thereof,to
Other Inspections Of fees 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 outsido 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: (, i-s
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
r
occur ately report fixtures could result in increased sewer fees �>1 Y eGf.`fiFt4t" tym Yn ' . , s., ,p, ,,
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 engineer.
-Jacuzzi/Whirlpool _ - 0 New exterior plumbing site utilities for any complex structure
Car Wash: -Each Stall as defined in OAR918-780-0040.
-Drive Thru
Cuspidor/Water Aspirator ._--- El Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial El Any multipurpose fire sprinkler system.
❑ Any complex structure as defined in OAR918-780-0040.
Domestic
Drinking Fountain
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink: -2" Tit
-.
[1 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: -LavBar 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 he issued.
Urinal
Other Fixtures:
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