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Permit (14) CITY OF TIGARD PLUMBING PERMIT 4111 IIIII 1 COMMUNITY DEVELOPMENT Permit#: PLM2023-00253 Date Issued: 9/18/2023 T I G A RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S135BA00102 Jurisdiction: Tigard Site address: 10154 SW WASHINGTON SQUARE RD Project: BioLife Plasma Services Subdivision: OAKBURG Lot: 9 Project Description: Interior plumbing for TI:Capping(1)drinking fountain,(4)sinks,and(2)water closets;Adding(1)drinking fountain, (4)eye wash stations, (4)3"floor drains,(4)4"floor drains,(1)garbage disposal, (15)sinks, (6)water closets,and(2)urinals; Installing(1)expansion tank,(5)primers, (1)water heater,and(1)water piping/DWV. Contractor: PMSI LLC Owner: PPR SQUARE TOO LLC 8295 NW EVERGREEN PKWY#204 BY MACERICH RET HILLSBORO, OR 97124 PO BOX 4085 SANTA MONICA, CA 90411 PHONE: PHONE: 503-466-2222 FAX: 503-466-2211 FEES Quantity Description Date Amount 100 If Sanitary Sewer 07/19/2023 $62.54 Specifics: 100 If Water Service 07/19/2023 $62.54 1 ea Backflow Preventer 07/19/2023 $31.27 Type of Use: COM 1 ea Dishwasher 07/19/2023 $25.02 Class of Work: ALT 1 ea Drinking Fountain 07/19/2023 $25.02 Type of Const: 1 ea Expansion Tank 07/19/2023 $12.51 Occupancy Grp: 8 ea Floor Drain/Floor Sink/Hub 07/19/2023 $200.16 Stories: 1 ea Garbage Disposal 07/19/2023 $25.02 2 ea Hose Bib 07/19/2023 $50.04 5 ea Primer 07/19/2023 $62.55 15 ea Sink 07/19/2023 $375.30 2 ea Urinal 07/19/2023 $50.04 1 ea Water Piping/DWV 07/19/2023 $56.29 6 ea Water Closet 07/19/2023 $150.12 1 ea Water Heater 07/19/2023 $37.52 100 Misc Other Fee 07/19/2023 $100.08 Total $1,485.14 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 // J 1 ,,......c/ Issued By: I' ,�/yi',l�t ' 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 Permit Applicati ,. , Building Fixtures ED FOR OFFICE USE ONLY Received _ City of Tigard �UN 2 0 2023 (� )-o }3 i3- Pern .N1a-a,)3- 00]-5 Tj UatdBy: • 13125 SW Hall Blvd..Tigard.OR 9722 Plan Review � -'��jj,,�� 22 Phone: 503.718.2439 Far. 503.59 Date/By: "'- Inspectionot1�fT�yl'1°�1�0�7 ' QO 17�` Line: 503.639.4175I t i OF TIGARDIII 1 0 See Pa�_e z roe TIGARD g. BUILDING DIVISION Date Ready, ay: Juria Internet. wtlw ti drd-uLgOV Notified/Method: ��� ij 125, Supplemental Information I TYPE OF WORK 4 1 t2,46, FEE`" SCHEDULE ❑New construction ❑ Demolition Fo special information use checklist. Description Qty. I Ea. j Total Ei Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 it for each utility connection) CATEGORY OF CONSTRUCTION SFR(I)bath 312.70 El1-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 ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB STYE INFORMATION AND LOCATION Site utilities: .lob site address: Catch basin or area drain I8.76 10154 SW Washington Square Rd Drywell,leach line,or trench drain 18.76 City/State/ZIP: Tigard,OR 97223 Fooling drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: 1 Project name: �" ( 6L ce . (Q;jnA Manufactured home utilities 50.03 Cross street/directions to job site: 5,df fh" Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear Il.: Up) i Page 2 6 3.94?O., Storm sewer(no.linear ft.: ) Page 2 VA Water service(no.linear ft.:4a) I Page 2 601,5 Subdivision: 11)5 I35 0-0 l0y Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 1 31.27 31.27 DESCRIPTION OF WORK �*T" Backwater valve 12.51 " Clothes washer 25.02 Commercial TI for new medical fcacil34j:tenant Dishwasher 1 25.02 t ICe 25.02 Drinking fountain 1 25.02 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER ©`'TENANT Expansion tank 1 12.51 12.51 Name: I3ioLife Plasma Services Fixture/sewer cap 25.02 Floor drain/floor sink/hub 8 25.02 200.16 Address: 10154 SW Washington Square Rd Garbage disposal 1 25.02 25.02 City/State/ZIP: Tigard,OR 97223 Hose bib 2 25.02 50,04 Phone:( ) Fax:( ) Ice maker 12.51 ❑ APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Medical gas(value:$ ) Page 2 Business name: Faster Permits Primer 5 12.51 62.55 Contact name: BradleyVaughan Roof drain(commercial) 12.51 Address: 2000 SW 1st Ave 4 420 Sink/basin/lavatory 1 5 25.02 375.30 City/State/ZIP: Portland,OR 97201 Solar units(potable water) 62.54 Phone:( ) 503-880-3530 Fax: :( ) Tub/shower/shower pan 12.51 Urinal e_ 2i.02 50.04 E-mail: Bradley@'FasterPemiils.Com Water closet 0 25.02 150.12 CONTRACTOR - - Waterheater 1 37.52 37,52 Business name: To Bid QC\ \.:0� S t7 oz ",�(, .1ii (/ Water piping/DWV 1 56.29 l� 56.29 Address: Other: emergency 4 25.02 100.08 City/State/ZIP: eyewash Subtotal 1 .200.94 Phone:( ) Fax:( ) Minimum permit fee: $72.5(�'ll`3�6,0 , ���� J�-�tsq�� Plan review (25%of permit fee) CCB Lie.: PlumbingLic.no.: State surcharge(12%of permit fe 1571,M. Authorized signature: ��,��,�p �G�U i�yf TOT Al_PERMI r F.E 'i Print name: Bradley Vaughan Date: �� This permit application espires if a permit is not obtaine withi 0 days 06/12/2 i after it has been accepted as complete. °Fee methodolo5yyset by Tri-County Building Indusir Service Board. I'Hui IdinuVPermiisVPLML-PermitApp doe IO/0009 4411-4616T110/02/COAUWES �'y�) (03 „ Plumbing Permit Application Building Fixtures FOR OFFICE USE ONLY - City Tigard Reieed SW Da Ry• Permit No II ■ 13125 SW Hall Blvd.,Tigard.OR 97223 Plana Review Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Ohm Permit No TIGARD Inspection Line: 503.639.4175 Date Ready/By: orris El 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 1 Ea. 1 Total ❑x Addition/alteration/replacement ❑ Other: New I-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ❑ 1-and 2-family dwelling 0Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building ❑ Multi-family Each additional bath/kitchen 25.02 ❑ Master builder ❑Other: Fire sprinkler( sq. ft.) Page 2 JOB SITE,INFORMATION AND LOCATION Site utilities: Catch basin or area drain 18.76 Job site address: 10154 SW Washington Square Rd 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.: I Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear IL:_) Page 2 -- Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: Lot no.: Fixture or item: Fax map/parcel no.: Backflow preventer 1 31.27 31.27 Backwater valve 12.51 DESCRIPTION OF WORK Clothes washer 25.02 Commercial TI for new medical hs€4441?f tenant_ officeDishwasher 1 25.02 25.02 Drinking fountain 1 25.02 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER 0 TENANT Expansion tank 1 12.51 12.51 Name: BioLife Plasma Services Fixture/sewer cap 25.02 Floor drain/floor sink/hub 8 25.02 200.16 Address: 10154 SW Washington Square Rd Garbage disposal 1 25.02 25.02 City/State/ZIP: Tigard.OR 97223 Hose bib 2 25 02 50.04 Phone: ( ) Fax:( ) Ice maker 12.51 0 APPLICANT 0 CONTACT PERSON interceptor/grease trap 25.02 Medical gas(value:$ ) Page 2 Business name: Paster Permits Primer 5 12.51 62.55 Contact name: Bradley Vaughan Roof drain(commercial) 12.51 Address: 2000 SW Ist Ave#420 Sink/basin/lavatory 1 5 25.02 375.30 City/State/ZIP: Portland.OR 97201 Solar units(potable water) 62.54 Phone:( ) 503-880-3530 Fax: :( ) Tub/shower/shower pan 12.51 E-mail: Bradlev(ie'FasterPermits.Com Urinal 2 25.02 50.04 Water closet 6 25.02 150.12 CONTRACTOR Water heater 1 37.52 37.52 Business name: PMSI LLC Water pipinglDWV 1 56.29 56.29 Address: 21195 NW'EVERGREEN PARKWAY STE 204 Other: emergency 4 25.02 100.08 City/State/ZIP: Hillsboro.OR 97124 eyewash Subtotal 1 ,200.94 Phone:( 503 )466-2222 Fax:( ) Minimum permit fee: $72.50 Plan review (25%of permit fee) CCB Lie.: 158286 Plumbing Lic.no.: 34-434PB State surcharge(12%of permit fee) Authorized signature: 3 tQNi TOTAI.PERMIT FEE Print name: Bradley Vuu ban Date: p6/l2/23 This permit application expires if a permit is not obtained within 180 days g after it has been accepted as complete. *fee methodology set b Tri-Count>Buildine Industn'Servicc Board_ I,Bulldinp\Permits\PLMU-PermltApp.doe 10/01/09 440-4616'r(IONJCOM.M'EB) Accumulative Sewer Tally 14 p Tenant Name: BIOLIF'E PLASMA SERVICES SWR# 2023-00174 TIGARD Site Address: 10154 SW WASHINGTON SQUARE RD PLM# 2023-00253 Parcel#: 1 S 135BA00102 Fixture Previous Previous Credits Capped Fixture l.ixture 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 1 1 1 1 0 0 Eye Wash 1 0 0 4 4 4 4 Floor Drain/Sink: -2 inch 2 0 0 0 0 0 -3 inch 5 0 0 4 20 4 20 -4 inch 6 0 0 4 24 4 24 -Car Wash 6 0 0 0 0 0 Garbage Disposal: -Domestic(to 3/4 HP) 16 0 0 0 0 0 -Commercial(to 5 I IP) 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 13 26 11 22 -Bradley 5 0 0 0 0 0 -Com/Serv/Util-Food Related 3 0 2 6 2 6 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 2 12 6 36 4 24 Urinal 6 0 0 2 12 2 12 Previous EDU Count 0 0 Capped EDU Credit 0 TOTALS 0 0 7 23 36 129 29 106 Current Fixture Value 106 divided by 16= 6.625 Current EDU 1 EDU= $6,625.00 Previous Fixture Value 0 divided by 16= 0.000 Previous EDU Change 106 divided by 16= 6.625 over (under) $ 43,923.75 Enter EDU Change Here 6.630 *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: Authorized Name/Signature: BRANDEN TAGGART X2449 Date: 7/12/2023 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\ScwcrTallySheet_6625_070122.xlsx