Permit (6) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2021-00490
Date Issued: 1/5/2022
Tic;AR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel 2S1016B01300
Jurisdiction: Tigard
Site address: 11956 SW GARDEN PL
Project: Zoom+Care Lab&Pharmacy Subdivision: CROW PARK 217 Lot: 1
Project Description: Interior for TI:Adding(1)dishwasher,(3)eye wash,(1)3"floor dain/sink,(9)sinks,and(1)water filter; Installing
(1)water heater.
Contractor: DP PLUMBING INC Owner: BKM PARK BC 252 LLC
15825 NE SPRINGBROOK BY SLK GLOBAL SOLUTIONS AMERICA
NEWBERG, OR 97132 2727 LBJ FREEWAY STE 806
DALLAS,TX 75234
PHONE: 503-537-9492 PHONE.
FAX:
FEES
Quantity Description Date Amount
1 ea Dishwasher 12/03/2021 $25.02
Specifics: 1 ea Floor Drain/Floor Sink/Hub 12/03/2021 $25.02
g ea Sink 12/03/2021 $225.18
Type of Use: COM 1 ea Water Heater 12/03/2021 $37.52
Class of Work: ALT 100 Misc Other Fee 12/03/2021 $100.08
Type of Const: 1 12%State Surcharge- 12/03/2021 $49.54
Occupancy Grp: Plumbing
Stories:
Total $462.36
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 forth forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
Issued By: /0,0Pn, Permittee Signature: lA/% ,ff/L co
r�yF�
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.
4.
Plumbing Permit Application fwit, _ ,
Building Fixtures FOR OFFICE USE ONLY
Cityof Tigard RECEIVE •eceived �"th Permit No.:
a ate/By:: /Pith, A I' `d
. II13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Other Permit No.:
NOV �j DateBy: N � /~
TIGARD Inspection Line: 503.639.4175 r 1 5 2021 Date Ready/By: t s: H See age 2 for
Internet: www.tigard-or.gov Notified/Method: /O/j/�r iA Supplemental Information
TYPE OF WORK uiTY OF TIGARD a. t r� FEE* SCHEDULE
ID New construction ID 1114t1JUMG DIVISION For special information use checklist.
Description Qty. Ea. I Total
X Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ 1-and 2-family dwelling x Commercial/industrial
SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building 0 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:11956 SW Garden Place 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.: l Project name:Zoom+Care Lab&Pharmacy Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Off SW Hall Blvd at HWY 217&HWY 99W, SW Garden Place 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: I.ot no.: Fixture or item:
Tax map/parcel no.: 2S101 BB01300 Backflow preventer 31.27
Backwater valve 12.51
DESCRIPTION OF WORK
Clothes washer 25.02
Office T.I.within an existing office park building. 2 existing WCs,2 lays and 1 Dishwasher 1 25.02 2_57,0 x
mop sink to remain. New water heater&9 new sinks. Supply piping for 3 new Drinking fountain 25.02
duct mount humidifiers. Floor drain at air compressors. Gas piping to new RTU3 Ejectors/sump 25.02
0 PROPERTY OWNER
TENANT Expansion tank 12.51
Fixture/sewer cap 25.02
Name: Zoom+Care Contact:Jeffrey Schoenberg
Floor drain floor sink/hub 1 25•02 2.6-.-01
Address: 1455 NW Iriving St#600
Garbage disposal 25.02
City/State/ZIP: Portland,OR 97209 Hose bib 25.02
Phone:( 206) 852-8751 Fax:( ) Ice maker 12.51
X APPLICANT D[ CONTACT PERSON Interceptor/grease trap 25.02
Medical gas(value:S ) Page 2
Business name: Scott I Edwards Architecture LLC
Primer 12.51
Contact name: Mark Steinhardt Roof drain(commercial) 12.51
Address: 2525 E Burnside St Sink/basin/lavatory 9 25.02 225.18
City/State/ZIP: Portland, OR 97214 Solar units(potable water) 62.54
Phone:( 503) 896-5385 Fax: :( ) Tub/shower/shower pan 12.51
Urinal 25.02
E-mail: msteinhardt@seallp.com
Water closet 25.02
CONTRACTOR Water heater 1 37.52 3-75 z
Business name: NW Contractor is pro piiytkn.5 Water piping/DWV 56.29
� -� �• /5 fits- 4/ rk;* ra O'' Other: G)eta li 25.02 /0;1-GT
Address: (/_ &1% Ct 6,t��r B
City/State/ZIP: Portland, OR 9,�25 ��►tC ?ASA
ttu- Subtotal $3 i1i1:
Phone:( �-�g6.5 3 cm ?t,/ Fax: ) 1h/�3 Minimum permit fee: S72.50 -
/< Plan review (25%of pennit fee)
CCB Lic.: ( -825 1 � jtfr��s-- Plumbing Lic.no.:�O/S]/�/ State surcharge(12%of pennit fee) it 5-, oy
Authorized signature: ivl.-. 4,fa y ��7 TOTAL PERMIT FEE
Print name: Mark Steinhardt Date: 11/11/21 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.
I:\Building\Perm its'PLMU-PermiiApp.doc I0,D1/09 440-4616T(I 0/02/COM/WEB)
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Plumbing Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee:
Footing drain-1"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-I st 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 $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 or 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 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*. 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
❑ 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 Thnt
Cuspidor/water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
❑ Any multipurpose fire sprinkler system.
Dishwasher: -Commercial
Domestic 1 0 Any complex structure as defined in OAR918-780-0040.
Drinking Fountain
Eye Wash 3 Submit 2 sets of plans with any of the above.
Floor Drain/sink: -2"
-3" 1 Isometric 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 9
-Bradley
-Cum/Serv/Uti1 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: Water filter for Lab 1
eoument
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