Permit (111) IN CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2017-00452
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/01/2017
f Parcel: 2S113AB01400
Jurisdiction: Tigard
Site address: 7358 SW DURHAM RD
Project: Coram Subdivision: None Lot: None
Project Description: TI for interior plumbing:Adding(1)eye wash,and(1)sink.Capping temporary clean room fixtures:(1)eye wash,
(1)2"floor drain,and(1)sink.
Contractor: WHITTINGTON&SONS PLUMBING COMPANY Owner: PACIFIC REALTY ASSOCIATES LP
6375 SW CHERRYHILL DR ATTN: N PIVEN
BEAVERTON, OR 97008 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-536-5910 PHONE:
FAX: 503-648-0617
FEES
Quantity Description Date Amount
1 ea Ejectors/Sump 11/01/2017 $25.02
Specifics: 3 ea Fixture/Sewer Cap 11/01/2017 $75.06
1 ea Sink 11/01/2017 $25.02
Type of Use: COM 25 Misc Other Fee 11/01/2017 $25.02
Class of Work: ALT 1 12%State Surcharge- 11/01/2017 $18.01
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $168.13
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 o follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-00 %090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Rerraittee Signature AAM
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 i
Building Fixtures R ::A-
Ci of Tigard Received ,j���
g Permit No.:
13125 SW Hall Blvd.,Tigard,O 23 �� Date/By: /���// 7 rel � 1_7 j
Plan Review
a Phone: 503.718.2439 Fax: 503.598.1968N 3 3 - Plan y. Other Permit No.:/jj 4p4i()i 6.v`�3
Inspection Line: 503 639.4175 \"�y r ���1//4"
1 I G A R D .i Date Ready/By: Jona. ® See Page 2 for
Internet: www.tigard-or.gov , yt c )Notified/Method: Supplemental Information
Tn'E OF WO: . IAN I ,'.< FEE* SCHE1t%f,,,
❑New construction i* , .1 ion For special information use checklist.
Description Qty. I Ea. 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
El1-and 2-family dwelling Commercial/industrial SFR(2)bath 437.78
buildingSFR(3)bath 500.32
❑Accessory 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
sem.
JU13:SITE INFORMATION AND LOCATION;t Site utilities:
Job site address: ] C' Catch basin or area drain 18.76
�" �� J Drywell,leach line,or trench drain 18.76
City/State/ZIP: 1 i 1 a rt . 0 R Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: `f Project name: V5 p J lWb 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: 1 Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
,„ ' Backwater valve 12.51
ESCRIPTIO WORK
_,' ' ,> . .
,If/� f� d Clothes washer 25.02
q/i� ti I eye L J#-Smh n Dishwasher W� �SiS//�� � / s washer 25.02
C/ran room Drinking fountain 25.02
Ejectors/sump i 25.02 (9%
0 PROPER'T'Y'0 3'I IER "ri TENANT Expansion tank 12.51
Name: Fixture/sewer cap 3 25.02 75,040..
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
0 AI' 0 CONTACT PERS+()N Interceptor/grease trap 25.02
/' Medical gas(value:$ ) Page 2
Business name: J" I / 4 ,i fit„,,s 4
(� Primer 12.51
Contact name: �br ,� +y� Roof drain(commercial) 12.51
Address: Ise.k) rw' �1' `�
�j�jSink/basin/lavatory 1 25.02 A
City/State/ZIP / "4_, Solar units(potable water) 62.54 �►+�
Phone: 3') 536, 5 9 tb Fax::( ) Tub/shower/shower pan 12.51
E-mail:fi`i ® f td, -r� 1lir i te� Urinal 25.02
-�. Water closet 25.02
n CONTRACTOR
Water heater 37.52
Business name: atilt,
���' VV C t, i 4btt/e, Water piping/DWV 56.29
Address: �tJ
Other: Ile Lash ( 25.02 igi GI
City/State/ZIP: Subtotal /o.I)
Phone:( ) Fax:( ) Minimum permit fee: $72.50
CCB Lie.: Plum 'n Lic.no.: 6 Int Plan review (25%of permit fee)
gi
State surcharge(12%of permit fee) t .d i
Authorized signator . TOTAL PERMIT FEE l6 k, 13
Print name:1 WW/r6Prni fg Date: r/`i 1/-9--- This permit application expires if a permit is not obtained within 180 days
I after it has beed accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440 1616T(10/02/CAM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea)*i Total Stiiiii0 footage: `, Permit Feer=
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-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 Valua OO ',Permit Fee:
Storm&Rain Drain-1st 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
Other InsMons or Fees Qty. Fee CA) To each additional$100.00 or fraction thereof,to
l 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
Baptistry/Font ❑ Any new commercial building with water service 2"and
greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
engineer.
-Jacuzzi/Whirlpool Car Wash: -Each Stall ❑ New exterior plumbing site utilities for any complex structure
Drive as defined in OAR918-780-0040.
Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities.
Dishwasher: -Commercial sr ❑ Any multipurpose fire sprinkler system.
-Domestic ❑ Any complex structure as defined in OAR918-780-0040.
Drinking Fountain
Eye Wash I i Submit 2 sets of plans with any of the above.
Floor Drain/sink: -2"
3" metric or fliagram
4"
0 Isometric or riser diagram is required for new buildings
-Car Wash Drain
Garbage Domestic non-food that meet the qualifications above.
Disposal: -Domestic food relat
-Commercial food related
-Industrial food related
Ice Mach./Refrig.Drains Co mets regarding fixture work:
Oil Separator(Gas Station) (oci,"4 an,eye- idgt6 Ii 0i,,Cj S121144e..
r r
Rec.Vehicle Dump Station I� iIn ocii .
Shower: -Gang �� ��f4 I
-Stall
Sink: - ft�-Lav/Bar non-food related ' I --- ���`,� �%�'�" � ��}^^-
-Bradley it/1 to 6
-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:
I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2
Accumulative Sewer Tally
114 ■
Tenant Name: CORAM SWR# N/A
Site Address: 7358 SW DURHAM PLM# 2017-00452
TIGARD
Parcel#: 2S1 13AB01400
Fixture Value Previous Previous Credits Capped Fixture 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 1 1 1 1 0 0
Floor Drain/Sink: -2 inch 2 0 1 2 0 -1 -2
-3 inch 5 0 0 0 0 0
-4inch 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:
-Lav/Bar-Non-Food Related 2 0 1 2 1 2 0 0
-Bradley 5 0 0 0 0 0
-Com/Sery/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 _ 3 5 2 3 -1 -2
Current Fixture Value -2 divided by 16= -0.125 Current EDU 1 EDU= $5,500.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change -2 divided by 16= -0.125 over (under) $ (715.00)
Enter EDU Change Here -0.130 *
*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: ***CREDIT*** TEMPORARY CLEAN ROOM FIXTURES CAPPED.
Authorized Name/Signature: BRANDEN TAGGART X2449 Date: 11/1/2017
Building Division
rote: 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\SewerTallySheet_5500_070117.xlsx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
7358 SW DURHAM RD, TIGARD, OR, 97224 December 27, 2017 at
2:31 :20 PM
Record Type: Record ID:
Commercial - Plumbing PLM2017-00452
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor