Permit CITY OF TIGARD PLUMBING PERMIT
I pti ` I::` COMMUNITY DEVELOPMENT Permit #: PLM2010 -00047
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/12/2010
TIGARD Parcel: 1 S126CC00100
Jurisdiction: TIGARD
Site address: 9700 SW WASHINGTON SQUARE RD
Subdivision: Lot: 0
Project: Nordstrom - Bathroom Remodel
Project Description: Replace existing, cap existing and add new plumbing fixtures for bathroom remodel on 1st and
2nd floors.
Owner: FEES
PPR WASHINGTON SQUARE LLC Quantity Description Date Amount
C/O NORDSTROM, ATTN: TAX DEPT, PO BOX
2229 ._ i ?71- wA 9cf/ // 2 ea Drinking Fountain 02/12/2010 $50.04
1 ea Floor Drain /Floor Sink/Hub 02/12/2010 $25.02
PHONE: 16 ea Sink 02/12/2010 $400.32
3 ea Urinal 02/12/2010 $75.06
Contractor: 16 ea Water Closet 02/12/2010 $400.32
TAPANI PLUMBING 1 12% State Surcharge - 02/12/2010 $114.09
PO BOX 2350 Plumbing
BATTLE GROUND, WA 98604
PHONE: 360- 687 -3983
FAX: 360 - 687 -4494
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Total $1,064.85
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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: / �� / ta-‹ Permittee Signature: U - //_ 6LPP G / . e,17 . e
CaII 503.639.4175 by 7:00 a.m. for an inspection that business day.
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 ApplicaticR
Building Fixtures CIF .
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2010 f 1� y .� '+4'% � 1 "tj4 Ip w "A�..'w'W:4t�,Q�IY' -Ty1
r City of Tigard FEB 11 Reeaved
a Pe r mit N o . dog Y7
* '' 4i 13125 SW Hall Blvd., Tigard OR 97223 Date/By: /w i �L/�
�` Plan Review
o s Phone: 503.639.4171 Fax: 503.598 T�i OF TIGARD Date/By: Other Permit No.:
Inspection Line: 503.639.4175 5! pI'DING DIVI SION Iuris:
'r f is +A AIR.) V Da Ready/By: ® See Page 2 for
P Internet: www.tigard or,gov Notified /Method: Supplemental Information
� s v '' ,.+ .tie' l 1 a:: � I!• a "�.� 5 `Y, a ^e. i" '.
a ` I `: , @ ( a� M orons a:' t.� it sI r ro
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.n. 7+ � k9F �.:1�� ��•c' <'.
❑ New construction EJ Demolition For 'eclat in ormation use checklist
1 Description Qty, Ea. Total
® Addition /alteration/replacement ❑ Other: New 1. 2-family dwellings (includes 100 ft. for each utility connection) I
• has air e. i�it"y,.T�,�l ri i z
tiyM1Krr r,r�t ( �1 � `4 "'" 4,v. I .,r?, SFR (1) bath 312.70
..S -c. �. .. r . c`,(:aty 1 L t.4L4 .G., t., d!'� e "' Y M1 -. ,, � .�1
111 1- and 2- family dwelling 1 ® Commercial /industrial SFR (2) bath 437.78
❑ Accessory building SFR (3) bath 500.32
❑ Multi - family
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft) Page 2
'.., ." rwsfa,f c z � i3,,"• „Y rte- sr Q
^4tr r.d -n s` ',yb '
-�.. +. .. /. .f....k cex y ,�r„ , r .. ,+,..t, �" X .w.>t a,. s7 ...,r..; . ,'' -i:... as Site utilities:
Job site address: 9700 SW Washington Square Road 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: Nordstrom - Washington Sq Manufactured home utilities 50.03
Cross street/directions to lob site: Manholes 18.76
Rain dram connector 18.76
Sanitary sewer (no. linear ft: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Water service (no. linear R.: T ,) Page 2
Subdivision: Lot no.: Fixture or item:
Tax map /parcel � 1 C 1 / Backflow preventer 31.27
. 7 �. i r r f . ( : ; y( r y,�,, :11 row f�c 4 r Backwater valve 12.51
d A Yt,.(`,, , ,, r r . e t , .rr a > ,, ,, ,i.,y . "" ' i s t'r eJI4 .ftWit N
+ .. n aK .,», qe,:. +: °„,'.. •. %_.. 7...xv 4 cls k. k W' Clothes washer 25.02
Plumbing remodel of existing Nordstrom store. Remove old plumbing fixtures
Dishwasher 25.02 4'0. g l
and replace with new. Add plumbing fixtures w/ required piping at new Drinking fountain Ac2, I 25.02
locations. IIA/ / si 2 A /. rf , 772 -(wff5 Ejectors /sump 25.02
! " ' �r, r , ? z ,�... e -.J. '�,' .,e ta` �` t It ,: ; ` x . 00m ' Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub 1 25.02 25.02 ✓
Address: -.
Garbage disposal 25.02
City /State/ZIP: Hose bib m 25.02
Phone: ( ) Fax: ( ) Ice maker 12.51
: $n � r "� �" r n"' •
'c , y `' `
.' j ix :
� Interceptor /grease trap 25,02
t., : henir ,..� �.:, -..:. �awl.:.,..d:.. .. Lr'Etr"x....a.4`.S Q., ., . ,
Medical gas value: S
Business name: ( ) Page 2
Primer 12,51
Contact name: Roof drain (commercial) 12.51 7"
Address: I Sink/basin/lavatory _�4 </� 25.02 .75311
City /State /ZIP: I Solar units (potable water) 62.
Phone: ( ) I Fax: : ( ) Tub /shower /shower pan 12.51 s, 0tP
E -mail: Urinal /f ^ 25
l � ` Ia Sc�leG ,� -, / �. i _. , ,r .� y ,,.. I Water closets 25.02
; =r,, ,. , . r,., y ,( $ ,, "Trv �'' ^��5( . ,';/* „-.Y.t 4, ':' ,t. .';.,us .4t e%a u.
Water heater 37.52 ]�Qp
Business name: Tapani Plumbing Inc I Water piping/DWV I 56.29 II
Address: PO Box 2350 , Other: 25.02 ifig I
/ l e
City /State /ZIP: Battle Ground, WA 98604 Subtotal
Phone: (360) 687 -3983 Fax: (360) 687 -4494 Minimum permit fee: 57250 ,.43r
/for /1. .r • i
CCB Lic.: 60958 ell A3 j ti I Plumbin , no.: 37 -269PB 7//// / , i s
�V // State surcharge (124 %ofpemtit fee) � t�,t'
Authorized Signature: TOTAL PERMIT FEE .43
Print name: Ross Tapani Date: 2/11/2010 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
"Fee methodology set by Ir1- County Building Industry Service 0.oard. �
l:` Euilding�Per :ni[s■PLNfU- PcrmitAp0.4oc 10 /0lr09 a4p- a61GT(i0l0'. /CU�(/wEB) 1 t) p O
Pl Permit Application - City of Tigard /
Page 2 - Supplemental Information p l 2� �'� 0004-1
Fee Schedule: Residential Fire Sup . ression Systems:
t r ;;a r e , ) .,4 O9, $u - G y p. • 4: ' r 1 • ' ] nG - ,, • * 5- - - 1, i i 're � �. R .1' "1 a: g : - , `. '' -..: -- �,,,., . ♦-. ^ i
` i, r 0..._ k ;ice `sr•' � r i �
''5��,1 � .. ... ° . -. �1�- Ja e . 'Y�c�� x �`�` sl: "�. 'b � �a ?' �. � � � � °� � -�. � .
.�,c F �5. jh-. Ci+... Y� � 4S.ya k
Footing drain - 1' 100' 50.03 0 to 2,000 $121.90
Footing dram - each additional 100' 37.52 2.001 to 3,600 $169.69
Sewer 1st 100' ' 62 �4 3.601 to 7,200 $233.20
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 • r r 1 ,: , - 'nr .f . ' ,/:,;;;;;..4,-.- ; ,,
Storm &Rain Drain 1st 100' 62.51 ' ``LLt a, r^ 9,.. ` ` t " , t 4
$1.00 to 55,000.00 Minimum fee 572.50
Storm & Rain Dram - each additional 100' 37.52 55,001.00 to 510,000.00 $72.50 for the first 55,000.00 and $1.52 for
;�h� a4! �• Ah ��� v . ��� iti � + each additional 5100.00 or fraction thereof, to
+ and including $10,000.00.
Inspection of existing plumbing or for 510.001.00 to 525,000.00 $148.50 for the first $10,000.00 and 51.54 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 525 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 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 ", sI 7 1 s° b� ?! � ' '= N �C` i
please indicate work performed by fixture. Failure to Plan review is required for any of t he following.
accurately report fixtures could result In Increased sewer fees. Please check all that apply.
J
: ,, , t3iiatititZb ;(F dtr e)',WOrk` ❑ Any new commercial building with water service 2" and
rxture Type Replace greater, except systems designed and stamped by licensed
... erevrou. , • Cap¢ee , :,: id'ded ESiastimt . engineer -
Baptisuy /Font ❑ New exterior plumbing site utilities for any complex structure
Bath -Tub /Shower as defined in OAR918- 780 -0040.
•Jacuzzi/Whiripool ❑ Medical gas and vacuum systems for health care facilities.
Car Wash -Each Stall
-Drive Thru ❑ Any multipurpose fire sprinkler system.
•
Cuspidor /Water Aspirator CD Any complex structure as defined in OAR918 -780 -0040.
-
Dishwasher -Commercial
- Domestic
Submit 2 sets of plans with any of the above.
Drinking Fountain 2 2 ✓ r „ ,yy,,,,�.�a , n µ ,... '. .4,,,,_,..,, . , K ;y., +' . � t ,,
Eye Wa h / -_ ),i14*.
- L',... > +6.: -. F 1. 1.-.. ° .•1rrv u.1m+`.xear a:- `•ir.'a:MA : r` `"
Floor Drain/sink - 2" C / ✓ . ❑ Isometric or riser diagram is required for new buildings
that meet the qualifications above.
.4"
Car Wash Dram
Garbage - Domestic
Disposal - Commercial
Industrial Comments regarding fixture work:
Ice Mach./Refrig.Drains -
Oil Separator (Gas Station)
Rco. vehicle Diunp Station
Shower -Gang
-Stall
Sink - Bar/Lavatory 14 1 ' /-4. 1 `'''' 13. '�
- Bradley
- Cummcr iai 1 ✓ *Note: If the fixture work under this permit results in an
-Service increase of sewer EDUs, a sewer permit will be issued and
Swimming Pool Filter fees assessed for the sewer increase must be paid before the
Washer - Clothes plumbing permit can be issued.
Water Extractor
Water Closet - Toilet 16 3 ■ 13
Urinal _ 3 1 ✓ 2 ✓
Other Fixtures:
•
T:Active lobs \A - Construction \Nordstrom \Project Managing\Nordstrom PQumbing Permit App.doc
Accumulative Sewer Tally parcel # 1S126CC00100
Tenant Name: Nordstrom This SWR# N/A
Site Address: 9700 SW Washington Square Rd , This PLM# PLM2010 - 00047
Fixture Value Previous Previous Credits Capped Fixture Fixture New New
# value capped off value added added total total
count off #s count # value #s values
Baptisers /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 Drn 6 0 0 0 0 0
Garbage Disposal
- Domestic (to 3/4 I -IP) 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
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 - Bar /Lavatory 2 0 1 2 . 1 2 0 0
- Bradley 5 0 0 0 0 0
- Commercial 3 0 0 1 3 1 3
- Service 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 3 18 0 -3 -18
Urinal 6 0 1 6 0 -1 -6
Previous EDU Count 0 0
Capped EDU Credit. 0
TOTALS 0 0 5 26 3 7 -2 -19
Current Fixture Value -19 divided by 16 = -1.2 Current EDU 1 EDU = $ 3,600
Previous Fixture Value 0 divided by 16 = 0.0 Previous EDU
Change -19 divided by 16 = -1.2 over (under) $ (4,320.00)
Enter EDU Change Here -1.2
Notes:
�� f � / ) �/
Authorized Name /Signature: Dianna Howse r� `l • Date: 2/12/2010
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.
l: \Building \Sewer Tally \Sewer 1'allySheet- 3600.xls 06/25/08