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Permit 10 I 10 Rc_u ■ 3e_eA p im ►t ; ke loci ‘nr a I I fi)k -s %. 5 CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit #: PLM2010 -00316 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/30/2010 Parcel: 2S112DA01400 Jurisdiction: Tigard Site address: 6650 SW REDWOOD LN 215 Subdivision: PACIFIC CORPORATE CENTER Lot: 0 Project: Umpqua Bank Project Description: Interior plumbing: relocating (1) dishwasher, (1) 2" hub drain and (1) sink. Owner: FEES PACIFIC REALTY ASSOCIATES Quantity Description Date Amount 15350 SW SEQUOIA PKWY #300 PORTLAND, OR 97224 3 ea Fixture /Sewer Cap 09/30/2010 $75.06 PHONE: 503-624-6300 1 12% State Surcharge - 09/30/2010 $9.01 Plumbing Contractor: DEAN WARREN PLUMBING & REMODELING INC PO BOX 14701 PHONE: 503 - 236 -4152 FAX: 503- 296 -2218 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $84.07 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,. / 1 ' ermi ee Signature: � / Call 503.639.4175 by 7:00 a.m. for an inspection that bu mess day. This permit card shall be kept in a conspicuous place on the job site u • ' ompletion of the project. Approved plans are required on the job site at the time of each inspection. CITY OF TIGARD PLUMBING PERMIT a COMMUNITY DEVELOPMENT Permit #: PLM2010 -00316 T [ G A R L7 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/30/2010 Parcel: 2S112DA01400 Jurisdiction: Tigard Site address: 6650 SW REDWOOD LN 215 Subdivision: PACIFIC CORPORATE CENTER Lot: 0 Project: Umpqua Bank Project Description: Interior plumbing: capping (1) domestic dishwasher and (2) 2" hub drains. Owner: FEES PACIFIC REALTY ASSOCIATES Quantity Description Date Amount 15350 SW SEQUOIA PKWY #300 PORTLAND, OR 97224 3 ea Fixture /Sewer Cap 09/30/2010 $75.06 PHONE: 503-624-6300 1 12% State Surcharge - 09/30/2010 $9.01 Plumbing Contractor: DEAN WARREN PLUMBING & REMODELING INC PO BOX 14701 PHONE: 503 - 236 -4152 FAX: 503 - 296 -2218 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $84.07 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 , . 'ttee Signature: Call 503.639.4175 by 7:00 a.m. for an inspection that bp,iness day. This permit card shall be kept in a conspicuous place on the job site u4ftil completion of the project. Approved plans are required on the job site at the time of each inspection. Plumbing Permit Application , l , M Building Fixtures o p FOR oli ICI.: USE UNI.Y City of Tigard (�6 Received 4 permit No.: 11111 C U 13125 SW Hall Blvd., Tigard, OR 972 tJ 0 Date/By: , (7 j ,1 pifi l�j to vrt��, Plan Review P hone: 503.639.4171 Fax: 503.598. c1 % ti O Other Permit No.: .7 ate/By: I . i A it i Inspection Line: 503.639.4175 <Q ,GQ+ ate Ready/By: kris: ® See Page 2 for Internet: www.tigard- or.gov �`S A, ` 7 Notified/Method: 777) Supplemental Informa TYPE OF WORK (W j FEE* SCHEDULE ❑ New construction ❑ Demolit �, For special information use checklist: Description I Qty. Ea. I Total PI: Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRU so ON SFR (1) bath 312.70 ❑ 1- and 2- family dwelling ` ommercial/industrial SFR (2) bath 437.78 building SFR (3) bath 500.32 ❑ Accessory g ❑ Multi- family Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler (- sq. ft.) Page 2 JOB SITE / INFORMATION AND LOCATION Site utilities: Job site address: b c � S (_, e cl / _,a' 1 t :/- 1 % 5 Catch basin or area drain 18.76 S C City/State/ZIP: J ) u/ Drywell, leach line, or trench drain 18.76 Cit y r's ,F� . y � 9 Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: 5- I Project name: C., m7' et% v j epeAkik 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: I Lot no.: Fixture or item: Tax map /parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 / ji..i 1 O S - 7 p1 D w Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: A c 17-, / Fixture/sewer cap 25.02 '✓ O (0 / Floor drain/floor sink/hub I 25.02 I Address: / 7 3 S O S C. •••• • S try C. o: g / J h u. y' Garbage disposal 25.02 City /State /ZIP: jr-2,7t. . U;2, 9 7 i s V Hose bib 25.02 Phone: (' tf ) 2.-y - 6 30 Fax: ( ) Ice maker 12.51 ❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02 Business name: D a ,__ ( /Yew. 441 t.5 , 7 �, , / Medical gas (value: $ ) Page 2 Primer 12.51 Contact name: 0 z /2 c J c.) Roof drain (commercial) 12.51 Address: i 0. go i. /ti -7al Sink/basin/lavatory 25.02 City /State /ZIP: Po)--t: ci fl . 9 7 2 9 3 Solar units (potable water) 62.54 Phone: (5z' S ) - 7 B ci - 3 4 6 E; Fax: : (c:,z 3) 2 9 c - . i/ & Tub /shower /shower pan 12.51 E -mail: Urinal 25.02 CONTRACTOR Water closet 25.02 Water heater 37.52 Business name: Seivri_e__ as orgy /Le Water piping/DWV 56.29 Address: Other: 25.02 City /State /ZIP: Subtotal Phone: ( ) Fax: ( ) Minimum permit fee: $72.50 . 75: 0(, Plan review (25% of permit fee) CCB Lic.: / St/ 9/ Plumbing Lic. no.: 2 b -- - 7 3 6,- State surcharge (12% of permit fee) 9 t d Authorized signature f rcg,,,t TOTAL PERMIT FEE I vi. 6 7 Print name: a. D ate : 9 - - v 'I U This permit application expires if a permit is not obtained within 180 days S 6 Q after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. L\ Building \Permits\PLMU- PermitApp.doc 10/01/09 440- 4616T(10 /02/COM/WEB) 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 - 1st 100' 62.54 Medical Gas Systems: Water Service - each additional 100' 37.52 Valuation: 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 Inspections or Fees Qty. Fee (ea) Total each additional $100.00 or fraction thereof, to P 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 ", Plan Review for Plumbing Installations please indicate work performed by fixture. Failure to - Plan review is required for any of the following. accurately report fixtures could result in increased sewer fees * . Please check all that apply. Quantity by (Fixture) Work Performed ❑ Any new commercial building with water service 2" and Fixture Type: Replace greater, except systems designed and stamped by licensed Previous Capped Added Existing engineer. Baptistry/Font Tub /Sowr ❑ New exterior plumbing site utilities for any complex structure Bath - hower Tub /S erlpool as defined in OAR918- 780 -0040. -Each Stall ❑ Medical gas and vacuum systems for health care facilities. Car Wash Each aru ❑ Any multipurpose fire sprinkler system. Cuspidor/Water Aspirator ❑ Any complex structure as defined in OAR918- 780 -0040. Dishwasher - Commercial - Domestic 1 Submit 2 sets of plans with any of the above. Drinking Fountain Eye Wash Isometric or Riser Diagram Floor Drain/sink - 2" 0 - ❑ Isometric or riser diagram is required for new buildings 3 - that meet the qualifications above. -4" Car Wash Drain Garbage - Domestic Disposal - Commercial - Industrial Comments regarding fixture work: Ice Mach./Refrig. Drains Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar/Lavatory - Bradley - Commercial *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 Water Extractor plumbing permit can be issued. Water Closet - Toilet Urinal Other Fixtures: I:\ Building \Permits\PLMF- PermitApp.doc 2 Accumulative Sewer Tally Parcel # 2S112DA01400 Tenant Name: UMPQUA BANK This SWR# NONE Site Address: 6650 SW REDWOOD LN SUITE 215 This PLM# PLM2010 - 00316 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 Baptistry/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 1 2 0 -1 -2 Drinking Fountain 1 0 0 0. 0 0 Eye Wash 1 0 0 0 0 0 Floor Drain /Sink - 2 inch 2 0 2 4 0 -2 -4 - 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 0 0 0 0 - Bradley 5 0 0 0 0 0 - Commercial 3 0 0 0 0 0 - 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 0 0 0 0 Urinal 6 0 0 0 0 0 Previous EDU Count 0 0 Capped EDU Credit 0 TOTALS 0 0 • 3 6 0 0 -3 -6 Current Fixture Value -6 divided by 16 = -0.4 Current EDU 1 EDU = S 4,100 Previous Fixture Value 0 divided by 16 = 0.0 Previous EDU Change -6 divided by 16 = -0.4 over (under) $ (1,640.00) Enter EDU Change Here -0.4 Notes: ** *CREDITS * ** Authorized Name /Signature: BRANDEN TAGGART Date: 9/30/2010 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 \Scwer'1'allyShcct- 3600.xls 06/25/08 Accumulative Sewer Tally Parcel # 2S112DA01400 Tenant Name: UMPQUA BANK ** *REVISED * ** This SWR# NONE Site Address: 6650 SW REDWOOD LN SUITE 215 This PLM# PLM2010 - 00316 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 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 1 2 1 2 0 0 Drinking Fountain 1 0 0 0 0 0 II .:ye Wash 1 0 0 0 0 0 Floor Drain /Sink - 2 inch 2 0 1 2 1 2 0 0 - 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 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 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 0 0 0 0 - Bradley 5 0 0 0 0 0 - Commercial 3 0 1 3 1 3 0 0 - 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 0 0 0 0 Urinal 6 0 0 0 0 0 Previous EDU Count 0 0 Capped EDU Credit 0 TOTALS 0 0 3 7 3 7 0 0 Current Fixture Value 0 divided by 16 = 0.0 Current EDU 1 EDU = $ 4,100 Previous Fixture Value 0 divided by 16 = 0.0 Previous EDU Change 0 divided by 16 = 0.0 over (under) $ - Enter EDU Change Here 0 Notes: NO CAPS ALL RELOCATES Authorized Name /Signature: BRANDEN TAGGART Date: 9/30/2010 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. I: \ Building \ Sewer Tally \Sewer I'allySheet- 3600.xls 06/25/08