Permit CITY OF TIGARD PLUMBING PERMIT
s • COMMUNITY DEVELOPMENT Permit #: PLM2012 -00169
T [ G A O 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/12/2012
Parcel: 25101 DA00104
Jurisdiction: TIGARD
Site address: 13333 SW 68TH PKWY
Project: Triangle Point Subdivision: VARNS ACRES Lot: 9
Project Description: 3rd & 4th floor lobbies, cap (2) lays & (2) water closets, add (2) utility sinks, replace (8) lays, (12) water closets &
(4) urinals.
Contractor: RUSSELL & SONS PLUMBING INC Owner TRIANGLE POINTE LLC
PO BOX 192 901 NE GLISAN ST, #100
BATTLE GROUND, wa 98604 PORTLAND, OR 97232
PHONE: 360 - 263 -3377 PHONE:
FAX: 360 - 263 -3378
FEES
Quantity Description Date Amount
4 ea Fixture /Sewer Cap 06/12/2012 $100.08
Specifics: 2 ea Sink 06/12/2012 $50.04
8 ea Lavatories 06/12/2012 $200.16
Type of Use: 4 ea Urinal 06/12/2012 $100.08
Class of Work: 12 ea Water Closet 06/12/2012 $300.24
Type of Const: 1 12% State Surcharge - 06/12/2012 $90.07
Occupancy Grp: Plumbing
Stories:
Total $840.67
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
or dire • uestions • • UNC .y calling 503.232.1987 or 1.800.332.2344.
Iss :d By: / . %�/ � Permittee Sign ure:
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.
JUN - 07- 2012(THU) 12:26 RUSSELL & SONS PLUMBING (FRX)36026333 ?8 P.002 /004 .NCO
Plumbing Permit ApplicationREC l VE 1 ■
a.
Building Fixtures FOR OFFICE USE ONLY N
JUN 0 7 2012 R�ccivca \ O 404 - City of Tigard A PcnaltNn,:
nntemy:
. . 13125 SW Hall Blvd.. Tigard, OR 9 Ty OF TIGARD Plan Review / �. PAY � �l� y O
.11 Phone: 503.718.2439 Fax: 503.598 batellr Other Permit No.: 1
T I G A R D Ilupecuun line: 503.639 !DING DIVISION slam Randy/By: &I Soo Page 2 for f i
V
Internee www,ti�il- or.gov I q
�'1 Notified/Method: Su • • .�, total informailon
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❑ New construction ❑ Demolition - For special injormation use checklist
- Description I Qty I Ea. I Total i k
❑ Addition/alteration/replacement EI Other. T.I. New 1- 2- family Ii(Ift d_ wellings (includes 100 IL for each utility connection) p �
P- idiliiT (< 1ilii i I s mjH ' ; � n �( ' h ..._ n;. � i.-7 z:;. .n.lir4 If ls" ' i �
. f �iliiii i III SFR (1) bath ,- X11
i6 ulrt R,l . a. l�I.
❑ 1- and 2- family dwelling ® Commercial/industrial SFR (2) bath 437.78
❑ Accessory building ❑ Multi-family
SFR (3) bath 5110.32
Each additional bath/kitchon 25.02
Q Master builder ❑ Other
' 1 ')1 ,,,,.,,;, a n, r. Fire sptlnkler ( sq. ft.) Page 2
/ l ills YY l s s i .1' t i'�R r' ly�y�y i i,q.n ! 'RAMIE M ( {!f 1�{�. I pI , { i I+
• . 1 �4�1i lll�li .ta4a�rxi� , ,,,. ' ./• ,1 , �I ulrtllu ; ,rtt 1 ;,N� �t .. I - Site udlides:
Job site address: 13333 SW 68 Parkway Catch basin or area drain 18.76
Drywdl, leach lint, or trench drain 18.76
City /StatefZW: Tigard, OR 97223 - 1 1 2;4b 64-t Po/Jr- Footing drain (no. linear SL: _) Page 2
Suite/bldgiapt. no.: n/a I Project name: 3 & 4 Fir Lobby TI Manufactured home utilities 50.03
Cross street/directions to job site: Old Farmers Insurance Building Manholes 18.76
T
Rain drain connector 18,76
Sanitary sewer (no. linear R.: _) Page 2
Storm sewer (no. linear 1L: _) Page 2
Water service (no. linear R: ) Page 2
Subdivision: n/a ,4r /Q / v A. C b f O ef LLot no.: n/a Mixture or Item:
Tax map/parcel no.: rc33n/a Backflow pteventcr 31.27 1 7r t �!� � (1I� ! x
I(�11 1{ 1 11 11 } I11 �'•1{ AM f(1r ti 11 I d I lfllAll7i111 : iit Backwater valve 12.51
I';.. ;I x.1111, Iii�i1 +�s� 1 ����I�F_ Clothes washer 25.02
Renovate existing restroome to meet ADA requirements Dishwasher 25.02
Replace existing fixture's with new Drinking fountain 25.02
8jectors/sump 25.02
( r� y ) �1 p q. , �,
401111 +11i. 111 n 1 . li I i � �llErilt�Il �il li.d1l11i 11 I . O r'�Inttlrshlhillti ii + ;11 Expansion tank 1231
Name. Fixture/sewer cap 4 25.02 100.08
Address
Floor drain/floor sink/hub 25.02
r Garbage disposal 25.02
City /State/ZIP: Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12.51
1+ � ;{ i f It� E ', , p. .'.:m ,i I.p •rLltt l 1
: 1 li' f atil 1 :�'.; ; , flilRµfl+ fl�in1:11i I . 1 y, '{ ,, i IIIIIi1 I<�IP' .� a ' ' l u21 {Il`I-+ P lntciveptadgrcasc trap 25.02
.V ,, a �l� �� I �....,. �.,, i . �v fi is r ! III,„
Business name: Russell & Sons Plumbing Inc Medical gas (value: $ ) Paget
Contact name: Mark Muonlo Primer 12.51
Roof drain (commercial) 12.51
_ Address: PO Box 142
Sink/basin/lavatory 10 25.02 250.20
City/State/ZIP: Battle Ground, Wa 98604 Solar units (potable water) 62.54
Phone: (360) 263 3377 I Fax: : (360) 2633378 Tub/shower /shower pan 12.51
E -mail: mark@rsplombing.net Urinal 4 25.02 100.08
ig II Ii IlGi ;'t 10 1 1 111{1 1111tO rt, ,11111 11{ I'1('1�i �l I� i� IElli `:::,,,cater r eloaer _ 12 2s.o2 30024
nnnc ry ,. n hn 1.e, rf I I I 11rt 1 n TOl n a M 37.52
Business name: Russell & Sons Plumbing Inc Water piping/DWV - 56.29
Address: PO Bair 192 Other, 25.02
City/State/ZIP: Battle Ground, Wa 98604 Subtotal 750.60
Phone: (360) 263.3377 Minimum permit fee: $72.50
377 Fax: (360) 263.3378
1't 113 Plan review (25% of permit fcc) - I QomS .
CCB Lic.: 148999 P lumbingLic. no 37 -511PB 1�t 1'f p?
,A^ State surcharge (12% of penult fee) 00:00- 7
Authorized signature: Mock r /. � TOTAL PERMIT FEE 33
I Print name: Mark Muonio . I Date: 6.7.2012 This permit applkalloe expires If a permit ill not ohtalned within 1 Na dayx (
after It has been accepted as complete. * HO'
'Fee methodology set by Trri- County Building Industry Service Board. 0 1
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JUN- 07- 2012(THU) 12:26 RUSSELL & SONS PLUMBING (FRX)3602633378 P.003/004
Plumbing Permit Aanlication - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
ERIE Susnnwrmr r Ire p,Gbr ` dn•mu
�W r, p ,�5Q, rS 1� ry np 3i)1,11113 I � q_ N�rT F 1 all t 1 , +1 ,UA� �t + �p1 ` {1 1 r- t 1 ��
18• eli..'1t tins`, .''' (�rliillil n{ I1n�cluinE10 '1�1(di titlatiaili,I , 00.. 11i! G�'. 4rrnl�INllliJlltiliti1 ,�,�iiO41Jr�
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 5233.20
Sewer -1st 100' 62.54 7,201 ondgreater _ $327.54
Sewer- each additional 100' 37.52
Water Service -1st 100' 62.54 Medical Gas S stems:
Water Service - each additional 100' 37.52 +W1 Magian �I� I' l (1 I I! 1 Ali
.'L r�.Ql.�wf11A!111g1!l1n i '1 111 r u Vital Blab 11 I' ('1' ���1� lima iliiuucu
Storm Resin Drip -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 tint $5,000.00 and $1.52 for
- a rr, y, .. xux , true � , nn�pp l��x , � G r t � ' � f
........ {;M i t'; Y(11 IM A ° ' 'ill W1 each additional $100.00 or fraction thereof, to
Si a Irlf iu: 1, . a m 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 525,000.00.
Inspections outside of normal business 90.00/1w $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 faction thereof, to
Rcinspection Fees 9000/hr and including $50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the that $50,000.00 and $120 for
(minimum chime -1/2 hour) cash 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 * .
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' 0.l t i :.. Irtl ..h�l ll i � l�. _. L E >i�t gi ,1; � iatnt0thia .i rl ixttpe ti, NBA 1 rata " . , ..mm., .blia ll �d
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,l ' 1 , : r ;r 1 ! 1J 'g it n, „k�1J�iy7�y r { Pl review is required for any of the following.
_�. .t��,Pi'�ntrned: arurnrar,.�, ..,. :,,GI��,til 1.�,�1 ip; l!pl>�x� 1fI lifts i �llNeld �1 Y S•
Baptistry/Font Please check all that apply.
Bath Tub/Shower ❑ Any new commercial building with water service 2" and
_ - Jacuzzi/Whirlpool greater, except systems designed and stumped by licensed
Car Wash - Each Stall engineer.
Drive - ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator • as defined in OA1t918 - 780 - 0040.
Dishwasher - Commercial ❑ Medical gas and vacuum systems for health care facilities.
- Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918 -780 -0040.
Eye Wash
Floor Drain/sink - 2" Submit 2 sets of plans with any of the above.
-3"
tugs r IixAIIheLL "IN.l.hl4 I! rylIU11 1 r W x[( i x14
.4,. 11FE�g�lil�url magic tosoli �' r, aaulling It
Car Wash Drain ❑ Isometric or riser diagram is required buildings
ired for new bui din
Garbage -Dom stio-non -food g
Disposal - Domebrio -food related that meet the qualifications above.
- Commercial -food related
- Industrial -food related
Ice Mach./Refrig. Drains
oi separato (Gas station) Comments regarding fixture work:
Rec. Vehicle Dump Station Renovate existing restrooms to meet ADA
Shower -Gang Add 2 janitor sinks in new closet
smtl Th are 29 existing fixtures
5ink/Lnv -Non-food related 2 8 �' _
- Bradley There will be 26 fixtures after Tf
- Commercial - food related Existing W/1-1 to supply hot water
- Service 2
Swimming Pool Filter
Washer - Clothes *Note: If the fixture work under this permit results in an
water Extractor - increase of sewer FDUs, a sewer permit will be issued and
Water Closet - Toilet , 2 12 fees assessed for the sewer increase must be paid before the
Urinal 4 plumbing permit can be issued.
Other Fixtures:
R•\.Shnre d Dr:cuments \1 Current Jnhs \Cnmmcrcisl \Triangle Pnint 3rd Rt 4ttu Common Area TT\C•rnmict Doeumenta \Permits \PT.MF- PcrmitAnn.rinc
I tiv
p 0
A
Tenant Name: Triangle Point ** ccumula*CREDITS * ** e Sewer Tally SWR # N/A
t 1 G n It D Site Address: 13333 SW 68th Pkwy, 3rd & 4th floor lobbies PLM # 2012 -00169
Parcel #: 2S 101 DA00104
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 0 0 0 0
Floor Drain /Sink: - 2 inch 2 0 0 0 0 0
- 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
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 0 -2 -4
- Bradley 5 0 0 0 0 0
- Com /Sery /Util - Food Related 3 0 0 2 6 2 6
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 0 -2 -12
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 4 16 2 6 -2 _ -10
Current Fixture Value -10 divided by 16 = -0.6 Current EDU 1 EDU = $4,500.00
Previous Fixture Value 0 divided by 16 = 0.0 Previous EDU
Change -10 divided by 16 = -0.6 over (under) $ (2,700.00)
Enter EDU Change Here -0.6
Notes: ** *CREDITS * **
Authorized Name /Signature: Debbie Adamski Date: 6/12/2012
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 \SewerTallySheet- 4500.x!s 01/18/12
JUN- 07- 2012(THU) 12:26 RUSSELL & SONS PLUMBING (FRX)3602633378 P. 001 /004
•
5S!i,+ ., uit
RUSSELL & SONS' PLUMBING, INC. . ' '
P.O. BOX 192 , � ' Htlli : +1 �E!Iqu�� +� I!Ilk EElI
BATTLE GROUND, WA 98604 !� �wi 1 + � l�li1
PHONE: (360) 263 -3377 j k,' i i
FAX: (360) 263 -3378 ang
FAX
TO: City of Tigard FROM: Mark Muonio
ATTN: PAGES: 4 including cover
FAX: 503.598.1960 DATE: 6 -7 -2012
REGARDING: Plumbing Permit App & Payment
❑ URGENT ❑ REVIEW ❑ COMMENT ❑ REPLY
I understand the building permit has been applied for by the general contractor (SD Deacon). The
application # Is BUP2012-00101.
Please call me when plumbing permit is ready.
Thank you