Permit �° - . CITY OF TIGARD PLUMBING PERMIT
' ` 1 , 1 - COMMUNITY DEVELOPMENT
Permit #: PLM2013 -00048
TIGARD
I G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/26/2013
Parcel: 2S112DC00701
Jurisdiction: Tigard
Site address: 15957 SW 72ND AVE
Project: Bikram Yoga Subdivision: FANNO CREEK ACRE TRACTS Lot: 39
Project Description: Add (2) clothes washers, (1) drinking fountain, (1) 2" floor drain, (4) lavatories, (1) laundry sink, (3) shower stalls,
(4) water closets and (1) water heater.
Contractor: PMSI LLC Owner: PACIFIC REALTY ASSOCIATES
21195 NW EVERGREEN PKWY #204 ATTN: N PIVEN
HILLSBORO, OR 97124 15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 -466 -2222 PHONE:
FAX: 503- 466 -2211
FEES
Quantity Description Date Amount
2 ea Clothes Washer 02/20/2013 $50.04
Specifics: 1 ea Drinking Fountain 02/20/2013 $25.02
1 ea Floor Drain/Floor Sink/Hub 02/20/2013 $25.02
Type of Use: COM 1 ea Sink 02/20/2013 $25.02
Class of Work: ALT 4 ea Lavatories 02/20/2013 $100.08
Type of Const: 3 ea Tub /Shower /Shower Pan 02/20/2013 $37.53
Occupancy Grp:' 4 ea Water Closet 02/20/2013 $100.08 '
Stories: 1 ea Water Heater 02/20/2013 $37.52
1 12% State Surcharge - 02/20/2013 $48.04
Plumbing
Total $448.35
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 expire—if—vier. is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon - requires yo • ollow the les adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 thro , gh OAR 95 101 -0090. You may .'tain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
12"1 r x ,t
Issued By: , Permittee Sign. re: -0� =
Call 503.639.4175 by 7:00 a.m. for the next avail. de inspection d -
This permit card shall be kept in a conspicuous place on the jo : • e project.
Approved plans are required on the job site at the ti • • each inspection.
Feb1-2. 2013 8:50AM No. 6841 P. 1
Plumbing Permit AJplicati l4 .CEIVED
Building Fixtures roiz Oil .1(r USE ONL r
City of Tigard FEB 1 2013 ved 9- la b 3 sr Petmit :PL LO I 3- ,,
it 13125 SW Full Blvd, Tigard, OR�` i --�
i ' = P hone: 503.718.2439 Fax: 5 TIGARD ride ew Other Permit Ne. f2 ,mil 3 -00633 J
Inspection line: 503. 639.4175 BUILDING DIVISION DalaReady/By: eum ! 0 see Pogo 2 rot
1 i :\ Internet: www.ligard- or.gov Notified/Method: -fl co Supplemental Inform 'lion
TYPE OP WORK FEE* SCHEDULE O
❑ New construction ❑ Demolition
Far special information use drecklirm
Description I Qty. I Ee. I Total k
® Addition/alteration/replacement ❑ Other: New 1 - 2 dwellings (includes 100 fl. for each utility connection) 1
CATEGORY OP CONSTRUCTION SFR (1) bath 312.70
ID 1- and 2-family dwelling ® Commercial/industrial SFR (2) bad 437.78
- SPR (3) bath, 500.32
❑ Accessory building ❑ Multi- family
Each additional bathlldlchcn 25.02 '�
❑ Master builder ❑ Other. Pi sprinkler (_ sq. ft.) Page 2 ∎'
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 15957 SW 72 Ave • Catch basin or area drain 18.76
- Drywall, leach line, ar trench drain 18.76
City/S tate/ZIP: Portland, OR 97224
Footing drain (no. linear ft: ) Page 2
Suite/bldg./apt no.: I Project name: Blkram Yoga Studio Manufactured home utilities 50.03
Cross streoddireclions to job site: Manholes 18 -76
Rain drain connector 18.76
Sanitary sewer (no. linear It.: ) Page 2
Slam sewer (no. linear IL: ) Page 2
Water service (no. linear ft.: ___) Page 2
Subdivision: I Lot no-: Fixture or Item: .11
Tax map/parcel no.:
Backflow pteventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51 W
Clothes washer 2 * 50.04
Plumbing for tenant Improvement Dishwasher 25.02
Drinking fountain 1 25.02 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER I ❑ TENANT - Expansion tank 12.51
C.P
Name: F'' '•!.. crap 25.02
oor floor sink/hub e )..' 1 1 25.02 25.02 i
Address: e. : e disposal 25.02
City/State/Z1P: Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12.51 7\
❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02
Business name: Medical gas (value: $ ) Page 2
-'- Primer 1251
Contact name:
` of drain (commercial) 12.51
Address: St d •. rim .rjt • . 5 25.02 125.10
City /State/ZIP: Solar t.. • . e water) 62.54
Phone: ( ) I tax:: ( ) IL. $ahow4shower pan , 3 12.51 37.53
E - mail: Urine 25.02
Water closet 4 25.02 100.08
CONTRACTOR
Water heater 1 37.52 37.52
Business name: PMSI LLC . Waterpiping/DWV 56.29
Address: 21195 NW Evergreen Pkwy Suite 204 Other _ 25.02
City/Slate/ZIP: Hillsboro, OR 97124 Subtotal 400.31
Phone: (503) 466 -2222 Fax (503) 466 -2211 Mininwm permit fee $72.50
•
CCB Lie.: 150286 J q . Plumbing Lic. no.: 34-4134P0 Plan review (25% of permit fee)
Authorized signntu, "�ytll 1 l-- Slate surcharge (12% of permit fee) 48.04
TOTAL PERMIT PEE 448.35
I Print name: Land RoNinon I Date: 2/12/13 j This permit application expires Ira pemit r: not obtained within 150 days
after It bas been accepted as complete.
•Fen methodology set by •Iii .Coanly Building Industry Service Board.
Accumulative Sewer Tally
i1 0 ; a Tenant Name: Bikram Yoga SWR # 2013 -00033
Site Address: 15957 SW 72ND, TIGARD, OR 97224 PI .M # 2013 -00048
TIGAIt,t?
Parcel #:.2S1 12DC00701
Fixture Value Previous Previous Credits Capped Fixture Fixture New New
# value count capped #s value count added # added value total #s total 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 0 0 0 0
Drinking Fountain 1 0 0 1 1 1 1
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 6 0 0 0 0 0
Garbage Disposal:
- Domestic (to 3/4 I -IP) 16 0 0 0 0 0
- Commercial (to 5 1-IP) 32 0 0 0 0 0
- Industrial (over 5 1-IP) 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 3 6 3 6
Sink:
- lav /Bar - Non -Food Related 2 0 0 5 10 5 10
- Bradley 5 0 0 0 0 0
- Com /Scrv/Util - Food Related 3 0 0 0 0 0
Swimming Pool Filter 1 _ 0 0 0 0 0
Washer - Clothes 6 0 0 2 12 2 12
Water Extractor 6 0 0 0 0 0
Water Closet - "Toilet 6 0 0 4 24 4 24
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 _ 0 0 0 16 55 16 55
Current Fixture Value 55 divided by 16 = 3.438 Current EDU 1 EDU = $4,665.00
Previous Fixture Value 0 divided by 16 = 0.000 Previous EDU
Change 55 divided by 16 = 3.438 over (under) S 16,047.60
Enter EDU Change Here 3.440
Notes:
Authorized Name /Signature: Shirley Treat Date: 02/12/2013
Building Division
Note: The property owner shall retain the ORIGINAL. sewer tally record. I f 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 \ScwerTallyShcct- 4665.xls 07/01/12
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
15957 SW 72ND AVE, TIGARD, OR, 97224
Commercial - Plumbing
399 Plumbing final
04/18/2013 00:00
PLM2013-00048
FAIL
L/b. 4582 Dan 503-519-1229
1. Not ready for inspection. No inmspection made OPSC 103.5.1
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
15957 SW 72ND AVE, TIGARD, OR, 97224
Commercial - Plumbing
399 Plumbing final
04/23/2013 00:00
PLM2013-00048
PASS - No C of O
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
15957 SW 72ND AVE, TIGARD, OR, 97224
Commercial - Plumbing
399 Plumbing final
04/18/2013 00:00
PLM2013-00048
FAIL
L/b. 4582 Dan 503-519-1229
1. Not ready for inspection. No inmspection made OPSC 103.5.1
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
15957 SW 72ND AVE, TIGARD, OR, 97224
Commercial - Plumbing
320 Plumbing rough-in
03/26/2013 00:00
PLM2013-00048
FAIL
1. closet flange not attached to floor at: 2-ea bathrooms on right 314.5/407.3/407.5
Recall Inspection prior to final inspection. All else ok
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
15957 SW 72ND AVE, TIGARD, OR, 97224
Commercial - Plumbing
322 Shower pan
03/25/2013 00:00
PLM2013-00048
FAIL
1. Complete vent thru roof
Recall
Violation Summary:
Inspector Contractor