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Permit
CITY OF TIGARD PLUMBING PERMIT II I ti COMMUNITY DEVELOPMENT Permit #: PLM2013 00070 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/28/2013 Parcel: 2S 102AA00490 Jurisdiction: Tigard Site address: 12085 SW HALL BLVD 120 Project: Arellano's Market Subdivision: TIGARD HIGHWAY TRACTS Lot: 13 Project Description: Cap (1) drinking fountain, replace (6) 2" floor drains/ floor sinks, (6) commercial food prep sinks, (1) grease trap and (1) water heater. Contractor: PLUMBING CONCEPTS INC Owner: ARELLANO, OMAR PO BOX 1068 12085 SW HALL #120 CLACKAMAS, OR 97015 TIGARD, OR 97223 P PHONE: 971- 645 -6825 PHONE: 503 - 658 -5232 FAX: 503 - 658 -5232 FEES Quantity Description Date Amount 1 ea Drinking Fountain 02/28/2013 $25.02 Specifics: 6 ea Floor Drain /Floor Sink/Hub 02/28/2013 $150.12 , 1 ea Interceptor /Grease Trap 02/28/2013 $25.02 Type of Use: COM 6 ea Sink 02/28/2013 $150.12 Class of Work: ALT 1 ea Water Heater 02/28/2013 $37.52 , Type of Const: 1 12% State Surcharge - 02/28/2013 $46.54 Occupancy Grp: Plumbing Stories: Total $434.34 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 1- • " - Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules o • rest questions to NC b at'ng 503.232.1987 or 1.800.332.2344. Issued By: , 2; Permittee Signature: ■ 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 ApplicatimRECFI ED Building Fixtures City of Tigard FEB 2 8 2013 Received a O / � � 3 PermitNo.: AO /5 �Gb7d Date/By: III a 13125 SW Hall Blvd., Tigard, OR 97223 f� Plan Review C Phone: 503.718.2439 Fax: 503.598. OF TIGARD Date/By: Other Permit No.: 6ameya ,RV' 3 Inspection Line: 503.639.4175 BUILDING DIVISION Date Read /B Ju ris: ® See Page 2 for Internet: www.ti T I G n K D ard -or. ov Ready /By: g g g Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE New construction ❑ Demolition For special information use checklist Description I Qty. I Ea. I Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (I) bath 312.70 ❑ 1- and 2- family dwelling 'Commercial/industrial SFR (2) bath 437.78 SFR (3) bath 500.32 ❑ Accessory building ❑ 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: 1 a (7 g 5 ao Nck\� R\ 4 Catch basin or area drain 18.76 Drywell, leach line, or trench drain 18.76 City /State /ZIP: 3 6 . O(\ cAi a a 3 Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: I Project name: Ay.e,I Vorios Nay ke, {, 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.: A6 /C) (+f Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors /sump 25.02 ❑ PROPERTY OWNER ©TENANT Expansion tank 12.51 Fixture /sewer cap 1 25.02 0.6.09- Name: n relic n 0 g Mc i 4 Floor drain/floor sink/hub 25.02 `50 ■ /2 Address: i Z 085 6 IA! HO/ B I V J � � Garbage disposal 25.02 City /State /ZIP: - r4•64 Or Hose bib 25.02 Phone: ( (, 613 ZS" Fax: ( sea ) $SS- t{G Ice maker 12.51 ❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 1 25.02 x. Business name: Medical gas (value: $ ) Page 2 Primer 12.51 Contact name: Roof drain (commercial) 12.51 Address: Sink/basin/lavatory 6 25.02 / 50.0" City/State/ZIP: Solar units (potable water) 62.54 Phone: ( ) Fax: : ( ) Tub /shower /shower pan 12.51 E -mail: Urinal 25.02 CONTRACTOR Water closet 25.02 h Q n w }-� Water heater I 37.52 37, S.-7. Business name: ,plUm bl p nQ con l Inc., Water piping/DWV 56.29 Address: f) 0 1 em I Oe `^'Y Other: 25.02 City /State /ZIP: et Q ° Wm Q CA 91 QI 5 Subtotal 3 5 8' Phone: (503 ) `6 \ 1 Qls‘o-1/4 Fax: 6 o3) L/5 . `$553 Minimum permit fee: $72.50 CCB Lic.: 1 i 5 g Plumbing Lic. no.: 3 -act 309 Plan review (25% of permit fee) P State surcharge (12% of permit fee) 1/4„.5e/ Authorized signature: : -e TOTAL PERMIT FEE 1. V Print name: ��5& ' .� (2 d C� Date: This permit application expires it a permit is not obtained within 180 days I after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. 1:\ BuildingTermits \PLMU- PennitApp.doc 10/01 /09 440- 4616T00 /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", 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 CI Any new commercial building with water service 2" and greater, except systems designed and stamped by licensed Bath: - Tub /Shower - Jacuzzi/Whirlpool engineer. CI Car Wash: Each Stall New exterior plumbing site utilities for any complex structure Drive Stall as defined in OAR918- 780 -0040. 12 Cuspidor/Water Aspirator Medical gas and vacuum systems for health care facilities. Dishwasher: Commercial CI Any multipurpose fire sprinkler system. Domestic ID Any complex structure as defined in OAR918 -780 -0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: - 2" Ce 3" Isometric or Riser Diagram 4 " ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain Garbage Domestic non -food that meet the qualifications above. Disposal: - Domestic food related - Commercial food related - Industrial food related Ice Mach./Refrig. Drains Comments regarding fixture work: Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower: -Gang -Stall Sink: - Lav/Bar non -food related - Bradley - Com/Serv/Util food related (-C' - 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 WaterCloset - Toilet plumbing permit can be issued. Urinal Other Fixtures: • I:\Building\Permits\PLMF-PermitApp.doe 08/04/2011 2 „ Accumulative Sewer Tally "Tenant Name: Arellanos Market ** *CREDITS * ** SWR # N/A TIGARD Site Address: 12085 SW Hall Blvd PI ,M # 2013 -00070 Parcel #: 2S 102AA00490 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 1 1 0 -1 -1 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 - 4 inch 6 0 0 - 0 0 0 - Car Wash 6 0 0 0 0 0 Garbage Disposal: - Domestic (to 3/4 1 -IP) 16 0 0 0 0 0 - Commercial (to 5 HP) 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 0 0 0 Sink: - Lav /Bar - Non -Food Related 2 0 0 0 0 0 - Bradley 5 0 0 0 0 0 - Com /Serv/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 1 1 0 0 _ -1 -1 Current Fixture Value -1 divided by 16 = -0.063 Current EDU 1 EDU = $4,665.00 Previous Fixture Value 0 divided by 16 = 0.000 Previous EDU Change -1 divided by 16 = -0.063 over (under) S (279.90) Enter EDU Change Here -0.060 Notes: CREDITS Authorized Name /Signature: Debbie Adamski Date: 2/28/2013 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 I submitted to the City of Tigard Building Division to redeem credits towards future system development charges. I: \Building \Sewer Tally \Sewer'I'allyShcet- 4665xls 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 12085 SW HALL BLVD 120, TIGARD, OR, 97223 Commercial - Plumbing 305 Plumbing underslab 03/27/2013 00:00 PLM2013-00070 FAIL 1. Provide drawing of all fixtures, both existing, re-located and new installations to determine plumbing layout. 2. Food prep sinks shall be indirectly wasted. 801.2.3 3. Dishwashers shall be directly connected. 704.3 4. Remove 2-way clean out at upper terminal location and install Y fitting. 707.4 except 4 Do not cover 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 12085 SW HALL BLVD 120, TIGARD, OR, 97223 Commercial - Plumbing 399 Plumbing final 05/30/2013 00:00 PLM2013-00070 FAIL NOTE correction #2 from inspection dated 5/29/13, floor sink/capoff pass. Corrections #1 and #3 to come. 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 12085 SW HALL BLVD 120, TIGARD, OR, 97223 Commercial - Plumbing 399 Plumbing final 05/29/2013 00:00 PLM2013-00070 FAIL 1. Complete case drains, call when ready. 2. Remove floor sink and hard cap 2" drain. 310.0 3. Provide vacuum breaker on mop sink faucet. 310.0 info@plumbing-concepts.com. Jesse Violation Summary: Inspector Contractor