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Permit il NI CITY OF TIGARD • PLUMBING PERMIT : . COMMUNITY DEVELOPMENT • A- ' r .� Permit# PLM2014-00068 Date Issued: 03/17/2014 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503 718 2439 Iffil Parcel: 2S113A600700 Jurisdiction: Tigard Site address: 16255 SW UPPER BOONES FERRY RD Project: The Circuit Subdivision:COUNCIL VIEW ACRES(LOTS 21-44) Lot: 30 Project Description: Connecting to sewer service,adding bathrooms,(1)backflow preventer,(1)drinking fountain.(2)2"floor drains. (1) hose bib.(7)lays.(2)showers,(2)urinals.(4)water closets&(1)water heater Septic tank must be properly decommissioned.3/18/14:Reprinted to add contractor. Contractor: FIVE STAR PLUMBERS INC Owner: TIGARD INVESTORS LLC PO BOX 28 500 E BROADWAY#110 BANKS, OR 97106 VANCOUVER,WA 98660 PHONE 503-324-0717 PHONE FAX 503-324-0883 FEES Quantity Description Date Amount $0 If Sewer Service 03/17/2014 562 54 Specifics: 1 ea Backflow Preventer 03/17/2014 $31 27 1 ea Drinking Fountain 03/17/2014 $25 02 Type of Use: COM 2 ea Floor Drain/Floor Sink/Hub 03/17/2014 $50 04 Class of Work: ALT 1 ea Hose Bib 03/17/2014 $25 02 Type of Const: 7 ea Lavatories 03/17/2014 $175.14 Occupancy Grp: 2 ea Tub/Shower/Shower Pan 03/17/2014 $25.02 Stories: 2 ea Urinal 03/17/2014 550 04 4 ea Water Closet 03/17/2014 $100.08 1 ea Water Heater 03/17/2014 $37 52 1 12%State Surcharge- 03/17/2014 $69 80 Plumbing Total 5651 49 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 direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: /'7 �� 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. CITY OF TIGARD PLUMBING PERMIT - • COMMUNITY DEVELOPMENT Permit#: PLM2014-00068 Date Issued: 03/17/2014 T!GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S113A600700 Jurisdiction: Tigard Site address 16255 SW UPPER BOONES FERRY RD Project: The Circuit Subdivision:COUNCIL VIEW ACRES(LOTS 21-44) Lot: 30 Project Description: Connecting to sewer service,adding bathrooms. (1)backflow preventer, (1)drinking fountain.(2)2"floor drains,(1) hose bib,(7)lays,(2)showers.(2)urinals.(4)water closets 8 (1)water heater. Septic tank must be properly decommissioned. Contractor: Owner: TIGARD INVESTORS LLC 500 E BROADWAY#110 VANCOUVER. WA 98660 PHONE PHONE. FAX FEES Quantity Description Date Amount 80 If Sewer Service 03/17/2014 $62 54 Specifics: 1 ea Backflow Preventer 03/17/2014 $31 27 1 ea Drinking Fountain 03/17/2014 $25.02 Type of Use: COM 2 ea Floor Drain/Floor Sink/Hub 03/17/2014 $50 04 Class of Work: ALT 1 ea Hose Bib 03/17/2014 $25 02 Type of Const: 7 ea Lavatories 03/17/2014 $175 14 Occupancy Grp: 2 ea Tub/Shower/Shower Pan 03/17/2014 $25 02 Stories: 2 ea Unnal 03/17/2014 $50 04 4 ea Water Closet 03/17/2014 $100.08 1 ea Water Heater 03/17/2014 $37 52 1 12%State Surcharge- 03/17/2014 $69.80 Plumbing Total $651 49 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 direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344 Issued By: Permittee Signature: -___ � �I/lam✓ 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. q CITY OF TIGARD SEWER CONNECTION PERMIT s COMMUNITY DEVELOPMENT Permit#: SWR2014-00020 Date Issued: 03/17/2014 TIGART) 13125 SW Hall Blvd..Tigard OR 97223 503.718.2439 Parcel: 2S113AB00700 Jurisdiction: Tigard Site address: 16255 SW UPPER BOONES FERRY RD Project: The Circuit Subdivision: COUNCIL VIEW ACRES(LOTS 21-44) Lot: 30 Project Description: 3.69 EDU's Connecting existing structure to sewer service Contractor: Owner: TIGARD INVESTORS LLC 500 E BROADWAY#110 VANCOUVER, WA 98660 PHONE PHONE: FAX: FEES Description Date Amount Specifics: Sewer Connection Fee 03/17/2014 $17.712 00 Type of Use: COM Class of Work: ALT Install Type: Line Tap and Building Sewer Fixture Units: Number of Dwelling Units: 3.69 Total $17 712 00 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 direct questions to OUNC by calling 503.232 1987 or 1.800.332.2344_ - - -- _, Issued By: L- - +-� --- Permit a nature: Call 503.633.4175 ., 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 Application Building Fixtures� � FOR OFFICE USE ONLY City of Tigard Da ed e5 Er�� Permit No.: I r'. -ar), n 13125 SW Hall Blvd.,Tigard,OR 97223 , 1 2014 Plan Review G &0i 4/ • ' Phone: 503.718.2439 Fax: 503.598.1960 � Other Permit Na.: Y Inspection Line: 503.639.4175 (} (� Date/By: TI GAR D Internet: www.tigard-or.gov t,i I N Ur ) bAHL) Date Ready/By furls 65 See Page 2 for Il`'t�'p -_,-.1 ��f, Notified/Method Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑New construction ❑Demolition For special information use checklist g Description I Qty. I Ea. j Total -> ❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 El I-and 2-family dwelling ,Commercial/industrial SFR(2)bath 437.78 s ❑Accessory building Multi-family SFR(3)bath 500.32 ❑Multi-famil Each additional bath/kitchen 25.02 ❑ Master builder ❑Other: Fire sprinkler(_sq.ft.) Page 2 /6,9,5-5---JOB SITE INFORMATION AND LOCATION Site utilities: R Job site address f �, �'(J tole coZ�//� 4,y1Catch basin or area drain 18.76 ••� " / ! / Drywell,leach line,or trench drain 18.76 City/State/ZIP: Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: 1 Project name: �4 C/02.0....„,, a✓ Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) 0f Page 2 6,9.5-9 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear fl.: ) Page 2 Subdivision: Lot no.: Fixture or item: J Tax map/parcel no.: Backflow preventer ( 31.27 5/. ?7 DESCRIPTION OF WORK Backwater valve 12.51 ti -� Clothes washer 25.02 4 CLe &) ii-»<0 v 1 Dishwasher 25.02 312..1 t) I C.21 . - Drinking fountain 1 25.02 gS p� Ejectors/sump 25.02 ❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: Fixture/sewer cap 25.02 Floor drain/floor sink/hub Ol 25.02 9)-P q Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 1 25.02 (9, r 6102- Phone:( ) Fax:I ) Ice maker 12.51 ❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name: Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 7 25.02 /-75-,/if City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan A 12.51 ,A-.°')• E-mail: Urinal a. 25.02 5-,c'tf Water closet 14 25.02 /DO.4-II?'c" CONTRACTOR P Water heater 1 37.52 3'),ti?- Business name: S. -5 .Z fr/yrl f; C Water pipinglDW V 56.29 Address: /b, 'fox ,,2 Other: 25.02 City/State/ZIP: �),u/(s ` .0 17/66/ Subtotal (ig/.69 Phone:(S-63 ) 3j f!-07/ 7 Fax:(SV ) rod Sf. ocery Minimum permit fee: $72.50 --- CCB Lie.: /6.- -703 Plumbing Lic.no.: R/5/07... Plan review (25%of permit fee) ----- State surcharge(12%ofpermit fee) 6,9,'d Authorized signature: ' TOTAL PERMIT FEE '5-7_q I Print name: lc /J re S Q 3 .1 this permit application expires if a permit is not obtained within 180 days Date: f Y after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:1BuildingTennits\PLMU-PermitApp.doe 10/01/09 440-4616T(IOIO2ICOM/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- I" 10(1 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- Ist 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 I Replace/ Please check all that apply. Work Performed: Capped Added Relocate ❑ Any new commercial building with water service 2"and Baptistry/Font greater,except systems designed and stamped by licensed Bath: -Tub/Shower _ engineer. -Jacuzzi/Whirlpool Car Wash:Wash: -Each Stall New exterior plumbing site utilities for any complex structure Drive Stall as defined in OAR918-780-0040. Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities. Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system. Domestic ❑ 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" 3" Isometric or Riser Diagram ❑ 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/Rettig.trains 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 -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.doc 08/04/2011 2 Ell Accumulative Sewer Tally Name:The Circuit SWR# 2014-00020 Site Address: 16255 SW Upper Boone Ferry RJ PLN1# 2014-00068 Parcel#: 2S113AB00700 Fixture Value Previous Previous Credits Capped Fixture Fixture New New # value count capped#s value count added# added value total#s r,oral 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 11 0 0 0 0 -Drive through 16 0 0 0 0 11 Cuspidor/Water Aspirator I 11 0 _ 0 _ 0 0 Dishwasher: -Commercial 4 0 0 0 0 11 -Domestic 2 0 0 0 (1 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 2 4 2 4 -3 inch 5 0 0 0 0 0 -4 inch 6 O 0 0 (1 0 -Car Wash 6 0 0 (1 (1 0 Garbage Disposal: -Domestic(to 3/4 1111) 16 0 0 0 (1 0 -Commercial(to 5 11P) 32 0 _ 0 0 0 0 -Industrial(over 5 III)) 42 0 0 0 0 0 Ice Machine/Refrigerator Drain 1 0 0 0 0 0 Living Unit 16 0 0 11 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 n ) 4 2 4 Sink: -l.av/Bar-Non-Food Related 2 0 0 7 14 7 14 - Bradley 5 0 _ 0 0 0 0 -Com/Serv/Util-Food Related 3 0 0 0 0 0 Swimming Pool Filter I 0 0 0 0 0 Washer-Clothes 6 0 0 0 11 0 Water Extractor 6 0 0 0 0 0 Water Closet-Toilet 6 0 0 4 24 4 24 Urinal 6 0 0 2 12 2 12 Previous I1.13II Count 0 0 Capped I{I)11 Credit 0 TOTALS 0 0 0 0 18 59 _ 18 59 Current Fixture Value 59 divided by 16= 3.688 Current EDU 1 EDU = 54,800.00 Previous Fixture Value 0 divided by 16= 0.000 Previous EDU Change 59 divided by 16= 3.688 over (under) S 17,712.00 Enter EDU Change Here 3.690 Note,: I',Nast*structure previously on septic, pre-existing bathrooms capped prior to PI.M2014-00068. Authorized Name/Signature: Debbie Adamski Date: 3/13/2014 Building Division r■ ote: The property owner shall retain the ORIGIN.11.sewer tally record. If credits exist,this document will serve as a voucher which must be ubmitted to the City of Tigard Building Division to redeem credits towards future system development charges. 1:\Building\Sewer Tally\Sewerfalktiheet_48(0._)70113.xlsv Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 16255 SW UPPER BOONES FERRY RD, TIGARD, OR, 97224 Commercial - Plumbing 399 Plumbing ﬁnal FAIL PLM2014-00068 George Heimos 1. Add the following inspection types to existing permit: water service 330, storm piping 340, and catch basin 545. 103.4.1 2. Backﬂow device "clearance's and leave trench open" corrections as per inspection correction dated not completed. 05/27/14. 3. Provide backﬂow device test results. 603.3.3 4. Provide septic tank pump receipt and approved tank backﬁll, as per inspection correction 05/27/14. 5. Provide listing for lav faucets as per inspection correction dated 05/19/14 6. cleanout needs ﬂush plug at: outside sanitary sewer, causes tripping hazard 707.12 7. Complete women's P trap primer assy. 103.5.4 8. Provide cast iron cleanout on front rain drain. 1101.12.2 9. Complete laundry tub installation. 103.5.4 10. Correct water pressure, it exceeds maximum of 80 PSI, (100psi+) PRV required. 608.2 11. Provide pump receipt for catch basin cleaning. 310.4 12. Owner/installer, Andy, to provide letter of veriﬁcation for Chens concrete sink sealer application installed as to manufacturers installation instructions. 310.4. Men's and woman's sinks were produced from concrete as "alternative materials, design and methods of construction...." and accepted. 101.3.1 13. Recall inspection when corrections have been completed. Re-inspection required. 103.5.6.1 Andy. andy@thecircuitgym.com Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 16255 SW UPPER BOONES FERRY RD, TIGARD, OR, 97224 Commercial - Plumbing 399 Plumbing ﬁnal FAIL PLM2014-00068 George Heimos 1. Provide access panel for PRV in utility room. 2. Corrections #3,4,5 & 12 inspection dated, 07/28/14, not completed, call for inspection when ready. 3. Provide Site Plumbing ﬁnal Plumbing Approval. NOTE: corrections shown on this permit dated 07/28/14, #1,6,8 & 11 were called incorrectly on the interior plumbing permit and should have been called in on Permit #PLM2014-00117 and will be ﬁnaled on that permit. Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 16255 SW UPPER BOONES FERRY RD, TIGARD, OR, 97224 Commercial - Plumbing 399 Plumbing ﬁnal PASS - No C of O PLM2014-00068 George Heimos *Septic tank pump receipt received. Aloha Sanitary Service, Inv, No. 18378, dated 09/09/14. *visually veriﬁed tank ﬁlled with "P" gravel *backﬂow test results received. 1" watts, model 007MI, Serial No. 006106 Violation Summary: Inspector Contractor