Permit CITY OF TIGARD PLUMBING PERMIT
111 COMMUNITY DEVELOPMENT Permit#: PLM2014-00146
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/13/2014
TIGARD Parcel: 1S126DB02800
Jurisdiction: Tigard
Site address: 9370 SW GREENBURG RD 603
Project: Dr. Linh Tran Subdivision: 1991-018 PARTITION PLAT Lot: 1
Project Description: Add(3)sinks for TI.
Contractor: CASCADE PLUMBING CO Owner: FRANKLIN COMMONS ASSOCIATES, LLC
2416 N HAYDEN ISLAND DR BY NORRIS& STEVENS
PORTLAND, OR 97217 621 SW MORRISON STE 800
PORTLAND, OR 97205
PHONE: 503-289-7095 PHONE.
FAX: 503-283-9514
FEES
Quantity Description Date Amount
1 ea Sink 05/06/2014 $25.02
Specifics: 47 Minimum Fee Adjustment- 05/06/2014 $47.48
Plumbing
Type of Use: COM 9 12%State Surcharge- 05/06/2014 $8.70
Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: �N ��Z--/etg-7-70 _ j
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. /V
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
... .
Plumbing, Permit Application .REcEivE.1
Building Fixtures MAY 5 2014 FOR OFFICE USE (311.1'
•
l'N
City of Tigard Received
Dmili , ,,r PCTMit M)/2/102.0/y.Z161$%
1,1 . 13125 SW Hall Blvd.,Tigard,OR 972234ITYOF AGAR. Plan Revie ■
It Phone: 503.718.2439 Fax: 503,598.1 Ocher Pemait14,4dieao/Y-11002...i ,
Insp.tiOn UDC 503.639,417$ ILDINAMIIIRIOtitrp.dytey- h 0 Sev Fitt 2 tor
TIGARD
ldtamet: www.tigard-or.gov Notified/Mediod: supplemental Inthrinattort._ :....t.
girgE510104,00:::,e40.0..***00;.:.i..,;::0!::.161S:;6.0.g:::..:T:::Agra g.;:g1ROINSVP*******:,::'4.,k4:,;,.::,,..,,
_ For eclat in rotation meg chezklit.
0 New construction D Demolition
— Description Q , I I . Total
ditionfalterat I On/replacement El Oth Cr: .. ..2-1! Lunil dwellii.._viin cludeg 100 ft for each utili con ee.tiool C=1
r•: ''''''''''''''H"'.'''''' . . ekiiaitiii5Of taiditueflori ,.,4,; SFR(1)bath 31170
V‘
ED I-and 2-family dwelling deg-Commercial/industrial -SFR(2)bath
-- 11111 437.78
— SFR(3)bath 500.32
El Accessory building C)Multi.fthilly , .
— Each additional bath/kitchen 25.02
..
0 Master builder 0 Other: Fire sprinkler( sq.ft.) I Page 2
S,11E1:R4F,90.,,10611r 441**117cATIO,r,Ve/,..,.:::'..•!:;:,.: ;:...!,:.,;;!i..,::: Site utilities:
- r • Catch basin or area drain 18,76
lob site addreSS: q5
; Jtt) arodve 4z:I .. Orywell,leach line,or trench drain 18.76
City/State/ZIP: .(... a.-.../.a. ,:)./...' i,..
Footing drain(no.linear ft.; —)
Page 2 1
-7. ,
Suite/bldg./apt no I Pr...ci!....ml.....11n e; 'ithi&ectYl:i ...4 Manufaentred home utilities I 50.03 i
--.1
Cross street/directions to job site: Manholes 18.76
--— -----
--- —
I Rain drain connector 18.76
---------
- Sanitary sewer(no,linear ft.: 1 Page 2
---
- — ------ Storm sewer(no.linear ft.: ) — Page 2
,
Water service(no.linear(t.: ) Page 2
Subdivision: .:
-I Lot no,:n0 Fixture or Nom: ________
1
.._.„ . .., - . .
..._,” 7177-1
Tax map/parcel no.; BackIlow!imager
:.;•-,,.:.i.i'il.,N),.;•"41.,%'§i ,A.nOi.i . iiii•Vii. .;',.:.;:!4:,..,:iftivi:c::•; 6:777:777,7k.T:Kt : Backwater valve _ Si
i.41'"‘&161P0:41f:VAiMWON.1.),?:..P!m-,5,*,,;i...,,V'71:1,,m4,7,Y.:171"'4.'4'0$AWA'4:01:6.,t;xiK''4:;'"`".''':'';',''';', --"'""-- — -
•' '" " Clothes washes 25.02
1W 1i. ' i ) ..4 i. 1,.. e.'e.t. . -. . - .1,6'—.,..1-.. Dishwasher . -
IIIIII 25-02
r A EN/ II
-Drinking fountain 111111 25-02 NM
Ejectors/sump 25.02 _
,•;;;;;==,440: tg .M.v.,;0.1Wils,.■,.....4.,1,.....• q:,a, fixpartaton lank I 12.51
:§1:14...,:t0;:x4;•,mI.,mus.afgw17,e, .1,11,,HILIty,:: ok.o.,;•,.:w..,,:f0...&‘:i:.1..00rtee■sfrmeit4.,:liF,,s;::1: :W: ,- ---
Fixturestwer cap NM 25 02
Name: ,— — Floor drain/floor sink/hub ME 25.02
Address: Garbage disposal III 25,02
City/State/ZIP: — - '-'
Hose bib 25.02
----- --- .. -
Phone:( ) Fax;( ) Ice inaker NI 12.51 I.
—.
It,:'tigNipivArfiwookfispirte ,§.,Anclattai44eriiiiiiikim,,,ii;• I Interceptor/Le-ease trap 25,02
.40,4„,,,i,., „r: ,..:.,.,.,..r,.,...,.,•„ ..„,„,,„..hir,•.;,,,A,•:::,4....■?..ggz‘ ..i..q,,:oge.....11:'4■7,.....,4.... ..e...,014.,,,V.,:■%,,.,,''ts.'.!,'4'`',,
: liCna
Business name:Same as below Medical gas(value S )
— - Primer 12.51
Contact name: —..
.---.—__--- -- Roof drain(commercial) Nip 12.51 MEI
Address: • •-"'elrit sin/lavatory_ 'Ian- 25°2 Irtiril
Cit y/Sate/ZIP: Solar units(potable water) 62,54 MEM
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
- _
Urinal / P...(1(+.-- 25,02
&mail:
„Mt q)• , . V;4:*;tililVd1..11;!,t,,)■..%..,4,,ii'T s..',.:P Water cl_r.2_,I_____ ANI11111•1111 25.02
.i.,_21_.. .,&e4.#M4!,=..i,',,y,,.;*..1., •44V:264*:; ;'60j4V14 h g"V't:F4'4"`U'.ii 1' Water hotter tfjIMIIIIIEESEIIIIMIII
Business name:Cascade Plumbing Co --. 7.
Water piping/DW v 5629
- ..._ ...-
Address:I416 N.Hayden Island Drive Other 25.02
.-- '
City/StatetZIP:Portland,OR 97217 Subtotal sil '',,.••
Minimum permit fee: V2.50
Phone:(503)289-7095 Fax:(503)283-9514 ---
. -- •- —_— -. Plan review (2$%of permit fee) ; I)
CCB Lie.: 1201193 Plunthing Lic.00.:34-412PB --. ----____
i? State surcharge(12%of permit fee) 1.7 . ".• i
AuthoriZed signature( '"-/-)4_1./14 ii L— ,./'; ,L2.•<..,1.) . TOTAL PERMIT FEE
•
-- Thig permit application expires If a permit fa oat obtained nit .days
Print name:Crystal Jones ,
,. Date:47) ..5'' after it has been accepted as complete.
- ....... . '-
9 t 'Fee methodology set by Tri-Courity riuildillg Industry Service Board. 2..0
1
'11L.4)'
. i . ..:-', -1.• L.. ' «X.1°°r
. ..■ i/c3Lug,P Penn' Apt 16,01109 440.4616T(10'02COWNEB)
) •
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TO'd tIS6C8ZEOS 03 buTcpanTd apu0sp3 Wd00:ZO 17T/SO*0uiip.d)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire ression S 'stems:
....,...den
,,�h, .. ............... ...: .:,.:,........:.,.., ... ,..::...........� 3 1ii;aiilit;;Vt±a .. f.::,• Rt, a; 5.,-
t�
Footing drain-1' IOW lall 50.03 EMI 0 to 3,000 5121.90 {
Footing drain•each additional 100' 37.57 Mil 2.001 to 3,600 $169,69
3.tiU1 tu7200 S233.20
Sewer• 1st 100' � � T 7 201 and greater $327.54 -- V..-.l
W ater Service•I�t
IU)
h327.
Medical Gas Systems:stcns
Water Service a dditional 100 � "i, r :
. ;,,,t,�
Stunt &Rain Drain-1st 100' 62.54 S1.00 to S5,000.00 I Minimum fee$72.50
Stnnn&Rain i.)tuin-each additional 1(10' 37.52 55,001.00 to S10.000.00 572„50 for the first$5,(100.0(1 and S1.52 for
„ . ..:..1,r.... C . :t? .$ " c<;Qtyrs' :.,,: ;(i"{ f':Q11ji
each additional SIpU(KI or fraction tlxrsx ,to
andincluditt i 510,000.00.
Inspection of existing plumbing or for E S10,001.00 M$25,1)0.00 S 148.50 for the first 510,000(H)and Si I.54 for
which no fee is specifically indicated IIII 90.00.1,r M each additional 5100,00 or(faction thereof;to
(Minimum char•r- 112 hour) --- atxlincludin $25,000.00.
Inspections outside of nortnal business 90 0011w 525,001.00 to$50.000.0() S379.S0 for the first 52504).00 and S I.45 for
hours(minimum chantc-•2 hours) i each additional SU)0.00 or fraction thereof,to
Reinspet tion Fees ")6.00/hr anti inclndi S50,000 00,
Additional tan review for revisions 90.00.hr S50,001.00 and up 1 $742.00 for the first 550,000.00 and S 1.20 for
(minimum ha, e.. ('2 hour) t--,--,,,-„-„_ '._each additional 5100.00 or fraction thereof
.•.,-._....._.-..— Subtotal:
c,onimereiai 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*.
.:..r.: ..,.:.j...::,.,:.
our �.�%tw`�' mb�� if«alla '�!
1lira tt:'l f9r 1. ,....•: ,.
D Fisfurt't' tl
u 7Pc .�%�= `�: Plan review is required for any of the following.
>Wairk:P�'fari�dtsi';�4::!t>; r.ilrs<. `,i:"'•'r,i:•,• Please check all that apply.
Ba ist rFont —,,,w,
Bath =1'uri'Shuwa' ❑ Any new commercial building with water service 2"and
-Jacuzzi/Whirlpool �.m greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
'Drive That ❑ New exterior plumbing site utilities for any complex structure
(ucpl(SM'Water Asintcrr
°�- as cloned in OAR9I 8-780-0040.
——"— -"""" ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher -Commercial ,
-Domestic _ ❑ Any multipurpose tire sprinkler system.
IA irilcing Fountain ❑ Any complex structure as defined in OAR9t8-780-1040,
F,re Wash
-)door,)rain/sink 2" Submit 2 sets of plans with any of the above.
,....-.,••..-..„. _.......-..,. a; y}� t �y,S'',p•,�;”' 4,. ��{.r`I v... :,;:a:
(ar wash Drain ❑ Isometric or riser diagram is required for new buildings
Gartoge 'Domestic-non-haul �.
Disposal -Domestic.,food related that meet the qualifications above.
Commercial-rood related
-Industrial-food related
lac Mach.iRcfig.Drains l
Oil Sam aret r(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station _..
•
Shower -Gang .. .....-
-Stalt '
Sink/Las -Non-fwxl related — 1
-Bradley r--
-Commercial-fait related 1
-Service
Swimming Pool Filter - - { * _
Washer•Clothes
Note: If the fixture work under this permit results in an
Water Extractor increase of sewer E DUs,a sewer permit will be issued and
Water Closes-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
C:\Users\Owner\Downloads\PLM F-Pcnni1App.doc
ZO-d 6TS6£8Z£0S 03 buTcpnTa apnosn3 Wd00:Z0 6T/50/S0
74 Accumulative Sewer Tally
_ Tenant Name: Dr.Linh Tran
SWR# 2014-00043
Site Address: 9370 SW Greenburg Rd.,Ste.603 PLM# 2014-00146
TIGARD
Parcel#: 1S126DB02800
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
-4 inch 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 11P) 42 0 0 0 0 0
Ice Machine/Refrigerator Drain 1 0 0 0 0 0
Living Unit 16 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 2 4 2 4
-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 0 0 2 4 2 4
Current Fixture Value 4 divided by 16= 0.250 Current EDU 1 EDU= $4,800.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change 4 divided by 16= 0.250 over (under) $ 1,200.00
Enter EDU Change Here 0.250
Notes:
Authorized Name/Signature: Dianna Howse Date: 5/7/2014
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\SewerTallySheet_4800._070113.xlsx
City of Tigard 1111
13125 SW Hall Blvd. • -
Tigard, OR 97223 •
Phone: 503-639-4171
T I GARD
FAX TRANSMITTAL
Date May 6,2014 5/7,//y
Number of pages including cover sheet 3
To: Crystal Jones From: Dianna Howse
Co: Cascase Plumbing Co: City of Tigard
Fax#: 503-283-9514 Fax#: 503-598-1960
Ph#: 503-718-2430
SUBJECT: PLM2014-00146& SWR2014-00043
MESSAGE:
Hi Crystal,
Per your request, I have attached a copy of the sewer tally sheet and invoice for the sewer connection
fees due on this project. I have paid the plumbing permit fees with your payment authorization form
and made the plumbing permit ready to issue pending payment of the sewer connection fees.
Thank you and please let me know if you have any questions.
/9-777C/71—e--7 e- '/2 E7//S t ��Gt/�Z. 711-6 L7-
/�.�vu cE6 ,/2-cC/ (3) 7v �' z) c,,jicS ,
I:\Building\Forms\FaxTransmittal-T.doc 1/18/07
TRANSMISSION VERIFICATION REPORT
TIME : 05/05/2014 19: 39
NAME : CITY OF TIGARD
FAX : 5035981960
TEL : 5037182449
SER. # : BROH7J690762
DATE,TIME 05/05 19:38
FAX NO./NAME 5032839514
DURATION 00:00: 45
PAGE(S) 03
RESULT OK
MODE STANDARD
ECM
City of Tigard
1111
13125 SW Hall Blvd. 11111
Tigard, DR 97223 Phone: 503-639-4171
TIGARD
FAX TRANSMITTAL
Date May 6,2014
Number of pages including cover sheet 3
To: Crystal Jones From: Dianna Howse
Co: casca.se Plumbing Co: Cjgy_Qfaigard
Fax#: 23-283-9514 Fax#: 303-598-1960
Ph#: 503-718-2430
SUBJECT: PLM2014-00146 &SWR2014-00043
MESSAGE:
Crystal,
Per your request, I have attached a copy of the sewer rally sheet and invoice for the sewer connection
fees due on this project. I have paid the plumbing permit fees with your payment authorization form
and made the plumbing permit ready to issue pending payment of the sewer connection fees.
Thank you and please let me know if you have any questions.
TRANSMISSION VERIFICATION REPORT
TIME : 05/06/2014 20: 37
NAME : CITY OF TIGARD
FAX : 5035981960
TEL : 5037182449
SER. # : BROH7J690762
DATE,TIME 05/06 20:36
FAX NO./NAME 5032839514
DURATION 55' 50: 38
PAGE(S) %2
RESULT OK
MODE DARD
CM
City of Tigard q
13125 SW Hall Blvd.
T
14 •
igard, OR 97223
Phone: 503-639-4171
TIGARD
FAX TRANSMITTAL
Date May 6, 2014 5 �! /7
Numk►ct of pages including cover sheet 3
To: C stalIones From: Dianna Howse
Co: Cascase Plumbing Co: City of Tigard
Fax#: 503-283-9114 Fax#: 503-598-1960
Ph#: U3-718-2430
SUBJECT: PLM2014-00146&SWR2014-00043
MESSAGE:
Hi Crystal,
Per your request, I have attached a copy of the sewer tally sheet and invoice for the sewer connection
fees due on this project J have paid the plumbing permit fees with your payment authorization form
and made the plumbing permit ready to issue pending payment of the sewer connection fees.
Thank you and please let me know if you have any questions.
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9370 SW GREENBURG RD 603, TIGARD, OR,
97223
Commercial - Plumbing
399 Plumbing final
FAIL
PLM2014-00146
George Heimos
1. Work not completed, no inspection made. Recall when ready. 103.5.4
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9370 SW GREENBURG RD 603, TIGARD, OR,
97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2014-00146
George Heimos
Violation Summary:
Inspector Contractor