Permit n CITY OF TIGARD PLUMBING PERMIT
1 $ COMMUNITY DEVELOPMENT Permit#: PLM2014-00253
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/28/2014
Parcel: 1 S 135BA00102
Jurisdiction: Tigard
Site address: 10114 SW WASHINGTON SQUARE RD
Project: Pieology Subdivision: OAKBURG Lot: 9
Project Description: Convert exisitng retail space to restaurant. Capping(2)2"floor drains,(2)lays&(2)water closets. Adding(1)
backflow preventer,(1)expansion tank,(10)3"floor drains,(2)hose bibs,(1)ice maker,(1)interceptor/grease
trap,(2)primers,(5)sinks,(2)lays,(2)water closets,(1)water heater,(1)tea dispenser,(1)RPV,(1)water meter,
Contractor: MODERN PLUMBING Owner: PPR SQUARE TOO LLC
11120 SW INDUSTRIAL WAY PO BOX 847
TUALATIN,OR 97062 CARLSBAD,CA 92018
PHONE: 503-691-6166 PHONE:
FAX: 503-691-6771
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 08/28/2014 $31.27
Specifics: 1 ea Expansion Tank 08/28/2014 $12.51
6 ea Fixture/Sewer Cap 08/28/2014 $150.12
Type of Use: COM 10 ea Floor Drain/Floor Sink/Hub 08/28/2014 $250.20
Class of Work: ALT 2 ea Hose Bib 08/28/2014 $50.04
Type of Const: 1 ea Ice Maker 08/28/2014 $12.51
Occupancy Grp: 1 ea Interceptor/Grease Trap 08/28/2014 $25.02
Stories: 2 ea Primer 08/28/2014 $25.02
5 ea Sink 08/28/2014 $125.10
2 ea Lavatories 08/28/2014 $50.04
2 ea Water Closet 08/28/2014 $50.04
1 ea Water Heater 08/28/2014 $37.52
175 Misc Other Fee 08/28/2014 $175.14
1 12%State Surcharge- 08/28/2014 $119.34
Plumbing
Total $1,113.87
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
issuan , r i wor is—suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utif Notification Center. ' ose rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or irect questions to OUNC by • ng 583.232.1987 or 1.800.332.2344. -
I sued By: �� ` Pennittee Signature:41111111111k
Call 503.639.4175 by 7:00 a.m.for the next available inspec 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.
Aug. 13. 2014 8: 58AM Modern Plumbing No. 5427 P. 1
Plumbing Permit Applic CFIVED
Building Fixtures
City of Tigard AUG 1 3 2014 arcied C1 i � Permit Na.: L/-/gp/ �/�53
II 13125 SW HaII Blvd.,Tigard,OR 97223 �a1�By.
ilitt. ARD PlatrReview
Phone: 503.718.2439 Fax: 50 Other Permit No.: 7 /�
_ n5►aray: ��,PAC' 8/
T t t .A f:n Inspection Line: 5ga0r3.639�4175p,�� �� I�� I Due Ready/By: ,/ / n 2 Imis See Page 2 for
Internet: www.li d-or, v Butt el Notilielabood: b �7 I f Supplemental pplemeatal laform anon
TYPE OP WORK 3/0,41-Ed k,"o -r-.. FEE/ SCHEDULE
New construction ❑Demolition Fors' dal Information use checklist
Description Qty. Ea. Total
El Addition/alteration/replacement ❑Other: New 1-2-l8mlly dwellings(includes 100 R.for each utility connection) ti)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70 r.
❑ I-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
WI
ID Accessory building ❑Multi-family SFR(3)bath 50032
Each additional bath/kitchcn 25.02
❑Master builder ❑Oar: Fire sprinkler(_sq.ft.) Page 2 4j
JOB SITE INFORMATION AND LOCATION Site utilities;
Job site address:10114 SW Washington Square Road Catch basin or area drain 1 5.76 r`
City/State/ZIP:Tigard,OR 97233 Drywdl,leach line,or trench drain 18.76 .v
Pooling drain(no.linear R.: ) Page 2
Suite/bldgJapt.no.: Project name:Pleology Manufactured home utilities 50.03
Cross street/directiOnS to jOb Site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear It.: ) Page 2
Stone sewer(no.linear 4.: ) Page 2
Water service(no.linear II.:) Page 2
Subdivision: [Lot no.: Fixture or item:
fax map/parcel no.:
j 1
Backflow preventer 31.27 31.27
DESCRIPTION OF WORK Backrraler Yalve I2.51
_ - - -•_ Clothes washer 25.02 _
Tenant Improvement-Pizza Restaurant
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER I ❑ TENANT Expansion tank _ --'1,.._ I 12.51 12.51
Name: Fixture/sewercap ,, 25.02 /riC.r3-
Floor drain/Boor sink/hub , 10 25.02 250.20
Address: Garbage disposal 25.02
City/State/ZIP: Hose bib v 2 25.02 50.04
~Phone:( ) 1 Fax:( ) Ice maker ,d 1 12.51 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap ,. 1 25.02 25.02
Business name:
Medical gas(value:$ ) Page 2
Primer ,, 2 12.51 25.02
Contact name:
Roof drain(commercial) 12.51
Address; Sink/basin/lavatory ch,)�1 4 7 25.02 175.14
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/showcr/shower pan 12.51
Urinal 25.02
E-mail: t r■ tfv,-,a L ,
~ Water closet ,, 2 25.02 50.04
CONTRACTOR Water healer i 1 37.52 37.52
Business name:Modern Plumbing Willer piping/DWV 56.29 r4
Address:11120 SW Industrial Way,Bldg.9-3 Other:Tea Dispenser d 1 25.02 25.02-
City/State/ZIP!Tualatin,OR 97062 /. QP✓ .4,ca.c.-.s3 I'd.°'- Subtotal 4.7P-tyel.
Phone:(503)691 6166 Fax:(503)691-ti771 /-it -2-rlsr'd.- Minimum permit fc*: $72.50
/..d'4 P`"'S° -,Plan review (25%of permit Ice) .4 4
CCB Lie.:87906 PI mbing Lie,no.:34-250PB ,{�r 41 --.4State tate surcharge(12%of permit fee) ern
Authorized Signutunr \AijijAtt....., TOTAL PERMIT FEE $7
I This lleatlon mires If a permit is not obtained within 180 days
Print name:Deborah George Date:8�� s perm appafter It has been accepted as complete. .t" 11���.
*Fee methodology set by'lb-County Building Industry Induy Service Board.
11.1Buitdia ra>oa vu.tu-Per.vupp.aoc 10001,09 470-4616T(IOR?/COld/WE6)
Aug. 13. 2014 8: 59AM Modern Plumbing No. 5427 P. 2
Plumbing Permit Application-City of Tigard
Page 2-Supplemental Information
Fee Schedule: _ Residential Fire Suppression Systems: _
Site Utilities Qty. J 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$1.52 for _
Other Inspections or Fees Q11/7 Fee(ea) T0121 each additional$loo.00 or fraction thereof,,to
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 SI.54 for
which no fee is specifically indicated 90.00/hr
(minimum charge-12 hour) and additional$100.00 Or fraction lhucot:to
and d 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 51.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Rcinspcction Fees 90.00/hr and including$50,000.00.
Additional plan review for revisions 90.00/lu $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'. .. .. _.-._-- _. - • - • -
QuanMy by FixtureType Plan Review for Plumbing Installations _
Work Fixture Type for Replace/ Plan review is required for any of the following.
Work Performed: Capped Added Relocate e9 Y J;
Baptislry/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 stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru ❑ New exterior plumbing sitc utilities for any complex structure
Cuspidor/Waics.2nrator as defined in OAR918-780-0040.
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" _--a�__ Submit 2 sets of plans with any of the above,
-3" i b
Car Wash Drain - Isometric or Riser Diagram-
Garbage -Domestio-non-food ❑ Isometric or riser diagram is required for new buildings
Disposal -Domestio-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice MachiRefrig.Drains 1
Oil Separator(Gas Station) - Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall -
Sink/Lay -Non-food related
-12tradlcy _ _
-Commercial-food related -
-Service l
Swimming Pool Filter -
Washer-Clothes *Note: If the fixture work under this permit results in on
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet•Toilet •_ fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
C:\Users\deborah\Downloads\PLMF-PermitApp(2).doc 2
)
Plumbing Permit ApplicatioQ RECEIVED Building Fixtures 1'ED 1O1( ()II l( r. 1 sl. ON1 1
City of Tigard RDeacee
tBiveyd: p ,/ /1/ Permit No.: �I Y/_GO,P53
13125 SW Hall Blvd.,Tigard,OR 9722AUG 4 2014 Plan Review
■ . Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.:
,/�,�
Inspection Line: 503.639.4175 CITY OF TIGA RD Ready/By: a 4 it 4G�`� g
T l G A R D Internet: wwtiv.ti ardor. OV Date Read B Juris: � See Page 2 for
g g citified/Method: Supplemental Information
TYPE OF MILDING DIVISION G`l?....._ �� G/Ian -� FEE* SCHEDULE
®New construction ❑Demolition (� ♦•. , t%',r'., •For s t ecial in ormafion use checklist li-
t scription Qty. Ea. Total _rC
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) -•
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 U
❑ 1-and 2-family dwelling ®Commercial/industrial SFR(2)bath • 437.78
❑Accessory building ❑Multi-family
SFR(3)b. • 500.32
Each ad.'ional bath/kitchen 25.02
❑Master builder ❑Other: Fire s inkier( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Si utilities:
Job site address:10114 SW Washington Square Road retch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97223 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name:Pieology Pizzeria �k 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: Lot o.: Fixture or item:
Tax map/parcel no.: I5/ 35--/g4-(,40 hJ"` Backflow preventer J 31.27 3 t.a7
DESCRIPTION OF WORK f ''1,
Backwater valve t 12.51
Clothes washer 25.02
Restaurant tenant improvement(2,440 sq.ft.)in vacant pace 1
t en exhatT -land"
Dishwasher 25.02
c k
• Drinking fountain 25.02
ralWAR MIE Ejectors/sump 25.02
❑ PROPERTY OWNER ® 'p rI ANT Expansion tank / 12.51 /;-51
Name:iL Boushe � Fixture/sewer cap I I 25.02 /$Q./7
Floor drain/floor sink/hub 25.02
Address:70 SW Century Drive,Suite 10016
4%.**) Garbage disposal 25.02
City/State/ZIP:Bend,OR 97702 Hose bib 25.02
Phone:(541)639-2074 F:x:( Ice maker 0' ( 12.51 /2,. /
® APPLICANT i C NTACtPERSON Interceptor/grease trap
/ 25.02 .95-.e T
Business name:Western Design Group
\':3' Medical gas(value:$ ) Page 2
Primer 4 12.51 SO•'"
Contact name:David Hardister
/ Roof drain(commercial) 12.51
Address:2300 East Third Loop,Suite 110 Sink/basin/lavatory ell rt 25.02 /75-,l
City/State/ZIP:Vancouver,WA 98661 Solar units(potable water) 62.54
Phone:(360)699-5317 Fax::(360)699-0511 Tub/shower/shower pan 12.51
E-mail:dhardister @westerndesigngroup.net Urinal 25.02
Water closet 'j 25.02 /i,e
CONTRACTOR .1/-i ;
Water heater / 37.52 97.53*
Business name: Water piping/DWV 56.29
Address: Other: 25.02
City/State/ZIP: Subtotal 5((q./7
Phone:( ) ax ( ) Minimum permit fee: $72.50 ✓--
/
CCB Lic.: / Plumbing Lic.no.:
Plan review (25%ofpermit fee) -�
C `
State surchar ge(12%of permit fee) ,72 d
Authorized signature: /�'� //�� TOTAL PERMIT FEE h_.yC� .q 1
Print name:David Hardister Date:07.01.14 This permit application expires if a permit is not obtained within 80 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
l:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(I0/02/COM/WEB)
a h,9 IS 6_ C 6-0- e--t `oo-b
Plumbin! 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 79.50 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 u• $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 es*.
Quantity by Fixture Typ. Plan Review for Plumbing Installations
Fixture Type for Re'act
Plan eview is re uired for an of the followin
Work Performed: Capped Added ' ocat'e that Y g
R:�ptistryiPont
e check all that apply.
Bath Tub/Shower Any new commercial building with water service 2"and
-Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain Airif ❑ 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,. 'f yr:ii�l>•�
4.. Isometric or Riser Diagram
Car Wash Drain
Garbage Domestisrnon-food ❑ Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains I
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related 2-
-Bradley Tel-
-Service related
-Service(n4cp)
Swimming Pool Filter _ *Note: If the fixture work under this permit results in an
Washer-Clothes
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet . .. fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
R:\WDGUob Files 2014\Pieology\Washington Square 2\Jurisdiction\Appltgations\Plumbing Permit App.doc
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
10114 SW WASHINGTON SQUARE RD,
TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
FAIL
PLM2014-00253
George Heimos
1. maximum water pressure 80psi or less required (86psi), PRV needed 608.2
2. Recall inspection when corrections have been completed. Re-inspection required.
103.5.6.1
All else ok.
genek@westernconstruction.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
10114 SW WASHINGTON SQUARE RD,
TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
FAIL
PLM2014-00253
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 Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10114 SW WASHINGTON SQUARE RD,
TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2014-00253
George Heimos
Pressure 72psi
Violation Summary:
Inspector Contractor