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Permit CITY OF TIGARD PLUMBING PERMIT tliI ' COMMUNITY DEVELOPMENT Permit#: PLM2014-00272 T WARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/25/2014 Parcel: 1 S134BC00200 Jurisdiction: Tigard Site address: 12180 SW SCHOLLS FERRY RD Project: Pharmaca Subdivision: GREENWOOD TERRACE CONDO Lot: 17 Project Description: Capping(1)dishwasher,(1)4"floor drain,(1)garbage disposal,(2)ice machine drains,(1)food prep sink,(1) service sink,&(1)urinal. Replace/relocating(1)4"floor drain,(4)non food prep sinks&(2)water closets. Contractor: CASCADE PLUMBING CO Owner: ATLAS GREENWAY LLC 2416 N HAYDEN ISLAND DR 333 NW NINTH AVE, STE 1009 PORTLAND, OR 97217 PORTLAND, OR 97209 PHONE: 503-289-7095 PHONE: FAX: 503-283-9514 FEES Quantity Description Date Amount 8 ea Fixture/Sewer Cap 08/18/2014 $200.16 Specifics: 1 ea Floor Drain/Floor Sink/Hub 08/18/2014 $25.02 2 ea Interceptor/Grease Trap 08/18/2014 $50.04 Type of Use: COM 2 ea Sink 08/18/2014 $50.04 Class of Work: ALT 2 ea Lavatories 08/18/2014 $50.04 Type of Const: 2 ea Water Closet 08/18/2014 $50.04 Occupancy Grp: 1 ea Water Heater 08/18/2014 $37.52 Stories: 1 12%State Surcharge- 08/18/2014 $55.54 Plumbing Total $518.40 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: aeactizt" p Permittee Signature p ` r/ (L`� JJJ 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 Applica> EcEIvEp Building Fixtures jL FOR Of F ICI. t St: 011.1 City of Tigard I Received Tigard I(� 18 2014 Date/By. 6 I� 1 Permit No.: l �7� 13125 SW Hall Blvd.,Tigard,OR 9i/ig p�- ■ Phone: 503.718 2439 Fax: 503.598.1960 Dan Review Other Permit No.: �/' Inspection Line: 503.639.4175 CITY c r ( A i' Date/By ��-��`` TIGARD O[ IJ1GAkU DateReadyBy: iuis: ® See Page 2for Internet: www.tigard-or.gov p ��tt c Notified/Method: Supplemental Information TYPE j3UJJ INCI DIVISION FEE* SCHEDULE ❑New construction ❑Demolition For special information use checklist. Description I Qty. I Ea. r Total psi Addition/alteration/replacement ❑ Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ❑ I-and 2-family dwelling ❑ Commercial/industrial SFR(2)bath 437.78 Accessory building SFR(3)bath 500.32 Z El ry g ❑ Multi-family Each additional bath/kitchen 25.02 d ❑Master builder ❑ Other: Fire sprinkler( sq.ft.) Page 2 1 JOB SITE INFORMATION AND LOCATION Site utilities: z Job site address: 1 a / S O GJ • Sc.1 D//5" Fef 1 Catch basin or area drain 18.76 City/State/ZIP: Drywell,leach line,or trench drain 18.76 O �� Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: Project name: a r t a C a Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 °1 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 no.: Fixture or item: Tax map/parcel no.: Iii 3q cO,rX)C.) Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 / Clothes washer 25.02 Ns �1-,�r /l e(,� ,'X ,1e ('e /c Gp��i� Dishwasher 25.02 Z C>'� 1- . tip]Q CI FT)C c S Drinking fountain 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: Fixture/sewer cap 8. 25.02 CZ.I4 Floor drain/floor sink/hub I 25.02 a S-a 4 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 ❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap ?j 25.02 60.04 Business name:Same as below Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 25.02 (Q O.O$ 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 A 25.02 5-0.bq Business name:Cascade Plumbing Co Water heater ' 37.52 3?,sa Water piping/DWV 56.29 Address:2416 N.Hayden Island Drive Other: 25.02 City/State/ZIP:Portland,OR 97217 Subtotal I f(1,t b Phone:(503)289-7095 Fax:(503)283-9514 Minimum permit fee: $72.50 ------ Plan review (25%of permit fee) -- CCB Lic.:120893 ` Plumb' Lic.no.:34-412PB State surcharge(12%of permit fee) 55.4D Authorized signature: / TOTAL PERMIT FEE 5/i,CIO ~L This permit application expires if a permit is not obtained within 80 days Print name:Crystal Jones Date: after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. t:\Building\Pamits\PLMU-PermitApp.doc 10,01/09 4404616710/02ICOM/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- 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- I st 100' 6254 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 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 ❑ Any new commercial building with water service 2"and Bath: -Tub/Shower greater,except systems designed and stamped by licensed -Jacuzzi/Whirlpool engineer. Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure Drive Thru 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 -Car Wash Drain / ❑ Isometric or riser diagram is required for new buildings Garbage Domestic non-food that meet the qualifications above. Disposal: -Domestic food related -Commercial food related / -Industrial food related Ice Mach./Refrig.Drains r� 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 '✓ j• -Service f *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 p Water Extractor fees assessed for the sewer increase must be paid before the waterCloset-Toilet plumbing permit can be issued. Urinal Other Fixtures: I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 114 Accumulative Sewer Tally Tenant Name: Pharmaca allill. SWR# N/A Site Address: 12180 SW Scholls Fern'Rd 11.1\1# 2014-00272 Parcel#: 1S134BC00200 Fixture \.iln, Previous Previous Credits Capped I'ixturc 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 11 -Drive through 16 0 0 0 0 0 Cuspidor/Water Aspirator 1 0 0 0 0 0 Dishwasher: -Commercial 4 0 1 4 0 -1 -4 -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 I 6 0 -1 -6 -Car Wash 6 n 0 0 0 0 Garbage Disposal: -Domestic(to 3/4 11P) 16 0 0 0 0 0 -Commercial(to 5 HP) 32 0 1 _ 32 0 -1 -32 -Industrial(over 5 I IP) 42 0 0 0 0 0 Ice Machine/Refrigerator Drain 1 0 2 2 0 -2 -2 Living Unit I6 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 2 6 0 -2 -6 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 1 6 0 -1 -6 Previous EDU Count 0 0 Capped EDU Credit 0 TOTALS 0 0 _ 8 _ 56 u 0 -8 -56 Current Fixture Value -56 divided by 16= -3.500 Current E1)1' 1 EDU = $4,900.00 Previous Fixture Value 0 divided by 16= 0.000 Previous EDU Change -56 divided by 16= -3.500 over (under) $ (17,150.00) Enter EDU Change Here -3.500 Notes: arialar Authorized Name/Signature: Debbie Adamski Date: 8/18/2014 Building Division The property owner shall retain the ORIGINAL sewer tally record. I f credits exist,this document will serve as a voucher which must be u miffed to the City of Tigard Building Division to redeem credits towards future system development charges. 1:\Building\Sewer Tally\SewerTallySheet_4'9($)._070114.xlsx 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 12180 SW SCHOLLS FERRY RD, TIGARD, OR, 97223 Commercial - Plumbing 399 Plumbing ﬁnal PASS - No C of O PLM2014-00272 George Heimos Violation Summary: Inspector Contractor