Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2014-00392
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 �� Date Issued: 12/04/2014
Parcel: 1 S134BC00300
Jurisdiction: Tigard
Site address: 12268 SW SCHOLLS FERRY RD
Project: Spec Space Subdivision: GREENWOOD TERRACE CONDO Lot: 17
Project Description: Capping(1)toilet and(1)lavatory,and repairing broken pipe under slab. 12/24/14,Revised,adding(13)additional
fixtures to be capped.
Contractor: RAY'S PLUMBING DBA PIPER MECHANICAL Owner: FW OR-GREENWAY TOWN CENTER LLC
PO BOX 685 PO BOX 790830
BRUSH PRAIRIE,WA 98606 SAN ANTONIO,TX 78279
PHONE: 360-892-8700 PHONE:
FAX: 360-892-9644
FEES
Quantity Description Date Amount
2 ea Fixture/Sewer Cap 12/04/2014 $50.04
Specifics:, 1 ea Water Piping/DWV 12/04/2014 $56.29
1 12%State Surcharge- 12/04/2014 $12.76
Type of Use: COM Plumbing
Class of Work: ALT 13 ea Fixture/Sewer Cap 12/24/2014 $325.26
Type of Const: 0 12%State Surcharge- 12/24/2014 $39.03
Occupancy Grp: Plumbing
Stories:
Total $483.38
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 - - 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 qua- ons to OUNC . calli ! 03.232.1987 or 1.800.332.2344.
Issued =. : I /� Permittee Signre: r
Call 503.639.4175 by 7:00 a.m.for the next available ins•- ion 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
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12268 SW SCHOLLS FERRY RD, TIGARD, OR,
97223
Record Type: Record ID:
Commercial - Plumbing PLM2014-00392
Inspection Type: Inspector:
305 Plumbing underslab George Heimos
Result:
FAIL
Comments:
1 . Add to existing permit, 13 cap-offs, recall final plumbing inspection when completed.
Only 2 cap-offs on permit, 15 cap-offs total. 2014 OPSC 101 .4.1 .2
gtubeson @jrabbott.com
Violation Summary:
Inspector Contractor
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lv4 off, � -
4)eig- -. w/ Ctit 41(1.Li /�CeP.Na tub;
3 " 00-f 5; -1"--.°
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Accumulative Sewer Tally
Tenant Name: SPEC SPACE SWR# N/A REVISED 12/24/14
Site Address: 12268 SW SCI lOLLS I:I:12I2Y RD l'LM# PI A12014-00392
Parcel#: 1S134BC00300
Fixture Value Previous Previous Credits Capped Fixture Fixture New New
# value count capped#s value count :Ruled # 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 0 0 0 0
Eye Wash 1 0 0 0 0 Il
Floor Drain/Sink: -2 inch 2 0 0 0 0 0
-3 inch 5 0 6 30 0 -6 -30
-4 inch 6 0 0 0 0 0
-Car Wash 6 0 0 0 0 0
Garbage Disposal:
-Domestic(to 3/411P) 16 0 0 0 0 0
-Commercial(to 5 I IP) 32 0 0 0 0 0
-Industrial(over 5 IIP) 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 4 8 0 -4 -8
-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 4 24 0 -4 -24
Urinal 6 0 1 6 0 -1 -6
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS _ 0 0 _ 15 68 0 0 -15 -68
Current Fixture Value -68 divided by 16= -4.250 Current EDU 1 EDU = $4,900.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change -68 divided by 16= -4.250 over (under) $ (20,825.00)
Enter EDU Change Here -4.250
Notes: Revised 12/24/14,added(13)additional capped fixtures.
Authorized Name/Signature: Debbie:\damski Date: 12/24/2014
Building Division
Note: The property owner shall retain the ORIGIN Al,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\ScwerTallyShcct_4900._070114.xlss
CITY OF TIGARD PLUMBING PERMIT
'F1 $ COMMUNITY DEVELOPMENT Permit#: PLM2014-00392
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/04/2014
Parcel: 1 S134BC00300
Jurisdiction: Tigard
Site address: 12268 SW SCHOLLS FERRY RD
Project: Spec Space Subdivision: GREENWOOD TERRACE CONDO Lot: 17
Project Description: Capping(1)toilet and(1)lavatory,and repairing broken pipe under slab.
Contractor: RAY'S PLUMBING DBA PIPER MECHANICAL Owner: FW OR-GREENWAY TOWN CENTER LLC
PO BOX 685 PO BOX 790830
BRUSH PRAIRIE,WA 98606 SAN ANTONIO,TX 78279
PHONE: 360-892-8700 PHONE:
FAX: 360-892-9644
FEES
Quantity Description Date Amount
2 ea Fixture/Sewer Cap 12/04/2014 $50.04
Specifics: 1 ea Water Piping/DVW 12/04/2014 $56.29
1 12%State Surcharge- 12/04/2014 $12.76
Type of Use: COM Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $119.09
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.
Issued By: ermittee 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 Application I . a
Bdilding Fixtures FOR 01'1-1( I 1 sI 0v l l
•
Date/By: Permit No.: f
III - City of Tigard y /y �i i
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.: ' .
- .
TI G A R D Inspection Line: 503.639.4175 Date Ready/By: un• M See Page 2 for
Internet: www tigard-or.gov Notified/Method: ' Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑New construction I ❑Demolition For special information use checklist
--1 Description I Qty. 1 Ea. L Total
®Addition/alteration/replacement ❑Other: , New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRICTION SFR(1)bath 312.70
❑ 1-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
I 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 LOCAT:CN Site utilities:
Job site address:12268 SW Scholls Ferry Rd Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97223
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: 12268 Project name: 5'i"c Ss :t, 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
1 I Storm sewer(no.linear ft.:, ) Page 2
I Water service(no.linear ft.:_) Page 2
I Subdivision: 1 Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK �'� kwater valve 12.51
,_'iothes washer 25.02
Repair broken pipe under slab,demo and cap toilet and lavatory
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER 7 TENANT ==lxpansion tank 12.51
Name:
7ixture/sewer cap 2 25.02 50.04
Door drain/floor sink/hub 25.02
Address:
/iarbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fa,.: ' lee maker 12.51
® APPLICANT _ C 0\l".'-,-C T =a:7.3N interceptor/grease trap 25.02
Business name:Piper Mechanical,Inc Medical gas(value:$ ) Page 2
, I ?rimer 12.51
Contact name:Andy Davis
Roof drain(commercial) 12.51
Address:9317 NE 72"d Ave Sink/basin/lavatory 25.02
City/State/ZIP:Vancouver,WA 98665 Solar units(potable water) 62.54
Phone:(360)892-8700 Fax: :I, 1 Tub/shower/shower pan 12.51
E-mail:andy @pipermechanical.com �r:nal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:Piper Mechanical,Inc Water P� �i ma WV 1 56.29 56.29
P
Address:9317 NE 72"d Ave I Other: 25.02
City/State/ZIP:Vancouver,WA 98665 _ Subtotal 106.33
Phone:(360)892-8700 Fu\::' ) Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lic.:33217 . P'.t n,bina Lie.r.3.:37-149PB
State surcharge(12%of permit fee) 12.76
Authorized signature: TOTAL PERMIT FEE 119.09
This permit application expires if a permit is not obtained within 180 days
Print name:Alex Kempp• nen Date: 12/4/2014
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:\Building\Permits\PLMU-PermitApp.doc 10/01/09 44C-45161 10/02/COM/WEBI
Plumbing Permit Aaalication - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. 1 Fee(ea) Total uare Footage: ; Permit Fee:
Footing drain-l'100' 50.03 0 to 2,000 , $121.90
Footing drain-each additional 100' r 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
Water Service-each additional 100' 37.52 Medical Gas Systems:
Storm&Rain Drain-1st 100' 62.54 'V 1giun: Permit Fee:
$1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' ;7.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Other Inspections or Fees ! Qty. I ee(e``` 're"! each additional$100.00 or fraction thereof,to
and including$10,000.00.
Inspection of existing plumbing or for S10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated I 190.00/hr I I each additional$100.00 or fraction thereof,to
(minimum charge-1/2 hour) 1 I and including$25,000.00.
Inspections outside of normal business 90.00/hr 1 1 S25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours(minimum charge-2 hours) I 1 each additional$100.00 or fraction thereof,to
Reinspection Fees j 90.00/hr I 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
i ninimum charge-1/2 hour) i 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*.
Quantity by Fixture Tyne 1 Per. Review for Plumbing Installations
Fixture Type for Re;-,.ace Plan rep ie\s is required for any of the following.Performed: Capped -,:.ca.. i:e.,cate 9 Y g
Baptistry,Font Please check all that apply.
Bath -1 ub/Shower I ❑ 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 0.AtR918-780-0040.
Dishwasher -Commercial I ❑ 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" ! Submit 2 sets of plans with any of the above.
-3"
isometric or Riser Diagram
Car Wash Drain I -
Garbage Domestic-non-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
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station `
Shower -Gang
-Stall
Sink/Lav -Non-food related 1
-Bradley
-Commercial-food related
-Service
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
Waver Closet-Toilet 1 fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
X:AProject Managing\Active Jobs\21451 GNP'TC'startup.iermits\PLMFTermitApp.doc
Accumulative Sewer Tally
i Tenant Name: SPEC SPACE SWR# N/A
ric,ARI)
Site Address: 12268 SW SCI LOLLS FERRY RD PLM# PLM2014-00392
Parcel#: 1 S134BC00300
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 HP) 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 (l 0 0 0 0
Sink:
-I.av/Bar-Non-Food Related 2 0 1 2 0 -1 -2
-Bradley 5 r 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 1 6 0 -1 -6
Urinal 6 0 0 0 0 0
Previous EDU•Count 0 0
Capped EDU Credit 0
TOTALS 0 0 2 8 0 0 -2 _ -8
Current Fixture Value -8 divided by 16= -0.500 Current EDU 1 EDU= $4,900.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change -8 divided by 16= -0.500 over (under) $ (2,450.00)
Enter EDU Change Here -0.500
Notes:
Authorized Name/Signature: BRANDEN TAGGART X2449 Date: 12/4/2014
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.
1:\Building\Sewer Tally\SewerTallySheet_4900._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
12268 SW SCHOLLS FERRY RD, TIGARD, OR,
97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2014-00392
George Heimos
Violation Summary:
Inspector Contractor