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Permit q CITY OF TIGARD PLUMBING PERMIT s ' COMMUNITY DEVELOPMENT Permit#: PLM2015-00007 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/20/2015 Parcel: 1S135BD00200 Jurisdiction: Tigard Site address: 9785 SW SHADY LN Project: Starbucks Subdivision: ASHBROOK FARM Lot: 5 Project Description: Install(4)backflow preventers,(1)dishwasher,(1)expansion tank,(7)2"floor drains,(2)hose bibs,(1)ice maker, (1)primer,(2)lays,(1)service sink,(6)food prep sinks,(2)toilets&(1)water heater. Contractor: WOODBURN PLUMBING INC A CORP OF WASHING? Owner: NORED, STANLEY D&AUDENE C 3311 SE MCKEVER RD 511 NE 21ST PL CAMAS,WA 98607 CANBY, OR 97013 PHONE: 360-834-2889 PHONE: FAX: FEES Quantity Description Date Amount 4 ea Backflow Preventer 01/15/2015 $125.08 Specifics: 1 ea Dishwasher 01/15/2015 $25.02 7 ea Floor Drain/Floor Sink/Hub 01/15/2015 $175.14 Type of Use: COM 2 ea Hose Bib 01/15/2015 $50.04 Class of Work: ALT 1 ea Ice Maker 01/15/2015 $12.51 Type of Const: 1 ea Primer 01/15/2015 $12.51 Occupancy Grp: 7 ea Sink 01/15/2015 $175.14 Stories: 2 ea Lavatories 01/15/2015 $50.04 2 ea Water Closet 01/15/2015 $50.04 1 ea Water Heater 01/15/2015 $37.52 1 12%State Surcharge- 01/15/2015 $87.07 Plumbing 1 ea Expansion Tank 01/15/2015 $12.51 Total $812.62 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 N. • . . • -r. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or di ct questions to OU • •y •: "ng 503.232.1987 or 1.800.332.2344. Is= ed By: } I " r Permittee Signature: V 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. Jan 15 2015 8:16PM HP Fax page 1 Plumbing Permit ApplirainP ED Building Fixtures JAN 15 2015 City of Tigard ++ D / /5 /S i Permit N°.: L/•/Aj/5- 4447, "� • 13125 5509 7182439 Tig& �1k.r ~ ,,TIGARD Date/By:Review Other Permit No.: ' �N DIVISION Da1e/BP-,;�iE�' +et)3 Inspection Line: 503.639. Date Ready/By Atria 0 See Page 3 for 1 '`'`�' t w Internet: ww.tigard•or.gov Notified/Method: / /'S/7 -' Sap. - alai lirtarmation I Total❑ New construction ❑Dennolitio•" For special information use checklist i �� a. ®Addition/alterstion/replacement ❑Other: � Description I Qty. Ea 0.)New 1-2-family dwellings(includes 100 ft.for each utility connection) fi „ .. SFR(l)bath 312.70 ❑ 1-and 2-family dwelling ®Commercial/industtial SFR(2)bath 437.78 QJ SFR(3)bath 500.32 ❑Accessory building ❑Multi-family Each additional bath/kitchen 25.02 .r�� ❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 �. _. . . Site utilities: lob site address:9785 SW SHADY LANE Catch basin or area drain 18.76 Q 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.: I Project name:STARBUCKS Manufactured home utilities 50.03 NI v 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 S tvtsion: I Lot no.: Fixture or item: Backllow preventer 4 31.27 125.08 Tax map/parcel no.: /J 1 3r-J t� �--- Backwater valve 12 51 Clothes washer 25 02 PLUMBING WORK FOR STARBUCKS STORE Dishwasher 1 25 02 25.02 Drinking fountain 25.02 'O Ejectors/sump 25 02 Expansion tank 1 12 51 12.51 "\) Fixture/sewer cap 25.02 t Name:MAJ STARBUCKS,TIGARD,LLC Floor drain/floor sink/hub 11 7 25.02 175.14 C\ Address!300 W.1NTH STREET SUITE 200 Garbage disposal 25.02 ii City/State/ZIP:VANCOUVER,WA.98660 Hose bib 2 25.02 50.04 I Phone:( ) Fax:( ) Ice maker 1 12.51 12.51 lnkroeptor/grease trap 25.02 Business name:WOODBURN PLUMBING,INC. Medical gas(value:$ ) Page 2 Primer 1 12.51 12.51 Contact name:VICTOR COMPHER Roof drain(commercial) 12.51 iAddress:3311 SE MCKEVER ROAD Sink/basin/lavatory 9 25.02 225.18 City/State/ZIP: CAMAS,WA.9867 Solar units(potable water) 62.54 ■ Phone:(360)834-2889 I Fax: :(360)833-2889 Tub/shower/shower pan 12.51 E-mail:woodburnplumbing @woodburnplumbing.com Urinal 25.02 Water closet 2 25.02 50.04 Water heater 1 37.52 37.52 V Business name:WOODBURN PLUMBING,INC. Water pipingrDWV 56.29 Address:3311 SE MCKEVER ROAD Other: 25.02 / '� 42y v_ City/State/ZIP:CAMAS,WA.98607 Subtotal ,P 1 72' Phone:(360)834-2889 Fax:(360)833-2889 Minimum permit fee: $72.50 Plan review (25%of permit fee) ^ CCB Lic.:97064 Plumbing Lic.no.:37-38SPB D? \ State surcharge(12%of permit fee) .YB-S $1.. Authorized signatur TOTAL PERMIT FEE . 824.63" ,- J Print VICTOR COMPILER Date:1115/2015 This perrk application expires If a pertait is eat*beamed whir 180 days i nt name: after It has been accepted as complete. "Fee methodology set by Tri-County Building Industry Service Board. O t (((c7� I IJBuddm5WmmiWPUtU-P naidApp.doc 10"OIiO9 N0-46I61(10M12ICOM/WEB) V../ Jan 15 2015 8:16PM HP Fax page 2 Plumbing Permit Application - City of Tigard Page 2 -Supplemental Information Fee Schedule: Residential Fire Su ression S stems: Oto2,000 $121.90 Footing drain-1°100' 50.03 - 2,001 to 3,600 5169.69 Footing drain-each additional 100' 37.52 3,601 to 7,200 1-$T3 .0 . Sewer-let 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st t00' 62.54 Medical Gas S stems: Water Service-each additional 100' 37.52 62.54 Minimum fee$72.50 Storm&Rain Drain-1st 100' $1.00 to$5,000.00 Storm&Ran Drain-each additional 100' 37.52 $5,001.00 to$10,000 00 572.50 for the first 55,000.00 and$1.52 for each additional$100.00 or fraction thereof,to and including$10,000.00. Inspection of existing plumbing or for $10,001.00 10$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 how) 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 90.00/1u 90.00/hr , and including$50,000.00. $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for Additional plan review for revisions each additional$100.00 or fraction thereof (minimum charge-112 how) Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately re''rt fixtures could result in increased sewer fees*. __ ? , Plan review is required for any of the following. Please check all that apply. 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 -Desch Stall - ❑ New exterior plumbing site utilities for any complex structure -Drive ohm as defined in OAR91 S-780-0040. Dishwasher -Commercial ❑ 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 a sets of plans with any of the above. Floor Drain/sink -2" _3" 4" Car wash Drain • Isometric or riser diagram is required for new buildings Do -Domestic-non-food that meet the •ualifications above. Dispsposa l -Dorneslie-food related -Commercial-food related -Industrial-food related Ice MachlRefrig.Drains Oil Separator(Gas Station) Comments regarding fixture work: Rec.Vehicle Dump Station WE WILL BE USING THE EXSISTING WATER AND Shower -Gang SEWER COMING INTO AND LEAVING BUILDING -Stall Sink/Lav -Non-food related _ -Bradley -Commercial-food related , -Service Swimming Pool Filter - *Note: If the fixture work under this permit results in an washer-clothes Close increase of sewer EDUs,a sewer permit will be issued and Water C Water Extractor fees assessed for the sewer increase must be paid before the t-Toilet Urinal plumbing permit cam be issued. Other Fixtures: I C:1Users\vcampher\DownloadslPLMF-PermitApp.doc 2 1.. w,..n,) (4A-110- ri S/n 14.5 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 9785 SW SHADY LN, TIGARD, OR, 97223 Commercial - Plumbing 399 Plumbing ﬁnal FAIL PLM2015-00007 George Heimos 1. Corrections #1 and #4 previous inspection not completed (Eco lab soap equip. And kitchen 3-comp. and hand sink not attached and caulked, all else ok Back ﬂow preventers test results: 1/2" watts model LF009QT serial number 54612, back bar/ 1/2" watts model LF009QT serial number 54511, back bar drive thru sink/ 1/2" watts model LF009QT serial number 50207, under sink counter 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 9785 SW SHADY LN, TIGARD, OR, 97223 Commercial - Plumbing 399 Plumbing ﬁnal FAIL PLM2015-00007 George Heimos 1. Provide caulking in all plumbing ﬁxtures. 310.3/407.2 2. Provide 2-ea backﬂow test results for double check valves. 310.3/407.2 3. Remove kitchen ﬂoor drain plugs. 2-ea. 310.3 4. Remove Eco lab water ﬁtting attachment at 3-compartment sink and provide separate hot/cold water supplies for soap dispensing equipment. 310.3 5. Recall inspection when corrections have been completed. Re-inspection required. 103.5.6.1 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 9785 SW SHADY LN, TIGARD, OR, 97223 Commercial - Plumbing 399 Plumbing ﬁnal PASS - No C of O PLM2015-00007 George Heimos Violation Summary: Inspector Contractor