Permit CITY OF TIGARD PLUMBING PERMIT
•'r1 _ ' COMMUNITY DEVELOPMENT Permit#: PLM2015 00015
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/21/2015
Parcel: 1 S134BC00300
Jurisdiction: Tigard
Site address: 12268 SW SCHOLLS FERRY RD
Project: Orange Theory Fitness Subdivision: GREENWOOD TERRACE CONDO Lot: 17
Project Description: Interior plumbing for TI: Adding(1)drinking fountain,(4)2"floor drains,(2)shower stalls,(2)sinks,(1)service
sink,and(2)water closets. Applied sewer credits from revised 12/24/14 sewer tally for PLM2014-00392.
Contractor: WESTERN PLUMBING Owner: FW OR-GREENWAY TOWN CENTER LLC
9460 SW TIGARD AVE SUITE 101 PO BOX 790830
TIGARD, OR 97223 SAN ANTONIO,TX 78279
PHONE: 503-639-5296 PHONE:
FAX: 503-684-9015
FEES
Quantity Description Date Amount
1 ea Drinking Fountain 01/21/2015 $25.02
Specifics: 4 ea Floor Drain/Floor Sink/Hub 01/21/2015 $100.08
3 ea Sink 01/21/2015 $75.06
Type of Use: COM 2 ea Tub/Shower/Shower Pan 01/21/2015 $25.02
Class of Work: ALT 2 ea Water Closet 01/21/2015 $50.04
Type of Const: 1 ea Water Heater 01/21/2015 $37.52
Occupancy Grp: 1 12%State Surcharge- 01/21/2015 $37.53
Stories: Plumbing
Total $350.27
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: /XI Permittee 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.
01/15/2015 07:10 5036849015 WESTERN PLUMBING INC PAGE 01/02
Plumbing Permit ApriiiftiLetIVED
Building Fixtures i i,R ,H = I, I I `1 t t\I 1
City of Tigard JAN 2 0 2015 Received: `/ Permit No.: AA _./
'PI
- 13125 SW Hall Blvd.,Ti OR 97223 P Review
Phone: 503.718.2439 # s 9�GARD Date/By: °then Permit N°- �i� ��aa
Ii; r) Inspection Line: So3.j1LSDING DIVISION DateReadyBy: Jerir BSee 2fer r7
Internet www.tigsrd-or.gov Notified/Method;
..'.... I SeppkaT t.nr talInformation I ' 1 ! t 4 . R N11
llM:', k ,,Y ;. r 1 g�M,F,Aar 1l lw § r 1�I' n 7.V " 9 1 r.n 2}.411;1 Y� {.I t ll 1 P� n r el .n ; � i
❑New construction ❑Demolition For special information use checklist
Description .1 Qty. I Ea. Total
Addition/alteration/replacement ❑Other' I New 1-2-family dwellings(includes 100 R.for each utility connection)
54.'1:' q, ki` ' " ` SFR(1)bath 312.70
❑ 1-and 2-family dwelling rCommercr iatrndusarial SFR(2)bath 437.78
{ SFR(3)bath 500.32
0 Accessory building ❑Multi-family
1 Each additional bath/kitchen M1 25.02
❑Malta builder ❑Other: 1 Fire sprinkler( sq.ft.) Page 2
t f d� t-mot l: r, 1?'� 7 ".:.7..^71v,.:7, ' :Y" 1 I' Site utilities
. 1 f .�i M1�h/G '.�5r,17:t.:, 11: ,7::::11.:,',..: �I! . ,� �.. ' �t:t. t). ,�„ i
Job site address:\cYo')l D `4i L 01„,,,cI S q Catch basin or aroa drain 18.76
1��� Drywell,leach line,or trench drain 18.76
City/Stete/ZIP: Tr x -1 1� " Footing drain(no.linear ft.'_ ) Page 2
Suite/bldg./apt.no.; Project name:$it, ,.ts Lt\t 6,1. r It Manufactured home utilities 50.03 .__...
Cross street/directions to job site: Manholes _ 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_,J Page 2
Storm sewer(no.linear ft.;_) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: f Lot no.: Fixture or item: -
Tax map/parcel no.: Backflow preventer 31.27
, y !,-, r. -Backwater valve 12.51
7g .r �417;k.`t'',1e7'....`.,,.�,S�;I .:!..:',1:..;.., .a, ,.r^ .,c .. ... .,.a..,.. ,.'1.1:2:',..4.....a_: :. .S.r. Clothes washer { 25.02
\C5`f' 1 l.M TWAS4 Dishwasher 25,02
Drinking fountain t \ 25.02 ,c)
Ejectors/sump 25.02
./,ir, .1P:7 m,a m o r} rr- te w^* T a % 1 Expansion tank 12.51
h',.A lb4.,∎.• :3r+'a;.a-;ir . t .,I,tf.,r. �iA .d. wy!M. ..
Name: Fixture/sewer cap 25.02 L 7e
Floor drain/floor sink/hub,tk>{ 4 25.02 I l .'VQ /
Address: Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax( ) Ice maker 12.51
� �N1 s r , r h rt-••^r se{ 1A,b 1 ,
'/ ... T I' 1„...r Interceptor/grease trap 25.02
Medical gas(value:S ) Page 2
Business name:
Primer 12.51
Contact name: ', 1
Roof drain(commercial) 12,51
Address: i Sink/basin/lavatory 11i 3 25.02 '1;
City/State/ZIP: _Solar units(potable water) 62.54 1. /
Phone:( ) Fax::( ) Tub/shower/shower pan V a 12.51 I, ,G`1)_, J
E-mail Urinal 25.02 t t�
�qr-*'t Vin^ '7 .4� t water closet 25.02 tal.'Q
- };•3i.i';rr ,y.,:; , _ .:- , . . .,. t.`..::.,a'.`i,._r:,., .. .' water heater k 1 37.52 sl,GS'
Business name'Western Plumbing,Inc. Water piping/DWV 56.29
Address:9460 SW Tigard Street,Suite 101 Other: 25.02
City/State/ZIP:Tigard,OR 97223 Subtotal Ia
Phone:(503)639-5296 Fax:(503)684-9015 t
, Plan review (25%of permit fee)
CCB Lic.:2439 Plumbing Lic.no.:3429PB r53
State surcharge(12%of perrnit fee i Authorized signature: _
.....111 �. :Al :AL....
/i This permit application expires if a permit to not obrat We I80 days
r Print name: 1 4 q .%.x._ Date: ,�l - after it has been eccepted at complete.
"Fee methodology set by Tn-County Building Industry Service Beard
I.\Buildin>:1PwmitaLMti-Pete App doe 10/01/09 .140-4616T110/07/COM/WEB)
01/15/2015 07:10 5036849015 WESTERN PLUMBING INC PAGE 02/02
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Sul •ression S stems:
ax,t '+aYS iNi 1� rya A� 'd"'Y .0 .m•r n.1:+.. * wY"q»i"".,, 7" k ,y i.�1�1X,''G1�.
:a M nli -. .0::rriiNA4 r7..Mi.1:,AI VX.7r �7 Y 4{,..n, c 6�o, ,A;4 1,;ell,l. ''it..-:;;.. ,mw;.1+1.w....,j,.. .!,:;;' i,,Ai,'. .. ,....i .t..,.?"Ai,q l. 1! ;!'M�:1?iiJ 1!iiffilll.
Footing drain 1'100- 50.03 0 to 2,000 $'121.90 Mil 2.001 to 3,600 $169.69
Footing drain-each additional 100' 3,bo1 m 7,200 $231.20
Sewer- 1st 100' 10111_ II-7,201 and greater $327.54
Sewer-each additional 100' Mill 37.52
Water Service•1st 100' - 62.54 _ Medical Gas S stems:
Water Service-each additional 100- -- ,Y It"" ` 'iT n v . '
1 ...'..' +.+,;w.s.,_.1 -;;try ,
Storm&Rain Drain-1st 100' 62.54 M $100 to$5,000.00 Minimum fee$'72.50
Storm&Rain Drain-each addifiianat 100' 37.52 $5,001.00 to$10,000.00 572.50 for the first$5.000,00 and$1.52 for
each additional$100 00 or fraction thereof,to
1; and including$10,000 00
Inspection of existing p or 1br i $10,001.00 to$25,000.00 5148,50 foi 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 char' -112 hour) j and including$25,000.00.
Inspections outside of normal business III 90.00/hr $$25,001.00 to$50.000.00 $379.50 for the first$25,000.00 and$1 45 for
hours minimum char,e-2 hours each additional$100.00 or fraction thereof,to
Rcinspcetion Fees En 90.00/hr ! and including$50,000.00.
Additional plan review for revisions - 90.00/hr $50,001,00 and up S742.00 for the first$50,000.00 and$1.20 for
(minimum charge-1/2 hour) [__._, each additional$100.00 or fraction thereof.
Subtotal: ME�_
■ m -
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*.
T d w , a """w t�x�^"" e , t w r + y a. a tr.. ,.. 1
.•iz' t 4 4;r.y11.r 1 r4tNil .,� a1"... "'" 9 c 1?+"� f y t d -c-a t. ..'7........ �s ee.mw�. ir:.•
': 4 t,i 9 n-al 1'! , , �( 11:as . Hula .,t...- .k--:.at,., �..,,.:....i,4•,kit .-ws r•' ,t ii or :, i i Plan review is required for any of the following.
1 iF:4 7-41 y.bliai .p,, r1 i t r. ;,,, ' it i 1 Q Y
,>a...r_t), s._,-. `n' ' - .tici� .:* Please check all that apply.
Baptistry/Font
Bath -Tub/Shower 0 Any new commercial building with water service 2"and
-Jacuzzi/Whirl/mot Tub/S ower greater,except systems designed and stamped by licensed
engineer.
Car wash -Each Stall
-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 i % ❑ Any complex structure as defined in OAR918-780-0040.
Eye Wash J
Floor Drain/sink -2" ;k_ Submit 7 sets of plans with any of the above.
4 V.7,7, 77,7 ,t `t1.. �,s. �,u+ 1!i`w--c e „,,o/. +'"tity..t4rr'". ',4t l uTf1j'n'
't',_ 4 i.1 t1.1:. M .,v.,.r ........ w e.rr,,. , t 1 .„T r54�4:gittt '
Car Wash Drain ❑ Isometric or riser diagram is required for new buildings
Garbage -Domestic,-non-food
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-industrial-food related
Ice Mach./Refrig.Drains
Oil SeparatorJGas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station .
Shower -Gang
-Stall
Sink/Lay -Non-food related
-Bradley
Commercial food related ,
-Service �- i
Swimming Pool Filter If the fixture work under this permit results in an
Washer-Clothes increase of sewer EDUs,a sewer permit will be issued and
Water Extractor
Vdater Closet-Toilet 0 fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
http//www.tigard-or.gov;city_hall/department s/ed/docs/PLMF-PermitAplfldoc
IIIAccumulative Sewer Tally
4"`y Tenant Name: ORANGE TI IEORY FITNESS SWR# N/A
E t t.\3t 1 Site Address: 12268 SW SCl IOLLS FERRY RD PLM# 2015-00015
Parcel#: 1S134BC00300
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 1 1 1 1
Eye Wash 1 0 0 0 0 0
Floor Drain/Sink: -2 inch 2 0 0 4 8 4 8
-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 0 0 2 4 2 4
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 1 3 1 3
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 2 12 2 12
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 4.25 68
TOTALS 0 0 0 0 12 _ 32 _ 12 _ -36
Current Fixture Value -36 divided by 16= -2.250 Current EDU 1 EDU= $4,900.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change -36 divided by 16= -2.250 over (under) $ (11,025.00)
Enter EDU Change Here -2.250
Notes: ***CREDIT***PREVIOUS CREDITS APPLIED FROM 12/24/14 REVISED PERMIT PLM2014-00392(CREDIT OF 4.25 EDU'S).
Authorized Name/Signature: BRANDEN TAGGART X2449 Date: 1/21/2015
Building Division
rote: The property owner shall retain the ORIGINAL sewer tally record. If credits exist,this document will serve as a voucher which must be
bmitted to the City of Tigard Building Division to redeem credits towards future system development charges.
I:\Building\Sewer Tally\SewerTallySheet_4900._070114.xlsx
111 CITY OF TIGARD PLUMBING PERMIT
7111 �' COMMUNITY DEVELOPMENT Permit#: PLM2014-00392
TIGARD 13125 SW Hall Blvd..Tigard OR 97223 503.718.2439 Date Issued: 12/04/2014
Parcel: 1S134BC00300
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/DVW 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 que ons to OUNC s calli n1503.232.1987 or 1.800.332.2344.
Issued B : / //,3 �J Permittee Sign ture: �� r
Call 503.639.4175 by 7:00 a.m.for the next available inspe 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.
Accumulative Sewer Tally
Tenant Name: SPI.(. SPACE SWR# N .\ 2I`.VISED 12%24- 14 )
Site.\ddress: 12268 SW S(.11011.S 11 FR1t1'RD 1'1,61# PI,A42014-00392
z[c. RC) parcel#: 1S134BC00300
I:ixture Value Previous Previous Credits Capped Fixture Fixture New New
# value count capped#s value count added# added value total#s total values
Baptiser)jFont 4 0 0 0 0 0
Bath: - Tub/Shower 4 0 0 0 0 0
- Jacuzzi.'\\'hirlpool 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
I)ishwasher: ( ontn,ercial 4 0 0 0 0 0
-Domestic 2 0 0 0 0 0
Drinking Fountain 1 0 0 0 0 0
Nye\\'ash 1 0 0 0 0 0
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 3/4 11P) 16 0 0 0 0 0
-Commercial(to 5 I IP) 32 0 0 0 0 0
- Industrial(over 5 I1P) 42 0 0 0 0 0
Ice Machine/Refrigerator Drain 1 0 0 0 0 0
I.,v,ng Unit 16 0 0 0 0 0
()1l Sep((ias 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:
-I.ay.'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 IViltcr 1 0 0 0 0 0
Washer-(:lathes 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 l-DU Count 0 0
Capped EDU Credit 0
'IY>1'.\1,S 0 0 15 68 0 0 -15 -68
Current Fixture Value -68 divided by 16= -4.250 Current 11)1,1 1 EDU= $4,900.00
Previous Fixture Value 0 divided by 16= 0.000 Previous IM1.1
Change -68 divided by 16= -4.250 over (under) S (20,825.00)
Enter EDU Change Here -4.250
Notes: Revised 12/24/14,added(13)additional capped fixtures.
Authorized Name/Signature: Debbu. .\damskt Date: 12 24/2014
Building Division
Note: "l'he 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\Serw cr'roily er'1-nllyShect_49th_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
FAIL
PLM2015-00015
George Heimos
1. Complete both handheld shower assemblies. 310.0
2. Remove plastic 2" test cap from front bathroom floor drain. 314.4
3. Recall inspection when corrections have been completed. Re-inspection required.
103.5.6.1
Violation Summary:
Inspector Contractor