Permit 111 u CITY OF TIGARD PLUMBING PERMIT
s. COMMUNITY DEVELOPMENT Permit#: PLM2015-00063
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/19/2015
Parcel: 15135 BA00102
Jurisdiction: Tigard
Site address: 10218 SW WASHINGTON SQUARE RD
Project: Noodles&Company Subdivision: OAKBURG Lot: 9
Project Description: Capping(1)commercial dishwasher,(11)3"floor drains,(1)commercial garbage disposal,(1)ice maker drain,(4)
non-food sinks,(5)food related sinks&(2)toilets. Adding(1)commercial dishwasher,(16)3"floor drains,(3)4"
floor drains,(1)ice machine drain,(5)non-food related sinks,(3)food related sinks,(2)toilets,(2)backflow
Contractor: ROCK CONSTRUCTION INC Owner: PPR SQUARE TOO LLC
PO BOX 2118 PO BOX 847
WILSONVILLE, OR 97070 CARLSBAD, CA 92018
PHONE: 503-568-4043 PHONE:
FAX:
FEES
Quantity Description Date Amount
2 ea Backflow Preventer 03/18/2015 $62.54
Specifics: 1 ea Dishwasher 03/18/2015 $25.02
1 ea Expansion Tank 03/18/2015 $12.51
Type of Use: COM 1 ea Fixture/Sewer Cap 03/18/2015 $25.02
Class of Work: ALT 19 ea Floor Drain/Floor Sink/Hub 03/18/2015 $475.38
Type of Const: 1 ea Hose Bib 03/18/2015 $25.02
Occupancy Grp: 2 ea Ice Maker 03/18/2015 $25.02
Stories: 1 ea Interceptor/Grease Trap 03/18/2015 $25.02
4 ea Primer 03/18/2015 $50.04
7 ea Sink 03/18/2015 $175.14
2 ea Lavatories 03/18/2015 $50.04
2 ea Water Closet 03/18/2015 $50.04
1 ea Water Heater 03/18/2015 $37.52
425 Misc Other Fee 03/18/2015 $425.34
1 Plan Review 03/18/2015 $365.91
1 12%State Surcharge- 03/18/2015 $175.64
Plumbing
Total $2,005.20
Required Items and Reports(Conditions)
1 .
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: ,'-----7 - Permittee Signature:
It
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 A li r EIVED
Building Fixtures FOR OFFICE. USE ONLY
City of Tigard MAR C 2015 Received Permit No.
1111 :
• 13125 SW Hall Blvd.,Tigard,OR 97223 5 Date/By: 01 S �5 t G/1;49 l'5- �O[JG1
Phone: 503.718.2439 Fax: Plan Review
' ®�°TIGARD Date/By: J-f6-j.3 40/2 Other Permit No, ;Q,0p/5-oct6900
T I G A R D Inspection Line: 503.639.4 I LDI NG DIVISION Date Ready/By: ik 46./ Juris: ® See Page 2 for
Internet: www.tigard-or.go�{� Notified/Method:.3,* -i Supplemental Information
TYPE OF WORK c A)�L &' -- FEE* SCHEDULE
Okf ew construction CI Demolition JJ'� For special information use checklist
93
Description 1 Qty. I Ea. 1 Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) 111Yy
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 h.
ID 1-and 2-family dwelling OCommercial/industrial SFR(2)bath 437.78 1
SFR(3)bath 500.32 %
❑Accessory building ❑Multi-family
G0
Each additional bath/kitchen 25.02 ,
El Master builder 12 Other: Fire sprinkler(_sq.ft.) Page 2 r
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: Catch basin or area drain 18.76
/0-2(SL 5 w w mss\-1;.s ,.ST u� red.
Drywell,leach line,or trench drain 18.76
City/State/ZIP:
k3c.roll l C)s<-' Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name:N c4.10 d- Co.---1210.,/ 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: Q I Lot no.: Fixture or item:
Tax map/parcel no.: /6 1356A DD/Q�+' Backflow preventer 2. 31.27 (,a.5t/
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
■ _..& i1 _ .a•► A l f • _. Dishwasher / 25.02 ;".•5-•4;-/
Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER I ❑ TENANT Expansion tank I 12.51 i ,S(
Name: Fixture/scwcr cap 02
Floor drain/floor sink/hub ` q 25.02 1/75,31./
Address:
Garbage disposal * 25.02
City/State/ZIP: Hose bib / 25.02 46%0?
Phone:( ) Fax:( ) Ice maker a i• 12.51 1.42.% -'1#
❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap / 25.02 61 c,D Z
Business name: io� Medical gas(value:$ ) Page 2
Sa'"" `�' Primer q 12.51 50,, 1/
Contact name: iE .k &IIS(e Roof drain(commercial) 12.51 4;i5
Address: Sink/basin/lavatory 9 e 25.02 "'
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
Urinal 25.02
E-mail:
roc*C o,,s'iw e fitoFJ G . c.J I .(..0 rv.
Water closet .2 25.02 �0.�"1
CONTRACTOR
Water heater / 37.52 37.`",?e,
Business name: R.oe.,k C,•‘5-)N,,tc- _c ■ Water piping/DWV 56.29
Address: P� 4.,..x o I t g Other: /7 aft ATrNfD /25.02 4Z
S3,
City/State/ZIP: (N�tSo�„v�l'� , Or, 70-1 �'yr subtotal
Phone:(5-43) 5-6 g- (404 3 Fax:( ) Minimum permit fee: $72.50
CCB Lic.: ( 12. 7 7 0 Plumbing Lic.no.: 9-(8y>Qi Plan review (25°/a of permit fee)
State surcharge(12%of permit fee) /,,,2,t2._,63
Authorized signature-e/J TOTAL PERMIT FEE 11•�-}t;�
Print name: �or k L ( (t L Date:Y'-j"IS~ This permit application expires if a permit is not obtained within 180 days
f after it has been accepted as complete.
*Fee methodology set by Tri-County Building Indus ervice Board.
eu To er z__ - 4I/ (ps TTr44-�
I:1 BuildingWenmits\PLMU-PermitApp.doe 10/01/09 440-4616T(10/02/COM/WEB) pL�at, , �,41630
SG C.q1 4 �/,
s7_ gN.ltertrr.2a,1F -l7s•i,ti ai ,
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-1a 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
Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
Other Inspections or Fees 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
❑ Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower engineer.
-Jacuzzi/Whirlpool
Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure
Drive Stall as defined in OAR918-780-0040.
El Cuspidnr/Water Aspirator Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial El Any multipurpose fire sprinkler system.
Domestic CI 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
El Isometric or riser diagram is required for new buildings
-Car Wash Drain
Garbage Domestic non-food that meet the qualifications above.
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
Ice Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -LavBar non-food related
-Bradley
-Com/Serv/Util food related
-Service *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 fees assessed for the sewer increase must be paid before the
Extractor Extr acactor or
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
•
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- I"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- I st 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*.
Quantity by Fixture Type Plan Review for Plumbing Installations
Fixture Type for Replace) Plan review is required for any of the following.
Performed: Capped Added Relocate q Y g
Baptistry/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 site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial 1 / ❑ 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.
4.. 3
Car Wash Drain Isometric or Riser Diagram
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 MachiRefrig.Drains / I
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related 1yt 5
-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
Water Closet-Toilet 2 fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
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1
WCW ENGINEERS, INC.
Consulting Engineers LETTER OF TRANSMITTAL
760 Creel Drive
Wood Dale, Illinois 60191 DATE : 03/13/15 JOB NO. 14199.01
630-595-8800/FAX 630-595-8818
ATTENTION: George Heimos RECEIVED
TO CITY OF TIGARD PROJECT:
13125 SW Hall Blvd. MAR 16 2015
Tigard, Oregon 97223 Noodles & Company#819 BU CITY DING DIVISION
(503) 367-7118
Tigard, Oregon
WE ARE SENDING YOU: ®Attached, via UPS the following items:
❑ Submittal/Shop Drawings ❑ Specifications ® Prints ❑ Calculations
❑ Letter ❑ Field Report ❑ Other:
COPIES DATE NO DESCRIPTION
2 03/13/15 5 Drawings P1.0, P1.1, P2.0, P3.0,and P3.1 (Signed and Sealed—JGT)
THESE ARE TRANSMITTED as checked below:
❑ For permit ❑ Code comments ❑ For your use
❑ For bid ❑ Owner revisions ® As requested
❑ Addendum ❑ Change order ❑ For review & comment
❑ For construction ❑ Additional Signed & Sealed
REMARKS:
George, these drawings are a follow up to our phone conversation on Wednesday 3-11-2015. We had a
couple follow up emails on Thursday 3-12-2015.
Copy To: file Signed: Christopher Winnie
H:\14199\Doc\14199_t02.docx II enclosures are not as noted,kindly notify us at once.
FOR OFFICE USE ONLY—SITE ADDRESS: /v-/g A.)64 • , a.
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
III ■ Transmittal Letter
I ,,,,,,, ,, 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: DATE ' L.L. _ I
DEPT: BUILDING DIVISION
MAR 16 2015
FROM: (-3,--)--- -41-4/1-<-0---- CITY OF 1i A11f
BUILDING DIVlS11 '
COMPANY: (AD L A-
PHONE: toc— 595 g oo ��
RE: I bbl c -% -V,0_,44,\c i-v- a Pt. 0,6---006 6 3
(Site Address) 'ernut ` ,Lt---1(Project name or subdivision name and lot number) 41 1
3 1
ATTACHED ARE THE FOLLOWI ITEMS:_
Copies: I Description: .opies: Description:
Additional set(s)of plans. Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain): '
REMARKS: a ,.Asp . jJ UC1R_e O p-L,, -,,,
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: Initials:
Fees Due: ❑ Yes ❑ No Fee Description: Amount Due:
/ $
$
I
$
Special
Instructions:
Reprint Permit(per PE): _ ❑ Yes ❑No ❑ Done
Applicant Notified: Date: Initials:
1:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
gi Accumulative Sewer Tally
Tenant Name: Noodles&Company SWR# 2015-00020
Site Address: 10218 \1'\\:chin}am Square Rd PLM# 2015-00063
Parcel#: 1S135BA00102
Fixture Value Previous I Previous Credits Capped I,ixture Fixture New New
# value count capped#s value count ,ulded# 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.\spirator 1 al 0 0 0 0
Dishwasher. -Commercial 4 0 1 4 1 4 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 11 55 16 80 5 25
-4 inch 6 0 0 3 18 3 18
-Car Wash 6 0 0 0 0 0
Garbage Disposal:
-Domestic(to 3/4 HP) 16 0 0 0 0 0
-Commercial(to 5 I IP) 32 0 1 32 0 -1 -32
-Industrial(over 5 HP) 42 0 0 0 0 0
Ice Machine/Refrigerator Drain 1 0 1 1 1 1 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 5 10 1 2
-Bradley 5 0 0 0 0 0
-Com/Serv/Util-Food Related 3 0 5 15 3 9 -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 2 12 2 12 0 0
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS _ 0 0 25 127 31 134 6 7
Current Fixture Value 7 divided by 16= 0.438 Current EDU 1 EDU= $4,900.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change 7 divided by 16= 0.438 over (under) $ 2,156.00
Enter EDU Change Here 0.440
Notes:
Authorized Name/Signature: Debbie.\damski Date: 3/5/2015
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.
I:\Building\Sewer Tally\SewerTallySheet_49(N)._070114.xlsx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10218 SW WASHINGTON SQUARE RD,
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2015-00063
Inspection Type: Inspector:
399 Plumbing final George Heimos
Result:
FA I L
Comments:
1 . Caulking required on fixture(s) at: kitchen 3-ea hand sinks/3-comp/pre-rinse/2-
compartment sink/dishwasher/ prep-sink/mop sink 310.3/407.2
2. Remove tape from kitchen floor drain. 310.0
3. Floor drain near cooler and water heater needs to be primed. 310.0
4. Soda equipment not installed, call when installed. 103.5.4
5. Recall inspection when corrections have been completed. Re-inspection required.
103.5.6.1
1/2" Watts model LF009QT serial number 67482
1 1/2" Watts model F007M2QT serial number 007485
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
10218 SW WASHINGTON SQUARE RD,
TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
FAIL
PLM2015-00063
George Heimos
1. P trap primer not working for floor drain in front of kitchen stove. 1007.4
2. P trap primer not working for floor drain to the left of walk in cooler. 1007.4
3. Recall inspection when corrections have been completed. Re-inspection required.
103.5.6.1
All else ok.
Jamason.lindeman@roconstruction.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
10218 SW WASHINGTON SQUARE RD,
TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2015-00063
George Heimos
Violation Summary:
Inspector Contractor