Permit CITY OF TIGARD PLUMBING PERMIT
II'n
11111 COMMUNITY DEVELOPMENT Permit q: PLM2015-00073
T wARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/08/2015
Parcel: 1S 135BB00800
Jurisdiction: Tigard
Site address: 10645 SW GREENBURG RD
Project: IFLY Subdivision: HILLSBORO Lot: PTS 1-2
Project Description: Interior plumbing for new indoor skydiving facility. Other fixtures:(3)water hammer arrestors,(1)PRV-pressure
reducing valve,&(1)circ pump.
Contractor: OREGON CASCADE PLUMBING&HEATING Owner: EWING IRRIGATION PRODUCTS INC
1728 22ND ST SE 3441 E HARBOUR DR
SALEM, OR 97302 PHEONIX,AZ 85034
PHONE: 503-588-0355
PHONE:
FAX:
FEES
Quantity Description Date Amount
4 ea Catch Basin or Area Drain 06/08/2015 $75.04
Specifics: 2 ea Backflow Preventer 06/08/2015 $62.54
1 ea Backwater Valve 06/08/2015 $12.51
Type of Use: COM 1 ea Dishwasher 06/08/2015 $25.02
Class of Work: NEW 1 ea Drinking Fountain 06/08/2015 $25.02
Type of Const: 3 ea Ejectors/Sump 06/08/2015 $75.06
Occupancy Grp: 1 ea Expansion Tank 06/08/2015 $12.51
Stories: 7 ea Floor Drain/Floor Sink/Hub 06/08/2015 $175.14
1 ea Garbage Disposal 06/08/2015 $25.02
3 ea Hose Bib 06/08/2015 $75.06
2 ea Ice Maker 06/08/2015 $25.02
5 ea Primer 06/08/2015 $62.55
4 ea Roof Drain(Commercial) 06/08/2015 $50.04
5 ea Sink 06/08/2015 $125.10
7 ea Lavatories 06/08/2015 $175.14
1 ea Urinal 06/08/2015 $25.02
Total $1,799.51
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 503.232.19879.,3
1:8832.2344.
Issued By: Permittee Signature..
/ AIIIIIU p1"----
Call 503.639.4175 by 7:00 a.m.for the next available insp 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
7111 ■ Tenant Name: Hly SWR# 2015-00026
(;A(t n Site Address: 10645 SW Grecnburg Rd PIN# 2015-00073
Parcel#: 1S 135BB00800
Fixture \.ilu( Previous Previous (:rcdits Capped Fixture Fixture New New
# v.clue count r.y,ped#5 value count added# added value total#s total valtn
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 I 0 0 0 0 0
Dishwasher: -Commercial 4 0 0 0 0 0
-Domestic 2 0 0 I 2 1 2
Drinking Fountain I 0 0 I 1 1 1
Eye Wash I 0 0 0 0 0
Floor Drain/Sink: -2 inch _' 0 0 I 2 1 2
-3 inch , 0 0 6 30 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 1113) 32 0 0 0 0 0
-Industrial(over 5 I IP) 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 0 7 14 7 14
-Bradley 5 0 0 0 0 Il
-Com/Serv/Util-Food Related 3 0 0 5 15 5 15
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 6 36 6 36
Urinal 6 0 0 I 6 1 6
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 0 0 28 106 _ 28 106
Current Fixture Value I i(6 divided by 16= 6.625 Current EDU 1 EDU= $4,900.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change 106 divided by 16= 6.625 over (under) $ 32,487.00
Enter EDU Change Here 6.630
Notes:
Authorized Name/Signature: Debbie Adamski Date: 4/15/2015
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_490()._070114.xlsx
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Plumbing Permit ApplicatiECEIVED
Building Fixtures 1'i FOR OFFICE USE ONLY
City of Tigard MAR 16 2015 gy. 3 I to l 5 Permit No.: �,
III
= • 13125 SW Hall Blvd.,Tigard,OR 97223 _ 1 LN aUl 5�GOG r3
OFTIGARD Plan Review
Phone: 503.718.2439 Fax: 503. Plan ' -` Other Permit No.: �OOCa
�O/S .Z�O-
TIGARD Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready .y: s. 53 See Page 2 for
Internet: www.tigard-or.gov Notified/M-I od: r. 41 ir Supplemental Information
TYPE OF WORK ,. (v l�� E' SCHEDULE
®New construction ❑Demolition For special information use checklist
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)_ CIO
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 Z
❑ 1-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78 1
building SFR(3)bath 500.32
❑Accesso ry g
g ❑Multi-family
Each additional bath/kitchen 25.02 .�
❑Master builder ❑Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION ite utiliti�ff '^�
Job site address:10645 SW Greenburg Rd Catch bad a din z‘412 18.76 73-,py
City/State/ZIP:Tigard,OR 97223 ell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) ; Page 2
Suite/bldg./apt.no.: Project name:iFly Manufactured home utilities 50.03
Cross street/directions to job site:Greenburg Rd,behind Ewing Irrigation 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: l Lot no.: Fixture or item:
Tax map/parcel no.: 151356.(3c00 O� Backflow preventer P:644 .. - 31.27 347T
DESCRIPTION OF WORK Backwater valve 1 12.51 12.51
Clothes washer 3 25.02 X702'6-
Complete plumbing system for new iFly building
Dishwasher i 25.02 d.6i.05.
Drinking fountain ,/ 1 25.02 25.02 /
Ejectors/sump J 3 25.02 75.06 '
❑ PROPERTY OWNER I ❑ TENANT Expansion tank / 1 12.51 12.51 1
Name:Ewing Irrigation Products,Inc. Fixture/sewer cap 25.02
Floor drain/floor sink/hub / 7 25.02 175.14 -
Address:3441 E Harbour Dr
Garbage disposal / 1 25.02 25.02
City/State/ZIP:Phoenix,Az 85034 Hose bib ✓ 3 25.02 75.06 �
Phone:( ) Fax:( ) Ice maker ✓ 2 12.51 25.02
❑ APPLICANT CONTACT PERSON ' Interceptor/grease trap 25.02
Business name:Oregon Cascade Plumbing and Heating,Inc. Medical gas(value:$ ) Page 2
Primer ✓ 5 12.51 62.55 ., 0i
Contact name:Kevin Miller d`
Roof drain(commercial) 12.51 25.02-
Address:1728 22nd St SE �`}�
Sink/basin/lavatory !A 25.02 _1.7-5 722Yf/
City/State/ZIP:Salem,OR,97302 Solar units(potable water) 62.54
Phone:(503)269-1581 Fax::(503)264-3376 Tub/shower/shower pan 12.51
E-mail:kevin.miller@oregoncascade.com
Urinal ✓ 1 25.02 7.y.off- e /t1
CONTRACTOR Water closet `e, 25.02 4.2.57t& IV
Water heater ✓ 1 37.52 37.52 1
Business name:Oregon Cascade Plumbing and Heating,Inc. Water P�P� €�1 in WV 56.29
Address:1728 22°d St SE Other:
tu�1r£2 l4rtMI�fLAQQ, � 25.02 �aj.Cg
City/State/ZIP:Salem,OR,97302
I C12L P4M� Subtotal sl
1
Phone:(503)588-0355 Fax:(503)364-2276 Minimum permit fee: $72.50 13 I ' 0
CCB Lie.:127 Plumbing Lie,no.:24-33PB Plan review (25%of permit fee) 254!/S.aQ,g 4.9
State surcharge(12%of permit fee) Ia" ref r•
Authorized signature: w, -» TOTAL PERMIT FEE 13.79'65'
Print name:Frank P.Dyemartin Date:02-26-15 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete. 1!j
"Fee methodology set by Tri-County Building Industry Service Board. '
1 I\Building\Permits1PLMU-PemmitApp.doc 10/01/09 440-4616T(10/02/COM/wEB) 4 Il�
I
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-1'100' 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
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/
Work Performed capped Added Relocate Plan review is required for any of the following.
Baptistry/Font I'lease check all that apply.
Bath Tub/Shower El 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 ❑ 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„
-4' Isometric or Riser Diagram
Car Wash Drain ❑ Isometric or riser diagram is required for new buildings
Garbage -Domestic-non-food m g re q
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 - VIM' wipww v'. i■INIP••
Sink/Lav -Non-food related
0
-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 fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures.
C:\Users\Frank\AppData\Local\Microsoft\Windows\INetCache\Content.Oltlook\ENF3LWML\PLMF PetmitApp Tigard.docx
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Plumbing Plan Review Worksheet ..\el
Tenant Name: C
Site Address: l c��y�
i,1y.fueti tO ,uC,(0 -n
Bath: - Tub/Shower
'� ,P'"i �ti
Jacuzzi/Whirlpool
Car Wash: - Each Stall
- Drive through
Dishwasher: - Commercial
- Domestic I
Drinking Fountain / 0 i
Eye Was}i
Floor Drains: - 2 inch f 12 i
- 3 inch l
fN t
4
- 4 inch
- Car Wash
Floor Sinks: -2 inch
-3 inch
- 4 inch 1 j) i
Hub Drains: -2 inch
- 3 inch
- 4 inch _ / /r) /
Garbage Disposal:
- Domestic (to 3/4 HP) / 0
- Commercial (to 5 HP)
- Industrial over 5 HP) _
Ice Machine/Refrigerator Drain
Oil Sep (Gas Station)
Shower: - Gang (per head)
- Stall
Sinks:
Lav/Bar - Non-Food Related /NI 11 7
Commercial Food Related
Service Sink 1 11 ti
Utility/Mop Sink '
Washer - Clothes
Water Closet - Toilet 1114 ( ‘ 0
Urinal ,I 1 /
Other )Fixtures:
147PV) Przsr5 0- Pco ,N.� /
pvnTG2 f1,4ofmGil- 4✓ves*t've S 2)
Glgc- 1 Leo i?. — 1
Notes: r
Authorized Name/Signature: Date:
3-3o /sue
.400. F 4E* 2µU pis6. P4AIJ
F't' 1 se-i 7
)t c42&141 4(j. :f/Is4/4
ogyvrt.e,44. -;eytt.ell..,_ GL-fAecc2
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
10645 SW GREENBURG RD, TIGARD, OR,
97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
November 6, 2015 at 2:50:14
PM
PLM2015-00073
Don Sylvester
1. note: provide a copy of test results for RP device for make up water to chiller.
Violation Summary:
Inspector Contractor