Permit CITY OF TIGARD PLUMBING PERMIT
11111 - COMMUNITY DEVELOPMENT • 1 Permit#: PLM2015-00211
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 t Date Issued: 07/06/2015
r� a-7 Parcel: 2S104BB07900
Jurisdiction: Tigard
Site address: 14350 SW BARROWS RD 2
Project: Mathnasium Subdivision: RUSSELL'S SCHOLLS FERRY Lot: A
Project Description: Interior plumbing:Creating a new ADA compliant restroom and adding(1)sink,(1)water closet,and(1)water
heater. 7/14/15,reprinted to add capping of(18)fixtures((12)floor sinks&(6)floor drains).
Contractor: THE PLUMBERS INC. Owner: SPIRIT SPE HG 2015-1 LLC
90 NW 150TH AVE BY HAGGEN OPCO SOUTH LLC
BEAVERTON, OR 97006 2211 RIMLAND DR, STE 300
BELLINGHAM,WA 98226
PHONE: 503-519-6644 PHONE:
FAX: 503-684-1202
FEES
Quantity Description Date Amount
1 ea Sink 07/06/2015 $25.02
Specifics: 1 ea Water Closet 07/06/2015 $25.02
1 ea Water Heater 07/06/2015 $37.52
Type of Use: COM 1 12%State Surcharge- 07/06/2015 $10.51
Class of Work: ALT Plumbing
Type of Const: 18 ea Fixture/Sewer Cap 07/14/2015 $450.36
Occupancy Grp: 0 12%State Surcharge- 07/14/2015 $54.04
Stories: Plumbing
45 Misc Administration Fee 07/14/2015 $45.00
Total $647.47
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 xpi - if irk not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law require you to o ow • rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 95 -001-119,. Y. obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: # Permittee Signature:
iJa A� c
sJ� 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 . oject.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application �
Building Fixtures . iilS10 FOR OFFICE USE ONLI
City of Tigard % l Received
Date/By: 7I7 S T/ ermit No.: [✓`��� - l�
• 13125 SW Hall Blvd.,Tigar. 97223 O
Plan Review
Phone: 503.718.2439 Fax: 503.598.19 Other Permit No.: ,J'
MI
Date/By: pWQ?4,/S 04:=64
Inspection Line: 503.639.4175 \\ �► Date Read B y kris: 65 See Page
Z for I G A R D Internet: www.ti arc-or. ov .6 Notified/Method:
Supplemental Information
TYPE O ,
0 New construction ttton For special information use checklist
4 Description I Qty. I Ea. I Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
T SFR(1)bath 312.70
CATEGORY OF CONSTRUCTION
❑ 1-and 2-family dwelling JCommercial/industrial SFR(2)bath 437.78
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 INFORMATIO Site utilities:
Job site address: 113 5-6 `yam J 6'�T.Z f J " -A6.2-
Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: 7) � I ci!`P
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name: /1� G
- ),A-7 /14-4,1, /►') Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
(711 O Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: j Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTI I I F WORK Backwater valve 12.51
�t , r t Clothes washer 25.02
`V 1 r (.' (41 Z•i,(. St.. kS Dishwasher 25.02
- �,i1 J .-e_...,)■o o C --le..,c-:)-> Est`„‘ S q 4.•■ . Drinking fountain 25.02
(10-21 c r Si vk Aw,X r d Ail Ejectors/sump 25.02
0 PROPERTY OWNER Expansion tank 12.51
'i 1 4 �` Fixture/sewer cap /1' 25.02 f( .3(0
Name: �•'y�•r L✓� `
106 C �k�, A- Garbage Floor
drain/floor disposal siric/hub 25.02
Address: J
Gazbage disposal 25.02
City/State/ZIP: rvl-`�� Cg-- 11 Z L 1 Hose bib 25.02
Phone:(S)' ) 'Z b b I g `1 Fax:( ) Ice maker 12.51
0-APPLICANT AlCONTACT PERSON Interceptor/grease trap 25.02
Business name: ��^^ Medical gas(value:$ ) Page 2
` nom Business 4 Primer 12.51
Contact name: -- -
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) I Fax::( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
Water closet 25.02
CONTRACTOR.
Water heater 37.52
Business name: 72t, / /4/y ,,,-..r/�� Water piping/DWV 56.29
Address: Other: 25.02
City/State/ZIP: Subtotal •l.(St. 3(v
Phone:( ) Fax:( )
Minimum permit fee: $72.50
Plan review (25%of permit fee) ,Ul-/
CCB Lic.: Plumbing Lic.no.:
State surcharge(12%of permit fee) 1
Authorized sig CL-ture: 1 l TOTAL PERMIT FEE Rohl.tom,
Print name: S Jt Date, ((i 1r This permit application expires if a permit is not obtained within 180 days
Srti 1 after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:1Building\Permits\PLMU-PenmitApp.doc 10/01/09 440-46I6T(10/02/COM/WEB)
Plum bins 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 S stems:
Water Service-each additional 100' 37.52
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
each additional$100.00 or fraction thereof,to
1 t er ns i OIIB 0 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 Plumbin: Installations
Quantiy 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
Baptistry/Font ❑ Any new commercial building with water service 2"and
greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
-Jacuzzi/Whirlpool engineer.
Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure
Drive Stall as defined in OAR918-780-0040.
Cuspidor/Water Aspirator ❑ 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 2 sets of plans with any of the above.
Floor Drain/sink: -2" %j7
3" ,`' t,. ) I;i
• Isometric or riser diagram is required for new buildings
-Car Wash Drain
Garbage Domestic non-food that meet the I ualifications 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-Clothes fees assessed for the sewer increase must be paid before the
Water Extractor
WaterCloset-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
y p CITY OF TIGARD PLUMBING PERMIT
;(1 $ COMMUNITY DEVELOPMENT Permit#: PLM2015-00211
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/06/2015
Parcel: 2S104BB07900
Jurisdiction: Tigard
Site address: 14350 SW BARROWS RD 2
Project: Mathnasium Subdivision: RUSSELL'S SCHOLLS FERRY Lot: A
Project Description: Interior plumbing:Creating a new ADA compliant restroom and adding(1)sink,(1)water closet,and(1)water
heater.
Contractor: THE PLUMBERS INC. Owner: SPIRIT SPE HG 2015-1 LLC
90 NW 150TH AVE BY HAGGEN OPCO SOUTH LLC
BEAVERTON, OR 97006 2211 RIMLAND DR, STE 300
BELLINGHAM, WA 98226
PHONE: 503-519-6644 PHONE:
FAX: 503-684-1202
FEES
Quantity Description Date Amount
1 ea Sink 07/06/2015 $25.02
Specifics: 1 ea Water Closet 07/06/2015 $25.02
1 ea Water Heater 07/06/2015 $37.52
Type of Use: COM 1 12%State Surcharge- 07/06/2015 $10.51
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $98.07
Required Items and Reports(Conditions)
I
This permit is issued subject to the regulations contained in the Tigard Municipal Code, Sta - of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will .xpir• if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law require ou 6 follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 9', '1 019' You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.198�f.800"39Y-B3 4�
Issued By: Permittee Signature:
kl
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 completio. .f the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application ,ZS • , . %le _ '-
Building Fixtures FOR OFFICE USE ONE)
Received
City of Tigard Ytttj� MM Permit No.: , • `t;
.4 13125 SW Hall Blvd.,Tigard,OR 97 v �j)°
Date/By: ��.��
Plan Review �Q 7 d'
Phone: 503.718.2439 Fax: 503. � �j Other Permit No4314 I C,^�0p It
Date/By:
Inspection Line: 503.639.4175
T I c A K D Date Rea B y la See Page
2 for
Internet: www.tigard-or.gov Notified/M ethod: Supplemental
Information
❑New construction ❑Demolitjtx;lab For special information use checklist
, ``,, VV►► ` Description I Qty. Ea. I Total
,r •ddition/alteration/replacement ❑ .` ,��1510 New 1-2-family dwellings(includes 100 ft.for each utility comection)
SFR(1)bath 312.70 ?`
❑ 1-and 2-family dwelling Ai CommerciaUndustrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
Site utilities:
Job site address: (I-('3 s(( S W et k,r.a v Catch basin or area drain 18.76
City/State/ZIP: �j'`` �� ����� Drywell,leach line,or trench drain 18.76
10 Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name: ,,, „‘^a_$ ` Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
1 A`�v 1. k- �� �, Rain drain connector 18.76
1^' Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
•
DESCRIPTION OF WORK fit Backwater valve 12.51
Clothes washer 25.02
lr.Sa,\\ w.,..3 /RO k CO W./A.w.+4 14.61-111rv■• Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER Expansion tank 12.51
Name: L,;, 1,,_9
Fixture/sewer cap 25.02
oc� � t�� r C s ""_'~ Floor drain floor sink/hub 25.02
Address: ( ( L C 6 ,� �`L i s
c5 Garbage disposal 25.02
City/State/ZIP: 91 2...I-1 '0•4 `k*+b ct_s Hose bib 25.02
Phone: ? ) CI L` `L I'll Fax:( ) Ice maker 12.51
❑ APPLICA immi, CONTACT PERSON Interceptor/grease trap 25.02
Business name: Medical gas(value:$ ) Page 2
Primer 12.51
Contact name: S b
C�.n LS-v.\ Roof drain(commercial) 12.51
Address: L ' .L co 5 w ,,,.), M Sink/basin/lavatory 1 25.02 ?..5--.a r.
City/State/ZIP: 1\sr.4- 07-, ''l Z ( 1 Solar units(potable water) 62.54
Phone:(S p)) 1 7 (0 Z$1 I Fax::( ) Tub/shower/shower pan 12.51
E-mail: 5,,�A-�,��, U�j..o„� C yt,.�,4,1,�,..0.S,ti-., - Urinal 25.02
( CONTRACTOR L Water closet 1 25.02 as'cia'
Water heater / 37.52 3 7 9_
Business name: A) \,.) ....„,,t e,n v o x 4, '■-•: / P...Li, .; Cater piping/DW V 56.29
Address: t U Z C 5 -4.) (O L t L A-)- qD kV ( ' -Other: 25.02
City/State/ZIP: - , c A-Z (j� °n Z Z 3 Su(-c- q - Subtotal ).•"]_Sv
Phone:(S 03) L(al - S s S . -EaBx(S b, 63-t i - /G 1/L Minimum permit fee: $72.50
CCB Lic.: : ti ii
! Plan review (25%of permit fee)
,t, 1 177214 Plumbing Lic.no.: 1-7
State surcharge(12%of permit fee) to. 5-f
Authorized signature: w� I/ ; TOTAL PERMIT FI cy u 7
a 1�r1 _
Print name: Date:6 mem This permit application expires if a permit is not obtain ithin 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board. l,
t:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(I0/02/COM/WEB) -/-42. S3 ‘'t.til�)
.2_ ati i", v)
r -
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Jill& 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
Storm&Rain Drain-1st 100' 62.54 - Iuat1O11: Pg dllt.Fee
$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
2r nsectlons o 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
Reinspcction 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*. j I 1 ■i 1
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'Ont greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
-Jacuzzi/Whirlpool engineer.
Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure
Drive Stall as defined in OAR918-780-0040.
Cuspidor/Water Aspirator ❑ 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 2 sets of plans with any of the above.
Floor Drain/sink: -2"
3"
4"
• Isometric or riser diagram is required for new buildings
-Car Wash Drain
Garbage Domestic non-food that meet the 'ualifications 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 Filer increase of sewer EDUs,a sewer permit will be issued and
Washer-Clothes fees assessed for the sewer increase must be paid before the
Water Extractor
WaterCloset-Toilet 1 plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
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
14350 SW BARROWS RD 2, TIGARD, OR,
97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2015-00211
Chip Barnett
Violation Summary:
Inspector Contractor