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Permit t .° PLUMBING PERMIT lril�� CITY OF TIGARD ,: g.,,,. COMMUNITY DEVELOPMENT 1 Permit#: PLM2015 00314 TIGARD 13125 SW Hall Blvd ,Tigard OR 97223 503 718 2439 /D /y® Date Issued: 09/17/2015 Parcel: 2S113AA00400 Jurisdiction: Tigard Site address: 16240 SW 72ND AVE B2 Project: Spec Space Subdivision: ROSEWOOD ACRE TRACTS Lot: C Project Description: TI for future tenant Capping(2)2"floor drains,(1)lay,(1)toilet&(1)urinal. Relocate/replace(1)2"floor drain, (3) lays/sink&(2)toilets 10/14/15,REPRINTED to add(1)hose bib&(1)backflow. Contractor: DEAN WARREN PLUMBING& REMODELING INC Owner: PACIFIC REALTY ASSOCIATES PO BOX 14701 ATTN N PIVEN PORTLAND, OR 97293 15350 SE SEQUOIA PKWY#300 PORTLAND, OR 97224 PHONE 503-236-4152 PHONE FAX 503-296-2218 FEES Quantity Description Date Amount 5 ea Fixture/Sewer Cap 09/17/2015 $125 10 Specifics: 1 ea Floor Drain/Floor Sink/Hub 09/17/2015 $25 02 1 ea Primer 09/17/2015 $12 51 Type of Use: COM 1 ea Sink 09/17/2015 $25 02 Class of Work: ALT 2 ea Lavatories 09/17/2015 $50 04 Type of Const: 2 ea Water Closet 09/17/2015 $50 04 Occupancy Grp: 1 ea Water Heater 09/17/2015 $37.52 Stories: 1 12%State Surcharge- 09/17/2015 $39 03 Plumbing 1 ea Backflow Preventer 10/14/2015 $31 27 1 ea Hose Bib 10/14/2015 $25 02 0 12%State Surcharge- 10/14/2015 $6.75 Plumbing 45 Misc Administration Fee 10/14/2015 $45 00 Total $472 32 • 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 dir questions • •UNC by calling 503 232 1987 or 1 800 332 2344 sued By: t Permittee Signature: / Call 503.639.4175 by 7:00 a m for the next available inspe on date. This permit card shall be kept in a conspicuous place on the job - ntil completion of the project. Approved plans are required on the job site at the time of each inspection. CITY OF TIGARD PLUMBING PERMIT 1 COMMUNITY DEVELOPMENT Permit#: PLM2015-00314 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/17/2015 Parcel: 2S113AA00400 Jurisdiction: Tigard Site address: 16240 SW 72ND AVE B2 Project: Spec Space Subdivision: ROSEWOOD ACRE TRACTS Lot: C Project Description: TI for future tenant:Capping(2)2"floor drains,(1)lay,(1)toilet&(1)urinal. Relocate/replace(1)2"floor drain,(3) lays/sink&(2)toilets. Contractor: DEAN WARREN PLUMBING& REMODELING INC Owner: PACIFIC REALTY ASSOCIATES PO BOX 14701 ATTN: N PIVEN PORTLAND, OR 97293 15350 SE SEQUOIA PKWY#300 PORTLAND, OR 97224 PHONE: 503-236-4152 PHONE: FAX: 503-296-2218 FEES Quantity Description Date Amount 5 ea Fixture/Sewer Cap 09/17/2015 $125.10 Specifics: 1 ea Floor Drain/Floor Sink/Hub 09/17/2015 $25.02 1 ea Primer 09/17/2015 $12.51 Type of Use: COM 1 ea Sink 09/17/2015 $25.02 Class of Work: ALT 2 ea Lavatories 09/17/2015 $50.04 Type of Const: 2 ea Water Closet 09/17/2015 $50.04 Occupancy Grp: 1 ea Water Heater 09/17/2015 $37.52 Stories: 1 12%State Surcharge- 09/17/2015 $39.03 Plumbing Total $364.28 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• - ions to •i by c. .•• 503.232.1987 or 1.800.332.2344. Issue; By: / Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspepfon 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 Appli ELVEP Building Fixtures FOR OFFICE liSE ONLI �-P172015 • City of Tigard Date/B Permit No.. c !4" 13125 SW Hall Blvd.,Tigard�,O`pld, �7/�,1 1 r DateB - _ C[-d w'1L' 3 III Phone: 503.718.2439 Fax: 5 M 01.10 Plan Review �1 c n Date/By: Other Permit No.: T I G A R D Inspection Line: 503.639.40i n{*iG I d I lIl lN Date Ready/By: Iuris: H See Page 2 for Internet: www.tigard-or.goILl/11� Notified/Method: Supplemental Information TYPE OF WO FEE* SCHEDULE ❑New construction ❑Demolition For special information use checklist. Description I Qty. I Ea. I Total Addition/alteration/replaccment ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ❑ 1-and 2-family dwelling ❑Commercial/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 INFORMATION AND LOCATION Site utilities: Job site address: / 6.4y G /7x,Ji Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name: . '/ pr•o / ,r Manufactured home utilities 50.03 Cross street/directions to job site: vv `` 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 It.: ) Page 2 Subdivision: /� I Lot no.: Fixture or item: Tax map/parcel no.: , 2 5 I/3 pii-}7 C,o C{OD Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER 1116, ❑ TENANT Expansion tank 12.51 Name: 00&74n.,57- Fixture/sewer cap 25.02 /I Floor drain/floor sink/hub /-' 25.02 � Address: / 5 3sz S u $af(JO r r� /)1,-(A.A./ Garbage disposal 25.02 City/State/ZIP: r .5 .4o/- c ?l 11( Hose bib 25.02 Phone:(� ) 6)#-( 300. / Fax:( ) Ice maker 12.51 ❑ APPLICANT .. ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name: 00,94,-_ Le wy,,,,_- ,/}y j t'/3b-rho,,/.../ Medical gas(value:$ ) Page 2 ' a� Primer I 12.51 Contact name: Roof drain(commercial) 12.51 Address: PC A04 /4 7t.1 Sink/basin/lavatory 3, 25.02 City/State/ZIP: Peip4-, G, - 9 7j c3 Solar units(potable water) 62.54 Phone:(c ) '2g O - 914 g(' Fax: :( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 CONTRACTOR ^. Water closet I 2 25.02 Water heater f 37.52 Business name: Water piping/DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal Phone:( ) Fax:( ) Minimum permit fee: $72.50 �� Plan review (25%of permit fee) CCB Lic.: ( 5 .j S� Plumbing Lic.no.:24 -? 3Gl State surcharge(12%of permit fee) Authorized signature. 9._ TOTAL PERMIT FEE 3.3-( y.2g Print name: T� R �cJ‘ Date: I.-0 y This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. iFee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) 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 Storm&Rain Drain-1st 100' 62.54 V.a ift lt. Permit Fee: $1.00 to$5,000.00 Minimum Ice$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 t er` ns ectlons or Fees Qh ee 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*. 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 Baptistr ,i unt _ _ greater,except systems designed and stamped by licensed Bath: -Tub/Shower -Jacuzzi/Whirlpool engineer. Car -Each Stall ❑ New exterior plumbing site utilities for any complex structure C as defined in OAR918-780-0040. -Drive Stall Thru 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" 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-Clothes fees assessed for the sewer increase must be paid before the Water Extractor WaterCloset-Toilet F ;� plumbing permit can be issued. Urinal I Other Fixtures: I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 IN ___ , Accumulative Sewer Tally Tenant Name: Spec Space SWR# N/A Site Address: 16240 SW 72nd Ave PLM# 2015-000314 Parcel#: 2S 113AA00400 Fixture Value Previous Previous Credits Capped Fixture Fixture New New # value count capped#s v aloe count added# added value total#s total values Baptistry/Pont 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 0 0 0 Eye Wash 1 0 0 0 0 0 Floor Drain/Sink: -2 inch 2 0 2 4 0 -2 -4 -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 3/41 IP) 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 0 0 0 Sink: -I,av/Bar-Non-Food Related 2 0 I 2 0 -1 -2 -Bradley 5 0 0 0 0 0 -Com/Serv/Util-Food Related 3 0 0 0 0 0 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 1 6 0 -1 -6 Urinal 6 0 1 6 0 -1 -6 Previous EDU Count 0 0 Capped EDU Credit 0 TOTALS 0 0 5 18 0 0 -5 -18 Current Fixture Value -18 divided by 16= -1.125 Current EDU 1 EDU= $5,100.00 Previous Fixture Value 0 divided by 16= 0.000 Previous EDU Change -18 divided by 16= -1.125 over (under) $ (5,763.00) Enter EDU Change Here -1.130 * *Round EDUs to the nearest 1/100th: a count ending in.005 shall be rounded up to.01,and a count ending in.014 or less shall be rounded down to.01. Notes: Authorized Name/Signature:Debbie Adamski Date: 9/17/2015 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 Ci of Tigard Building Division to redeem credits towards future system development charges. I:\Building\Sewer'rally\SewerTallySheet_51(A)_070115.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 16240 SW 72ND AVE B2, TIGARD, OR, 97224 Commercial - Plumbing 399 Plumbing ﬁnal PASS - No C of O December 8, 2015 at 10:51:08 AM PLM2015-00314 Don Sylvester 1. 3/4" watts D. C. Located in riser room ser# 042493 - ok with test. Violation Summary: Inspector Contractor