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Permit (175) CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit#: PLM2015-00433 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/05/2016 Parcel: 1 S 136DC04500 Jurisdiction: Tigard Site address: 7501 SW DARTMOUTH ST 100 Project: Winco Subdivision: 1995-013 PARTITION PLAT Lot: 2 Project Description: Rough-in and install water supply and waste for(3)3"floor drains/floor sinks&(3)food related sinks. Contractor: EVOLUTION PLUMBING LLC Owner: WINCO FOOD LLC 7715 NE 33RD DR SUITE D ATTN:TAX DEPARTMENT PORTLAND, OR 97211 PO BOX 5756 BOISE, ID 83705 PHONE: 503-655-3388 PHONE: FAX: 503-305-8373 FEES Quantity Description Date Amount 3 ea Floor Drain/Floor Sink/Hub 01/04/2016 $75.06 Specifics: 3 ea Sink 01/04/2016 $75.06 1 12%State Surcharge- 01/04/2016 $18.01 Type of Use: COM Plumbing Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $168.13 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: 1 ittee Signature: /Uy 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. From: 12/30/2015 11:23 0074 P.001/002 Plumbing_Permit Appl* Site Utilities Received City of Tigard 4� DateiBy, Pcnrli P • 13125 SW Hall Blvd.-,Tigard,OR 0?22-� Plan Review Phone. 503.718.2439 Fax: 503.598-1960 Date/By: Other Permit No.'w4w�;�a-�23'5 Inspection Line: 503.639.41171 1 Ready,'By: J"is: .4 Date 0 SecPage2for Internet: www.tigard-ongoy� Notified/Method: Supplemental Information LE New construction ❑Demolition C7 For special information use checklist. Description I Qty- I E Addition/alteration/replacement ❑Other: New I-2-family dwellings(includes 100 ft.for each utility connection) lrl CATEGORY OF CONSTI_ttJCTitfN SFR(i)bath 1 312.70 F-1 I-and 2-family dwelling Commercial/industrial SFR(2)bath 437.78SFR(3)bath 500.32 ❑Accessory building El Multi-family Each additional bath/kitchen 25.02 ED Master builder El Other: Fire sprinkler(_sq.ft.) Page 2 3OB:SITB,iNRORMAIION ANI) LOCATION Siteutilities: Job site address:7501 SW Dartmouth St Catch basin or area drain 18,76 Drywell,leach line,or trench drain 18.76 City/State/ZIP.Tigard,OR 97223 Footing drain(no.linear ft.: Page 2 Suiteibldg./apt.no.: /�o I Project name:Winco Sushi Kiosk Manufactured home utilities 50.03 Cross street/directions to job site:"w/SW Dartmouth 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: Lot no.: Fixture or item: Tax map/parcel no.: /6136 Z) e- C C/5-o0 Backflow pi eventer 31.27 DESCRIPTION OF Wt1RIZ Backwater valve 12.51 Clothes washer 25.02 rough in and install waters and waste for(6)new fixtures Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 Expansion tank 12.51 PROPERTY OWNER 'AN T Fixture/sewer cap 25.02 Name:Wineo Foods Floor drain/floor sink/hub 3 25.02 75.06 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone: lee maker 1251 NTA �' Interceptor/grease trap 25.02 Medical gas(value;S Page 2 Business name:Evolution Plumbing,LLC Primer 12.51 Contact name:Suzanne Postula Roof drain(commercial) 12.51 Address:7715 NE 33rd Drive,Suite D I Sink/basin/lavatory 3 25.02 75.06 City/State/ZIP:Portland,OR 97211 Solar units(potable water) 62.54 Phone:(503)655-3388 Fax: (503)305-8373 Tub/shower/shower pan 12.51 - E-mail:suzanne.postulaCi�.evoplumbing.net Urinal 25.02 Water CIO,et 25.02 CONTRACTOR, Water heater 37,52 Business name:Evolution Plumbing,LLC Water piping/DWV 56.29 Address:7715 NE 33"'Drive,Suite D Other: 25.02 City/State/ZIP:Portland,OR 97211 Subtotal 150.12 Phone:(503)655-3388 Fax:(503)305-8373 minimum permit fee: $72.50 CCB Lic.: 189876 PB834 Plan review (25%of permit fee) - State surcharge(12%ol7permit fee) 18,01 Authorized signature: TOTAL PERMIT FEE 168.13 SuzannePrint name Postula Date: 12/30/15 This permit application expires if permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology get by Tri-C'ounty Building Industry Service Board. IBuilding Pamin PIMU-I'mnitApp doe 1001,09 441)-4616T(1002 COM WEB) From: 12/30/2015 11:23 #074 P.002/002 Plumbing Permit Application - City of Tigard Page 2 -Supplemental Information Fee Schedule: Residential Fire Sup ession Systems: Site Utilities : + 1Fee(ea). rntat S, uare.Fiota e:' fermi# 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-Est 100' 62.54 7.20E and greater $327.54 Sewer-each additional 100' 37.52 Water Service-Ist 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 V R1113ititJl!' I'ermllt � Storm&Rain Drain-Ist 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 Lith; '15,0 C�iOIIS,or Fees � � Total ' eacfi additional$100.00 or fraction thereof,to and including 510,000.00. 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) I and including$25,000.00. Inspections outside of normal business 90.00/lir $25,001.00 to$50,000.00 5379.50 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 AO and up $742.00 for the first$50,000.00 and S1.20 for (minimum charge-1/2 hour) each additional 5100.00 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*. spit b Fixti►re T l'laln iteviewOr:Plitrlllnbiu :IIIstallations Fixture Type for, Reptaee! Plan review is required for any of the following. Work Performed: Capped Added Please check all that apply. Baptistry/Font. pp y' Bath Tub/Shower ❑ Any new commercial building with water service 2"and -Tub/Shower owe -Jacuzzi/Whirlpool of greater,except systems designed and statnped 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-(1(140. Eye Wash Floor Drain/sink 2" Submit 2 sets of plans with any of the above. 3" 4„ Isometric or.user Dis rain Car Wash Drain _ 1:1 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 Mach./Refti .Drains Oil Separator(Gas Station) Comments regarding fixture work: Rec.Vehicle Dump Station Shower -Gang -Stall Sink/lav -Non-food related Bradley -Commercial-food related -Service Switruning 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: http://www.tigard-or.gov/document_center/Building/PLM U_PeniiitApp.d2c 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 7501 SW DARTMOUTH ST 100, TIGARD, OR, 97223 Commercial - Plumbing 399 Plumbing ﬁnal PASS - No C of O PLM2015-00433 Don Sylvester 1. Note: provide strainers for ﬂoor sinks. Violation Summary: Inspector Contractor