Permit CITY OF TIGARD PLUMBING PERMIT
8.— COMMUNITY DEVELOPMENT Permit#: PLM2016-00064
T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued:
Parcel: 1S136CD02200
Jurisdiction: Tigard
Site address: 7850 SW DARTMOUTH ST
Project: Costco Subdivision: PALMER ACRES Lot: 3
Project Description: Interior plumbing:Relocating(3)sinks,and installing(2)ejector pumps and(1)water heater for optical center
remodel.
Contractor: BATES MECHANICAL LLC Owner: COSTCO WHOLESALE CORPORATION
PO BOX 1112 PROPERTY TAX DEPT 111
LONGVIEW,WA 98632 999 LAKE DR
ISSAQUAH,WA 98027
PHONE: 360-957-4789 PHONE:
FAX:
FEES
Quantity Description Date Amount
2 ea Ejectors/Sump 02/08/2016 $50.04
Specifics: 3 ea Sink 02/08/2016 $75.06
1 ea Water Heater 02/08/2016 $37.52
Type of Use: COM 1 12%State Surcharge- 02/08/2016 $19.51
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $182.13
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 9�009S 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: Permittee Signature: r —
Call 503.639.4175 by 7:00 a.m.for the next available inspec on da`"')
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 Application
Building Fixtures
iiilCity of Tigard c.,y N _ o �' ] . /(y - Permit No.:■ 13125 SW Hall Blvd.,Tigard,OR 9 t , 3� Plan Review �LM�jlt- �,��• Phone: 503.718.2439 Fax: 503.59Other Permit No.:
Inspection Line: 503.639.4175 Date Ready/By:i \i, 11 p '1- \ Date lois ® See Page 2 for
Internet: www.tigard-or.gov $ U Notified/Method: D Supplemental Information
o New construction ❑ ttFor special information use checklist
q � rFor
Qty. 1 Ea. I Total
®Addition/alteration/replacement ❑ ll i New 1-2-family dwellings(includes 100 ft.for each utility connection)
calgocetyor t, •$1: ,$ - .,t SFR(1)bath 312.70
0 1-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
0 Accessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
JOB nil Iil T,1NI) LOCATION Site utilities:
Job site addressr185SS.W.Dartmouth street 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
Suite/bldg./apt.no.: I Project name Optical Remodel�V aruhouca- ( Manufactured home utilities 50.03
Cross street/directions to job site:Tigard Costco 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: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
r. D ON OF WORK Backwater valve 12.51
,2
"" , Clothes washer 25.02
�Detmr T s bough in 3 new lays with two undersink ejector pumps and one 5 gal Dishwasher 25.02
Water heater Drinking fountain 25.02
Ejectors/sump 2 25.02 50.04
.1 PROPERTY OWNER ( 0 NANr Expansion tank 12.51
t Fixture/sewer cap 25.02
Name:Costco
Floor drain/floor sink/hub 25.02
Address:7855 S.W.Dartmouth Street Garbage disposal 25.02
City/State/ZIP:Tigard OR 97223 Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
FA APPLICANT l CONTACT num Interceptor/grease trap 25.02
Business name:Bates Mechanical LLC Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Brett Bates
Roof drain(commercial) 12.51
Address:185 Brodie In. Sink/basin/lavatory 3 25.02 75.06
City/State/ZIP:Longview WA 98632 Solar units(potable water) 62.54
Phone:(360)575-3333 Fax::(360)575-3333 Tub/shower/shower pan 12.51
E-mail:brett@batesmech.com Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 1 37.52 37.52
Business name:Bates Mechanical LLC Water piping/DWV 56.29
Address:185 Brodie In. Other: 25.02
City/State/ZIP:Longview WA 98632 Subtotal 162.62
Phone:(360)957-4789 Fax:(360)575-3333 Minimum permit fee: $72.50
CCB Lic.:203378 '7//,(c Plumbing Lic.no.:PB1495 '�//117 Plan review (25%of permit fee)-
State surcharge(12%of permit fee) 19.51
Authorized signature: '�'�,„,,�.` TOTAL PERMIT FEE 182.13
Print name:Brett Ba �,/ Date:2/06/2016 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Peimits\PLMU-PermitApp.doc 10/01/09 4404616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
s064
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 $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 Inf Ii* ` 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 Mai Review,for Plumb,"installation*'
Fixture Type for Replace/ Plan review is required for anyof the following.
Work Performed: lipped Added R Please check all that apply,
Baptistry/Font
Bath Tub/Shower
0 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 0 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 0 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"
Isomettic`or Riser Diagram
Car wash Drain ❑ Isometric or riserdiagramrequired for new buildings
Garbage -Domestic-non-food is g
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
Sink/Lav -Non-food related )c 3
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under thisermit results in an
Washer-Clothes p
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\Brett\Downloads\PLMF_PermitApp.doc 2