Permit (42) III CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2016-00398
T f(;AR E 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/28/2016
Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9624 SW WASHINGTON SQUARE RD G07
Project: Amazon Books Subdivision: None Lot: None
Project Description: Interior plumbing for TI:Adding(1)sink and(1)service sink;Relocating(1)drinking fountain and(1)sink;Installing
(1)water heater.
Contractor: PMSI LLC Owner: PPR WASHINGTON SQUARE LLC
21195 NW EVERGREEN PKWY#204 PO BOX 847
HILLSBORO, OR 97124 CARLSBAD, CA 92018
PHONE: 503-466-2222 PHONE:
FAX: 503-466-2211
FEES
Quantity Description Date Amount
1 ea Drinking Fountain 07/27/2016 $25.02
Specifics: 3 ea Sink 07/27/2016 $75.06
1 ea Water Heater 07/27/2016 $37.52
Type of Use: COM 1 12%State Surcharge- 07/27/2016 $16.51
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $154.11
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.
r
Issued By: Permittee Signature: , ,.- '?
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.
,,'lumbing Permit A pli n i5 l�Coc t)6t)3 u- t • . 5
Building Fixtures FOR OFFICE USE ONLY
aeceiyea1111 At �� ��+' c� °0��� �3.
#)25 U Ila Tigard t)ate.`Ily . `�--/ - i'e init Ne/9
tit2iSWttalll?tvd litardt � 72i�? i���l '�� "
� (fan Review
Phone 503 718.2439 Fax 501.598 1960 other Permit No'
Date/13y
-TIGAR1)
Inspection O16s9417� (,
P ;) Date Ready'By ,1J :. E7 Vee age for
Internet ssww ti>artii-or.gov' ' ,•- ` Nottlied Methcrd104+� Sapptemental Information
'a e 3 N; FEE* SCI1133UL.E
New construction ❑Demolition
.icor spea'io)l nfor»tation use checklist
1/.
-...__..�.-..^.� nn ?it Fa _ tal .
.f Additionnalterationrre (accmcnt ❑()their: sesv 1-2family dwellings(Includes iCO ti.tar tali utility i<tirtection))
CATEGORY OF CONSTRUCTION '' SFR(1)bath 312.70
❑ 1 and family dwelling Ci Commercial industrial SFR(2)bath 437 78
SFR(3)bath 500.32
❑ Accessory building 0 Multi-family
Each additional bathlkitchen 25.02
❑ Master'builder Cl Other:
_ _ t=ire sprinkler( sq.ft.) Page 2
Job site address: JOB962SITE INFORMATION AND LOCATION Site utilities
SW Washington Square Road :stela b r m or area drain �...___I
Drywell,leach line,or trench dram I 18.76
CitylStatelltY Tigard,OR 97223 Footing dram(no linear ft.' ) Page 2
. Sent rbldu_.'a 1 }pt.no,: Irojeet narne:Amazon-Washington
J Z, Sq Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary'sewer(no,linear It ) Page 2
-- - - E Storm sewer(no.linear 11_: ) Page 2
_...�__..,_....__ Water service(no,linear ft.:_____._) Page 2
Strbdivrston: Lot no.: Fixture or item:
Tax map/parcel no.:: 1 Backflow prey :x1.27
fiackwatcr valve € 12 51
DESCRIPTION OF WORK }
-- - Clothes washer 25.02
Plumbing for tenant improvement - . ..............-.-.__
Dishwasher 25.02
Drinking tiauntain I 25.02 25.02
t'jcctors/sump 25.02 i
0 PROPERTY OWNER 0 TENANT Expansion tank 12,51
Name Fixturelsewer cap 25.1)2
_ - __.
Floor drains Floor sink/Jath 25.02li
Address: I i
_. . ! Garbage disposal 25.02 i
CitylStatc/LlP: Huai-s..bib 2
_.___.____.._. 25.1}�
Phone:( ) i, Fax:( ) Ice maker 12.51 1
0 APPLICANT 0,CONTACT PERSON Interceptorrgrease trap 25 02
Business name: S+ledicail _as(value:$ ) Page 2
_. ...,...._.._._......._..__._____
-- Primer 12.51
Contact name: - --
_ . Roof drain(commercial) 12.51 ,
Address:
_........_... Sinkfba inllatvatory 3 23 U2 75.06
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) lax::( ) 'Tuh/showershower pan 12.51
E-mail:
Urinal 25.1)2
.--;------":7--- Water closet 25.02
CONTRACTOR
Water heater 1 37.52 37.52
Business name:PyISI 1-1,C
.._ .. _.._„-,... s 4water piper°i)W V 56.29
Address:21195\W Evergreen Parkway Suite 204 Other 25502 I
City/State/ZIP:Ilillsboro,OR 97124 Subtotal ! 137,60
Phone:(503)466-2222 Fax:(503)466-2211 Minimum permit tee'. 572,50
I St Plan review (�wnn of pemtit fee)
Plan C°C'B l.ie.: 158286 Pleurabing Lie.no.:34-434PB
._, surcharge(12%of pemut fee) 16.51
to au ar
Authorized signtturc IC)IA1 P1 RMII Fhli, 1:54,11
Print name: Brandy Solano �� # Date:7/21/16 1 This permit application expires if a permit is not obtained within ISO days
�. atter it has been accepted as complete.
"Fee niethodo+logy set by'1;1-County t.uilding Industry Service Board.
I 111101ciing1,Peflnitc t'LMi,.i'eunei pp dos 100 i;tuu 440.4616.r(liyo2lCONINTBi
.. Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: ,
ResidentialFire Suppression Systems:
Site Utilities Qty. fee(e40 ' Mtal Square Footage: _..t Permit Fee
„.. . . .
Footing drain-DI 100 50.03 i Ito 2000 1 $121 90
1--1:00I"to 1,000 1 5169.01
Footing drain-each additional 100' 37.52 ___ — ........„.„„___
---- -„.... 3,601 to 7,200 I 5233.20
Sewer- 1st 100' 62.547
7201 ndsfeater 1--
. a , $12 ,54
L •
--- - ., ,
Sewer-each additional 100' 37,52
---
Water Service- ha 100' 1 02.54 Medical Gas Systems:
Water Service-each additional 100' • 37.52 L.Valuation: Permit Fee: I
Menu&Rain f5rain- 1st 100' 62 54 _. _____ ,
$1.00 to'35,?in-0.06.- MMimum roc 572.50
Storm(I:4 Rain I -each additional 100' 37.52 --$.570-0 I.00MVo,000700 572 50 for the first$5,000.00 and$1.52 or
— - - . each'additional$100.00 or fraction thereof,to
Other Inspections or Fees Qty-°- vee(") Tu'tal
and including$10,000,00,
Inspection of-,..t skiing plumbing or for $10(8)1 00 to$25.000.00 $148.50 for the first$10.000,Cifand$1.54 for
which no fee is specifically indicated 90.00ihr each additional$100 00 or fraction thereof,to
(minimum charge . 1-112 hour) 1 .,, and including525,000,00.
Inspections outside of normal business 00.00d.;17 1 $'5A)u1:00 (111 io$50,000.00 70 50 tot the first$25,000,00 ad iI:-15 for
hours(minimum charge-2 hours) , additional$100.00 or fraction thereof.to
,
,
Reinspection f ees 90.607Fir — i and including$50.000.(8).
1
Additional plan review for revisions 90 00/hr $50,001 Ott and up • $742,00 for the first$50,000.00 and$1.20 for
(minimum charge- 1/2 hour) 1 _ ___.......9chadditiorird$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' It)'Fixture'fype Plan Review for Plumbing Installations
... .
Fixture Type for Replace/
Plan rview is required or any of the fo I lowing.
Work Performed: Capped Added Relocate ef
Please check all that apply.
liapikely./Font —_,
Path -Tilb/SflOWCI 0 Any new commercial building with water service 2"and
-Jacuzzi/Whirlpool
greater,except systems designed and stamped by licensed
...
Car Wash -E _ach Stall engineer.
_
-Drive Thru 0 Ness exterior plumbing site utilities for any complex structure
. — - — as delmed in OAR9 I 8-780-0040.
'Cuspidor/Water A- ' tcr
. spud ii
Dishwasher -Commercial ' __„._ 0 Medical 1.2,as and vacuum systems for health care lheilitics.
-l)ornestic „ — 0 Any multipurpose tire sprinkler system.
Drinking Fountain 1 0 Any complex structure as defined in OAR9[8-780-0040,
lye Wash
Floor Drainisink Submit 2 sets of plans with any of the above.
,.... . ..
.. -
W . , Isometric or Riser Diagram
Oar ash Drain
IGar1; 1 0 Isometric or riser diagram is required for new buildings
0-e, -Domestic-non-food
_
I Disposal -Domestic-food related that meet the qualifications above.-Commercial-Mod related ----
_
-Industrial-food related
fee MachiRefrig.Drains
Oil Separator((lila Station i . Comments regarding fixture work:
...._
ace,veh,,,le Dump StationI
Shower -Dung
-Stall I
Sink/Lay -Non-Mod related 1. i- I
-Bradley _ — -- ---
-Commercial-food related
-Service . ,
t _
Swimming Pim]niter ....... ,
-'--'--- , *Note: If the fixture work under this permit results in an
Washer-Clothes
Water lixtraelor .
—' increase of sewer EDLis,a sewer permit will be issued and
_
Water C —loset-'toilet ' i fees assessed for the sewer increase must be paid before the
...„....„_... .
Urinal ,--...-...... *-----n
plumbing permit can be issued.
......
(Slier It slates:
M:).101)Files\PMSI Jobss20062-Amazon Washington SquareTennit.doc ')
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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
9624 SW WASHINGTON SQUARE RD G07,
TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2016-00398
Don Sylvester
Violation Summary:
Inspector Contractor