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Permit (45) CITY OF TIGARD PLUMBING PERMIT _ ' COMMUNITY DEVELOPMENT j Permit#: PLM2016-00424 13125 SW Hall Blvd.,Ti and OR 97223 503.718.2439 /6. Date Issued: 08/10/2016 Tr(;;tr<.r) s Parcel: 1 S135BD01300 Jurisdiction: Tigard Site address: 10830 SW GREENBURG RD Project: Washington Square Hotel Subdivision: MEADOW VIEW Lot: 8 Project Description: Replacement of existing fixtures in various locations through out hotel.(2)backflow preventers,(1)clothes washer, (1)ejector/sump pump,(2)primers,(2)lays,(10)tub/showers/stalls&(2)water closets. 10/20/16 REPRINTED to add(1)grease interceptor/trap. Contractor: COMMERCIAL PLUMBING SERVICE Owner: SCHAEFER, ROBERT M&SALLY J& 21185 NW EVERGREEN PKWY SUITE 105 MILLER, GERALD V HILLSBORO, OR 97124 BY SHILO INN-WASHINGTON SQUARE 11600 SW SHILO LN PORTLAND, OR 97225 PHONE: 503-439-9999 PHONE: FAX: 503-439-1999 FEES Quantity Description Date Amount 2 ea Backflow Preventer 08/10/2016 $62.54 Specifics: 1 ea Clothes Washer 08/10/2016 $25.02 1 ea Ejectors/Sump 08/10/2016 $25.02 Type of Use: COM 2 ea Primer 08/10/2016 $25.02 Class of Work: ALT 2 ea Lavatories 08/10/2016 $50.04 Type of Const: 10 ea Tub/Shower/Shower Pan 08/10/2016 $125.10 Occupancy Grp: 2 ea Water Closet 08/10/2016 $50.04 Stories: 1 12%State Surcharge- 08/10/2016 $43.53 Plumbing 1 ea Interceptor/Grease Trap 10/20/2016 $25.02 0 12%State Surcharge- 10/20/2016 $3.01 Plumbing Total $434.34 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 / Permittee Signature: ... ignature: ! _ /f , Call 503.639.4175 by 7:00 a.m.for the next available inspection date. deifY� 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:windy Moffett Fax:(503)439-1999 To:5035981960@RCFAX.t Fax: +15035981960 Page 3 of 3 10/20/2016 8:14 AM Plumbing Permit Applicati E Building Fixtures FOR OFFICE USE ONLY City of Tigard rr�� Received O�� Pcrnut Vo.: m 13125 SSS-Hall Blvd.,Tigard,OR 97223OCT0 2 0 U ue B 0 a �`�. �� b? ilh Ilan RevIew Phone: 503 718.2439 Fax 503.598.1960 li Other Permit No: Inspection Line: 503619.417 CITY OF TIGARD raie,t3, T1GARt] Date Retl fiv rtes. e7tu• Internet INwss tigard of got ) �� '3ohhedl+Rcthnd t Y1 F Oi F � .' 1 L1.°SC 1 Suppkmentd Information ❑Nesvconstruction ❑Demolition For special information use checklist. Description i Qty. I Fa. Total ei Addition'altel'ation,teplacenicnt ❑Other: New 1-2 family dwellings(includes 10011.for each utility connection) ('ATC(,ORY OF C O457RUiiii,6N % 'SIR(I)bath 312.70 ❑ 1-and 2-family dwelling ® SFR(2)bath 437.78 CovmttcrclaLindustrial 0 Accessory building 0 Multi-family - -� SFR(3)bath 500.32 --.. Each additional bath/kitchen 25.02 0builder 0 Other: `-re MasterFire sprinkler( sq.ft.) Page 2 JOB Si`h.E INFOORMATION;Ar-1'} I,OCATLOh Site utilities: Job site address:10830 sw greenberg rel Catch basin or area drain - 18.76 6 Drywell leach line,or trench drain 18.76 Citi/State/ZIP:Tigard,Oregon,97223 Footing drain(no.linear ft.: ) Page 2 Scute,Ibldg./apt.no.: Project name:LaQuinta(1'Fashington Squat - _.-__....._.,,__...._..._........_..._..._,.._,___-�. NIanufaciured home utilities 50.03 Cross street/directions to job site: 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.: _____.._ ._ .._.._ histure or item: 'fax map/parcel no.: Backflow preventer 31.27 L)F CR1P TON Oi Backwater valve 12.51 �1 OLiiC Clothes washer 25.02 Addition to permit#p1m2016 00424 _ Dishwasher 25.02 Drinking Fountain 25.02 Fjectors/sump 25.02 PROPui i Y Ow?N' ll ❑ 7L?1 ANT , I xpansion tank 12.51 2sI Name:Gregg Guerra Fixture/sewer cap �._._... 25.02 Floor drain/floor sink/hub 25.02 Address:10830 Sw Greenberg rt! _ Garbage disposal 25.02 j City/State/ZIP:'figard,Oregnn,97223 ---._._...._.._._._..._....__._,_.__ _ Hose bib 25.02 Phone:(503)740-9823 Fax:( ) lee maker 12.51 ❑ riik;.t01: ` ►d CN'I'At`C PFR.._S_.� 3 1 aterceptor/gre ase trap_.....___. 1 25.07 25.02:5. :: .: 0 „ A ,- :; O Business name:Commercial Plumbing Service Medical gas(value:S ) page 2 Primer 12.51 Contact name:Heather Farmer Root-drain(commercial) 12.51 Address:21185 NW Evergreen Pkwy Suite 105 Sink/basin/lavatory 25'.02 City/State/ZIP:Ilillaboro,Oregon,97124 Solar units(potabtc,water) 62,54 Phone:(503)439-9999 1 Fax::(503)439-1999 lob/shower/shower pan 12.51 Urinal 25.02 E-mail:diva tch;ir cps-scrvices.biz COR11C�A aer usel25.02 y\%atcr heater 37.52 Business name:Commercial Plumbing Service Address:21185 N11"Evergreen Pkwy Other: 25-02 City/State/ZIP:Hillsbor•o,Oregon,97124 Subtotal Phone:(503)439-9999 Fax:(503-)439-1999 Minimunt permit fee: `"72.50 Plan review (25%ofermit fee) - CCB Lie.:126015 Plumbing Lie.no.:37-421pb -- p - `- -- State surcharge(12%of permit fee) 3o/ � - Authorized signature:� r t / 7�. TOTAL PERMIT FF.F. A g.o3 1. Print name:Heather Farmer c 2 This permit application expires if a permit is not obtained within 180 days Date:10/1 I/_Ol6 after it has been accepted as complete. .._ ..____...,.._.._.,_, ..._.._..._.,_... _ *Fee methodology sel by Tn-Count)Building Industry Scrvice Board. I.Inuildino.Pennii s'PLStt:-permit App.do. I 0i01,1:9 4-10-4616I'(10102/CONIUM) FromCindy Woollett Fax:(503)439-1999 To:5035981960@RCFAX.t Fax: +15035981960 Page 1 of 3 10/20/2016 8:14 AM F A X Date: 10/20/2016 Pages including cover sheet: 3 To: 5035981960@RCFAX.CO From : Cindy Woollett Commercial Plumbing Servil 21185 NW Evergreen Pkwy Hillsboro OR 97124 Phone Phone 15034399999 Fax Number +15035981960 Fax Number (503) 439-9999 NOTE: Addition to permit #p1m2015-00424 71 CITY OF TIGARD PLUMBING PERMIT 8 . COMMUNITY DEVELOPMENT Permit#: PLM2016-00424 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/10/2016 Parcel: 1 S135BD01300 Jurisdiction: Tigard Site address: 10830 SW GREENBURG RD Project: Washington Square Hotel Subdivision: MEADOW VIEW Lot: 8 Project Description: Replacement of existing fixtures in various locations through out hotel.(2)backflow preventers,(1)clothes washer, (1)ejector/sump pump,(2)primers,(2)lays,(10)tub/showers/stalls&(2)water closets. Contractor: COMMERCIAL PLUMBING SERVICE Owner: SCHAEFER, ROBERT M&SALLY J& 21185 NW EVERGREEN PKWY SUITE 105 MILLER,GERALD V HILLSBORO, OR 97124 BY SHILO INN-WASHINGTON SQUARE 11600 SW SHILO LN PORTLAND, OR 97225 PHONE: 503-439-9999 PHONE: FAX: 503-439-1999 FEES Quantity Description Date Amount 2 ea Backflow Preventer 08/10/2016 $62.54 Specifics: 1 ea Clothes Washer 08/10/2016 $25.02 1 ea Ejectors/Sump 08/10/2016 $25.02 Type of Use: COM 2 ea Primer 08/10/2016 $25.02 Class of Work: ALT 2 ea Lavatories 08/10/2016 $50.04 Type of Const: 10 ea Tub/Shower/Shower Pan 08/10/2016 $125.10 Occupancy Grp: 2 ea Water Closet 08/10/2016 $50.04 Stories: 1 12%State Surcharge- 08/10/2016 $43.53 Plumbing Total $406.31 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: t, \ ` 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. From:Cindy Woollett Fax:/503)439-1999 To:5035981960@RCFAX.t Fax: +15035981960 Page 4 of 4 08108/2016 9:56 AM Plumbing Permit Application Building Fixtures � 6.1J -, FOR OFFICE USE ONLY Ili �City of Tigard + eceived q 13125 SNF Hall Blvd., Tigard,OR 9722 � .1 - I Date;gy. ! tel/�( t� PerntitNo.: � �� (� Plan view Phone: 503.718 2439 Fax: 503.598.1960 B Other Permit Nu 4OaetTJ'i 1�� Dttediv Inspection line 503.6394175 TIGARD � 1,I 6 O 8 ,1110 By. Date Ready . rune El See Page 2 for Internet: www.tigard-or.gov l Nolified'Method. Supplemental Information I'YPE OF WORK .qs{` f. 5. It ... F.FC* •SCITI.DU7'.E ❑New construction ❑Detnoltti r t Fors ecrtrl information use checklist. / .a % )� Description .,___ I Qty, Ea. 1 Total ►� lddition.aheratio3/reply eenseut ❑�1k1K Ness 1-2-family dwellings(includes 1001:1.for each utility connection) CATEGORY OF CONSTRUCTION SIR(l)bath 312,70 • 1=11-and 2-family dwelling ®Connnercial/industrial SFR(2)bath 437.78 m 0 Accessory building [-JMulti-familySFR(3)bath 500.32 Each additional hath/kitchen 25.02 0 Master builder E Other: - - - --. Fire sprinkler( sq.It.) 1 Page 2 JOB SITE INFORMATION AND LOCATION I Site utilities: Job site address:10830 SWGreenberg rd Catch basin or area drain I 18.76 - Drywell,leach line.or trench drain 18.76 City/State/ZIP:1•igard,Oregon,97223 Footing drain(no.linear ft,: I Page 2 Suite/bldg./apt.no.: Project name:Washington Square Hotel Manufactured home utilities 50.03 Cross street/directions to job site:SW Cascade ave Manholes 18.76 Rain drain connector 18.76 _.. _.,....-..--- _......._.._...-- Sanitary sewer(no.linear ft.: ) Page 2 Storni sewer(no.linear ft.: ) Page 2 Water service(no.linear if: ) Page 2 Subdivision: _I'.ot no,: F_- -__ Fixtttce or item: Tax Harp/parcel no.: Backflow preventer 2 31.27 # 62.54 -1-1-1-- . -. -"-_.- Backwater valve 12.51 i)1 SCRIP7ION OF lVORIi code updating-- 6"1-f�Ct M Cr..)T OF t Clothes washer 1 25.02 25,02 X!S%/1�v Pt X�42E$! D si. hwasher 25.02 - _ VA-12fous Loerrtoy, 'tijt2.ott oc�T /4-arEt_ __.__ 6k- Drinking fountain 25,02 Ejectors./sump 1 25.02 25.02 02PROPERTY OWNER 0.TENANT ____ • Expansion tank 12.51 Name:Greg Guerra Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:10830 SW Greenberg Rd Garbage disposal 25.02 City/State/Z1P:"Tigard,Oregon,97223 -. I lose Iib 25.02 Phone:(503)740-9823 Fax:{ ) Ice maker I2.51 0 APPLICANT lntcrec tor! terse try) ... ® GOti`1'A(1' PERSON P g' l 25.02 Business name:Commercial Plumbing Services - Medical gas(value:S_) Page 2 Contact name:Hans Halverston Primer 2 12.51 25.02 - Root'drain(commercial) 12.51 Address:21185 NW Evergreen Parkway Suite 105 Siry 2 25.02 50.04 Sink/basin/lavatory _ City/StateIZIP:Hillsbot•o,Oregon,97124 Solar units(potable water) j 62.54 Phone:(503)439-9999 Fax::{503)439-1999 - Tub/shower/shower pan _ 10 12.51 125.10 1;-mail dispatchoseps services.biz Urinal I 25.02 Water closet 2 25.02 50.04 CONTRACTOR ..___ Water heater 37.52 Business name Commercial Plumbing Serivice Water piptzlsy!T)j�V 4ti-oriD TO 36 29 Address:21185 NW Evergreen Parkway Suite 105 Other: .9-'0)e"L 25.02 - leg City/State/ZIP:Millsboro,Oregon,97124 Subtotal „41911-7--369-. Phone:(503)439-9999 Fax:(503)439-1999 Minimum permit fee: S72.50 CCB Lie.:126015 - Plumbing Lie,no.:37-42T 1'B �� Plan review (25%of permit fee) ' C'S ' /...- w / - State surcharge(12%of permit fee) cry-xi' l 3 Authorized signature: TOTAL PERMIT FIT 46 Print name:Heather"Farmer Date:08/08/16 This permit application es ' es if a permit is not obtained within 180 days 17 I after it has been accepted as complete. "Fee methodology set by Tri-County Building lydustry Service Board. N x d�, i i k3uildin .P�� ermits\PI.AMU-Parris App_doe 10,01;09 440-4eI6T(I o;D2nCOM/30'13) "' [CC From:Cindy Woollett Fax:(503)439-1999 To:5035981960@RCFAX.t Fax: +15035981960 Page 3 of 4 08108/2016 9:56 AM Plumbinz Permit Application - City of Tigard Page 2 -Supplemental Information Fee Schedule: Residential Firc Suppression Systems: Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee: _ Footing drain-l' 100' 50.03 0 to 2,000 $121,90 Footing drain-each additional 100' 37.52 2,001 to 3,000 $109.69 Sewer-1st 100' 62.54 3,601 to 7.200 $233.20 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 Valuation: Permit Fee: 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 Inspections or Fees Qty. Fee(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 fcc is specifically indicated 90.00/hreach 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 S25,001.00 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 S50,000.00. Additional plan review fur revisions 90.00/hr 550,001.00 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 Plan Review for Plumbing installations Fixture Type fur Replace/ Plan review is required for anyof the following. Work Performed: Capped Added Relocate q Baptistry/Font Please check all that apply. Bath Tub/Shower ❑ Any new commercial building with water service 2"and Jacuzzi/1Vlrirlpool greater,except systems designed and stamped by licensed Car Wash -Each Stall engineer. -Drive'tuts ❑ 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 OAR918-780-0040. Eye Wash Floor Drain/sink -2" Submit 2 sets of plans with any of the above. -3" Isometric or Riser Diagram Car Wash Drain Garbage Domestic-twn-loud ❑ 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./Refrig.Drains Oil Separator(Gas Station) Comments regarding fixture work: Rec.Vehicle Dump Station Shower -Gang -Stall Sink/Lav -Non-food related --- --Bradley -Commercial-fond related -Service Swimming 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: C:1Users\Dispatch21permitl'1'lGARD PLUMBING PERMIT.doc 2 From:Cindy Woollett Fax:(503)439-1999 To:5035981960@RCFAX.1 Fax: +15035981960 Page 1 of 4 08108/2016 9:56 AM F A X Date: 08/08/2016 Pages including cover sheet: 14 To: 5035981960@RCFAX.CO From : Cindy Woollett Commercial Plumbing Servii 21185 NW Evergreen Pkwy Hillsboro OR 97124 Phone Phone 15034399999 Fax Number +15035981960 Fax Number (503) 439-1999 NOTE: l permit From:Cindy Woollett Fax:(503)439-1999 To:5035981960@RCFAX.t Fax: +15035981950 Page 2 of 4 08/08/2016 9:56 AM % PLUMBING SERVICE