Permit IN CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT '` ". 4 Permit#: PLM2016-00448
Date Issued: 08/17/2016
T[G fry R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 e gb /4, ate.,.
Parcel: 2S110DCO2200
Jurisdiction: Tigard
Site address: 15660 SW PACIFIC HWY A-8
Project: Hops On Tap Subdivision: 1997-016 PARTITION PLAT Lot: 2
Project Description: Interior plumbing: Relocating(1)commercial dishwasher, (1)sink, and(1)utility sink;Adding(2)sinks;Capping(2)
non-food related sinks and(1)utility sink. 10/26/2016: Add(1)grease trap to sink and dishwasher.
Contractor: T&T PLUMBING& DRAINS Owner: ROTC OREGON LLC
PO BOX 33045 ATTN: SCHOEBEL, RICHARD
PORTLAND, OR 97292 8905 TOWN CENTRE DR, STE 108
SAN DIEGO, CA 92122
PHONE: 541-337-3080 PHONE:
FAX:
FEES
Quantity Description Date Amount
ea Dishwasher 08/17/2016 $25.02
Specifics: 3 ea Fixture/Sewer Cap 08/17/2016 $75.06
4 ea Sink 08/17/2016 $100.08
Type of Use: COM 1 12%State Surcharge- 08/17/2016 $24.02
Class of Work: ALT Plumbing
Type of Const: 1 ea Interceptor/Grease Trap 10/26/2016 $25.02
Occupancy Grp: 0 12%State Surcharge- 10/26/2016 $3.00
Stories: Plumbing
Total $252.20
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 cop of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
-
Issued By: Permittee Signature: .,4//
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.
Plumbing Permit Application m '
BuildingalkFixtures - } � A
City of Tigard l i CI
2 2016 RDeactee/iBveyd: /v 2 6/4 /lK7yYL_, Permit NV/?0/6
a yy,F-I
• 13125 SW Hall Blvd.,Tigard,OR 97223
= Phone: 503.718.2439 Fax: 503.59841" Plan Review
-t 4'`k k r Y Date/By- Other Permit No.:
Inspection Line: 503.639.4175 t� #"lta C
T I G A R D Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov BUILDINi; Notified/Method: Supplemental Information
TYPE OF WORK '?; FEE* SCHEDULE °
❑New construction 0 Demolition For special information use checklist.
Description Qty. Ea. I Total
ri"'Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION , SFR(1)bath 312.70
❑ I-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
0 Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 15"((0 _5:4:_i"/ ;f'.(_ A y
Catch basin or area drain 18.76
n` Drywell,leach line,or trench drain 18.76
City/State/ZIP: �i .r1�G� L�� z
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: i Sr 1 Project name: ' /
�� 0/V ��� Manufactured 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: 1 Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION Off' WORR>. Backwater valve 12.51
"' se J Clothes washer
�- .r� /,�`.a. { �� 25.02
Dishwasher 25.02
Pi61-4 A,'ri les Drinking fountain 25.02
Ejectors/sump 25.02
=y d i'ROPEtTY;O R 1 `ENANT Expansion tank 12.51
Fixture/sewer cap 25.02
Name: '1-3�v,.e--_,(09i l'+t ti v,
/i n ,./ A Floor drain/floor sink/hub 25.02
/
Address: y'g c3L> .5 12 4 v L
Garbage disposal 25.02
City/State/ZIP: /ice` _e'i' Op-r' 9 7 p C C7 Hose bib 25.02
Phone:(54.3) �'2 2_- /
'L(/7 Z Fax:( ) Ice maker 12.51
AP LICANT >; y 0 CONTACT '7,:;,71N N Interceptor/grease trap 2 25.02
Business name: c, 1 ;Ai/' Z G Medical gas(value:$ ) Page 2
Primer 12.51
Contact name: I f
Yd '� !moi ^‘ Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
Water closet 25.02
CONTRACTOR
.- Water heater 37.52
Business name: j f
/�' /+a✓t /7 ;0L 4 Water piping/DWV 56.29
Address: Other: 25.02
City/State/ZIP: Subtotal
Phone:(c7/) 6 (iJ'3( Fax:( ) Minimum permit fee: $72.50
CCB Lic.: / mb' g Licii. Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signatu _� / TOTAL PERMIT FEE
Print name: Date: 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\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:
Fee(ea) Total
Site Utilities Qty.' Square Footage: Permit Fee:
Footing drain-151 100' 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 Valuation: ; Permit Fee:
$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 F ( 0 Total
each additional$100.00 or fraction thereof,to
h 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 Plumbiingwnstallations
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
0 Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
engineer.
Jacuzzi/Whirlpool
Car Wash: -Each Stall 0 New exterior plumbing site utilities for any complex structure
as defined in OAR918-780-0040.
-Drive Thru
Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial
0 Any multipurpose fire sprinkler system.
Domestic 0 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"
3" >,. Isometric or'Riser Diagram
0 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: -Lav/Bar 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
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
IliCITY OF TIGARD PLUMBING PERMIT
I ' COMMUNITY DEVELOPMENT
Permit#: PLM2016-00448
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/17/2016
Parcel: 2S 110DCO2200
Jurisdiction: Tigard
Site address: 15660 SW PACIFIC HWY A-8
Project: Hops On Tap Subdivision: 1997-016 PARTITION PLAT
Project Description: Interior plumbing:Relocating(1)commercial dishwasher,(1)sink,and(1)utility sink;Adding(2)sinks;Capping(2)Lot: 2
non-food related sinks and(1)utility sink.
Contractor: T&T PLUMBING&DRAINS Owner: ROIC OREGON LLC
PO BOX 33045 ATTN: SCHOEBEL, RICHARD
PORTLAND, OR 97292 8905 TOWN CENTRE DR, STE 108
SAN DIEGO, CA 92122
PHONE: 541-337-3080 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Dishwasher 08/17/2016 $25.02
Specifics: 3 ea Fixture/Sewer Cap 08/17/2016 $75.06
4 ea Sink 08/17/2016
Type of Use: COM $100.08
Class of Work: ALT 1 12%State Surcharge- 08/17/2016 $24.02
Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $224.18
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 :e:.-•-.- -•
Issued By: �a "'� Permittee Signat
Call 503.639.4175 by 7:00 a.m.for the next availab • inspection date.
This permit card shall be kept in a conspicuous place on the job -le u r it completion of the project.
Approved plans are required on the job site at the tim- • each inspection.
Plumbing Permit Application
Building Fixtures _.• •
FOR OFFICE USE ONLY
111 City of Tigard ' 1 I dt yl Received /
■ 13125 SW Hall Blvd.,Tigard,OR 972ili, --' B ::�'It 0- '° Date/By: g l 7 p ? ` Permit No.: J��
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review �y IV/6I��y
Inspection Line: 503.639.4175 Date/By: Other Permit No.:
TIC7AKD Y DateRead Ready/By:
`;U G 1 t ?it i y y I See Page 2 for
Internet: www.tigard-or.gov
Notified/Method: Supplemental Information
TYPE OF WORK if 41L,Ti ARID FEE* SCHEDULE
❑New construction °
o beinol t For special information use checklist
iT 1 I eC) �i t.P Description
Addition/alteration/replacement C )QtA r: ' Qty. Ea. l Total
New 1-2-family dwellings(includes 100 ft.for each utility connection)
, CATEGORY OF CONSTRUCTION SFR(1)bath I 312.70
❑ I-and 2-family dwelling Commercial/industrial SFR(2)bath 437.78
o Accessory building 0 Multi-family SFR(3)bath 500.32
❑Master builder Each additional bath/kitchen 25.02
❑Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE,INFORMATION AND LOCATION Site utilities:
Job site address: t 5( 00 6 W �U C,ciL �w C+�t . n ,2,
Catch basin or area drain 18.76
City/State/ZIP: �; (..„:„(c!, OR 0112�� J t"1Drywell,leach line,or trench drain 18.76
Suite/bldg./apt.no.: J Project name: ' Footing drain(no.linear ft.:_) Page 2
)P ��N �DLQ Manufactured home utilities 50.03
Cross street/directions to job site: I
Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.:_) Page 2
Subdivision: Water service(no.linear ft.: ) Page 2
I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WOE{ 7 , Backwater valve 12.51
= Clothes washer 25.02
- Dishwasher ,e I 25.02 res 0)
Drinking fountain 25.02
Ejectors/sump 25.02
0,PiOlkitiiir'01-04R 1 "TENANT- Expansion tank 12.51
Name:J O ,\0.( 1 Fixture/sewer cap %j 25.02 -75-;(1,2,
Address: O ��� (�2"d J Floor drain/floor sink/hub 25.02
Garbage disposal 25.02
City/State/ZIP: "t
'ciyd6 09._ all -L-Lki
Hose bib 25.02
Phone:(503 )9(L of Cl1(Z Fax:( )
Ice maker 12.51
Cr APPLICANT
0 CONTACT PERSON • Interceptor/grease trap 25.02
Business name: ih, oil Act? vie•
Medical gas(value:$ ) Page 2
Primer
rc0 -t/ltt t \`(YIC..-ter 12.51
Contact name:
Address:`► 114 Roof drain(conunercial) 12.51
��� C2 Ak) Sink/basin/lavato
City/State/ZIPf t D r 25.02 Aid I
l TIC( 0 C� "I 1 z Z..`( Solar units(potable water) 62.54 �� L<(l
Phone:ebo�)c�l_ C(L(Zc, I Fax::( ) Tub/shower/shower pan 12.51
E mail:��t_ �l'P�ooZll�`� (Y1Git�
rl ,C��.yr Urinal 25.02
j.,. , ACTOR Water closet 25.02
XBusiness name: T T �� Water heater 37.52
`�- ""i r- cm GGC_ Water i m DWV
Address: g�^; � � p p � 56.29
`T k) S /r1r'4,Other: 25.02
City/State/ZIP: 76/G1 j/<i
Phone: 0� Ci-70 3.1).' Subtotal *ti 10
( )541 _ '517--3,0 Fax:( ) Minimum permit fee: $72.50
CCB Lic.: n.� < , . Plan review (25%of permit fee)
��t1./ q ` i'fy/'7 Plumbing Lic.no.: Pa t 5 7
Authorized signature: ( •7//h 7 State surcharge(12%of permit fee) ,0).
TOTAL PERMIT FEL it i 0
Print-n e: c ��y, Date: �/`-� 4(� This permit application expires if a permit is not obtained wi hin 180 days
I •
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:)Building its)PLMU-Permit App.doe 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: ,
oto 2,000 $121.90
2,001 to 3,600
Footing drain-l'100' 50.033752 $169.69
Footing drain-each additional 100' 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 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
Total each additional$100.00 or fraction thereof,to
Other Inspections or Fees
Qty. . Fee(ea) 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.
$50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
90.00/hr
Additional plan review for revisions each additional$100.00 or fraction thereof.
(minimum charge-1/2 hour)
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 Review1r Plumbing Instlno_
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 0 Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower engineer.
-Jacuzzi/Whirlpool 0 New exterior plumbing site utilities for any complex structure
Car Wash: -Each Stall as defined in OAR918-780-0040.
-Drive Thru ❑ Medical gas and vacuum systems for health care facilities.
Cuspidor/Water Aspirator ❑ Any multipurpose fire sprinkler system.
r
Dishwasher: -Commercial 0 Any complex structure as defined in OAR918-780-0040.
-Domestic
Drinking Fountain Submit 2 sets of plans with any of the above.
Eye Wash
Floor Drain/sink: -2"
-3"
Isometric or Riser,Diagram, - ,*:
4"
0 Isometric or riser diagram is required for new buildings
-Car Wash Drain that meet the qualifications above.
Garbage -Domestic non-food
Disposal: -Domestic food related
-Commercial food related
-Industrial food related Comments regarding fixture work:
Ice Mach./Refrig.Drains
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall n
Sink: -Lav/Bar non-food related o�
-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 plumbing permit can be issued.
Water Closet-Toilet
Urinal
Other Fixtures:
1:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
Accumulative Sewer Tally
_ Tenant Name: HOPS ON TOP` SWR# N/A
Site Address: 15660 SW PACIFIC HWY SUITE A-8 PLM# 2016-00448
Parcel#: 2S110DCO2200
Fixture Value Previous Previous Credits Capped Fixture Fixture New New
# value count capped#s value count added# added value total#s total values
Baptisery/Font 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 0 0 0
0
-3inch 5 0 0 0 0 0
-4inch 6 0 0 0 0 0
-Car Wash 6 0 0 0 0 0
Garbage Disposal:
-Domestic(to 3/4 HP) 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
Living Unit 16 0
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
-Stall 2 0
0 0 0 0 0
Sink:
-Lav/Bar-Non-Food Related 2 0 2 4 2 4 0
0
-Bradley 5 0 0 0 0
0
-Com/Sery/Util-Food Related 3 0 1 3 0 -1
-3
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 0 0 0
Urinal 6 0 0
0 0 0 0
Previous EDU Count 0
0
Capped EDU Credit
0
TOTALS 0 0 3 7 2 4 -1 -3
Current Fixture Value -3 divided by 16= -0.188 Current EDU 1 EDU= $5,300.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change -3 divided by 16= -0.188 over (under) $ (1,007.00)
Enter EDU Change Here -0.190 *
*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: ***CREDIT***
Authorized Name/Signature: BRANDEN TAGGART X2449 Date: 8/17/2016
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 City of Tigard Building Division to redeem credits towards future system development charges.
I:\Building\Sewer Tally\SewerTallySheet_5300_070116.xlsx 111
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
15660 SW PACIFIC HWY A-8, TIGARD, OR,
97224
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
November 3, 2016 at 1:47:27
PM
PLM2016-00448
Don Sylvester
Corrections complete
Violation Summary:
Inspector Contractor