Permit (49) CITY OF TIGARD PLUMBING PERMIT
" COMMUNITY DEVELOPMENT Permit#: PLM2016-00355
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/06/2016
Parcel: 25101 BA00101
Jurisdiction: Tigard
Site address: 7500 SW DARTMOUTH ST 110
Project: Joy Teriyaki Subdivision: None Lot: None
Project Description: Adding(1)dishwasher,(2)2"floor drains,(1)3"floor drain,(1)grease trap,(1)primer,(4)food related sinks&(1)
water heater.8/9/16,adding(1)2"floor sink.
Contractor: MODERN PLUMBING Owner: WAL-MART REAL ESTATE BUSINESS TR
11120 SW INDUSTRIAL WAY BY PROPERTY TAX DEPT STORE 5935-00
TUALATIN, OR 97062 PO BOX 8050
ATTN MS 0555
BENTONVILLE,AR 72716
PHONE: 503-691-6166 PHONE:
FAX: 503-691-6771
FEES
Quantity Description Date Amount
1 ea Dishwasher 07/28/2016 $25.02
Specifics: 3 ea Floor Drain/Floor Sink/Hub 07/28/2016 $75.06
1 ea Interceptor/Grease Trap 07/28/2016 $25.02
Type of Use: COM 1 ea Primer 07/28/2016 $12.51
Class of Work: ALT 4 ea Sink 07/28/2016 $100.08
Type of Const: 1 ea Water Heater 07/28/2016 $37.52
Occupancy Grp: 1 12%State Surcharge- 07/28/2016 $33.03
Stories: Plumbing
1 ea Floor Drain/Floor Sink/Hub 09/06/2016 $25.02
0 12%State Surcharge- 09/06/2016 $3.00
Plumbing
Total $336.26
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct s-t OUNC by calling 503.232.1987 or 1.800.332.2344.
Issue By: Permittee Signat re:¢ ,-
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Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Applic n wY
t
Site UtilitiesIII
City of Tigard Received
01 �U N 3 0 2 01 Re eiv 7 (Thep, Permit No.:
13125 S W Hall Blvd.,Tigard,OR 97223 Plan Review CoCD Ito a/x/6-co.35-5-
Plan• Phone: 503.718.2439 Fax 1
4,;N:.,,,,, Date/By: Other Permit No.: wit 1�00 8
Inspection Line: 503.639.417$ }I IDate Ready/By: ! � /1
I I G A R U t; a"e y."y Y o� l0 Jura: S See Paget 2l nr
Internet: www.tigard-or.gov t. i \ (�
" Notified/Method: InformationSuppleountal
TYPE OF WORK FEE! SCHEDULE -- ---
❑New construction 0 Demolition For special information use checklist.
Description I Qty. I Ea. I Total F
3:1,Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) 7)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 tl `
❑1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 vJ
❑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 SITE INFORMATION AND LOCATION Site utilities: C
Job site address:7500 SW Dartmouth St. Catch basin or area drain 18,76 Q
City/State/ZIP:Tigard Drywell,leach line,or trench drain 18.76 J
Footing drain(no.linear ft.: ) Page 2 , +
Suite/bldg./apt.no.:110
l Project name:Joy Teriyaki 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: I Lot no.: Fixture or item:
Tax map/parcel no.: p`5 to/ 4100/0/ Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
1 f v-N a ' v.' . p�v vv-e✓\-'� Dishwasher r 25.02 05.1.YZ
Drinking fountain 25.02
Ejectors/sump 25.02
El PROPERTY OWNER. l: 0 TENANT Expansion tank
12.51
Name: Fixture/sewer cap 25.02 rpp,og
Address: Floor drain/floor sink/hub V25.02 7.5-46,
Garbage disposal 25.02
City/Slate/ZIP: Hose bib
25.02
Phone:( ) Fax:( ) Ice maker 12.51
0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap ' 25.02 a5 OZ
Business name:Modern Plumbing Co. Medical gas(value:$ ) Page 2
Contact name:Don George Primer ( 12.51 0,5
Roof drain(commercial) 12.51
Address:11120 SW Industrial Way,Bldg.9-3 Sink/basin/lavatory 9 25.02Uti(A
City/State/ZIP:Tualatin,OR 97062 Solar units(potable water) 62.54
Phone:(503)691-6166 Fax::(503)691-6771 Tub/shower/shower pan 12.51
E-mail:deborah@modernplumbing.us Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater / 37.52 37,57
Business name:Modern Plumbing Co.
Water piping/DWV 56.29
Address:11120 SW Industrial Way,Bldg.9-3 Other: 25.02
City/State/ZIP:Tualatin,OR 97062 Subtotal 2 r °
Phone:(503)691-6166 Fax:(503)691-6771 Minimum permit fee: $72.50 36°
CCB Lic.:87906 lumbing Lic.no.:34-250PB Plan review (25%of permit fee)_ 03
•
State surcharge(12%of permit fee) ^7°
Authorized signature: _
TOTAL PERMIT FEE t�
Print name:Deborah George Date:C0 j 0I1 k) This permit application expires if a permit is not obtained withi days g. ,
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.3l'u'/Q
I:113uilding\Permits\l'LMU-PcrmitApp.doc 10/01/09 440.4616T(10/02/COM/w1i11)
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:
Footing drain-1'100' 50.03 0 to 2,000 $121.90
2,001 to 3,600 $169.69
Footing drain-each additional 100' 37.52 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
Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
Other Inspections or Fees 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
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*.
Quantity by Fixture'l'ype Plan Review for Plumbing Installations
Fixture Type for Replace/ Plan review is required for any of the following.
Work Performed: Capped Added Relocate
Baptistry/Font Please check all that apply.
Bath -Tub/Shower 0 Any new commercial building with water service 2"and
-Jacuzzi/Whirlpoolub/Shower 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 1 0 Medical gas and vacuum systems for health care facilities.
-Domestic 0 Any multipurpose fire sprinkler system.
Drinking Fountain 0 Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" 5 '. Submit 2 sets of plans with any of the above.
-3„
Isometric or Riser Diagram
Car Wash Drain ❑ Isometric or riser diagram is required for new buildings
Garbage -Domestic-non-food
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-food related 9
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes increase of sewer EDUs,a sewer permit will be issued and
Water Extractor
Water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
C:\Users\mary\Documents\Downloads\PLMU_PermitApp(2).doc 2
Debbie Adamski
From: Deborah George, Modern Plumbing <george4715@comcast.net>
Sent: Friday, August 05, 2016 8:52 AM
To: Debbie Adamski
Subject: Permit PLN2016-00355
Hi Debbie -
I need to add 1 Floor sink to the permit for Joy Teriyaki - PLM2016-00355.
This is the one where they have not paid the sewer fees yet.
I am not sure if adding a floor sink changes the sewer fees or not but I wanted to get
this floor sink added before they came in to pay the fees.
Please let me know if you need any additional information.
Thank you
Deborah George _
deborah@modernplumbing.us
503-691-6166
. May love and laughter fill your day ., c7c
0(01.9_12 f , AJ2 )
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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
7500 SW DARTMOUTH ST 110, TIGARD, OR,
97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2016-00355
Don Sylvester
Violation Summary:
Inspector Contractor