Permit (25) CITY OF TIGARD ® ii PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2017-00029 f�
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/09/2017
T t C.;ti I<.I: g Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 15350 SW SEQUOIA PKWY
Project: PacTrust Subdivision: 1996-048 PARTITION PLAT Lot: 2
Project Description: Upgrades and additions to entire building's common area plumbing:adding(2)2"floor drains,(1)expansion tank,
(2)shower stalls,(3)lays,(2)water closets&(1)water heater. Replacing(3)drinking fountains,(12)lays,(16)
water closets&(6)urinals. 3/14/17: REPRINT to add tankless water heater.
Contractor: DEAN WARREN PLUMBING&REMODELING INC Owner: PACIFIC REALTY ASSOCIATES
PO BOX 14701 ATTN: N PIVEN
PORTLAND, OR 97293 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE 503-236-4152
PHONE: 503-624-6300
FAX: 503-296-2218
FEES
Quantity Description Date Amount
3 ea Drinking Fountain 01/31/2017 $75.06
Specifics: 1 ea Expansion Tank 01/31/2017 $12.51
2 ea Floor Drain/Floor Sink/Hub 01/31/2017 $50.04
Type of Use: COM 15 ea Lavatories 01/31/2017 $375.30
Class of Work: ALT 2 ea Tub/Shower/Shower Pan 01/31/2017 $25.02
Type of Const: 6 ea Urinal 01/31/2017 $150.12
Occupancy Grp: 18 ea Water Closet 01/31/2017 $450.36
Stories: 1 ea Water Heater 01/31/2017 $37.52
1 12%State Surcharge- 01/31/2017 $141.11
Plumbing
1 ea Water Heater 03/14/2017 $37.52
0 12%State Surcharge- 03/14/2017 $4.50
Plumbing
Total $1,359.06
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 SUNC by calling 503.232.1987 or 1.800.332.2344.
OF
Issued By: 411PPermittee Signature: V
Call 503.639.4175 by 7:00 a.m.for the next available insp•,S'on 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.
CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2017-00029
13125 SW Hall Blvd.,Ti Date Issued: 02/09/2017
T[C�;�kt. and OR 97223 503.718.2439 9
Parcel: 2S 112 DA01400
Jurisdiction: Tigard
Site address: 15350 SW SEQUOIA PKWY
Project: PacTrust Subdivision: 1996-048 PARTITION PLAT Lot: 2
Project Description: Upgrades and additions to entire building's common area plumbing:adding(2)2"floor drains,(1)expansion tank,
(2)shower stalls,(3)lays,(2)water closets&(1)water heater. Replacing(3)drinking fountains,(12)lays,(16)
water closets&(6)urinals.
Contractor: DEAN WARREN PLUMBING&REMODELING INC Owner: PACIFIC REALTY ASSOCIATES
PO BOX 14701 ATTN: N PIVEN
PORTLAND, OR 97293 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-236-4152 PHONE: 503-624-6300
FAX: 503-296-2218
FEES
Quantity Description Date Amount
3 ea Drinking Fountain 01/31/2017 $75.06
Specifics: 1 ea Expansion Tank 01/31/2017 $12.51
2 ea Floor Drain/Floor Sink/Hub 01/31/2017 $50.04
Type of Use: COM 15 ea Lavatories 01/31/2017 $375.30
Class of Work: ALT 2 ea Tub/Shower/Shower Pan 01/31/2017 $25.02
Type of Const: 6 ea Urinal 01/31/2017 $150.12
Occupancy Grp: 18 ea Water Closet 01/31/2017 $450.36
Stories: 1 ea Water Heater 01/31/2017 $37.52
1 12%State Surcharge- 01/31/2017 $141.11
Plumbing
Total $1,317.04
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: 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.
Plumbing Permit Application�i
Building Fixtures ;. -.1 '71
City of Tigard Received ,�j ,I^/, �7
g t � Date/By: , 21 7 Permit No.:
Nil 13125 SW Hall Blvd.,Tigard,OR Q� 33 I i.i
li r Plan Review i(,__�d�l 4/3
Phone: 503.718.2439 Fax: 503.59 Date/By:
1960 Other Permit No.: O � u
1
T l G A t D Inspection Line: 503.639.4171ir,A / co_
kJuris:
Internet: www.tigard-or.gov .- 1 't./ 1/ yNotified/Method: Supplemental Information
TYPE 11; G DIVISION
FEE* SCHEDULE
❑New construction 0 Demolition For special information use checklist
Description I Qty. Ea. Total
ffiff 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
❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
buildingSFR(3)bath 500.32
❑Accessory 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION ,"" Site utilities:
Job site address: / ,rG 9 t.v S� u.z.c Catch basin or area drain 18.76
�'t a ��Y Drywell,leach line,or trench drain 18.76
City/State/ZIP: -,,, 44,eJ G?„ S Yy(
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name: /49/` 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.: O2 S/`2. (D f}o/libe Backflow preventer 31.27
Backwater valve 12.51
DESCRII>TIQ$OF WORK ..
�l Clothes washer 25.02
rLe w 14eA,�/Aro.,"S,4v-' ,.��:y1-S,,.A, /i�y fo;,f lyp i,H/t til Dishwasher 25.02
1
42€17/r4ur+I Drinking fountain 3 25.02
Ejectors/sump 25.02
0 PROARTY OWNER 0 TENANT Expansion tank / 12.51
Name: l<s 7- Fixture/sewer cap 25.02
Floor drain/floor sink/hub 2 25.02
Address: / f s'(a.i S' Csb tj P
v-dy Garbage disposal 25.02
City/State/ZIP: �rs,JNei a4, 91)-a9 Hose bib 25.02 ,
Phone:( co'3) C)-if G 3-v o Fax:( ) Ice maker 12.51
AiRPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name: P ca,D'u-(LIW-til/tA,41 ,-�t /�✓e
7 Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address: PoI 1 4 i '/ Sink/basin/lavatory j S- 25.02
City/State/ZIP: pol.- &A, 9 )2 S 3 Solar units(potable water) 62.54
Phone:(5r ,) -.2 g c, 9 y F c Fax::( ) Tub/shower/shower pan 2 12.51
E-mail: Urinal 6- 25.02
. Water closet 18 25.02
CONTRACTOR'm .
�
Water heater ( 37.52
Business name:
Water piping/DWV 56.29
Address: Other: 25.02
City/State/ZIP: Subtotal
Phone:( ) Fax:( ) Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lic.: / " j 9/g Plumbing Lic.no.: 16 7 3 Ci°47
State surcharge(12%of permit fee) il
Authorized signature ,4--. TOTAL PERMIT FEE / 3/'01
Print name: ' e /) Date:�_�j_/7 This permit application expires if a permit is not obtained within i80 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Pennits\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:
Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee:
Footing drain-16'100' 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 Qty' Fee �) 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*. Plan Review for Plumbing Installation
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 ❑ New exterior plumbing site utilities for any complex structure
-Drive as defined in OAR918-780-0040.
Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial
0 Any multipurpose fire sprinkler system.
Domestic ❑ 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" Isometr o ser 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
Ice Mach./Refiig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall 2
Sink: -Lav/Bar non-food related 3 /
-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 Z ' (p plumbing permit can be issued.
Urinal (Q
Other Fixtures:
I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15350 SW SEQUOIA PKWY, TIGARD, OR, 97224
Record Type: Record ID:
Commercial - Plumbing PLM2017-00029
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor