Permit (81) CITY OF TIGARD PLUMBING PERMIT
. ' COMMUNITY DEVELOPMENT Permit#: PLM2017-00185
13125 SW Hall Blvd.,Ti Date Issued: 05/18/2017
T[tUAta. and OR 97223 503.718.2439 9
Parcel: 1 S 1260000300
Jurisdiction: Tigard
Site address: 9329 SW WASHINGTON SQUARE RD 107
Project: Sephora Subdivision: None Lot: None
Project Description: Interior plumbing for TI:Adding(1)sink.
Contractor: CALIBER PLUMBING&MECHANICAL INC Owner: PPR WASHINGTON SQUARE LLC
10940 SW BARNES RD#114 PO BOX 847
PORTLAND, OR 97225 CARLSBAD, CA 92018
PHONE: 971-563-1672 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Sink 05/18/2017 $25.02
Specifics: 1 12%State Surcharge- 05/18/2017 $8.70
Plumbing
Type of Use: COM 47 ea Minimum Fee Adjustment- 05/18/2017 $47.48
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
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 copy of the rules
or direct. - ".i to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issu•d By: I / ,r, Permittee Signature: x.
te
!Al
Call 503.639.4175 by 7:00 a.m.for the next available inspec ' ate.
This permit card shall be kept in a conspicuous place on the job site un completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application 5 r =._ :,, t_ . _, .
Building Fixtures Folz orrlcL I SE ()NEN
Cl of Tigard yriAN aLA, 1 Received
`� ll ,� L7 /7 Permit No.: a k c ''
III _ ■ 13125 SW Hall Blvd.,Tigard,OR 97223 Plan : 7 t 7-t � J
ry Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 y 1 7 'l t Date/By: Other Permit No.:ejt n 17_2U 3 .
Inspection Line: 503.639.4175 �{ D. t/ / M'
T I G A R D eady/By: orris: 0 See Page 2 for
Internet: www.tigard-or.gov �v, 1 ethod: 1 Supplemental Information
TYPE OF WORK C� i"lioN FEE* SCHEDULE
El New construction El Demol iat G ? For special information use checklist
Description Qty. I Ea. I Total
®Addition/alteration/replacement El 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 ®Commercial/industrial SFR(2)bath 437.78
ElAccessory building ElMulti-familySFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder El Other:
Fire sprinkler( sq.ft.) Page 2
JOR SITE INFORMATION AND LOCATION Site utilities:
Job site address: SW Washington Square Rd. Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Portland OR 97223
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.:T-07 1 Project name:Sephora Skincare Studio 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.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Rough in and install one Island sink and faucet
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER 0 TENANT Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:Caliber Plumbing&Mechanical Inc. Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Matt Dorn
Roof drain(commercial) .12.51
Address:6036 N Cutter Circle Ste#360' Sink/basin/lavatory ! 25.02 ? o.
City/State/ZIP:Portland OR 97217 Solar units(potable water) 62.54
Phone:(503)206-7591 Fax::(503)285-5769 Tub/shower/shower pan 12.51
E-mail:office@calibermechanical.com Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:Caliber Plumbing&Mechanical Inc.
WaterPiP t m DWV 56.29
Address:6036 N Cutter Circle Ste#360 Other 25.02
City/State/ZIP:Portland OR 97217 Subtotal 2.5 C
Phone:(503)205-7591 Fax:(503)285-5769 Minimum permit fee: $72.50 7,01,.5Zl
Plan review (25%of permit fee)
CCB Lic.:208245 Plumbing Lic.no.:PB1658
State surcharge(12%of permit fee) V 70
Authorized signature: TOTAL PERMIT FEE 0
Print name:Ernie Beasley Date:4-28-2017 This permit application expires if a permit is not obtained within 10 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I\Building\Permits\PLMU-PermitApp_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:
Footing drain-Pt 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
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
each additional$100.00 or fraction thereof,to
Other Inspections or Fees Qty. Fee(ea) Total
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*.
Quantity by Fixture Type Plan Review for Plumbing Installations
WorkType for Relocate Plan review is required for anyof the following.
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/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru ❑ 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-non-food ❑ 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-food 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:\Users\Desiree\Downloads\PLMF_PermitApp(3).doc 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9329 SW WASHINGTON SQUARE RD T07, June 9, 2017 at 8:13:43 AM
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2017-00185
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Protective cover for exposed plumbing under fixture to be installed by contractor. Left
exposed for inspection.
Violation Summary:
Inspector Contractor