Permit (66) CITY OF TIGARD PLUMBING PERMIT
2 - COMMUNITY DEVELOPMENT Permit#: PLM2017-00327
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/17/2017
Parcel: 2S102BD01503
Jurisdiction: Tigard
Site address: 12800 SW PACIFIC HWY
Project: Storquest Self Storage Subdivision: FREWING'S ORCHARD TRACTS Lot: 1
Project Description: Plumbing fixtures for new,3-story self-storage facility: 1,050'storm sewer,(1)drinking fountain,(1)expansion
tank,(4)2"floor drains,(4)primers,(1)roof drain,(4)lays,(1)mop sink,(1)break room sink,(4)water closets&
(1)water heater.
Contractor: EK PLUMBING Owner: 12740 SW PACIFIC SP LLC
PO BOX 1898 BY THE WILLIAM WARREN GROUP INC.
BATTLEGROUND,WA 98604 201 WILSHIRE BLVD STE 102
SANTA MONICA, OC 90401
PHONE: 360-687-4648 PHONE:
FAX: 360-687-6473
FEES
Quantity Description Date Amount
1050 If Storm Sewer 08/16/2017 $437.74
Specifics: 1 ea Drinking Fountain 08/16/2017 $25.02
1 ea Expansion Tank 08/16/2017 $12.51
Type of Use: COM 4 ea Floor Drain/Floor Sink/Hub 08/16/2017 $100.08
Class of Work: NEW 4 ea Primer 08/16/2017 $50.04
Type of Const: 1 ea Roof Drain(Commercial) 08/16/2017 $12.51
Occupancy Grp: 2 ea Sink 08/16/2017 $50.04
Stories: 4 ea Lavatories 08/16/2017 $100.08
4 ea Water Closet 08/16/2017 $100.08
ea Water Heater 08/16/2017 $37.52
1 12%State Surcharge- 08/16/2017 $111.07
Plumbing
Total $1,036.69
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.
4:29",
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.
,
` : FIVED
Plumbing Permit Applica�- l ,
44 , Building Fixtures AUG0 FOR OFFICE USE ONLY
City of Tigard
AUG"I(� 1 + Received
lig • 13125 SW Hall Blvd.,Tigard,O p� g� Date By: /V /7 ,d4714 -/- J.,J7 ao�,22
Q• Phone: 503.718.2439 Fax: 50 5- 1 6� ' l d t� Date/B vie �L�
Date/By: Other Permit No.:
TiCiARn Inspection Line 503639417 y� DING
Internet: www.tigard-or.gov u , Inv] Date / ...Joos
Ready/By {��7 , /' BI See Page 2 for
Notrfied/Metho '
3�` _;,� -' ! ����: .t ,i,4 .4 Supplemental Information
@ t1 � ' t,T�p 1"4?.�� h - �p r a . . G t wx ' I
New construction 1:1Demolition For special information use checklist _
Description I Qty. I Ea. I Total
0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
'i 1, .m .u_ r-A. t,r- c llo-yo (eaN �t,l i' c:o..4,1„ 9i_ ,,A;;,, SFR 1 bath
` o- $ �v _ , , 312.70
0 1-and 2-family dwelling ( Commercial/industrial SFR(2)bath
437.78
ElAccessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen
n 25.02❑Master builder 0 Other Fire sprinkler( sq.ft.) Page 2
14 JI y(� t•lttTA f£ l I QCArIN qdr Site utilities:
J Job site address: 12800 SW Pacific Hwy Catch basin or area drain 18.76 Q
_ Drywell,leach line,or trench drain 18.76 IsZt
City/State/ZIP: Tigard / Oregon / 97224
J Footing drain(no.linear ft.: ) Page 2 C
'\,e. Suite/bldg./apt.no.: I Project name: StorQuest Self Storage g Manufactured home utilities 50.03
Cross street/directions to job site: North West corner of Pacific Hwy. Manholes
18.76
(Hwy. 99) and McKenzie Rain drain connector 18.76
4 4 Sanitary sewer(no linear ft.:
- Stir= >C?`{ s=IXea"`_1 1 Page 2pitv 1,050'
...9..
Water service(no.linear ft.:_) Page 2
�, Subdivision: Frewing's Orchard Tracts Lot no.:
I 1 Fixture or item:
Backflow preventer
ter 31.27p. Tax map/parcel no S 0 �"B 10i �n 12.51�V 'l t , " 4i C ( 6i,
� � ° y�G � ° Backwater valve'1nt 1 17ernaCiiewtitclin �'s li11 "Cr 1 ` ' 4' Clothes washer 25.02" f thebasement
1/4
and provide complete plumbing Dishwasher 25.02
systemfor fixtures listed in the Fee Schedule Drinking fountain 1 25.02 25.02
�� 1 ao �� Ejectors/sump 25.02
m( o- . �' u� 'i �(1o- .' o-i} I ''t it
roll" `1r-` rot 4 . Expansion tank 1 12.51 25.02
r,
ItName:12740 SW Pacific SP, LLC by the William Warren GrcuDFixture/sewer cap 25.02
O
IJP Address: 201 Wilshire Blvd. Ste. 102 Floordrain/floorsink/hub 4 25.02 100.08
Garbage disposal 25.02
-- City/State/ZIP:Santa Monica / OC / 90401
Hose bib 25.02
Phone:(949) 272-2841 Ice maker
'j '4 b [3 Air Li Aitila l:.it r �( ) 12.51
1 ,nn a a, a: 1. 7fr i, .��! re'y .�a, ]' o-ONTAc,T ER -, , ri , i- Interceptor/grease trap 25.02
Business name: Campbell Development Medical gas(value:$ ) Page 2
Contact name: Vince Parravano Primer 4 12.51 50.04
Address: Roof drain(commercial) 1 12.51 12.51
23026 N. 16th Lane Ste. 101 Sink/basin/lavato
City/State/ZIP: Phoenix/Arizona /23026 Solar units ry - �a 25.02 150.20
(potable water) 62.54
Phone:(623) 434-8500 I Fax: :(623) 434-9020 Tub/shower/shower pan 12.51
E-mail: vUrinal 25.02
incepam
Ca�cpbell development corn
1 o- de ,gr ,ui'i i ' Water h
o- 1 Water closet 4 25.02 100.083
eater 7.52
,P Business name: EK Plumbing 1 37.52
W Water piping/DWV 56.29
otr Address: PO Box 1898 Other:
25.02
3City/State/ZIP: Battleground /WA/ 98604 Subtotal 500.47
Phone:(360)687-4648 Fax:( ) Minimum permit fee: $72.50
ccs Lie.: 1293634,0)0J Plumbing Lic.no.: 37-430-PB Plan review (25%of permit fee)
..
fl
dnr,gneenv a„Mede State surcharge(12%of permit fee) 60.06
Authorized signature: Jeff Massiet9 40.0 00
pasa:<°-0'° TOTAL PERMIT FEE b60.53
Print name: Jeff Massie Date: $/10/2017 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.
l:\Buildinng\Permits\PLMU-PerrmitApppdoc 10/01/09 4440-466i 6T((10/02/COM/WEn)
/I/O /6)Z/91-4/ ,2/ClJ 4672141
/2,-C-2:
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
LG z I _ ( ��1 e(e :w. ToS ,t!,-
AFT
tF �)^P:.- 1 cam:
. ; - �r:. ,��i T ��ie-s: '�l u: m; fit' '> e `--`' Itgr >< � ik � �,5?: �x...
Footing drain-1"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 _� g�t I ,
Storm&Rain Drain-1st 100' 62.54 it �� r' ' "_
$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
����" deeeu m,Tvtal� each additional$100.00 or fraction thereof,to
I)lipeettunls ofFeeS�v L-' ,viii( 1 --�Ii'�' 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:
CiAudiejtiallFileffirotik
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* til ' 1'ion
Quantity by Type Plan review is required for any of the following.
Fixture Type fair Repla�el Please check all that apply.
Work Perfbrtnesl: -'Capped Addcd Reioete PP Y•
Baptistry/Font ❑ Any new commercial building with water service 2"and
Bath: Tub/Shower greater,except systems designed and stamped by licensed
-Jacuzzi/Whirlpool engineer.
ElCar Wash: Each Stall New exterior plumbing site utilities for any complex structure
Drive Thru as defined in OAR918-780-0040.
Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system.
-Domestic 0 Any complex structure as defined in OAR918-780-0040.
Drinking Fountain
Submit 2 sets of plans with any of the above.
Eye Wash 4
Floor Drain/sink: -2" y
Isii n..eti4& . 1 1 r
4
0 Isometric or riser s
diagram is required for new buildings
-Car Wash Drain g q g
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 4 r1 L-4 VS
Shower: -Gang i 612_20 ilva M
-Stall �g
Sink: -LavBar non-food related flop SINK--
-Bradley
-Com/Serv/Util food related
-Service 1 tine *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
Water Extractor fees assessed for the sewer increase must be paid before the
Water Closet-Toilet 4 plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
INIAccumulative Sewer Tally
a Tenant Name: StorQuest Self Storage SWR# N/A
Ti GARD Site Address: 12800 SW Pacific Hwy PLM# PLM2017-00327
Parcel#: 2S102BD01503
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 1 1 1 1
Eye Wash 1 0 0 0 0 0
Floor Drain/Sink: -2 inch 2 0 0 4 8 4 8
-3 inch 5 0 0 0 0 0
-4 inch 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 0
Living Unit 16 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 0
-Stall 2 0 0 0
0 0
Sink:
-Lav/Bar-Non-Food Related 2 0 0 5 10 5 10
-Bradley 5 0 0 0 0 0
-Com/Sery/Util-Food Related 3 0 0 1 3 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 4 24 4 24
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 4.1 65.6
TOTALS 0 0 0 0 15 46 15 -19.6
Current Fixture Value -19.6 divided by 16= -1.225 Current EDU 1 EDU= $5,500.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change -19.6 divided by 16= -1.225 over (under) $ (6,765.00)
Enter EDU Change Here -1.230 *
*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: 1.23 EDU CREDITS remain for future use at this address.
Authorized Name/Signature: Dianna Howse Date: 8/14/2017
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_5500_070117.xlsx
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
12800 SW PACIFIC HWY, TIGARD, OR, 97223 July 17, 2019 at 12:51 :39 PM
Record Type: Record ID:
Commercial - Plumbing PLM2017-00327
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor