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Permit (57) CITY OF TIGARD PLUMBING PERMIT :11 2 . . COMMUNITY DEVELOPMENT Permit#: PLM2017-00456 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/06/2017 F ,"� Parcel: 2S113AC00103 Jurisdiction: Tigard Site address: 7204 SW DURHAM RD 300 Project: Kelley Imaging Subdivision: None Lot: None Project Description: Interior plumbing for TI:Capping(1)drinking fountain,(1)2"floor drain,(2)sinks,(3)water closets,and(1)urinal; Adding(1)sink. Contractor: ALWAYS FAITHFUL PLUMBING LLC Owner: PACIFIC REALITY ASSOCIATES LP PO BOX 757 ATTN: N PIVEN WILSONVILLE, OR 97070 15350 SE SEQUOIA PKWY#300 PORTLAND, OR 97224 PHONE: 503-780-9486 PHONE: FAX: FEES Quantity Description Date Amount 8 ea Fixture/Sewer Cap 11/06/2017 $200.16 Specifics: 1 ea Sink 11/06/2017 $25.02 1 12%State Surcharge- 11/06/2017 $27.02 Type of Use: COM Plumbing Class of Work: ALT Type of Const: Occupancy Grp: Stories: 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 copy of the rules or direct questionsonto OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: ! Permittee Signature: !/ %L. 4 Gam— , Call 503.639.4175 by 7:00 a.m.for the next available inspe tion 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 . n 'i/ G)f�` Building Fixtures ii ` ,t q // FOR OFFICE USF. OSI.I City of Tigard NO V `�`7 Date/By: �// /) 107" Permit No.:/fv) i 7-...C lel Sii IN • 13125 SW Hall Blvd.,Tigard,OR 97223 ' 1 g �; ,�;� Plan Review I Phone: 503.718.2439 Fax: 503.598,1W i ' G;3 � .,,+4 Date/By: Other Permit No.:/a�t�77plf....0 Inspection Line: 503.639.4175 t t -'� SJ !7 v P e t 1 y t t -''' Date Ready/By: Juris: gi See Page 2 for T I G A R D Internet: www.tigard-or.gov I" Notified/Method: e, Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑New construction 0 Demolition For special information use checklist Description Qty. Ea. Total 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 commercial/industrial _SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND-LOCATION 1 Site utilities: Job site address: 1,20.1 5,„,-:,, �1n1 gp _Catch basin or area drain 18.76 i City/State/ZIP:'lii ICW.O ij Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: 5491, I Project name: M 44jr Jm ` J,a 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 Backwater valve 12.51 . DESCRON OF WORK { E27 +3 l 1 t ? 1 sAIi �J t D4- Clothes washer 25.02 vL'"'©� 64e J' +c✓' i Dishwasher 25.02 LA V.5. Drinking fountain 25.02 ADO t (Aertd $()A Ejectors/sump 25.02 , 'ROPERTY OWNER "`.0 TENANT ` - .: Expansion tank 12.51 Name: kl- ', itt1 sir--- Fixture/sewer cap _/7 25.02/100 ,10 Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 APPLICANT 0 CONTACT FERN Interceptor/grease trap 25.02 Business name: Awi c,,T}ipV1,� .etwinai,k3G Medical gas(value:$ ) Paget Primer 12.51 Contact name: Lel 11 Roof drain(commercial) 12.51 Address: TO 1' DlL sl. Sink/basin/lavatory 1 25.02 `� City/State/ZIP: (AN VI' E,„, t, ( . 7 ) Solar units(potable water) 62.54 Phone:x )-3. 614�/U Fax::( ) /� Tub/shower/shower pan 12.51 Q, {.��-+ [J Urinal 25.02 E-mail: 54.s"`0 'LYt+Wr)tmew cep,' s Water closet 25.02 CON TRACTOR Water heater 37.52 Business name: A'M$ LovrticvA,i, turn 3a 0C Water piping/DWV 56.29 Address: co 9 ti' `ti":'+ Other: 25.02 �J City/State/ZIP: Otte,t VC LLE, Cilth'+(63 _ Subtotal ;y4,5 it Phone:(5fj`)Iq(i' Fax:( ) Minimum permit fee: $72.50 "�CCB Lic.:0 ,. T. Plumbing Lic.no.: 17/iii Plan review (12%of permit fee) i State surcharge(12/o of permit fee) 7, t Authorized signature: TOTAL PERMIT FEE Print name: ('jr*j;E GGG..../// Date:1 -O& 3 This permit application expires if a permit is not obtained wit 'n 180 days v IN..)1 after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\PLMU-PermitApp.dor 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 Fee(e�) rtal Square Footage: Permit Fee: 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 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 Other Inspections or Fees each additional$100.00 or fraction thereof,to Qty. `*'ee(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*. Plan Review for Plumbing Instillations 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 Baptistry/Font 0 Any new commercial building with water service 2"and greater,except systems designed and stamped by licensed Bath: -Tub/Shower -Jacuzzi/Whirlpool engineer. Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure Drive as defined in OAR918-780-0040. hm Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities. Dishwasher: Commercial ❑ 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" 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 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 be paid before the Water Extractor must Water Closet-Toilet plumbing permit can be issued. Urinal ! 1 Other Fixtures: I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2 IIIAccumulative Sewer Tally _; Tenant Name: KELLY IMAGING SWR# N/A TIGARD Site Address: 7204 SW DURHAM RD SUITE 300 PLM# 2017-00456 Parcel#: 2S11AC00103 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 1 1 0 -1 -1 Eye Wash 1 0 0 0 0 0 Floor Drain/Sink: -2 inch 2 0 1 2 0 -1 -2 -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: -Lay/Bar-Non-Food Related 2 0 2 4 0 -2 -4 -Bradley 5 0 0 0 0 0 -Com/Sery/Utd-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 3 18 0 -3 -18 Urinal 6 0 1 6 0 -1 -6 Previous EDU Count 0 0 Capped EDU Credit 0 TOTALS 0 0 8 31 1 3 -7 -28 Current Fixture Value -28 divided by 16= -1.750 Current EDU 1 EDU= $5,500.00 Previous Fixture Value 0 divided by 16= 0.000 Previous EDU Change -28 divided by 16= -1.750 over (under) $ (9,625.00) Enter EDU Change Here -1.750 * *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: ***CREDITS*** Authorized Name/Signature: BRANDEN TAGGART X2449 Date: 11/6/2017 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 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 7204 SW DURHAM RD 300, TIGARD, OR, 97224 December 14, 2017 at 1 :17:10 PM Record Type: Record ID: Commercial - Plumbing PLM2017-00456 Inspection Type: Inspector: 399 Plumbing final Aaron Cillo-Gobel Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor