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Permit (146) nCITY OF TIGARD PLUMBING PERMIT 111 COMMUNITY DEVELOPMENT Permit#: PLM2017-00481 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/22/2017 Parcel: 2S113AB01201 Jurisdiction: Tigard Site address: 16290 SW UPPER BOONES FERRY RD Project: Oregon State Treasury Subdivision: None Lot: None Project Description: Cap plumbing fixtures for office rebuild: CAP(1)2"floor drain,(1)3"floor drain,(1)break room sink and(1)mop sink. Contractor: ALWAYS FAITHFUL PLUMBING LLC Owner: PACIFIC REALTY 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 4 ea Fixture/Sewer Cap 11/22/2017 $100.08 Specifics: 1 12%State Surcharge- 11/22/2017 $12.01 Plumbing Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $112.09 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: 4t. Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available ins ection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Plumbing Permit Applicati ;1JJ / Building Fixtures FOR OFFICE LSE O'LV City of Tigard NOV 22 20 17 Received II Date/By: //2.7/17 Agga Emit NA.0a0/7'6/0 "/ 111 13125 SW Hall Blvd.,Tigard,OR OF TIGAt s Phone: 503.718.2439 Fax: 503.= Plan Review Date/By: Other Permit No.: TI G A R D Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By: Iws: ® See Page 2 for Internet: www.tigard-or.gov 1�e 91YNotified/Method: Supplemental Information TYPE"`OF WORK. FEE* SCHEIULE For special information use checklist 0 New construction 0 Demolition Description I Qty. Ea. Total Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) J 4xx CIT GORY OF-CONSTRUCTION "y SFR(1)bath 312.70 ❑ 1-and 2-family dwelling [.Commercial/industrial SFR(2)bath 437.78 1 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 ❑Master builderEach additional bath/kitchen 25.02 0 Other: Fire ( sq.ft.) sprinklerPage 2 'J p � JO$ SITE INFORMATION AND LOCATION Site utilities: Job site address: �c6 5th 4P�� cr-„� Catch basin or area drain 18.76 City/State/ZIP: 90 ��0 t2. t-C.0 �) Dtywell,leach line,or trench drain 18.76 f / 1 L Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name: 1 RA:451A gy 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 ,:,,i, a DESCIUi'TION,OF'WORE :y Backwater valve 12.51 CAeQ If ""p Clothes washer 25.02 �1 '„ S LC51 f� I a in Of G 110 i ( 1 'a u t-0, Dishwasher 25.02 1 . AZA 1P). Drinking fountain 25.02 Ejectors/sump 25.02 ... 12.51yPROPERTY Ovg. ER 1 © TENANTExpansion tank Name: Q� v6.1-� Fixture/sewer cap 25.02 Address: Floor drain/floor sink/hub 25.02 Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 iAPPLICANT " 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: /limo FA►THc CGayt /V a"no 1 q(LIMedical gas(value:$ ) Page 2 Contact name: Q�l Primer 12.51 " ` Roof drain(commercial) 12.51 Address: 170 130.4. '')5'3- Sink/basin/lavatory 25.02 City/State/ZIP: W‘L.504 kJ)L.L.F. t ci),2. 441-953'Y/S Solar units(potable water) 62.54 Phone:( 7a jQ„e�'t4,,A9 Fax::( ) Tub/shower/shower pan 12.51 E-mail: i`✓z'1Q/]'5 PATTI/(io .a 1� inbipy gyw, Urinal 25.02 CONT ACTOR Water closet 25.02 Water heater 37.52 Business name:Au,sopys trucU..1_, P�.v',MRj`'G Water piping/DWV 56.29 Address: rV !. 0.1. 751_ a� Other: 25.02 City/State/ZIP: t',.. 0p u i 1,.1.E O. C m Subtotal %dt a OP Phone:(,ib3)` c$(0 Fax:( ) Minimum permit fee: $72.50 CCB Lic.:d r'} O L Plumbing Lic.no.:R5 i l y� Plan review (25%of permit fee) �Y State surcharge(12%of permit fee) fg. v/ Authorized signature i----. TOTAL PERMIT FEE H;.jf Print name:Gm? Alm 6ELA i rk! I Date: i i..'2 j r 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. :\Building\Permits\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: SiteVUtilites gtyFee(ea) Total ` 'Square Footage: Permit Fe±e: ;m , Footing drain-1st 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' 37.52V l ti011 . w ` PermitFee: 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 Fee ea) -n 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*. A, A 'Man Review for Plumbing I stallatiofS Quantity by Fixture Type ' Plan review is required for any of the following. Fixture Type forams 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 0 New exterior plumbing site utilities for any complex structure Car Wash: -Each Stall as defined in OAR918-780-0040. -Drive Thru 0 Medical gas and vacuum systems for health care facilities. Cuspidor/Water Aspirator 0 Any multipurpose fire sprinkler system. Dishwasher: -Commercial 0 Any complex structure as defined in OAR918-780-0040. -Domestic Drinking Fountain Submit 2 sets of plans with any of the above. Eye Wash Floor Drain/sink: -2" N { ,. ;. ilsonietriwouRIser Rbigtalil , 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 Comments regarding fixture work: Ice Mach./Refrig.Drains Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -Lav/Bar non-food related 1 -Bradley -Com/Sery/Util food related -Service 1 *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 plumbing permit can be issued. Water Closet-Toilet Urinal Other Fixtures: I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2 cmAccumulative Sewer Tally Ill Tenant Name: Oregon State AT Treacusury SWR# N/A T I G n R D Site Address: 16290 SW Upper Boones Ferry Rd PLM# 2017-00481 Parcel#: 2S 1 13AB01201 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 0 0 0 Eye Wash 1 0 0 0 0 0 Floor Drain/Sink: -2 inch 2 0 1 2 0 -1 -2 -3 inch 5 0 1 5 0 -1 -5 -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 2 4 0 -2 -4 -Bradley 5 0 0 0 0 0 -Com/Sery/Util-Food Related 3 0 0 0 0 0 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 0 0 0 Urinal 6 0 0 0 0 0 Previous EDU Count 0 0 Capped EDU Credit 0 TOTALS 0 0 4 11 0 0 -4 -11 Current Fixture Value -11 divided by 16= -0.688 Current EDU 1 EDU= $5,500.00 Previous Fixture Value 0 divided by 16= 0.000 Previous EDU Change -11 divided by 16= -0.688 over (under) $ (3,795.00) Enter EDU Change Here -0.690 * *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: Authorized Name/Signature: Dianna Howse Date: 11/22/2017 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: 16290 SW UPPER BOONES FERRY RD, November 28, 2017 at TIGARD, OR, 97224 9:04:01 AM Record Type: Record ID: Commercial - Plumbing PLM2017-00481 Inspection Type: Inspector: 399 Plumbing final Aaron Cillo-Gobel Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor