Permit (95) CITY OF TIGARD PLUMBING PERMIT
111 11 COMMUNITY DEVELOPMENT ' 7 Permit#: PLM2017-00269
d Date Issued: 01/04/2018
T 1 C;AR;f3 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S102CB00200
9 & /P ..-/-2i
Jurisdiction: Tigard
Site address: 13115 SW PACIFIC HWY
Project: Specialty Retail Subdivision: None Lot: None
Project Description: Site utilities for new 13,222 sf specialty retail store. 9/11/2018: REPRINT permit to correct site address.
Contractor: WILDFANG CONST LLC Owner: TIGARD PACIFIC RE LLC
PO BOX 8285 C/O LEADERSHIP CIRCLE LLC
COBURG, OR 97408 1521 OXBOW DR STE 210
MONTROSE, CO 81401
PHONE: 503-370-9070 PHONE:
FAX:
FEES
Quantity Description Date Amount
6 ea Catch Basin or Area Drain 12/19/2017 $112.56
Specifics: 473 If Footing Drain 12/19/2017 $200.11
3 ea Manholes 12/19/2017 $56.28
Type of Use: COM 5 ea Rain Drain Connector 12/19/2017 $93.80
Class of Work: NEW 346 If Sanitary Sewer 12/19/2017 $175.10
Type of Const: 1137 If Storm Sewer 12/19/2017 $475.26
Occupancy Grp: 30 If Water Service 12/19/2017 $62.54
Stories: 2 ea Backflow Preventer 12/19/2017 $62.54
1 ea Backwater Valve 12/19/2017 $12.51
1 Plan Review 12/19/2017 $312.68
1 12%State Surcharge- 12/19/2017 $150.08
Plumbing
Total $1,713.46
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: �G�� �` �� �� Permittee Signature: ._-,
Gf f QaV �?°� i C� i /e A,'
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.
CITY OF TIGARD PLUMBING PERMIT
114 2: COMMUNITY DEVELOPMENT Permit#: PLM2017-00269
TEGA o 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/04/2018
.
Parcel: 2S102CB00200
Jurisdiction: Tigard
Site address: 13125 SW PACIFIC HWY
Project: Specialty Retail Subdivision: None Lot: None
Project Description: Site utilities for new 13,222 sf specialty retail store
Contractor: WILDFANG CONST LLC Owner: TIGARD-TUALATIN SCHOOL
PO BOX 8285 DISTRICT 23J
COBURG, OR 97408 6960 SW SANDBURG ST
TIGARD, OR 97223
PHONE: 503-370-9070 PHONE:
FAX:
FEES
Quantity Description Date Amount
6 ea Catch Basin or Area Drain 12/19/2017 $112.56
Specifics: 473 If Footing Drain 12/19/2017 $200.11
3 ea Manholes 12/19/2017 $56.28
Type of Use: COM 5 ea Rain Drain Connector 12/19/2017 $93.80
Class of Work: NEW 346 If Sanitary Sewer 12/19/2017 $175.10
Type of Const: 1137 If Storm Sewer 12/19/2017
$475.26
Occupancy Grp: 30 If Water Service 12/19/2017 $62.54
Stories: 2 ea Backflow Preventer 12/19/2017 $62.54
1 ea Backwater Valve 12/19/2017 $12.51
1 Plan Review 12/19/2017 $312.68
1 12%State Surcharge- 12/19/2017 $150.08
Plumbing
d
Total $1,713.46
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: "______Ft......ez...,
Permittee Signatur•.
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
" " Site Utilities _ FOR OFFICE USE ONLY
City of Tigard a cF iv Received permit No.: ,
IN ,Il 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: 7 �Q 7 (32.16
(.I i�C7+'Sr�
Plan Review "--l
C Phone: 503.718.2439 Fax: 503.598.1960 Date/By: `f-1/-/' (k-' Other Permit No.:
Inspection Line: 503.639.4175 J' G 17
Date Ready/By: Juris: See Page 2 for
TIGARD ���L `i ��� Y y 'A g
Internet: www.tigard-or.gov Notified/Method:11 17 / Supplemental Information
iN ' ° , t '' `' • 15t `
fir.=-..4 ,:. x... x.. ,�:.. � ..: , :., _ . ,, i'/. .tom 'p �. _ »4.�. Itg,. . , -' ,,�,,�,a.a_ ..- , .. ..,, a _s=. g
®New construction E F1514NOiV{S4ON For special information use checklist
t Description Qty. Ea. Total
0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
i -- i .
,. X01 O,' IY'i' r._� � SFR(1)bath 312.70
0 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 ❑Other: Fire sprinkler( sq.ft.) Page 2
'- W ri i i i La i:,. . • °: 4 Site utilities: /jJ.56
Job site address:13125 SW Pacific Highway Catch basin or area drain / -5 18.76 ..9-3.:•89.
City/State/ZIP:Tigard OR 97224 Drywell,leach line,or trench drain 18.76 r.
Footing drain(no.linear ft.:ti?;) Page 2 200.11
Suite/bldg./apt.no.: Project name:Specialty Retail Manufactured home utilities 50.03
Cross street/directions to job site:SW Pacific Highway and School Street Manholes 3 18.76 56.28
Rain drain connector 5 18.76 93.80 �%'
Sanitary sewer(no.linear ft.:34b) Page 2 175.10
Storm sewer(no.linear ft.:i)31) .i?S,J6 Page 2 .3015411-
Water service(no.linear ft.: .3(..)) Page 2 62.54 -9''''
Subdivision: Lot no.:200 Fixture or item:
Tax map/parcel no.:2S102CB00200 Backflow preventer a 31.27 (9,,54
Backwater valve i 12.51 la,S I
._r. .:.._: _ s Clothes washer 25.02
New single story specialty retail store;assocaited site work including parking
Dishwasher 25.02
lot,site furnishings and landscaping Drinking fountain 25.02
Ejectors/sump 25.02
:1 ,i,l f'' ► Expansion tank 12.51
Name:Vitamin Cottage Natural Foods Market Inc. Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:12612 W Alameda Parkway
Garbage disposal 25.02
City/State/ZIP:Lakewood,CO 80228 Hose bib 25.02
Phone:(303)986-4600 Fax:( ) Ice maker 12.51
Vgailliitkig
: glq:t • ' l:;-4;,..-4,:t�:-l4llel, , '� Interceptor/grease trap 25.02
Business name:DOWL Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Matthew Zinzer
Roof drain(commercial) 12.51
Address:720 SW Washington St STE 750 Sink/basin/lavatory 25.02
City/State/ZIP:Portland OR 97205 Solar units(potable water) 62.54
Phone:(971)280-8654 Fax: :( ) Tub/shower/shower pan 12.51
E-mail:mzinzer@dowl.com Urinal 25.02
„ ' Water closet 25.02
r t.. t� o .,:a C:TOR, . _x v
/� � /�� Water heater 37.52
Business name:TBD G'l.',4,04wi 1' L LG Water piping/DWV 56.29
Address: /ii' ✓ �{; Other: 25.02 east)„
City/State/ZIP: � ,, ' �''7`tea Subtotal Y 4896..83-
Minimum permit fee: $72.50
Phone:(5 ) .3-7c)., ' ' - Fax:( ) „)i;;,..
CCB Lie.: t` Plan review (25%of permit fee) ---26-1.7711-
7 " (> Plumbing Lic.no.:
I
//• � State surcharge
TOTAL PERMITIFEE fee)I
5C„c,
Authorized signature: /,/lA ,
/,
Print name: /---414/GAJ
This permit application expires if a permit is not obtained within 180 days
n Z J- Date: -7761/ after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMIJ-PermitApp.doc 10/01/09 440-4616T(10/02/COMhVEB) ..�' ,t'' ;,Ct /I r�3:44-
Plumbing Permit Application - City of Tigard
• Page 2 - Supplemental Information
Fee Schedule:
rAi..re aResidential Fire Suppression Systems:stems
Footing drain-1s`100' 1 50.03 50.03
0 to 2,000 $121.90
Footing drain-each additional 100' 4 37.52 150.08 2,001 to 3,600 $169.69
Sewer-1st 100' 1 62.54 62.54 3,601 to 7,200 $233.20
7,201 and greater $327.54
Sewer-each additional 100' 3 37.52 112.56
Water Service-1st 100' 1 62.54 62.54
Water Service-each additional 100' 37.52
Medical Gas Systems:
Storm&Rain Drain-1st 100' 1 62.54 62.54alit 4 0"tip° =- s' � "� '
$1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain each additional 100' t.a 37.52 25 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
i ea d `� zkl ' each additional$100.00 or fraction thereof,to
414 and including$10,000.00.
Inspection of existing plumbing or-for
which no fee is specifically indicated 90.00/hr $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
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
hours(minimum charge-2 hours) $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
Reinspection Fees 90.00/hr each additional$100.00 or fraction thereof,to
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 :; z ®
' : k * r� l<tm A g 41 ,l N i„r '
Fixture Typpe tar Replace! Plan review is required for any of the following.
WorkPerformia: Capped..', Added Relocate.
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 0 Medical gas and vacuum systems for health care facilities.
-Domestic 0 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"
4» t�,:� ;a
. ze ;..t.3: 1 I _., ' I!... :ter...., 1111
Car Wash Drain
Garbage Domestic-non-food
0 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:
Q:\22\Transition\21409110\Permit\Site Plumbing.doc 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13115 SW PACIFIC HWY, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2017-00269
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Corrections completed.
Violation Summary:
Inspector Contractor