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Permit (148) CITY OF TIGARD PLUMBING PERMIT ! COMMUNITY DEVELOPMENT 11;1 Permit#: PLM2018 00168 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/17/2018 Parcel: 2S110DB01300 Jurisdiction: Tigard Site address: 15290 SW ROYALTY PKWY Project: CARD-Center for Autism&Related Disorders Subdivision: 1996-010 PARTITION PLAT Lot: 2 Project Description: CAP(9)exam sinks,and relocate(1)dishwasher,(1)garbage disposal and(1)break room sink. Contractor: D&F PLUMBING Owner: TIGARD INVESTMENT PROPERTIES LLC 4636 N ALBINA AVE 11086 SE OAK ST PORTLAND, OR 97217 MILWAUKIE, OR 97222 PHONE: 503-282-0993 PHONE: FAX: 503-288-0604 FEES Quantity Description Date Amount 1 ea Dishwasher 04/17/2018 $25.02 Specifics: g ea Fixture/Sewer Cap 04/17/2018 $225.18 1 ea Garbage Disposal 04/17/2018 $25.02 Type of Use: COM 1 ea Sink 04/17/2018 $25.02 Class of Work: ALT Type of Const: 1 12%State Surcharge- 04/17/2018 $36.03 Plumbing Occupancy Grp: Stories: Total $336.27 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: 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. Accumulative Sewer Tally Tenant Name: CARD-Center for Autism&Related Disorders SWR# N/A T I G A R D Site Address: 15290 SW Royalty Pkwy PLM# 2018-00168 Parcel#: 2S 110DB01300 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 0 0 0 0 -3 inch 5 0 0 0 0 0 -4inch 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 9 18 0 -9 -18 -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 9 18 0 0 -9 -18 Current Fixture Value -18 divided by 16= -1.125 Current EDU 1 EDU= $5,500.00 Previous Fixture Value 0 divided by 16= 0.000 Previous EDU Change -18 divided by 16= -1.125 over (under) $ (6,215.00) Enter EDU Change Here -1.130 * *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: ***EDU CREDITS*** Authorized Name/Signature: Dianna Howse Date: 4/17/2018 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 1 0%4/16/2018 13 : 44 From : 5038283868 D and F Plumbing Webfax Page : 1,2 P.lumbin' Permit A lication Building Fixtures r. V K ' FOR OFFICE USE ONLY City of Tigard 1 ft� Received . �t vi t3125SWflail Blvd 'Tigard,OR 972 R k► 41, n,tc'tiy: 1 /f- ,� "tA � 0/1:4 a � �� r� Phone. 503.718.2439 .Fax. 503 Y).f 0_ A.,.,-.4.-,,,, l l m Redie :Ills eetrt�it Line: X03:G3S.4175 ‘,..1H �,,. T f 4 .''.1-1 �ate`Rn IN Other Pert ii Na. TIGARL7 pr):r Keidp 134 interact w�aw.tt a d rpr.eov t-'s E :r5 ``a furls IL )~ f '& r . T tt © Seem t i Information TYPIJ OF V1'ORK T T F* SCITEI)TJI;E E]New construction Q Demolition For special information ase checklist. E}escri ttion - ! Atldition/ilieration/icplacemcm 0 Other; l i Qty. Ia. � 'Eotaf ) New 1-2-!family dwellings(Mt:hides 100 It for etch utility connection) CAT--GORY OF'CONSTIRFf . TON SFR(I)bath i32.i0 0 1-and 2-family dwelling Commercial/industrial SPR(2)bath 437.73 F-0Accessor ❑Multi-family SFR(3)bait 500.32 Each additional bath/kitchen 25.02 0 Master builder 0 Other: • — Firesprinkler( sq.ft.) Paget 1 .73X-4/0: :10R SI T 1+;:"1NFORM9 I KON.i,ND LOCATIONij Site utilities: — Job site address: 13.76 ,� . Catch basin or area drain C)rywell leach line,ortrench drain C€ly/fita.e%21P: ; . F a c "'218.76 Footing chain mu.linear ft": ) Page 2 Suite/bldg./apt.no.: A A 1 Project name: ( yy � ,k !! � ��" i� .1`i'tJ 6tr,) 'Manufactured!tome utilities 50.03 Cross street/directions to job site: 1j Vit' 6C�r+ ha C1 manholes - 18.76.C) J � 1 ° sJirt v & 4 0 „ng r l * In. 9r, .! I I Rain drain connector 18.76 r ## 'Cir Sanitarysewer no.linear ft..: i Page 2 ��. tale ('� +. L Storm sewer(no 'Mem It.: ). Paye 2 Water service(no..l€ncar ft.: ) Page 2 Subdivision: 1 Lotno.: Fixture or item: Tax map/parcel no.; Back floiuprevc€iter T 31.27 . I L .J I'tbuRir1un:OF WORK Clothes washer 25.02�r7/J�/A✓6 � *. '��iV1l/( ( a� /z©�/7 y Dishwasher 25.02 5,o A//eS 6 -t-2vo/1 S tA//e` �/S � f,�i�-Crtkt Iimt< n .5.02J 6 622-6 /...i5,c7—f/#.e.— / 4 _ _- F)Cjl Aterrforsrsump 25.02 54'PRO1",,RTY OWNER . I 0,'.TENANT -,! f2,_. Eixpinsion tiink Name: • c,,i y€` 4- Fixture sewer cap 12;! ve 25.02 %�13 Address: 0,. ` 'or draM/door sink/hub 25,02 3 0 5 ,l 4.bJ .00ic, c' .t" r till. C- /; City/State/ZIP: 05 . i Garbage disposal � 25,02�-Lk '�i,+JcT3f,E� {C� � �"Fl? Hose bib 2s('7 •Phone:( p i) L 31 — . Fax: _ _ 4. +/ , ( ) I Ice Maker 12.51 E pt ic21 V I:, -.-. CONTAC:I', PERSON InterCCJrter/ nese trap 2.5.()2 j • Business name: hi ) p1016410:, A Medical gas(value:$ ) Page 2 : . i• Prier 12.1I Contact name: a 1 _ �1 Roolirain(commercial) 12.5 I - Address: 634, /1115•„,,, ,'" Sink/basin/lavatory • ^ 25.02 •(City 5tatc/7}P: 1 h e0 , l -d" / ( / Solar units(potable water) 62.54 Phone: f ola^.. ' 'Z. Fax:::( ) Tub shower shower pan 12,51 , llrina! 2502 E-mail: 8----f— iWt 4 is ! F i \ _i later closet 25,02CtNTRACCOR - I Water heater 3i_>>YF }J ,", §Business nate: Water pip ng11.)w'V 56.29 Address: tit3 - I tel c::, vt: Other. 2s.o-' f av t IRvv( ,. Te c 7 1 Subtotal ':t00.4.741 I Phone.(r03 ) u-`l t r`r€,��. C1„CC�� �1 F'ax:( ) I minimum periiiit feta_ 472 50 : CCB Lie.: plumbing J ic: 3o.V - Pian review (25%ofpermit Pee) . Authorized signature:'''-:,;,” State surcharge(12%of permit fee) D p TOTAL P1:RMI 1 FEE 1334: 7 2. Prtl€t name: �,�s n1(�� a:- ( pp This permit application plication ex Tres if a permit is not obtained within 180il in -I 6 Ft. d 410 ., 1 E)atf;: I f(i r I E *FCC inethodotoaefyrsetbh sTrbie-Corncutsc€Bfedang uImndpulet#e)- Service toted Itin;ldint,PermitliP€;tIL1-PerrnitApp.r/ae 10/Silo9 445-46 i OT(10r021COM/wl::€3) 0416/2018 13 : 44 From : 5838283868 D and F Plumbing Webfax Page : 252 . Plumbing.Permit Application - City of Tigard Page 2 -Supplemental Information Fee Schedule Residential Fire Suppression Systems: S t:te Utrlit res reg tea) rata! Footing drain-1°'100' quay 1"flOt�d a 121.90 it'F''&":"'•":-'''."''''''''' 50.03 0 Co 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 Sewer-1 sit t U0' ¢ G2 54 3,601 to 7,200 i$ $233.20 Sewer-each additional 100' 7,201 and greater I $;?7;4 J 3 7.52 th'ater:Service- 1st 100' 62.54 I Water Service-each additional 100' 37.52Medical Gas Systems: -----._ Storm&Rain Drain-1st 100' €62.54 aluat on Permit Fee: Storm&Raain each tddrtconnl 100 37.52 $1.00 to$5,000.0 Minimum]to $72 70 Rain Drain55,001.00 to$10,000.00 $72 0 for Lite first$5,000.00 1nd X1.52 far s P ) each additional$100.00 or fraction thereof,to Qt3 ee(eaIoralOtherIiipect}onorFes . Inspection of existing plumbing or for and including +10,000.(50. nn(re is spec]#icaU_y indicated 90.00/hr $10,001_00 to$25,000.00 $148.50 thr the first$10.000.00 and$1.54 for (minimum charge-1/2 hour) each additional$100.00 or fraction thereof:to inspections outside of normal business - 90.00/l1r • and including�'�000:00 hours{minimum Chani-2!tours) $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours l=ees 90.00/hr each additional *!01).00 or fraction"thereof fo Additional plan review for revisions and including$50 000.00. 90.00/1tr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for (minimum charge-1/2 hour) L , 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*. Quante b3FiAtttre Type Ftxtitre'rypefor aegraCe/ Pla•te IZeVIe'FV for Plilitibill iiStalt•ttiD125 A¢orft Performed: Capped :tddest Relocate ' Platt review is required for any of the fal€owing. t3aptisuy!Fant Please check all that apply. Bath -Tub/Shower ❑ Any new commercial building with water'service 2"and iacu72i/Whirlpoaf greater,except systems designed and stamped by licensed Car Wash -Each Stall engineer: -Drive Thai 0 New exterior plumbing siie utilities fire any complex•structure Cuspidor/Water Aspirator as defined in QAR918-780-0040. Dictnvaslter -Commercial , • 0 Medical gas and vacuum systems for health care facilities, -Domestic _ Drinking Fountain j / 0 Any multipurpose fire sprinkler system. Eye Wash 0 Any complex structure as defined in 0.AR918-%80-()0=10. HoorDrain/sink -2" --�_ 3„ Submit 2 sets of plans with any of the Above. Car Wash Drain ISUII' -le nr Riser Diagram Garbage -Domestic-non-food / ❑ isometric or riser diagram is required for new buildings Disposal Domestic food related that meet the qualifications above. -Commercial food relater! -liidusttial-food related Ice Mach-iRefrig.Drains Oil Separator(Gas Station) Ree.Vehicle Dump Station Comments regarding. fixture}vork: I, e„.,lir: . . .:- Shower -Gang Sial! 5 M. 14, . �` Sink/I..ay -Non-food related 9 i ) - �1- i '"° -Bradley �Q® i I17. tt -Commercial-food related vC Service Swimming Pool Filter luasher-Clothe, *Note: If the fixture work under this permit results in an ii Water Extractor ur t increase of sewer El)Us a sewer permit Will be issued an Urinal rvva a53CaJCu fhe sewer increase"must De paia before the Other Fixtures: plumbing permit can be issued. C:,l:sers\randy\App:)ata\Local\TempWLMLPermitApp.doc 2 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15290 SW ROYALTY PKWY, TIGARD, OR, 97224 Record Type: Record ID: Commercial - Plumbing PLM2018-00168 Inspection Type: Inspector: 399 Plumbing final Don Sylvester Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor