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Permit (169)
CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit#: PLM2018-00397 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/28/2018 T r C.!s I'.I� g Parcel: 1 S134BC00300 Jurisdiction: Tigard Site address: 12286 SW SCHOLLS FERRY RD A Project: Kaba Grill Subdivision: None Lot: None Project Description: Plumbing for TI: ADD(1)commercial dishwasher,(2)3"floor sinks,(1)ice machine,(2)lays,(1)3-compartment sink,(1)2-compartment sink,(1)mop sink,(1)hand sink,(2)water closets,(1)grease trap,and(1)water heater. Note: both compartment sinks drain into floor sinks. Contractor: PCI PERSONAL CONSTRUCTION Owner: FW OR-GREENWAY TOWN CENTER LLC 410 BEAVERCREEK RD, STE 513 PO BOX 790830 OREGON CITY, OR 97045 SAN ANTONIO,TX 78279 PHONE: 503-679-3461 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Dishwasher 08/28/2018 $25.02 Specifics: 2 ea Floor Drain/Floor Sink/Hub 08/28/2018 $50.04 1 ea Ice Maker 08/28/2018 $12.51 Type of Use: COM 1 ea Interceptor/Grease Trap 08/28/2018 $25.02 Class of Work: ALT 4 ea Sink 08/28/2018 $100.08 Type of Const: 2 ea Lavatories 08/28/2018 $50.04 Occupancy Grp: 2 ea Water Closet 08/28/2018 $50.04 Stories: 1 ea Water Heater 08/28/2018 $37.52 1 12%State Surcharge- 08/28/2018 $42.03 Plumbing Total $392.30 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:) o U 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 _ Building Fixtures '� FOR OFFICE l SE O Lv AUG iji Date/By:Receivedb-72.2_//r/f. / L-✓v'3V�(/ 0(N ! -2 City of Tigard „r' 0 I , I,,0 Perm o.: Illiq U 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review = Phone: 503.718.2439 Fax: 503.598.1960• o Inspection Line: 503.639.4175 Date/By: -- T I G A R D i Date Ready/By: Juris: tr See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE 0 New construction 0 Demolition For special information use checklist Description Qty. I Ea. I Total 0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUC'T'ION: SFR(1)bath 312.70 ❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 buildingSFR(3)bath 500.32 15 ❑Accessory 0 Multi-family Each additional bath/kitchen 25.02 1 ❑Master builder 0 Other: Q Fire sprinkler( sq.ft.) Page 2 7 JOB SITE INFORMATION AND LOCATION Site utilities: L Job site address:, �4410d S G/ c C' cs//S yrsJ /P� Catch basin or area drain 18.76 City/State/ZIP: Drywell,leach line,or trench drain 18.76 ! y � 'p //�� 3 Footing drain(no.linear ft.: ) Page 2 _ Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03 Cross street/directions to job site: * Manholes 18.76 �1er4n-' Airor !�' Rain drain connector 18.76 n�j ' "' i-L- Sanitary sewer(no.linear ft.:_) Page 2 �L. � G/� Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 -,,,;%.' : Backwater valve 12.51 ',4 DESCRIPT tI I OF WORK , ,,k... Clothes washer 25.02 at 1 i e o a <-- � i APDishwasher �/ / 25.02 ..' eyg fountain 25.02 Ejectors/sump 25.02 0 PROPERTY OWNER ❑ IANC '° Expansion tank 12.51 Name: Fixture/sewer cap 25.02 Floor drai oor stttk ub ✓ 2 25.02 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker ,/ / 12.51 0"APPLICANT 0 CONTACT PERSON 4, Interceptor/grease trap V / 25.02 �7 „Q✓ 1,t Medical gas(value:$ ) Page 2 Business name: / ' ...s,,,,..3_, S y-Gt B cy, Contact name: . /� / Primer 12.51 h r lr. < f7 / Roy dram(commercial) 12.51 Address: , >z) /�a,wa_-e'f wo 1, 61/, 74e-�/ 3 Sa/basin/lav ry ✓ 6 ? 25.02 City/State/ZIP ,_ ,,., �' e ' el i y�17 S Solar units(potable water) 62.54 Phone:(��7/1„7?�!-©s--7 , / Fax: :( )) Tub/shower/shower pan 12.51 E-mail: 7` Urinal 25.02 Water closet f 25.02 CONTRACTOR Water heater V / 37.52 Business name: / ©�fr -> � --L/ nvr Waterpiping/DWV 56.29 Address: / L•® ,5::.E2 _4_1-l„�Y4id,t;�� Y"-� / Other: 25.02 City/State/ZIP:jay p c;� i'-- 2 0 4L-� Subtotal Phone:�7/f 4",_r,' e......7� Fax:( ) Minimum permit fee: $72.50 � .Z O .- Plumbing Lic.no.:?5‘...-3940 p Plan review (25%of permit fee) CCB Lic.:/ l � State surcharge(12%of permit fee) Authorized signatur --- /� f t� {� TOTAL PERMIT FEE Print name: i 6 l ,^ (n� L�� Date:�t l C3' This permit application expires if a permit is not obtained within 180 days U' / after it has been accepted as complete. 111 *Fee methodology set by Tri-County Building Industry Service Board. I:Building/Permits PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/CAM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee: Footing drain-l'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 Storm&Rain Drain-1st 100' 62.54 Valuation: Permit Fee: $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 Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to 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 Installations. 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 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 Stall 0 New exterior plumbing site utilities for any complex structure Car Wash: -Each Tani as defined in OAR918-780-0040. -Drive Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities. Dishwasher: -Commercial / i ✓ 0 Any multipurpose fire sprinkler system. Domestic 0 Any complex structure as defined in OAR918-780-0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drai ii, -2" , .1t. ; , `j gIsometric or Riser Diagram 4„ 0 Isometric or riser diagram is required for new buildings -Car Wash Drain Garbage Domestic non-food that meet the qualifications above. Disposal: -Domestic food related -Commercial food related -Industrial food related Ice MachiRefrig.Drains i / ✓ Comments regarding fixture work: Oil Separator(Gas Station) VO / 3-Ce/1 --C./r✓/'- (I 2.-£ii'-?p S iN .1 Rec.Vehicle Dump Station I #1 S`r^fite-- / itier9A, S o,//'e._. Shower: -Gang Z.-Stall ✓ ,,/ /� Sink: -Lav/Bar non-food related .� V5 ,v T ( / Z re e C`H9777E 7 -mxs -Bradley b/Z1/Ni n/C-- f're -lTO, .:S`r/'✓/�s So -Com/Serv/Util food related ,i /I / ,,J ..1.46.e- E-Zr Ce/it, .SiM'rS - .4f--- -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 must be paid before the Water Extractor / Water Closet-Toilet ,! plumbing permit can be issued. Urinal Other Fixtures: 1:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2 11111 : 11 1 Tenant Name: Kaba Grill Accumulative Sewer Tally SWR# N/A TIGARD Site Address: 12286 SW Scholls Ferry Rd PLM# 2018-00397 CREDIT Parcel#: 1S 134BC00300 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 1 4 1 4 -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 5 25 2 10 -3 -15 -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 1 1 1 1 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 2 4 0 0 -Bradley 5 0 0 0 0 0 -Com/Sery/Util-Food Related 3 0 0 2 6 2 6 Swimming Pool Filter 1 0 0 0 0 0 Washer-Clothes 6 0 2 12 0 -2 -12 Water Extractor 6 0 0 0 0 0 Water Closet-Toilet 6 0 0 2 12 2 12 Urinal 6 0 0 0 0 0 Previous EDU Count 0 0 Capped EDU Credit 0 TOTALS 0 0 9 41 10 37 1 -4 Current Fixture Value -4 divided by 16= -0.250 Current EDU 1 EDU= $5,650.00 Previous Fixture Value 0 divided by 16= 0.000 Previous EDU Change -4 divided by 16= -0.250 over (under) $ (1,412.50) Enter EDU Change Here -0.250 * *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: ***CREDIT***Credits from PLM2017-00126 applied towards this permit;(2)compartment sinks are draining into(2)3"floor sinks and charged as floor sink rate. Authorized Name/Signature: Dianna Howse Date: 8/28/2018 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 / Accumulative Sewer Tally / Tenant Name: SPEC SPACE SWR# N/A Site Address: 12286 SW SCHOLLS FERRY RD PLM# 2017-00126 Parcel#: 1S1134BC00300 , re 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 5 25 0 -5 -25 -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/Util-Food Related 3 0 0 0 0 0 Swimming Pool Filter 1 0 0 0 0 0 Washer-Clothes 6 0 2 12 0 -2 -12 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 41 0 0 -9 -41 Current Fixture Value -41 divided by 16= -2.563 Current EDU 1 EDU= $5,300.00 Previous Fixture Value 0 divided by 16= 0.000 Previous EDU Change -41 divided by 16= -2.563 over (under) $ (13,568.00) Enter EDU Change Here -2.560 * *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: ***CREDIT*** 7 fit./fr/2 S Pt"--"J 49c A - 00.3 9 7 , Authorized Name/Signature:BRANDEN TAGGART X2449 Date: 4/10/2017 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\SewerI'allySheet_5300_070116.xlsx City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 12286 SW SCHOLLS FERRY RD A, TIGARD, OR, 97223 Record Type: Record ID: Commercial - Plumbing PLM2018-00397 Inspection Type: Inspector: 399 Plumbing final Don Sylvester Result: PASS - NoCofO Comments: 1 . Correction's are complete, plumbing final approved. 2. Note: provide a copy of test results for R P back flow device located by soda station. Violation Summary: Inspector Contractor