Permit Support Document (43) s
Plumbing Permit Application
Building Fixtures El/Elk/EC) FOR OFFICE rsl: O\l.l
City of Tigard I� ReceivedVor
`� y PermitN�L��'p4�Of)�' 72
•1 13125 SW Hall Blvd.,Tigard,OR 974 N 0 4 2 018 Date/By: �JC�j�/ v /
an Rev
iePhone: 503.718.2439 Fax: 503 E 11 �AR4J t r Date/By: Other Pe tLc ie ‘
/st:2Inspection Line: 503.639.41751 1 GARD Date Ready/By: RIM: fa See Page 2 forInternet: www.tigazd-or.govBUILDING DIVISION
Notified/Method: Supplemental Informa•,,
=. .., TYPE OF WORK ' FEE* SCHEDULE
0 New construction ❑Demolition For special information use checiis
Description .1 Qty. I 1 Total
®Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for .ch utility coction)
-" CATEGORY.OF CONSTRUCTION SFR(1)bath 312.70 \
El 1-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.
SFR(3)bath . 2 N,.,
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25 2
❑Master builder ❑Other:
Fire sprinkler( sq.ft.) age 2 t
JOB silt INFORMATION ANT) LOCATION Site utilities:
Job site address:WASHINGTON SQUARE.i.26741VASHINGTON SQ RD Catch basin or area drai 18.76
�� Drywell,leach line,o ench drain / 18.76
City/State/ZIP:TIGARD,OR,97223 9 /
Footing drain(no. ear ft.: ) Page 2
Ct
Suite/bldg./apt.no.:F06 Project name:DIN TAI FUNG Manufactured .me utilities 50.03
Cross street/directions to job site:NEAR SE CORNER OF MALL,NEAR MAIN Manholes 18.76
MALL ENTRY TO SEARS Rain drai"connector 18.76
Sani• sewer(no.lin .\\\-) Page 2
St. sewer(no. inet
_) Page 2
`'. eater servic o.I. az ft.: ) Page 2
Subdivision: t no.: Fixture or
Tax map/parcel no.:1S126CC00100 Backflow even r 1 31.27 31.27
D`ESCRIPTION OF WORK ,i, Bac ter ve 12.51
thes her 25.02
DEMOLITION AND RESTAURANT TENA T IMP OV ENT D' hwasher 3 25.02 75.06
;_,; rinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTYOWNER E " M Expansion tank 12.51
Name:DAVID WASIELEWSKY Name: cap 2 25.02 50.04
Floor drain/floor sink/hub 36 25.02 900.72
Address:700 BELLEVUE WAY NE,SUIT -:0
Garbage disposal 25.02
City/State/ZIP:BELLEVUE WA,98004 Hose bib 25.02
Phone:(206)953-0770 Fax:( ) Ice maker 3 12.51 37.53
0 APPLICANT ;-7,
., . 0 CONTACT P SON Interceptor/grease trap 25.02
Business name:CHIN-LEY/RECHE ASSOCIA S Medical gas(value:$ ) Page 2
Primer 6 12.51 75.06
Contact name:SERGIO CHIN-LEY
Roof drain(commercial) 12.51
', Address:1516 MELROSE AVE SUITE 20: Sink/basin/lavatory 20 25.02 500.40
City/State/ZIP:SEATTLE,WA 98122 Solar units(potable water) 62.54
Phone:(206)769-8601 I Fax::( ) Tub/shower/shower pan 12.51
E-mail:SERGIO@CHINLEY' HE.COM Urinal 3 25.02 75.06
- Water closet 7 25.02 175.14- . `'ti " c :;4.',•,,,-;,),,r,
i y; -44:7,44;,- ,v- sec :y.,, _ Y` erakr °rr . ,
I. Water heater 1 37.52 37.52
Business name:TBD
t Water piping/DWV 2 56.29 112.58
Address: i Other: 25.02
~City/State/ZIP: Subtotal 2070.38
Phone:( ) Fax:( ) Minimum permit fee: $72.50
: Plan review (25%of permit fee)
CCB Lic.: Plumbing Lic.no.: ,.
° ' 1 State surcharge(12%of permit fee)
Authorized signature: L TOTAL PERMIT FEE
Print name:SERGIO@CHINLEYRECHE.COM Date:04.30.18 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.
I:1Building\Permits\PLMO-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
lumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: s,41,10.4,,,,,,,,-46y0,4,14,
Residential Fire Suppressions System
s
V01, µ4 tct < e a, ` 4,14,
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 #1 tet: !.,
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$1.52 for
n . e F � ee. ear .Total and ieach ncluding ng$ional$10.00 0 0or fraction thereof,to
nth spe >< n.�� ,_
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*.
rrsr. tAMf "t „s. ,. :� i'+,�?1111I�111111'if `s, �at�l(11�+Sz��
htnre T e for Ar A ': Reptaed e Plan review is required for any of the following.
Wt rk esloruie�a i� ,. . ,.,, ?app <,.Addy x; ReikraS `,'
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 3 ❑ Medical gas and vacuum systems for health care facilities.
-Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain 0 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> 36 �s
0,007:0061,44.60010:4 C)G l`d I' ll# X ; .
Car Wash Dra
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 3
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related 2 7
-Bradley
-Commercial-food related 12
-Service 1
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 2 7 fees assessed for the sewer increase must be paid before the
Urinal 3 plumbing permit can be issued.
Other Fixtures:
•
\\CLRAFILESERVER\ProjectFolders\2017 Projects\1727 DTP Washingte Square\PERMITTING\PLMF_PermitApp.doc
V 0 I DdY3/1/ '
City
of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT ., 'd
14.
. Request for Permit Action JUL 3 1 201
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 • www.tigard-or.gov
CITY Or TIGARD
TO: CITY OF TIGARD BUILDING DIVISION
Building Division
13125 SW Hall Blvd.,Tigard, OR 97223
Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPennits@tigard-or.gov
FROM: ❑ Owner N. Applicant ❑ Contractor ❑ City Staff
Check(V)one
c�\ REFUND OR Name:
INVOICE TO: (Business or Individual) David Wasielewski / Sergio Chin-Ley
{ Mailing Address: 700 Bellevue Way suite 280
City/State/Zip:
Bellevue WA 98004
Phone No.: 206-953-0770
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓):
CANCELID PERMIT APPLICATION.
��
REF UN PERMIT FEES (attach copy of original receipt and provide explanation below).
❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below).
❑ REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit).
Permit#: PLM2018-00277
Site Address or Parcel#: 9724 SW WASHINGTON SQUARE RD
Project Name: DIN TAI FUNG
Subdivision Name: Lot#:
EXPLANATION: REQUEST TO VOID PERMIT PER
BRANDEN TAGGART
i/-J /cf-oo3, '1
Signature: Date: July 31, 2018
Print Name: Sergio Chin-Ley
Refund Policy
1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of:
• Any fee which was erroneously paid or collected.
• Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort
has been expended.
• Not more than 80%of the application or permit fee for issued permits prior to any inspection requests.
2. All refunds will be returned to the original payer in the form of a check via US postal service.
3. Please allow 3-4 weeks for processing refund requests.
FOR OFFICE USE ONLY
Route to Sys Admin: Date ; J / By Route to Records: Date 7 /„f•—• B
Refund Processed: Date A/ By /? Invoice Processed: Date By
Permit Canceled: Date f17/ci By /.p., '.rcel Tag Added: Date By
I:\Building\Forms\Req Permi to c tion_092 14.d oc
Branden Taggart
From: Branden Taggart
Sent: Monday, July 23, 2018 1:05 PM
To: 'Todd Bradford'; SERGIO CHIN-LEY
Cc: #Building Permit Technicians
Subject: RE: Din Tai Fun Plumbing Permit Submittal: PLM2018-00277; 9724 SW Washington
Square Rd.
Attachments: RegPermitAction_092314.pdf
Hi Todd,
We received the plans you sent us. Since the mechanical gas piping plans were submitted with the plumbing plans, I
separated them out and routed the mechanical permit for review as well. We have two separate plans examiners
completing the review for the mechanical and plumbing permits, and therefore we require separate sets of plans and
permits. Per my earlier email,the plumbing permit that was initially submitted for plan review differed from yours
rather substantially. Because of this, I needed to confirm the scope of work so that our plans examiner knew what
permit to complete the review under. The only thing we need before we being plan review is a signature at the bottom
of the revised plumbing application that you sent us. Once I receive a signature on the application, we will complete
plan review, which will take approximately two weeks to review. Both the mechanical and plumbing plan review will be
completed in approximately two weeks.
Sergio, since the plumbing contractor, Devco Mechanical, submitted plumbing plans that differ from yours, and they are
doing the work, we will need you to submit a Request for Permit Action form to void your permit (permit number
PLM2018-00277). I have attached the form above for you. If you have any questions, please let me know.
Thanks,
Branden Taggart
it City of Tigard
0 Senior Permit Technician
Community Development
TIC Aim
13125 SW Hall Blvd
Tigard,OR 97223
(503)718-2449
brandent +tigard-or.gov+
From:Todd Bradford <todd@devcomechanical.com>
Sent: Monday,July 23, 2018 9:31 AM
To: Branden Taggart<brandent@tigard-or.gov>
Subject: Re: Din Tai Fun Plumbing Permit Submittal: PLM2018-00277; 9724 SW Washington Square Rd.
Branden
See attached revised application. My take off is based on the current set of drawings. The figures above I am not
sure where they came from. I sent you two sets of drawings. One set for the plumbing review and one set for
the mechanical natural gas piping. There was an application attached to each set of drawings. Please let me
know what else you need. When can I expect the plan review to be completed?
Thanks
1
Todd Bradford
Devco Mechanical Inc.
Project Manager/Estimator
541-298-8889
Todd(&,Devcomechanical.corn
On Wed, Jul 18, 2018 at 8:38 AM, Dee Davidson<office@devcomechanical.com> wrote:
Dee Davidson
Office Manager
Devco Mechanical, Inc
Officeadevcomechanical.com
541-298-8889
Forwarded message
From: Branden Taggart <brandent@tigard-or.gov>
Date: Wed, Jul 18, 2018 at 8:36 AM
Subject: Din Tai Fun Plumbing Permit Submittal: PLM2018-00277; 9724 SW Washington Square Rd.
To: "office@devcomechanical.com" <office@devcomechanical.com>
Cc: SERGIO CHIN-LEY <sergio@chinleyreche.com>, #Building Permit Technicians
<TigardBuildingPermits @tigard-or.gov>
Hi Todd,
We received your plumbing permit and plans for Din Tai Fung in the mail this last Thursday. I was initially
looking for a mechanical permit when I spoke with you over the phone. I routed this permit for plan review;
however, the scope of work on the application is significantly different than what was initially submitted by
Sergio Chin-Ley from Chin-Ley/Reche Associates.
As noted on the application you submitted, the changes from Sergio's initial submittal are as follows:
• (2) additional backflow preventers
• (2) fewer dishwashers
• (1) expansion tank
• (2) additional floor drains
• (2) garbage disposals
2
. • (2) fewer ice machines
• (1) less urinal
• (2) fewer water piping/DWV
!
Also, the Commercial Fixture Work section on the second page of the application only lists (2) capped sinks
and (2) capped water closets and no "added" or new fixtures for this new restaurant. Please confirm the
plumbing fixture totals and revise the Commercial Fixture Work section. You are welcome to email me the
application. Lastly, please let us know which permit we should complete plan review on.
Thank you,
Brantlen Taggart
IICity of Tigard
Senior Permit Technician
Community Development
ticARn
13125 SW Flail Blvd
Tigard, OR 97223
(503)713-2449
brandent@tigard-or,gov
DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-
mail may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are
retained by the City of Tigard in compliance with the Oregon Administrative Rules "City General Records Retention
Schedule."
3
� R
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
4:1904
S
,,,„,;,,,,,,,,.. :,;,,x" &�y'.' $$a r",,. ,awJ,`` y .�'x.s`, z4%ski �; ✓;�. , =. y'r �.<a i e IJ 1lti�3 � :'
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 �'' - .b . il, , y� z•
, �-
'' 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
Qty yFey(ea) each additional$100.00 or fraction thereof;to
Other:Ins esti ns`o r 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
(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*.
Quanat�by F"ixtilreType � :v,::Plan Re ev o� Plui bing:Iin stallations.
Frxtar Type for iteplaed` Plan review is any re required forof the following.
`" Ca e t Add CtelgCat = q
Baptistry/Font Please check all that apply.
Bath Tub/Shower
0 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 3 ❑ Medical gas and vacuum systems for health care facilities.
-Domestic 0 Any multipurpose fire sprinkler system.
Drinking Fountain 0 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" 36
Car Wash Drain rankF . ,...,,:-..",...;_
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 3
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lay -Non-food related 2 7
-Bradley
-Commercial-food related 12
-Service 1
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 2 7 fees assessed for the sewer increase must be paid before the
Urinal 3 plumbing permit can be issued.
Other Fixtures:
\\CLRAFILESERVER\ProjectFolders\2017 Projects\1727 DTF Washingtbi Square\PERMITTING\PLMF PermitApp.doc
_ TN
DELIVERY NO. 1541014
2730 Occidental Ave S
Seattle,WA 98134 DATE 06/01/18
206-622-6000 RE( ENED
WO# 5326420
JUN 0 4 2018
a DELIVERY TICKET o Contact#26000
1-- CITY Oi- fitiFeRD r, ,--
a ._ ATTN: Bldg Division
iShipdocsBULDING DE
0 City of Tigard Permit Center
IIVISIO \
13125 SW Hall Blvd.
Tigard, OR 97223
111111111111111111111111111111111111111111111 JOB DUE: 06/04/18 at 17:00
CONTACT PHONE PURCHASE ORDER# SALES REP
Sergio Chin-Ley/CHIN-LEY/RECHE AS (206)938-1501 Lamar Middleton
JOB# JOB NAME BILLER LOC
DTF WA SQ DTF Washington Square Christine Warnock 052
3 '--', ...-,. ir---',-,,,,W.-4, e.,:(4 --' -,': -- ..4.' ,..0,1,,,s-....Z, :"iV-Affr;A;Vt-7,4w. f •Ve.,444-404.4 -0. 'iNt40" .4'4 V'' ' 0 '' "''''' ' -'^'''''''''' '-'4*' *
SUB TOTAL DISCOUNT SALES TAX TOTAL DEPOSIT BALANCE DUE
TERMS:
k .