Permit (113) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2018-00494
Date Issued: 10/18/2018
T f(;A 11..t7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9693 SW WASHINGTON SQUARE RD C09
Project: T-Mobile Subdivision: None Lot: None
Project Description: Interior plumbing for TI:Capping(1)sink and(1)water closet;Adding(1)drinking fountain,(1)2"floor drain,and
(1)service sink;Replacing(1)sink,(1)Bradley sink,and(1)water closet.
Contractor: REED PLUMBING LLC Owner: PPR WASHINGTON SQUARE LLC
PO BOX 2603 PO BOX 847
OREGON CITY, OR 97045 CARLSBAD, CA 92018
PHONE: 503-572-3785 PHONE.
FAX:
FEES
Quantity Description Date Amount
1 ea Drinking Fountain 10/18/2018 $25.02
Specifics: 2 ea Fixture/Sewer Cap 10/18/2018 $50.04
1 ea Floor Drain/Floor Sink/Hub 10/18/2018 $25.02
Type of Use: COM 3 ea Sink 10/18/2018 $75.06
Class of Work: ALT 1 ea Water Closet 10/18/2018 $25.02
Type of Const: 1 ea Water Heater 10/18/2018 $37.52
Occupancy Grp: 1 12%State Surcharge- 10/18/2018 $28.52
Stories: Plumbing
Total $266.20
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 952-001-00.0. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.23 ,1987 or 1.800.332.2344.
Issued By: % •a ignature: Aji
"C‘:
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 Applie.atio!
t ()lt ()lll( l lsC t1.l.1
Building Fixtures ' ,i a c
1 t r. •,-• , Parotic No.: IMI , ; .ar
City of Tigard Aare ll : , i . , -,..
11111 „--- 13125 SW Nall Blvd.,Tigard,OR 9 23 `y\ Plan Review Other Pamir No. A'L i`-
Phone: 503.718.2439 Fax 503.598.19601)1, Aate/By, ram ppm 2 for
t ' p Aare Ready/By:
Inspection Line: 503.639.4175 s� 5 l
d It►fortaa on
T c` I s) Internet: www.tigard�r.gav pi ^. � �. .cdlMerhod
' ,- �Fors,ec�oiirrJbrmation use checklist ,
a► Total
❑New construction
0 V x . Desai,60n
El Addition/a1teratiOn/replacernent . 0 Other: New 1-2-family dwellingasinciudes 100 R for each Mill connection)
SFR(I)bath 312.70
0 1-and 2-family dwelli rig ®Cotnimerctaltulduetrlal SIR(3)bade 50032
Q Accessory building
0 Multi-family Each additional bath/kitchen . 25.02
Page 2
❑Master builder ❑Other Fire sprinkler( sq-ft)
Site utilities:... ., :.. ,. Catchh basin or area drain
1 18.76
Job site address:9693 SW Washington Square Drywell,leach line,or trench dram
18.76
City/State/ZIP:Portland Footing drain(no.linear ft..,_)
Page 2
Suite/bldgJapt-no.: project name:T mobile Manufactured home utilities
50.03
Cross street/directions to job site:Washington Square Mail by Sears and Nord Manholes
111 18.76
Rain drain connector MI
Sanitary sewer(no.lineal i3-:.__^)
Storm sewer(no.'Meer ft.:__i Page 2
Water service(no.linear ft.:-_,__) Page 2
Subdivision: Lot no.: fixture or item: 3127
Backflow preventer
Tax map/parcel no.: `, ° 12.51
Backwater valve
is M Clodles washer
25.02
'Dishwasher .,�a5.02
T/1 of(mobile retail space,new bathroom,Water heater,drink ftn. l 25.02,02 ,tCS-�/
Drinking fountain
Ejectors/sump 25,02
Expansion tank 12.51
�-,7r r7,
< 25,02 .;,')
Fixture/sewer cap
Name: Floor drain/floor sink/hub 1 25.02 25.O
Address: Garbage disposal disposal 25.02 ,City/State/ZIP: ^ Hose bib 25.02
" 1251
Phone:( ) Fax (•. ) .. 25.02
Ice maker
lmrterceptarlgteaso trap
... gas(value;$ Page 2
,.'� r, ;'. ,: Medical —) ,�
Business name:Reed Plumbing LLC primer 12.51
Contact Mime;Julie Reed Roof drain(commercial) ' _ 12.51
Address:Po Box 2603 Sink/basin/lavatory 3 25.02 75.Uel
Solar units(potable water) ..62.54
City/State/ZIP:Oregon City,OR 97045 12.51
Fax
( ) Tub/shower/shower pan y
Phone:(503)572 785 Urinal 25.02
E-mail:juliestevenreed®comcasknet _Water closet 1 25.02 25.0,,
i .. Water heater 1 37.52 37.5;2.
:',.'.X.'`-.:3-',- ,.• ..li > y,
Business name:Reed Plumbing LLC Water piping/DWV 56.29
25ther: .02
Address:PO Box 2603 O Subtotal j
City/State/ZIP:Oregon City,OR 97045 , id
Phone:(503)572-3785 Fax: fee: $?2.50
(503) Minimum permit 656-1538 Plan review (2590 it permZ
it fee)
CCB Lie.:186365 Plumbing Lic.no.:".13071 p ?q State surcharge(12%of permit fee) ' ,.
1 r 'I A • TOTAL PERMIT F1 E
Authorized signature: ' v
Date 10117/21118 This permit application expires if a permit is not obtained within 180 da) tie
Print mune:Julie M.Reed atter it has been accepted as complete.
"Fee methodology set by Tri-County Building Industry Servimc Board.
I:\nu114ing1Permit8lPr.MtLFermihA,9D•doc 10/0t/D9 440.4616T(14101/COMFW$) '
Plumbing Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: -
Residential Fire Su 'ression S stems
$12
0
Footing drain-1"100' IIIIII50.03 MINI 0 0 to 2,000
0600 $121.90
Footing drain-each additional 100' 37.52 3 601 to 7,200 $233.24
Sewer-1st 100'
62.54 NM 7 201 and t er $327.54
Sewer-each additional 100' 11121111
Water Service-1st 100' 62.54 Medical Gas S stems:
Water Service-tach additional 100' IIIIII 37.52 ,. I
Storm&Rain Drain-1st 100' 11.11162.54MI $1.00 M$5 OOOAO Minimum fee$72.50
Storm Sc Rain grain each additional 100' 1111.12011111111.1 $5,001,00 to$10,000.00 .00 and$1.52 for
eaach dd thefirst 10 00 or on thereof,to
7 and iniad" :$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 flee is specifically indicated 90.00d<r each additional$100.00 or fraction thereof,to
and includin;$25 000.00.
(minimum ch a-1/2 hour
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 char:e-2 hours each additional$100.00 or fraction thereof,to
90,00/hr and induct 1$50 000,00.
Reinspection Fees
Additional plan review for revisions 90.00Atr S50,00100 and up $742.00 for the first$50,000.00 and$1.20 for
each additional$100.00 or fraction thereof,
minimum ohar_e-1/2 hour
Subtotal: 111111111
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurate re,ort fixtures could result in increased sewer fees*.
t r Cyt r a
,�,n , ,I Plan review is required for any of the following,
'1' 'f...:1,•', a':,. . �',1-,,l',-'',.' t.:' ,,,,.i:,.`.Ra„i.,. ° a„- .i i, -i„ Please check all that apply.
Battle /Font pools 0 Any new commercial building with water scruice 2"licensed
B -
Tub/Shower -� d
greater,except systems designed and stamped by
-7aCU7Zi/whirl,..1 engineer.
Car Wash Each StallMOM_ MOM ❑ New exterior plumbing site utilities for any complex structure
-Drive'film as defined in OAR918-780-0040.
C .•i ashen ter As.iratot illit 0 Medical gas and vacuum systems for health care facilities_
Dishwasher -Commercial w�� ❑ Any multipurpose fire sprinkler system.
Domestic El complex structure as defined in OAR918-780-0040.
Drinkin.Fountain ���
E e Wash MEI
Min I � Submit 2 sets of plans with any of the above.
Floor Drain/sink -2"
111111
Car Wash Drain b Isometric or riser diagram is required for new buildings
Garbage
sa -Domestic-non-foodctooadrolt meet the ' alifications above.
Disposal -Domestic-toad related
-Commercial-food related MEM
-Industrial-foodrnrelated ��
OilIce Ma a ator G.Drains o Comments regarding fixture work:
S �Grater Gas Station MINIM
Rho-Vehicle a Station
Shower {rang MEM MM
— __
-Stall
Sink/Lav -Non-food related f� 1I
-Bradley '
-Commercial-food ial-food related 1 —
-Service 1 /�
Swimmi :Fool Filter ' •„M11111111=111� *Note: If the fixture work under this permit results in an
Washer Extractor
�—disi ,rte increase of sewer EDUs,a sewer permit will be issued and
Water .® I fees assessed for the sewer increase must be paid before the
Water Closet-toilet ' � , 0 I
lifffiftWININIFAIIIMINIIIIMIIIII plumbing permit can be issued.
�
Other Fixtures;
C_\Users\juliestevenreed\Dowlloads\PI.MF PerinitApp(3).doc 2 •
Accumulative Sewer Tally
C Tenant Name:T-MOBILE SWR# N/A
T t G n K D Site Address: 9693 SW WASHINGTON SQUARE RD PLM# 2018-00494
Parcel#: 1S1260000300
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 1 1 1 1
Eye Wash 1 0 0 0 0 0
Floor Drain/Sink: -2 inch 2 0 0 1 2 1 2
-3 inch 5 0 0 0 0 0
-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 1 2 0 -1 -2
-Bradley 5 0 0 0 0 0
-Com/Sere/Util-Food Related 3 0 0 1 3 1 3
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 1 6 0 -1 -6
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 2 8 3 6 1 -2
Current Fixture Value -2 divided by 16= -0.125 Current EDU 1 EDU= $5,650.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change -2 divided by 16= -0.125 over (under) $ (734.50)
Enter EDU Change Here -0.130 *
*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: ***CREDIT***
Authorized Name/Signature: BRANDEN TAGGART X2449 Date: 10/18/2018
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
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9693 SW WASHINGTON SQUARE RD C09, December 3, 2018 at
TIGARD, OR, 97223 10:03:43 AM
Record Type: Record ID:
Commercial - Plumbing PLM2018-00494
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor