The URL can be used to link to this page

Permit (115) CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit#: PLM2018-00510 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/05/2018 TIGARDParcel: 2S101DA00104 Jurisdiction: Tigard Site address: 13333 SW 68TH PKWY, STE#20 Project: New Horizons Wellness Services Subdivision: VARNS ACRES Lot: 9 Project Description: Interior plumbing:Capping(7)sinks,(2)water closets,and(2)urinals;Adding(1)dishwasher and(1)clothes washer;Relocating(2)sinks. Contractor: COLUMBIA CONSTRUCTION INC Owner: TRIANGLE POINTE TWO LLC 28170 BOBERG RD 901 NE GLISAN ST, STE 100 WILSONVILLE, OR 97070 PORTLAND, OR 97232 PHONE: 503-427-0304 PHONE: 503-297-8791 FAX: FEES Quantity Description Date Amount 1 ea Clothes Washer 11/05/2018 $25.02 Specifics: 1 ea Dishwasher 11/05/2018 $25.02 11 ea Fixture/Sewer Cap 11/05/2018 $275.22 Type of Use: COM 2 ea Sink 11/05/2018 $50.04 Class of Work: ALT 1 12%State Surcharge- 11/05/2018 $45.04 Type of Const: Plumbing Occupancy Grp: Stories: Total $420.34 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: fJ 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. Plumbing Permit Application ' Building Fixtures FOR OFFICE USE ONLY City of TigardFi a eBY / f 0, " Permit No.: �Q'/�.) if ass 13125 SW Hall Blvd.,Tigard,OR 97223 l { / �! .`. Phone: 503.718.2439 Fax: 503.598.1960 an Review Other Permit No. QryCj°/t Inspection Line: 503.639.4175NOV9 Date/By: J3ti/ a--a-474 I y- E l 1: l? p U Y U Date Ready By: loris: ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information ,� II Mit y�ii () i i iii 0 k - Ild':pi,' ii) --,,,:_,47,m,..4 * 1 D _ 41'i f�i i fr-r�(1� El New construction 0 D." b t 1. For special information use checklist Description Qty. Ea. Total ®Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) Ilicii. ff , 'T' �OR fF' s T11 ISI;. I 11SFR(1)bath 312.70 -� d k,'a, ; „,„„„.i,w� _,,kr. - ❑ 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 0 Other: Fire sprinkler( sq.ft.) Page 2 .. . :� ti = � Site utilitiesND LO �f 9 ,„n-; ti ' J ,,1 i1, � � * ,�� oa i ,, Job site address:13333 SW 68th Parkway, Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard.OR,97223 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no. nc., Project name:New Horizon.Sees uices :,1(NQvj Manufactured home utilities 50.03 Cross street/directions to job site: 5 C Yl/i Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: ?.S/'t i 11} ad (Cl ti Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 11 a r!� '� ;:�,P�h� = I S I' wo t 11;1,-,---____,414,&,491%:011,0, Backwater valve 12.51 I 1,:b,,,,'41,11,311-77------t r ! !� _� �: ��- �r';� dil�� Clothes washer �/ 1 25.02 25.02 Demolition of 7 sinks,2 urinals,2 toilets.Re-locate 2 sinks and add 1 Clothes Dishwasher / 1 25.02 25.02 waasher box. Drinking fountain 25.02 Ejectors/sump 25.02 ❑ 'ROP 3ax i= i211111,1�Pr ;d.. ,' Expansion tank 12.51 Name: Fixture/sewer cap 11 25.02 275.22 Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 i�� "i) ! '� Interceptor/grease tra 25.02 +I�l,4i,, NT t ill❑ coC4 .'i ' "D oiilo- P Business name: Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: Roof drain(commercial) 12.51 Address: 2 25.02 50.04 Sink/basin/lavatory City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax: :( ) Tub/shower/shower pan 12.51 : 25.02 25.02 i iii � Water closet �i11�� NTIIi ' 1i " - , 11� I Water heater 37.52 Business name:Columbia Const.Inc Water piping/DWV 56.29 Address:PO Box 621 Other: 25.02 City/State/ZIP:Donald,OR 97020 Subtotal 375.30 Phone:(503)427-0304 Fax:( ) Minimum permit fee: $72.50 CCB Lie.:199903 Plumbing Lic.no.:PB1400 Plan review (25%of permit fee) State surcharge(12%of permit fee) 45.04 Authorized signature: jt . , , , TOTAL PERMIT FEE 420.3k Print name:Darren Placek vw Date:10/31/18 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:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: ' � areooageeA= i �1"p(I0 .. . 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 Per3 miP�I��)il��l�ll� il(INI ��G��Gii61ll Storm&Rain Drain-1st 100' 62.54 al-°` „ 4�w $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 Jee al �� tea) - e ; each additional$100.00 or fraction thereof,to �11gee 1° rf:r ��• 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*. Quantity bylrxture ype PlaII�` " r for P l mbililig i'4 i �', 'Fixture y pe for d,a0;N e ace/ Ca ed Aided e tate Plan review is required for any of the following. orke ©rd: p Please check all that apply. Baptistry/Font 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 1 ❑ 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" 10� sometx%c or R i Diagra , lu) Car Wash Drain ❑ Isometric or riserdiagramis required for new buildings Garbage -Domestic-non-food q g 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 7 2 -Bradley -Commercial-food related -Service Swimming Pool Filter *Note: If the fixture work under this permit results in an Washer-Clothes 1 Water Extractor increase of sewer EDUs,a sewer permit will be issued and Water Closet-Toilet 2 fees assessed for the sewer increase must be paid before the Urinal 2 plumbing permit can be issued. Other Fixtures: C:\Users\USER\Downloads\PLMF PermitApp.doc 2 UPIAccumulative Sewer Tally C Tenant Name: NEW HORIZON WELLNESS SERVICES SWR# N/A T I G n R D Site Address: 13333 SW 68TH PKWY SUITE 20 PLM# 2018-00510 Parcel#: 2S 101 DA00104 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 1 2 1 2 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 -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 7 14 0 -7 -14 -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 1 6 1 6 Water Extractor 6 0 0 0 0 0 Water Closet-Toilet 6 0 2 12 0 -2 -12 Urinal 6 0 2 12 0 -2 -12 Previous EDU Count 0 0 Capped EDU Credit 0 TOTALS 0 0 11 38 2 8 -9 -30 Current Fixture Value -30 divided by 16= -1.875 Current EDU 1 EDU= $5,650.00 Previous Fixture Value 0 divided by 16= 0.000 Previous EDU Change -30 divided by 16= -1.875 over (under) $ (10,622.00) Enter EDU Change Here -1.880 * *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: 11/1/2018 Building Division INote: 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: 13333 SW 68TH PKWY STE 20, TIGARD, OR, 97223 Record Type: Record ID: Commercial - Plumbing PLM2018-00510 Inspection Type: Inspector: 399 Plumbing final Don Sylvester Result: PASS - NoCofO Comments: 1 . Correction's are complete, plumbing final approved. Violation Summary: Inspector Contractor