Permit (43) CITY OF TIGARD PLUMBING PERMIT
iiii
: " COMMUNITY DEVELOPMENT Permit#: PLM2019-00021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/14/2019
Parcel: 2S 112DA00800
Jurisdiction: Tigard
Site address: 15115 SW SEQUOIA PKWY 150
Project: Westlake Consultants Subdivision: PACIFIC CORPORATE CENTER Lot: 2
Project Description: Interior plumbing for TI:Capping(1)sink and(1)water closet;Adding(1)dishwasher and(1)sink; Replacing(6)
sinks, (6)water closets,and(1)urinal.
Contractor: MIKE PATTERSON PLUMBING Owner: PACIFIC REALTY ASSOCIATES LP
15028 S MITCHELL LN ATTN: N PIVEN
OREGON CITY, OR 97045 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-632-7374 PHONE:
FAX: 503-632-5647
FEES
Quantity Description Date Amount
2 ea Fixture/Sewer Cap 01/14/2019 $50.04
Specifics: 7 ea Sink 01/14/2019 $175.14
1 ea Urinal 01/14/2019 $25.02
Type of Use: COM 6 ea Water Closet 01/14/2019 $150.12
Class of Work: ALT 1 12%State Surcharge- 01/14/2019 $48.04
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $448.36
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 mgyy obtain copy of the rules
or direct questions to OUNC by calling 503.232.19: : .:e+ 332.2344.
Issued By: �
� Permittee Signature: / � � �4
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 Tigard Received
Plan Re: /,,
// /% '4'17--
Plan
� Permit No.: �� �7�Iif-&t.,-.),;2/
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review / �/
I Phone: 503.718.2439 Fax: 503.598.19619-
114
03.598.19 ate/By: Other Permit No.:01� �1)`¢X136
TI G A R D Inspection Line: 503.639.4175 R E C E I V E Ccate Ready/By: urns: ® See
,Page 2 for !/
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK JAN 14 zui9 FEE* SCHEDULE
❑New construction ❑DenJ 1i nOF TIGARD For special information use checklist.
ILDING DIVISION Description Qty. Ea. Total
®Addition/alteration/replacement ❑Ot New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ 1-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
AccessorybuildingSFR(3)bath 500.32
❑ ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:15115 SW Sequoia Pkwy,Suite 150 Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.:150 I Project name:Westlake4y-yG./f/v�fj Manufactured home utilities 50.03
Cross street/directions to job site:Corner of SW 72'and SW Redwood Ln 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: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Existing Office TI/Improvement
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER 0 TENANT Expansion tank 12.51
Name: Fixture/sewer cap / 2 25.02 50.04
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
0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name:
Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory ✓ 7 25.02 175.14
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
E-mail: Urinal ,- 1 25.02 25.02
CONTRACTOR Water closet �/6 25.02 150.12
Water heater 37.52
Business name:Mike Patterson Plumbing,Inc. Water piping/DWV 56.29
Address:PO Box 850 Other: 25.02
City/State/ZIP:Gladstone OR 97027 Subtotal 4( /).3i
Phone:(503)655-4306 Fax:(503)655-4349 Minimum permit fee: $72.50
CCB Lic.:81746 Plumbing Lic.no.:3-359PB Plan review (25%of permit fee)
t .40 State surcharge(12%of permit fee) Or di
Authorized signature: /rip a TOTAL PERMIT FEE 7GI ii
Print name:Bryan O'Doherty 'i Date: /-/¢-21F/0 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:
Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee:
Footing drain-Pt 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*.
Quantity by Fixture Type Plan Review for Plumbing Installations
Fixture Type for Replace/ Plan review requiredan is for of the following.
Work Performed: Capped Added Relocate y owg'
Baptistry/Font Please check all that apply.
Bath Tub/Shower El 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 0 New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic 1 ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ 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"
4" _. Isometric or Riser Diagram
Car Wash Drain ❑ Isometric or riser diagramis required for new buildings
Garbage -Domestic-non-foodq 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 1 1 6
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter
Washer-Clothes *Note: If the fixture work under this permit results in an
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet 1 6 fees assessed for the sewer increase must be paid before the
Urinal 1 plumbing permit can be issued.
Other Fixtures:
C:\Users\scottt\Downloads\PLMF_PermitApp(1).doc 2
Accumulative Sewer Tally
IIIa Tenant Name: WESTLAKE CONSULTANTS SWR# N/A
TI G A R D Site Address: 15115 SW SEQUOIA PKWY SUITE 150 PLM# 2019-00021
Parcel#: 2S 112DA00800
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:
-Lav/Bar-Non-Food Related 2 0 1 2 1 2 0 0
-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 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 2 4 0 -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***
Authorized Name/Signature: BRANDEN TAGGART X2449 Date: 1/14/2019
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:
15115 SW SEQUOIA PKWY 150, TIGARD,
OR, 97224
Record Type: Record ID:
Commercial - Plumbing PLM2019-00021
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
1 . Plumbing final-Approved
Violation Summary:
Inspector Contractor