Permit (195) CITY OF TIGARD PLUMBING PERMIT
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: 2 . COMMUNITY DEVELOPMENT Permit#: PLM2019-00321
T[GARD D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/12/2019
Parcel: 1 S136DC04500
Jurisdiction: Tigard
Site address: 7501 SW DARTMOUTH ST 100
Project: Winco Foods Subdivision: 1995-013 PARTITION PLAT Lot: 2
Project Description: Relocate(1)2"floor sink.
Contractor: MCLANE PLUMBING INC Owner: WINCO FOOD LLC
7675 HIGHBANKS RD#3 ATTN:TAX DEPARTMENT
CENTRAL POINT, OR 97502 PO BOX 5756
BOISE, ID 83705
PHONE: 541-664-1880 PHONE:
FAX: 541-664-4216
FEES
Quantity Description Date Amount
1 ea Floor Drain/Floor Sink/Hub 08/12/2019 $25.02
Specifics: 1 12%State Surcharge- 08/12/2019 $8.70
Plumbing
Type of Use: COM 47 ea Minimum Fee Adjustment- 08/12/2019 $47.48
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
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 952-001-0090. 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:
OA/ 4--'/7 4/C'r%T 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 Applicatpt C E I V E D
Building Fixtures
City of Tigard AUG 8 2019 Received y p
114 e 13125 SW Hall Blvd.,Tigard,OR Date/By: O 1�`1/ Pemtit Nc � /�._�0
MI Phone: 503.718.2439 Fax: 503,,� O F TI GAR D Plan Review Other Permit No.
tS ENG DIVISION Date/By:
T I G A R D Inspection Line: 503,639.4175 Date Ready/By: - Jurit: E]See Page 2 for
Internet: www.tigard-or.gov Notified/Method:‘//'1��" - «. Su�pleme,,,,hqntal Information
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0 New construction 0 Demolition For special information use checklist
Description I Qty. I Ea. I Total
®Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
C*TEGORY OF CONSTRUCTION a, �s„ ,, SFR(1)bath 312.70
❑ 1-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
0 Master builderEach additional bath/kitchen 25.02
0 Other: Fire sprinkler( sq.ft.) Page 2
-17.4*-SITE" '*°R .1-1,-, TONA1'D LOCATION ''',,''''''',.,,,Y. Site utilities:
Job site address:7501 Dartmouth Street Catch basin or area drain I8.76
Drywall,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97223
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name:WinCo#23 Manufactured home utilities 50.03
Cross street/directions to job site: 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
'; ' ,-,u1'0 Oiit'RII'rTION O ,- 'ORI 1„��` v �� Backwater valve 12.51
Q"_u., ��. Clothes washer 25.02
Install 1 new floor sink
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OW1!IEF: �,* i °: -Qbr,TENAN'I, e! Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub 1 25.02 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
yt,, ,, t NTA "I'.PERSOitI Interceptor/grease trap 25.02
Business name:McLane Plumbing And Construction,Inc. Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Ryan McLane
Roof drain(commercial) 12.51
Address:7675 Highbanks Rd.Unit 3 Sink/basin/lavatory 25.02
City/State/ZIP:Central Point,OR 97502 Solar units(potable water) 62.54
_ Phone:(541)664-1880 __ _Fax:4541)-.6644216--- Tub/showcrlshnwerpan 11.11 -
E-mail:amanda@mclaneplumbing.com Urinal 25.02
_ 'y � - _ Water closet 25.02
i-�w,... ',.' ,-'n - I . COcr� : ,« .' F �� � Water heater
aur �. 37.52
Business name:McLane Plumbing And Construction,Inc. Water piping/DWV 56.29
Address:7675 Highbanks Rd.Unit 3 Other: 25.02
City/State/ZIP:Central Point,OR 97502 Subtotal 25.02
Phone:(541)664-1880 Fax:(541)664-4216 Minimum permit fee: $72.50 72.50
CCB Lic.:90332 Plumbing Lic.no.:15-146PB Plan review(25%of permit fee)
.a- State surcharge(12%of permit fee) 8.70
Authorized signature: -� -�..-.--�.•�-"• _�.'
"' TOTAL PERMIT FEE 81.20
Print name:Ryan Mc a Date:08/07/2019 This permit application expires it aa
permitis not obtained within 180 days
after it bas been accepted as complete
"Fee methodology set by Tri-County Building Industry Service Board.
I:\BuildingTPermits\PLMU-PermitApp.doe 10/01/09 .440.4616T(10//02/COMIWEB) i
1
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-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
Valuation „ 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' .Fee(ea) Total each additional$100.00 or fraction thereof,to
Other Inspections or 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*.
Quantity by Fixture Type Plan Review for Plumbing-installations,
Fixture Type for Replace/ `
Work Performed: Capped Added Relocate Plan review is required for any of the following.
.
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 0 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 0 Any multipurpose fire sprinkler system.
Drinking Fountain 0 Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" t Submit 2 sets of plans with any of the above.
-3,'
.,.., Qmetti
-4 �ti
� rr`Ria"�P`""1Yii!`g.'ratin `' -;"
Car Wash Drain
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
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial-food related
-Service
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 fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
C:\Users\remote_user\Desktop\TigardPlumbPermit.doc 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
7501 SW DARTMOUTH ST 100, TIGARD,
OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2019-00321
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor