Permit (6) 111 , CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2019-00383
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/30/2019
Parcel: 1S135BB00501
Jurisdiction: Tigard
Site address: 10575 SW CASCADE AVE 100
Project: Biamp Subdivision: None Lot: None
Project Description: Interior plumbing for TI. (1)trunk line cap for numerous fixtures and(2)other fixture caps. Capped fixtures include
(1)drinking fountain, (2)2"floor drains, (5)sinks, (3)water closets, and(1)urinal.
Contractor: DP PLUMBING INC Owner: ICON OWNER POOL 3 WEST LLC
15825 NE SPRINGBROOK BY INDCOR PROPERTIES
NEWBERG, OR 97132 2 NORTH RIVERSIDE PLAZA, STE 235
CHICAGO, IL 60606
PHONE: 503-537-9492 PHONE:
FAX:
FEES
Quantity Description Date Amount
3 ea Fixture/Sewer Cap 09/30/2019 $75.06
Specifics: 1 12%State Surcharge- 09/30/2019 $9.01
Plumbing
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $84.07
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: a/ H, ,
AI/CAs/
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 `N V FOR OI FI( I: iSF oNL)
V14
City of Tigard q 2Q19 ReRece/Bea G� Permit No.: ...64.2y3
al 13125 SW Hall Blvd.,Tigard,OR 9722t,c? p Date/By: /� �Tj' /94,743/1
� � c
Plan Review
Phone:p503.718.2439 Fax: 503.598.1 pep t Date/By: Other Permit No.: `l/.i!J,J rg_4?
T I G A R D
Inspection Line: 503.639.4175 q�y r ,�� /Vge for
Internet: www.tigard-or.gov j 1 ' ,4IS�` Note Ready/By: Juris: ® See Page 2
�, ..- g,l Notified/Method: '7 Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑New construction 51,Demolition For special information use checklist.
Description Qty. Ea. I Total
❑Addition/alteration/replacement El Other: 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 IN Commercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
❑Master builderEach additional bath/kitchen 25.02
0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: `os--7s
T S(„(ifCasC QIC Catch basin or area drain 18.76
1 Drywell,leach line,or trench drain 18.76
City/State/ZIP: �}�-1 1/CINCA
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: r00 I Project name: gj et,tyt. 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.: i 75-4240,,,l,--2f Backflow preventer 31.27
v� i Backwater valve 12.51
DESCRIPTION OF WORK
bA _ Q �.I. Clothes washer 25.02
>1. e t^ ++ ZV (.yld v e kt, 3 vi,L 4 " ,, Dishwasher 25.02
il i I.Q�V� L- S( t(` 6 F/ •fes Fl) ."1a /,�, 4Q y Drinking fountain 25.02
Ca c_ 7/:,t.4 '"Ejectors/sump 25.02
0 PROPERTY OWNER I 0 TENANT r�,, . Expansion tank 12.51
Name: Fixture/sewer cap 25.02 ?S
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
Business name: Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: n p P U ,�i Ite,
Water i in
'1 P P g/D 56.29
Address: iS82.r Ng S Oil Ik,4 litae,k Other: 25.02
City/State/ZIP: 6ie,ujiie Dk ✓ ^Z C?i, Subtotal `73';(,
Phone:(S-63)S l p_-7((i[`f1' Fax:( ) Minimum permit fee: $72.50 --
t Z'i Plan review (25%of permit fee)
CCB Lic.: 2_?..4 6 O Plumbing Lic.no.: Ft 2t-7(
State surcharge(12%of permit fee) q.0 I
Authorized signature: ri, p
_ /� Date: TOTAL PERMIT FEE $i, O7
Print name: Dt(_�r eLl p This permit application expires if a permit is not obtained within 180 days
ld,L ql�i b/l l after it has been accepted as complete.
66 *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-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
each additional$100.00 or fraction thereof.
(minimum charge-1/2 hour)
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*. Plan Review for Plumbing Installations
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate
❑ Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower engineer.
-Jacuzzi/Whirlpool ❑ New exterior plumbing site utilities for any complex structure
Car Wash: -Each Stall as defined in OAR918-780-0040.
-Drive Thru
Cuspidor/Water Aspirator El Medical gas and vacuum systems for health care facilities.
111Any multipurpose fire sprinkler system.
Dishwasher: -Commercial
al
Domestic 0 Any complex structure as defined in OAR918-780-0040.
Drinking Fountain I Submit 2 sets of plans with any of the above.
Eye Wash
Floor Drain/sink: -2" 7
Isometric or Riser Diagram
4"
0 Isometric or riser diagram is required for new buildings
-Car Wash Drain that meet the qualifications above.
Garbage -Domestic non-food
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
Ice Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
-
_
Sink: -Lav/Bar non-food related ij
-Bradley
-Com/Serv/Util food related
-Service I *Note: If the fixture work under this permit results in an
Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and
Washer-Clothes fees assessed for the sewer increase must be paid before the
_Water Extractor
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
Accumulative Sewer Tally
TenantII Name: BIAMP SWR#N/A
TIGARD Site Address: 10575 SW CASCADE AVE SUITE 100 PLM# 2019-00383
Parcel#: 1 S 135BB00501
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 1 1 0 -1 -1
Eye Wash 1 0 0 0 0 0
Floor Drain/Sink: -2 inch 2 0 2 4 0 -2 -4
-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 FLP) 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 4 8 0 -4 -8
-Bradley 5 0 0 0 0 0
-Com/Sera/Util-Food Related 3 0 1 3 0 -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 3 18 0 -3 -18
Urinal 6 0 1 6 0 -1 -6
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 12 40 0 0 -12 -40
Current Fixture Value -40 divided by 16= -2.500 Current EDU 1 EDU= $5,800.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change -40 divided by 16= -2.500 over (under) $ (14,500.00)
Enter EDU Change Here -2.500 *
*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: 9/26/2019
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:A Building\Sewer Tally\SewerTallySheet_5800_070119.xlsx