Permit (3) 1,1 , CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2019-00400
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/28/2019
Parcel: 1 S 126BC01506
Jurisdiction: Tigard
Site address: 9020 SW WASHINGTON SQUARE RD
Project: One Embassy Centre Subdivision: None Lot: None
Project Description: Plumbing for Commons area associated with TI:Adding(1)drinking fountain, (1)2"floor drain/sink, (2)shower
stalls,and(1)water closet; Relocating (1)sink; Installing (1)expansion tank and(1)water heater.
Contractor: PMSI LLC Owner: TOWMAN ONE EMBASSY CENTRE LLC
21195 NW EVERGREEN PKWY#204 BY TOWMAN LLC
HILLSBORO, OR 97124 25425 BASCOM AVE STE 230
CAMPBELL, CA 95008
PHONE: 503-466-2222 PHONE: 803-294-0400
FAX: 503-466-2211
FEES
Quantity Description Date Amount
1 ea Drinking Fountain 10/25/2019 $25.02
Specifics: 1 ea Expansion Tank 10/25/2019 $12.51
ea Floor Drain/Floor Sink/Hub 10/25/2019 $25.02
Type of Use: COM ea Sink 10/25/2019 $25.02
Class of Work: ALT 2 ea Tub/Shower/Shower Pan 10/25/2019 $25.02
Type of Const: 1 ea Water Closet 10/25/2019 $25.02
Occupancy Grp: 1 ea Water Heater 10/25/2019 $37.52
Stories: 1 12%State Surcharge- 10/25/2019 $21.02
Plumbing
Total $196.15
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: 1 Permittee Signature: f
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 ..
8
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Building Fixtures ki LI V L.311 p()R ()I,FR F I st, ONE 1
City of Tigard Received
OCT 1 2019 paw/By ifb/31/et e.7.,--__ penni,No.: iidimpuii_collot)
, . 13125 SW Hall Blvd..Tigard.OR 97223
IIPlan Review
1 111 Phone: 503.718.2439 Fax: 503.598.1960DiBy. Other Permit No54/(2‘;20/4-c0/41
!so,,A on ate
T I 6 A RD
Inspection Line: 503.639.4 I 75 - -: ' ' Date Readyilly: ,Juq 0 See Page 2 for
Internet. wn w.tigard-or.gov , , Noti Red•Method: / --:., Supplemental Information
TYPE OF WORK FEE* SCHEDULE J
0 New construction 0 Demolition For special information use checklist. 1
Description I ----7-C1---11a T-7-Total
11 Addition/alterationireplitcement El Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
-----
CATEGORNOF CONSTRUCTION SFR(!)bath 312.70
0 I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 300.32
0 Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORNIATION AND LOCATION Site utilities:
Catch basin or area drain 18.76
Job site address:9020 SW Washington Square Road
Dryweli,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97223 ., Footing dram(no linear ft.:_) Page 2
Suite/bldg./apt,no,: - _Project name:Embassy Center Commons 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.: l Page 2
Water service(no.linear It:_) Page 2
Subdivision: Lot no.: Fixture or item:
Backflow preventer 31.27
Tax map/parcel no.: ir 5 4,1,673(--e i 5-77.,,,
Backwater valve 12.51
DESCRIPTION OF WORK
-- Clothes washer 25.02
Plumbing for TI Dishwasher 25.02
Drinking fountain 1 25.02 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER 0-TENANT Expansion tank I 12.51 12.51
Fixture/sewer cap 25.02
Name:
Floor drain/floor sink/hub 1 25.02 25.02
Address: Garbage disposal 25.02
City/State/Z1P: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
_
Fr APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:PMS1
Medical gas(value:$ ) Page 2
1.1..0
Primer 12.51
Contact name:Brandy Solano
Roof drain(commercial) 12.51
Address:21195 NW Evergreen Pkwy.,Ste.204 Sink/basin/lavatory 1 25.02 25.02
City/State/ZIP:Ililisboro,OR 97124 Solar units(potable water) 62.54
Phone:(503)466-2222 Fax::(503)466-2211 Tub/shower/shower pan 2 12.51 25.02
Urinal 25.02
E-mail: bsolano,a'ms i-sy ste MS.COM
Water closet I 25.02 25.02
CONT'RACTOR I 37.52 37.52
Business name:PMS1 Eli' Water piping/DWV 56.29
Address:21195 NW Evergreen Pkwy.,Ste.204 Other: 25.02
City/State/ZIP:Hillsboro,OR 97124 Subtotal 175.13
i Phone:(503)466-2222 Fax:(503)466-2211 Minimum permit fee: $72.50
I - Plan review (25%of permit fee)
CCB Lie.: 158286 Plumbing Lie.no.:34-434PB
State surcharge(12%of permit fee) 21.02
Authorized signature: 4 4 4 "'-' TOTAL PERMIT PEE 196.15
This permit application expires if a permit is not obtained within 180 days
Print name:Brandy Solano Date:)/25/19 after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I\Building\Pennits\PIAW-Pertni(Apo doe I WO l Mo 440-4616T110/02/COMAVEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
_Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. 'Fee teat Twat S i uare Footage: Permit Fee:
Itiming dram-l'100' 50.03 0 to 2.000 $121.90
footing drain-each additional IOW 37.57 2,001 to 3.600 $1 69.69
---
3.601 to 7.200 $233.20
Sewer- Is! IOW 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 1)10' .37,52 $5,001.00 to$10,000.00 $72.50 for the first$5.600.00 and$1.52 for
Qty. Fee(ea) Total
Other Inspections or Fees each additional$100.00 or fraction thereof,to
and including$10.000,00.
Inspection of existing plumbing or for $103301.00 to$25.000.00 $148 50 for the first$10,000,00 and$1.54 for
winch no fee is specifically indieated 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 00,110/hr $25,001.00 to 550.000.00 $379. 0 for the first$25.000.00 and$1.45 for
hours(minimum charge-2 hours) each additional SI 00.00 or fraction thereof,to
Reinspection fees 90,00/hr and including$50.000,00.
Additional plan review Mr ret twits 90.00/hr $50..001.00 and up $742.00 for the first S50,00-0.00 1'(1$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*.
Quaritt,q'by Fixture Type Plan Review for Plumbing Installations
Fixture Type for Replace Plan review is required Mr any of the following.
Work Performed: Capped Added Relocate
Please check all that apply.
Baptistry/Etna
0 Any new commercial building with water service 2"and
Bath -lub/Shower „ greater,except systems designed and stamped by licensed
-Jactv/i/Whirlpool .,
Car Wash -liach Stall engineer,
-Dris,c Thni
0 New exterior plumbing site utilities for any complex structure
C'uspidor/Winer Aspiratoi -
as defined in MAR9 I 8-780-0040.
.
Dishwasher -commercial 0 Medical gas and vacuum systems for health care facilities.
-1/omestic 0 Any multipurpose tire sprinkler system.
Drinking Fountain i 0 Any complex structure as defined in OAR918-780-0040.
I se Wash
floor Drain/sink I Submit 2 sets of plans with any of the above.
...
. ' Isometric or Riser Diagram
Car h\ah Drain
0 Isometric or riser diagram is required for new buildings
Garbage 4.Minestie non-ltiod
Disposal 'Domestic food related that meet the qualifications above.
-Commercial-Mod related
-Industrial-food related _
Ice Mach./ReIrig,Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall 2
Sink/1,m -Non-Mod related I
-Bradley
-Commercial-Mod related
-Sery ice
Stx Miming Pool Filter
- - *Note: If the fixture work under this permit results in an
Washer-Clothes
increase of sewer EDUs,a sewer permit will be issued and
Water Extractor
Water Closet-toilet 1 fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures-
N4:"Job Files\PMS1 Jobs'.20314-Embassy('enter CommonsCity of Tigart2 Plumbing permit app.doc