Permit 7, CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2019 00453
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/12/2019
Parcel: 1 S 136DC04500
Jurisdiction: Tigard
Site address: 7501 SW DARTMOUTH ST 100
Project: Winco Foods Subdivision: 1995-013 PARTITION PLAT Lot: 2
Project Description: Replace produce wet rack cases.
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
4 ea Floor Drain/Floor Sink/Hub 11/12/2019 $100.08
Specifics: 1 12%State Surcharge- 11/12/2019 $12.01
Plumbing
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $112.09
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: fMr- Permittee Signature: ege / ,
lfi
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..r.-. 1 , ;!
Site Utilities Foil Or•F►(•►•; ► s►•: o'►,‘
City of Tigard (� Z019
Received
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a 13125 SW Hall Blvd.,Tigard,OR 97223 // r� r / �M L'�`/-lx ZS3
t� Plan Review
$ Phone: 503.718 2439 Fax: 503.598.1 Q60 - ' '4..)'-‘1:-1- Other Permit No.: CL, t r"
T I G A R D Inspection Line: 503.639.4175 �+ 1 � DateBy: lge 2 for - j� l
tJ Date Ready/By: kris. ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
0 New construction 0 Demolition For special information use checklist.
Description . Qty. I Ea. I Total
®Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
0 1-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
0 Master builder ❑Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE-INFORMATION AND LOCATION ' Site utilities:
Job site address: 7501 Dartmouth Street 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.: !(1;-6 J Project name:WinCo#23 Wet Racks 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
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
___ `��/7�efZGt-6,,„ of),..,2 { �A'- 5 .i'
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER " I ❑ TENANT Expansion tank 12.51
Name:WinCo Foods, LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 4 25.02 100.08
Address: 650 N.Armstrong Place
Garbage disposal 25.02
City/State/ZIP: Boise, ID 83704 Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
) APPLICANT 0 CONTACT PER_SON Interceptor/grease trap 25.02
Business name: Medical gas(value:$ ) Page 2
McLane Plumbing And Construction, Inc.
Primer 12.51
Contact name: 7675 Highbanks Rd. Unit 3
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State/ZIP: Central Point, OR 97502 Solar units(potable water) 62.54
Phone:(541 )664-1880 Fax: :( 541) 664-4216 Tub/shower/shower pan 12.51
E-mail: ryan@mclaneplumbing.com Urinal 25 02
CONTRACTOR Water closet 25.02
Water heater 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 100.08
Phone:(541 ) 664-1880 Fax:(541 ) 664-4216 Minimum permit fee: $72.50
CCB Lic.: 90332 Plumbing Lic.no.: 15-14_�pB--- Plan review (25%of permit fee)
State surcharge(12%of permit fee) 12.01
Authorized signature: TOTAL PERMIT FEE 112.09
Print name: Ryan Mc' Date: 11/8/2019 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.
1:\Building\Permits\PLMU•PermilApp.doc 10/01/09 440-4616T(I0/OZ/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
Other Inspections or Fees Qt3'• Fee(ea) Total each additional$100.00 or fraction thereof,to
11 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*.
Quentin'by Fixture Type Plan Review for Plumbing Installations
Future Type for Replace/ Plan review is required for anyof the following.
Performed: Capped Added Relocate 9
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 Thai ❑ 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 ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink; -2" 4 Submit 2 sets of plans with any of the above.
'
Isometric or Riser Diagram
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 increase of sewer EDUs,a sewer permit will be issued and
Water Extractor
Water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
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