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Permit it CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit#: PLM2020-00090 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/27/2020 T f C' h.t,:,;C3 g Parcel: 1S134AA02100 Jurisdiction: Tigard Site address: 10300 SW NIMBUS AVE PC Project: KG Investments Subdivision: IKOLL BUSINESS CENTER,TIGARD Lot: 3 Project Description: Interior plumbing for TI: Capping(1)water closet and(1)urinal;Relocating(2)sinks. Contractor: PINNACLE PLUMBING INC Owner: DIETRICH, NANCY BISHOP PO BOX 1053 ROBINSON, JERRY CHRISTOPHER TRUST GRESHAM, OR 97030 ROBINSON, LYNN ET AL 9701 SE MCLOUGHLIN BLVD MILWAUKIE, OR 97222 PHONE: 503-481-7492 PHONE: FAX: FEES Quantity Description Date Amount 2 ea Fixture/Sewer Cap 02/27/2020 $50.04 Specifics: 2 ea Sink 02/27/2020 $50.04 1 12%State Surcharge- 02/27/2020 $12.01 Type of Use: COM Plumbing 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 . . 4. c Issued By: • Signature: 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 City of Tigard eece v«I IIn 13125 SW Hall Blvd.,Ti ', Dal y: ,87� - PecmitNo.: ¢ Phone: 503.718.2439 Fax: 50 598.1960 02Q DPlaate/By: Other Permit No.: 1 Inspection Line: 503.639.4175 ? 0 2 ra for f TTGAiiD Date Rd/M thy: See Ior Internet: wvtiv.tigud-or.gov Notdied/Method: [ Supplemental Information TYPE OF WORK -`) FEE* SCHEDULE 11' ❑New construction 0 D�e�molition For special information use checklist Addition/alteration/replacement �Othar. Description I Qty I Ea. I Total New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONS`FRLCTION SFR(1)bath 312.70 ❑ 1-and 2-family dwelling Ai/Commercial/industrialSFR(2)bath 437.78 ❑Accessory building ❑Multi-family SFR(3)bath 500.32 ❑Master builder Each additional bath/kitchen 25.02 ❑Other: Fire sprinkler sq.ft.) Page 2 JOB SIM INFORMATION AND LOCATION Site utilities: Job site address: k��^y© �� ? '�rn�L ANC• c, 'D n Catch basin or area drain 18.76 City/State2IP: "'�=--,� J1G T V Footing 1,leach line,or r drain Page 2 "�� �/ Footing drain(no.linear ft.: 1 2 Suite/bldg./apt.no: p_ Project name: /[6 -TA/1X uy'Ati 'rJ 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.: 1 Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: Lot no.: U �7 Fixture Or item: Tax map/parcel no.: / 5 13j /, J Uvk}i) Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 v t Clothes washer 25.02 l A. l7TT�' CA \ Pi 6l - tnma. _ _ t �``` Dishwasher 25.02 �. e_. ==� :_-- -- (i( �` i n[ R Drinking fountain 25.02 �s Ejectors/sump 25.02 _: 0 PROPERTY OWNER ❑ TENANT Expansion tank 12.51 Name: Fixture/sewer cap .225.02 5-2, 04 Address: Floor drain/floor sink/hub 25.02 Cityress: /ZIP: Garbage disposal 25.02 Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 I ❑ APPLICANT 0 CON TACT PERSON Interceptor/grease trap 25.02 Business name: Medical gas(value:$ ) Page 2 Contact name: Primer 12.51 Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 25.02 .52).t)h City/State/ZlP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 ut CONTRACTOR Water closet 25.02 Business name: Water heater 37.52 P�>s� patN1 b}�G L I�G Water piping/DW V 56.29 Address: Po FPX t053 Other: 25.02 City/State/ZIP: r , o� Cri030 Subtotal ilk).v/ Phone:(5 )(,�aI-`7(F902 Fax:( ) Minimumperrnitfee: $7250 F IJ 1 q Plan review (25%of permit fee) CCB Lic.: jvC f`Z [ Plumbing Lie.no.: I C7 1 [ State surcharge(12%of permit fee) a 0/ Authorized signature: �r2-. .- Zc9-o r 7///1-6 TOTAL PERMIT FEE ,t 1 Print name: c4i� Date: 212-7J w I This permit application expires If a permit is not obtained within 18 day after it has been accepted as complete. *Fee methodology set by Tri-Comely Building Industry Service Board. l BuldiaglPeemhs1Pt.Ml1-Pcrmiv*pp.doe 10/01/09 440-1616r(10ro2/crotvwEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Q 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 $164.69 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&Ran» ;n-1st 100' Valuation: Permit Fee: , 62.54 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to S 10,000.00 $72.50 for the first$5,000.00 and$1.52 for Other Inspections or Fees Qt'' 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 (minimum charge-1/2 hour) each additional$100.00 or fraction thereof,to and including$25,000.00. Inspections outside of normal business 90.00lhr $25,001.00 to$50,000.00 $379.50 for the first S25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/hr and including S50,000.00. Additional plan review for revisions 90.00/1u S50,001.00 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*. Plan Review for Flumbing 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 Baptistry/Font ElAny new commercial building with water service 2"and greater,except systems designed and stamped by licensed Bath: -Tub/Shower -Jacu771/Whirlpool engineer. ElCar Wash: Each Stall New exterior plumbing site utilities for any complex structure -Drive Thru as defined in OAR918-780-0040. Cuspidor Water Aspirator ElMedical gas and vacuum systems for health care facilities. Dishwasher: -Commercial ❑ Any multipurpose fire sprinkler system Domestic ❑ Any complex structure as defined in OAR918-780-0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: -2" -3" Isometric or Riser Diagram 4 ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain Garbage -Domestic non-food that meet the qualifications above. Disposal: -Domestic food related -Commercial food related -Industrial food related Ice Mach✓Refrig.Drains Comments regarding fixture work: Oil Separator(Gas Station) t Gs re ff // .,/ C /_ Rec.Vehicle Dump Station a L/)-7/ge Shower: -Gang -Stall Sink: -Lav/Bar non-food related ,Z -Bradley -Com/Serv/Util food related -Service *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 Water Extractor fees assessed for the sewer increase must be paid before the Water Closet-Toilet 1 plumbing permit can be issued. Urinal Other Fixtures: I:\Building\Permits\PLMF_PertnitApp.doc 08/04/2011 2 III C Tenant Name: KG INVESTMENTS Sewer Tally SWR# N/A nit 11 Site Address: 10300 SW NIMUBS AVE SUITE PC PLM# 2020-00011 Parcel#: 1S134AA02100 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 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 -Sta0 2 0 0 0 0 0 Sink: -Lav/Bar-Non-Food Related 2 0 0 0 0 0 -Bradley 5 0 0 0 0 0 -Com/Serv/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 1 6 0 -1 -6 Previous EDU Count 0 0 Capped EDU Credit 0 TOTALS 0 0 2 12 0 0 -2 -12 Current Fixture Value -12 divided by 16= -0.750 Current EDU 1 EDU= $5,800.00 Previous Fixture Value 0 divided by 16= 0.000 Previous EDU Change -12 divided by 16= -0.750 over (under) $ (4,350.00) Enter EDU Change Here -0.750 * *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: 2/27/2020 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_5800_070119.xlsx