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Permit CITY OF TIGARD PLUMBING PERMIT 111 COMMUNITY DEVELOPMENT Permit#: PLM2020-00258 Date Issued: 06/29/2020 T!GARID 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S 101 DA00102 Jurisdiction: Tigard Site address: 13221 SW 68TH PKWY 460 Project: Spec Space Subdivision: None Lot: None Project Description: CAP(1)dishwasher,(1)2"hub drain and(1)sink. Contractor: GRIDLINE PLUMBING Owner: GK TRIANGLE CORPORATE PARK III L 14844 SW 109TH AVE ATTN KBS REALTY ADVISORS TIGARD, OR 97224 P 0 BOX 28270 SANTA ANA, CA 92709 PHONE: PHONE: 971-275-6167 FAX: FEES Quantity Description Date Amount 3 ea Fixture/Sewer Cap 06/26/2020 $75.06 Specifics: 1 12%State Surcharge- 06/26/2020 $9.01 Plumbing Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $84.07 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: O � '�-2eCmittee Signature: Call 503.639.4175 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Plumbing Permit Atmlication Building Fixtures RECEIVE. fl)1, ,)l I I, 1 , ,I )).1 , City of Tigard Received 7 Permit , • 13125 SW Hall Blvd.,Tigard,OR 97223 Daffy' `f7 '/? ` �' � M Z�t �� �U�5 UPI0 ' Phone: 503.718.2439 Fax: 503.598.1960 IJN 2�2!' Pl06 Re iew Date/By: Other Permit No.: Inspection Line: 503.639.4175 Internet: www tt ard-or v CITY OF TIGARL Daleod/Meey lone id See Page for 8 gA N tdnat/method R I m-m r-. r s ns. 3.. o .''' Supplemental Information ,57 4.r�` . s��` �1 T ?%{:., .:', 4r'., ,e.,'.r' t ^ `:4°,,111$S .�w F:A , �' a ❑New construction 0 Demolition For special information use checklist XAdtfiuon altcratioo/roplacement 0 Other- Description I I Ea. I Total AddiNew 1-2-fondly dwelliaga(includes 100 ft.for each utility connection) >x> >'YTd'': n.;. ',-4ti " " '�srr... '" SFR(1)bath I 312.70 ❑1-and 2-family dwelling Ctxnmercial/intfitstrial, SFR(2)bath 437.78 ❑Accessory building CI Multi-familySFR(3)bath 500.32 Each additional bath/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler( sq.It) Page 2 z t 4, -, a ,: :' Site edlideet Job site address: � �% Catch basin or area drain 18.76 Drywdl,leach line or trench drain 18.76 City/State/ZIP:ry © �� ` Footing drain(no.linear R:_) Page 2 Suite/bldg./apt.no.: -go° I Project name: Lisp Manufactured home utilities 50.03 Crossss�street/directions to job site: / ���/// Manholes 18.76 /r7�,4 / 'v//.,/! g _4/ �/ Ram drain connector 18.76 !l/iii"' �,•�/�/ , ` Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.Linear It: Page 2 Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preveo[er 31.27 ''"'.r}`q s;st .';R-` a '�Y�,5 +��pn 'og(-, ... toy, . "*3 Backwater valve 12.51 (5"7>,,, �`` " j9 Clothes washes 25.02 10!�"t�� �` ll�� j--- Dishwasher 25.02 i 12e-T •� /- v6 �r��v Drinkkingfountain 25.02 TL/.:iy� G � ' - 4, ... `E Ejectors/sump 25.02 :• I y : (, . . ': '`:' .or., Expansion tank 12.51 Name: Fixmre/sewercap X3 25.02 25,C6 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 t lntercpror/gase trap 25.02 Business name: Medical gas(value:S_) 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:I. ) Fax::( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 :.. ,' , ,;, z r Water closet 25.02 f - ° `` 'SJ Wader heater 37.52 Business name: /I � �4 �- ��1 Wader i m WV 56.29 /, PP B� Address:/9/ ��� Other: 25.02 City/State/ZIP: 7" / `i'l re Z 4/ Subtotal XS,c t Phone:( �/al- i//,/ Fax:( ) Minimum permit fee: S72.50 ,~l4z/9 n/ ��r�QL Plan review (25%of permit fee) CCB Lie.: /7 PlumbingLic.no.: �(pT/'�//�/ � �/ State surcharge(12%of permit fee) r Authorized signature: v/�1 TOTAL PERMIT FEE lii,e1 Print name: O/ ltiri Date; _C'_7...e, This permit appOcatlaa expires If a permh h sot obtained within loll days after It has been accepted as complete. 'Fee methodology set by Tri-Cuunty Building industry Service Board. 11-1rl,:m61.af..,.,,i1•\PI an 1-Pomnit Ann rips• mn,nima Mn e<itr.immrn,Inoco, Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: _Residential Fire Suppression Systems: 1 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 Sewer- 1st 100' 3,601 to 7,200 $233.20 62.54 7,201 and greater S327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 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 _ OF Fees QV'._ Fit;01* Tate- 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 S148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional S100.00 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 90.00/1r and including$50,000.00. 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 lifiISttillst10118. Quand,y(( by Fixture 7YPe Plan review is required for any of the following. Fixture Type for > Please check all that apply. Work Performed. Capped A4ded Relocate 0 Any new commercial building with water service 2"and Baptistry/Font greater,except systems designed and stamped by licensed Bath: -Tub/Shower -Jacuzzi/Whirlpoolengineer. Car Wash: Each S all 0 New exterior plumbing site utilities for any complex structure Drive tall as defined in OAR918-780-0040. Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities. Dishwasher: -Commercial CIAny multipurpose fire sprinkler system. -Domestic )S f 0 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" ?( / / Or D a -Car Drainitram- Isometric or riser diagram is required for new buildings 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) Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -Lav/Bar non-food related J( /-Bradley -Com/Serv/I1til food related -Service *Note: lithe 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 plumbing permit can be issued. Urinal Other Fixtures: 1:1Building\Pcrmits\PLMF PcrmitAon.doc 08/04/2011 1 Accumulative Sewer Tally m Tenant Name: Spec Space SWR# N/A TI GARD Site Address: 13221 SW 68th Pkwy,#460 PLM# 2020-00258 Parcel#: 2S 101 DA00102 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 1 2 0 -1 -2 Drinking Fountain 1 0 0 0 0 0 Eye Wash 1 0 0 0 0 0 Floor Drain/Sink: -2 inch 2 0 1 2 0 -1 -2 -3 inch 5 0 0 0 0 0 -4inch 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 -Stall 2 0 0 0 0 0 Sink: -Lav/Bar-Non-Food Related 2 0 1 2 0 -1 -2 -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 0 0 0 0 Urinal 6 0 0 0 0 0 Previous EDU Count 0 0 Capped EDU Credit 0 TOTALS 0 0 3 6 0 0 -3 -6 Current Fixture Value -6 divided by 16= -0.375 Current EDU 1 EDU = $5,800.00 Previous Fixture Value 0 divided by 16= 0.000 Previous EDU Change -6 divided by 16= -0.375 over (under) S (2,204.00) Enter EDU Change Here -0.380 *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: Authorized Name/Signature: Dianna Omelas Date: 6/24/2020 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:A Building\Sewer Tally\SewerTallySheet_5800_070119.xlsx