Permit v CITY OF TIGARD PLUMBING PERMIT
il l s COMMUNITY DEVELOPMENT Permit #: PLM2009-00084
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 06/02/2009
Parcel: 2S115BA02600
Jurisdiction: Tigard
Site address: 16230 SW PACIFIC HWY 100
Subdivision: Lot: 0
,
• Project: Panda Express
Project Description: TI of space.
Owner: FEES
SN PROPERTIES PARTNERSHIP Quantity Description Date Amount
1121 SW SALMON ST 10 ea Floor Drain /Floor Sink/Hub 06/02/2009 $166.00
PORTLAND, OR 97205 2 ea Ice Maker 06/02/2009 $33.20
PHONE: 1 ea Interceptor /Grease Trap 06/02/2009 $16.60
4 ea Sink 06/02/2009 $66.40
Contractor: 2 ea Laundry Tray 06/02/2009 $33.20
PMSI LLC 1 ea Lavatories 06/02/2009 $16.60
21195 NW EVERGREEN PKWY #204 1 ea Urinal 06/02/2009 $16.60
HILLSBORO, OR 97124 2 ea Water Closet 06/02/2009 $33.20
PHONE: 503-466-2222 1 ea Water Heater 06/02/2009 $16.60
FAX: 503 466 2211 1 Plan Review 06/02/2009 $103.75
1 12% State Surcharge - 06/02/2009 $49.80
Plumbing
1 ea Backflow Prevention - 06/02/2009 $46.40
Type of Use: COM COM
Class of Work: ALT Type of Const: 0 Plan Review 06/02/2009 $7.45
Occupancy Grp: 0 12% State Surcharge - 06/02/2009 $3.58
Stories: Plumbing
Total $609.38
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 . 'ended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility • ification Center. • - e• are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You • ay obtain a copy of the rules
Issued By: / t / Permittee Si. nature: r ' i-
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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 M o
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Building Fixtures RECEIVED FOR OFFICE USE ONLY
City of Tigard f' 2009 Received I 1 ' 1 � ' (J ` Y 12 C`b
g Date/BY. i \ _ Permit No.
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11111
• 13125 SW Ha ll Blvd., Tigard, OR 97223 Plan Review
■ Phone: 503.639.4171 Fax: 503.598.1960 - QG -1 _ Other Permit No.: SGJ Oe �'= 60031 7
Inspection Line: 503.639.4175 CITY OF TIGARD D ate V
T I GARD Date Ready/By: la See Page 2 for
Internet: www.tigard- or.gov BUll DING DIVISI Re
Notified/M ethod: \ Supplemental Information
TYPE OF WORK FEE* S EDULE
❑ New construction ❑ Demolition For special information use checklist
Description I Qty. I 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 249.20
❑ 1- and 2- family dwelling ® Commercial/industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION : r "s
Site utilities
Job site address: 16230 Pacific Highway, Suite 100 Catch basin or area drain 16.60
City/St. teJZIP: Tigard, Oregon Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: 100 I Project name: Panda Express Restaurant Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: SW Pacific Highway and SW Durham Road
Manholes 16.60
Tigard Town Square Shopping Center Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2
Tax map /parcel no • 115BA02600 Fixture or item
Absorption valve 16.60
DE IPTION OF WORK Backflow preventer l Page 2
Tenant Improvement for 2,000 square foot restaurant in vacant building. Backwater valve JP' 16.60 -1 -6:60
Clothes washer 16.60
Dishwasher 16.60
❑ PROPERTY OWNER Z TENANT Drinking fountain 16.60
Ejectors /sump 16.60
Name: Panda Express Inc. Expansion tank 16.60
Address: 1683 Walnut Grove Avenue Fixture/sewer cap 16.60
City /State /ZIP: Rosemead, California 91770 Floor drain/floor sink/hub 10 16.60 166.00
Phone: (626)799 - 9898 Fax: (626) 372 - 8288 Garbage disposal 16.60
® APPLICANT ® CONTACT PERSON Hose bib 16.60
Ice maker 2 16.60 33.20
Business name: Reiter Design Group Architects, Inc.
Interceptor /grease trap 1 16.60 16.60
Contact name: Scott A. Reiter Medical gas (value: $ ) Page 2
Address: 7965 SW Cirrus Drive Primer 16.60
City/State /ZIP: Beaverton, Oregon 97008 Roof drain (commercial) 16.60
Phone: (503) 574 -3036 I Fax: : (503) 574 -2916
Sink/basin/lavatory /) 6) 16.60 116.20
Tub /shower /shower pan 16.60
E - mail: ScottRDG @aol.com Urinal 1 ✓ 16.60 16.60
CONTRACTOR Water closet 2 ✓ 16.60 33.20
Business name: ' N...(. L k`� . - Water heater 1 16.60 16.60
Address: 2 t 9`J' w eJia er P ik, y 44.2t1 Other:
City /State /ZIP: (�c ,� D e 47 /2. ci Subtotal 415.20
Minimum permit fee: $72.50
Phone: (9 ,) zo -aa22 Fax: ( , ) e-16.. gi t / Residential backflow minimum permit fee: $36.25
CCB Lic.:. /6 „ , , Plumbing Lic. no.: 3 - /I3i/ P6 Plan review (25% of permit fee) 103.80
State surcharge (12% of permit fee) 49.82
/
Authorized signature: - I ., I TOTAL PERMIT FEE - $48e82
Print name: Scott Reiter Date: 3/16/09 This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service B rid
1:\ Building \Permits\PLMF- PermitApp.doc 12/27/06 440- 4616T(I0 /02/COM/WEB) •}�$O
C 38
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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' 55.00 0 to 2,000 $115.00
Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00
3,601 to 7,200 $220.00
Sewer - 1st 100' 55.00 7,201 and greater $309.00
Sewer - each additional 100' 46.40
Water Service - 1st 100' 55.00 Medical Gas Systems:
Water Service - each additional 100' 46.40
Valuation: Permit Fee:
Storm & Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each
Fixture or Item Qty. Fee (ea) Total additional $100.00 or fraction thereof, to and
including $10,000.00.
Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to
(minimum permit fee $36.25) 27.55 and including $25,000.00.
Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
Inspection of existing plumbing or each additional $100.00 or fraction thereof, to
specially requested inspections - per hour 72.50 and including $50,000.00.
Subtotal: $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
each additional $100.00 or fraction thereof.
Commercial Fixture Work: Plan Review for Plumbing Installations
Are you capping, adding or replacing fixtures? If "yes ", Plan review is required for any of the following.
please indicate work performed by fixture. Failure to Please check all that apply.
accurately report fixtures could result in increased sewer fees ❑ Any new commercial building with water service 2" and
Quantity by (Fixture) Work Performed greater, except systems designed and stamped by licensed
Fixture Type: Replace engineer.
Previous Capped Added Existing;', ❑ New exterior plumbing site utilities for any complex structure
Baptistry/Font as defined in OAR918- 780 -0040.
Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities.
- Jacuzzi /Whirlpool ❑ Any multipurpose fire sprinkler system.
Car Wash -Each Stall ❑ Any complex structure as defined in OAR918- 780 -0040.
-Drive Thru
Cuspidor /Water Aspirator Submit 2 sets of plans with any of the above.
Dishwasher - Commercial
- Domestic
Drinking Fountain Isometric or Riser Diagram
Eye Wash ❑ Isometric or riser diagram is required for new buildings
Floor Drain/sink - 2" that meet the qualifications above.
-3"
-4"
Car Wash Drain
Garbage - Domestic Comments regarding fixture work:
Disposal - Commercial
- Industrial
Ice Mach./Refrig. Drains
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar /Lavatory
- Bradley *Note: If the fixture work under this permit results in an
- Commercial increase of sewer EDUs, a sewer permit will be issued and
- Service fees assessed for the sewer increase must be paid before the
Swimming Pool Filter plumbing permit can be issued.
Washer - Clothes
Water Extractor
Water Closet - Toilet
Urinal
Other Fixtures:
i:\BuildingU'ermits\PLM- PermitApp.doc 12/27/06
•
Sewer Fixture Unit Worksheet
Business Name: PANDA EXPRESS Date: October 3, 2008
Site Address: 16230 SW Pacific Highway Suite #: 100
Fixture Description Fixture Volt Value Total Fixture
Baptistry/Font 4
Bath - Jacuzzi , 4
_�! �^ - Tub /Shower Combination 4
Car Wash - Each stall 6
- Drive- through 16
Cuspidor /Water Aspirator 1
Dishwasher - Commercial 4 _
- Domestic _ 2 —
Drinking Fountain 1
Eye Wash I
Floor Drain /Floor Sinkl - 2 -inch 2 10
- 3 -inch 5 25
- 4-inch 6
- Car wash drain 6
Garbage Disposal - 3 /4 horsepower 0/16
- 3 /4 -5 horsepower 32
- more than 5 horsepower 42
Ice Machine /Refrigerator Drains 1 2
Oil Separator (Gas Stations) 6
Recreational Vehicle Dump Station 16
Shower - Gang (per head)
- Stall 2
Sink - Bar 2
- Bradley — 5
_ - Commercial 3 15
- Service 3 q
Swimming Pool Filter
Washer, Clothes 6
Water Extractor 6
Water Closet, Toilet 6 4 Z '. v ;)
Urinal 6
- - — — )
Total Fixture Value: 73 79
Divided by 16 = EDU(s): - 16
Round EDU(s) to nearest 1 /10th (i.e., 1.76 = 1.8): 4.56,. 4't
r " _ Multiply EDU(s) by: x $24104,41
Total Sewer Connection Fee: $ 12,77
Note: Any fixture unit rating not addressed in this table shall he calculated pursuant to the current Stale S
Pfumbing Code.
The agency will count the greater of either the number of floor sinks or the units that drain into them, but
not both.
2 Fixture unit values for garbage disposals less than - /4 h.p. installed in non - residential applications shall be
based on the proposed use of the facility. Uses associated with commercial food processing, preparation,
handling, or group food service (cafeterias) shall be charged 16 FU. Uses for individual employee support (i.e.,
employee lunchrooms) shall not be separately charged.
Distributed by:
City of Tigard, Building Division, 13125 SW Hall Blvd., Tigard, OR 97223 503 718.2439
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