Permit CITY OF TIGARD PLUMBING PERMIT
a COMMUNITY DEVELOPMENT Permit #: PLM2012 -00080
TI G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/28/2013
Parcel: 25101 BA00101
Jurisdiction: Tigard
Site address: 7600 SW DARTMOUTH ST
Project: Tigard Retail Center Subdivision: WEST PORTLAND HEIGHTS Lot: 1 -3, PLl
Project Description: Site utility work for new retail center.
Contractor: KERR CONTRACTORS Owner: WAL -MART REAL ESTATE BUSINESS TRUST
PO BOX 1060 2001 SE 10TH STREET, MAIL STOP 5570
WOODBURN, OR 97071 BENTONVILLE, AR 72716 -5570
PHONE: 479 - 273 -4000
HONE: 971 - 216 -0050
FAX:
FEES
Quantity Description Date Amount
24 ea Catch Basin or Area Drain 05/28/2013 $450.24
Specifics:, 3800 If Footing Drain 05/28/2013 $1,438.27
25 ea Manholes 05/28/2013 $469.00
Type of Use: COM 750 If Sewer Service 05/28/2013 $325.18
Class of Work: NEW 4300 If Storm and Rain Drain 05/28/2013 $1,638.38
Type of Const: 4500 If Water Service 05/28/2013 $1,713.42
Occupancy Grp: 6 ea Backflow Preventer 05/28/2013 $187.62
Stories: 15 ea Roof Drain (Commercial) 05/28/2013 $187.65
1 Plan Review 05/28/2013 $1,602.44
1 12% State Surcharge - 05/28/2013 $769.17
Plumbing
Total $8,781.37
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: Permittee 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 Applicatio> � ''`
Site Utilities
City of Tigard A PR 6 20 DEEeY / Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223
11 1 11 ....19 r
ti Phone 5036394171 Fax: 503598 Other Permit No.: ,( it
Inspection Line: 503.639.4175 IY OF T(C �F , DateB Y /O Q �� o4T�0 /.� ...4,141,0 1 1 c , A R D Date Ready/By: p- n_ loos. See Page 2 for 1
Internet: www.tigard or.gov 1' ' iViS /(: ; ' Notified/Method: 0,1A 3 QaJ Supplemental Information Cj0-
TYPE , OF: WORN, r
® New construction ❑ Demolition For speclal information use checklist.
Description I Qty. I Ea. I Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CAT£GORY'Olr 0*.** 'ON - SFR (1) bath I I 312.70
❑ 1- and 2 -family dwelling ® Commercial/industrial SFR (2) bath 437.78
SFR (3) bath 500.32 Pa
❑ Accessory building ❑ Multi - family
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AN LOCH ON. Site utilities:
Job site address: 7400' 4 51 4 ) �Na� 77 70b . 7 0'7� Catch basin or area drain l 24 18.76 I 450.24
0n 9 4T�> Drywell, leach line, or trench drain k 18.76
City/State /ZIP: Tigard, OR 97223
Footing drain (no. linear ft.: 16 00) 3 s.... 0 Page 2 64 fr Val?'
Suite/bldg. /apt. no.: I Project name: Tigard Retail Center Manufactured home utilities 50.03
Cross street/directions to job site: South side of SW Dartmouth Street Manholes 25 18.76 469 r
between SW 72 Avenue and Highway 99W Rain drain connector 18.76 ' C .
Sanitary sewer (no. linear ft.: 1996)7 Page 2 .� 3 =£i9
Storm sewer (no. linear ft.: 4000) 4 Page 2 a' Z OO 0
Water service (no. linear ft.: 4500) Page 2 1713.42
Subdivision: I Lot no.: Fixture or item:
Tax map /parcel no.: 1 S 136CD TL 04200.25 I01 BA TL 00101.25 101 AB TL 01400 Backflow preventer 6 31.27 187.62
Backwater valve 12.51
DESCRIPTION OF w OlIK 3
Clothes washer 25.02
Shopping Center development on 18.16 -acre property, with 137,900 -sf anchor Dishwasher 25.02
building and two 12,000 -sf multi- tenant retail buildings Drinking fountain 25.02
Ejectors/sump 25.02 d
PROPERTY OWNER I ❑ TENA ' i Expansion tank 12.51
Name: Wal -Mart Real Estate Business Trust Fixture /sewer cap 25.02
Floor drain/floor sink/hub 25.02 f
Address: 2001 SE let" Street, Mail Stop 5570
Garbage disposal 25.02
City/State/ZIP: Bentonville, AR 72716 -5570 Hose bib 25.02
Phone: (479)273 -4000 Fax: ( ) Ice maker 12.51 •
' C] APPLICANT B . C QN ' TAirE fEP$ON Interceptor /grease trap 25.02 •
Business name: PACLAND Medical gas (value: $ ) Page 2
Primer 12.51
Contact name: Shawn Nguy
Roof drain (commercial) 15 12.51 187.65
Address: 6400 SE Lake Road, Suite 300 Sink /basin lavatory 25.02 r ...\
City/ State/ZIP: Portland, OR 97222 Solar units (potable water) 62.54
4
Phone: (503) 659 -9500 Fax: : (503) 659 -2227 Tub /shower /shower pan 12.51
E -mail: snguy @pacland.com Urinal 25.02
Water closet 25.02
CONTRACTOR
// /� )- y� Water heater 37.52
Business name: £2Q (SON t enc e5 / NC Water piping/DWV 56.29 V
Address: pp e X- / 0490 Other: _ 25.02
City/State /ZIP: �� / Kett 0 ,2_ ' 70 7 / Subtotal 489+54' gig
Phone: (97/ ) /it -- 006 Fax: ( ) Minimum permit fee: $72.50
CCB Lic.: 7 a, 5 Plumbing Lic. no.: a /- %3.7 Pb Plan review (25% of permit fee) J. 21.33- t
State surcharge (12% of permit fee) 40671V asLtre
Authorized signature: TOTAL PERMIT FEE 4616 9-' .
Print name: I Date: I This permit application expires if a permit is not obtained within 1 80 days
after it has been accepted as complete.
°Fee methodology set by Tri-County Building Industry Service Board. �C
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FOR OFFICE USE ONLY - SITE ADDRESS:
This form is recognized by most building departments in the Tri -County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
■ Transmittal Letter
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.ti and or.
-, g g ov
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TO: ( �e_e� -� DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
0 3 2012
FROM: C eti.' `1 (,I.�ARD
CITY
COMPANY: 'POLL_ , BUILDINGDWISIO N
PHONE: jO (..e ' B
RE: L Q.w,..)- � 4 Q3T r ao a -o p N
(Site Address) (Permit Number)
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: I Copies: I Description:
Additional set(s) of plans. Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor /roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other (explain): , (�
REMARKS: C �t� -tom Gl (ea-0. t�vl
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: Initials:
Fees Due: ❑ Yes El No Fee Description: Amount Due:
Special
Instructions:
Reprint Permit (per PE): El Yes El No ❑ Done
Applicant Notified: Date: Initials:
1:\Building\ Forms \TransmittalLetter - Revisions.doc 05/25!2012
CITY OF TIGARD
BUILDING DIVISION PERMIT #: col a'caoo
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 '�I
Inspection Requests (24 Hrs.): (503) 639 -4175 All "_...
INSPECTION WORKSHEET FOR DATE: la _ _ d O i3 TIME: PAGE:
SITE ADDRESS: 1 1(00 S.W. 11)avtma Sk • CLASS OF WORK:
SUBDIVISION: ••�;�0.t (X � c{� aa� LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: • PHONE #:
Inspection Request Scheduled For: Date: 15-` aar)404r3 Pour Time:
Code # Inspection Description Confirm # Contact # Message
11.`c
Corrections/Comments/Instructions:
b \ 4v.. S 1 (o ca +. d 0.T .+¢e! C'[ S Sri.& o-( kj0.1 Nti4 .54(11•41,-
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o)- 8A' R.D. LA. 1 oc.6.4 44 S. P `� ok Co
I PASS PARTIAL APPROVAL CANCEL NO ACCESS
FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: 1 S. Date: alan-a0I Phone #: (503) 718-
CITY OF TIGARD _
BUILDING DIVISION PERMIT #:PM 1(i! •OOOWo
13125 SW Hall Blvd.,Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639-4171 itt.JI�I
Inspection Requests (24 Hrs.): (503) 639-4175 "__..
INSPECTION WORKSHEET FOR DATE: 1 _ 10 - aovk TIME: PAGE:
SITE ADDRESS: r'j 5,h), Lek r rn CLASS OF WORK:
SUBDIVISION: LOT#: TYPE OF USE:
PROJECT NAME: 'Z"ic.sgk.r n R . (19 a 3
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE#:
Inspection Request Scheduled For: Date: 1 to_ 1 i4 Pour Time:
Code # Inspection Description Confirm # Contact # Message
cc) -y ,
Corrections/Comments/Instructions:
(.:/ CcrveL' E`ifsi :r,►.. eak CrtLA.,�tL piiv ,l_c,% "
. 10 .4 tNk N . e 4,,,1
❑ PASS ' PARTIAL APPROVAL El CANCEL ❑ NO ACCESS
} FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: .0 t]'N Date: 1—/O - .46141 Phone #: (503) 718-
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
7600 SW DARTMOUTH ST, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
FAIL
PLM2012-00080
George Heimos
1. Provide permits for landscapers lawn irrigation backflow devices, 2-ea. 103.4.1
2. Provide grouting on the following storm manholes: 4/5/12/13/32/54 and 58. 310.4
3. Provide approved cleanout caps and plugs for storm cleanouts on all storm cleanouts.
707.1, 316.1.1, 1101.12
3. Expose building backflow devices for inspection. 103.5.1.4/103.5.1.3/315.3
4. Provide pressure test on sanitary sewer manhole to the left of retail building #2, near
storm tech detention system. 310.0/732.0
Above corrections are for first plumbing final inspection and are a partial storm sewer
approval. All other items on correction email dated 07/03/14 have not been completed
and need to be called in for inspection.
NOTE: building backflow devices approved test provided for: Walmart, 3" Wilkins model
350, serial no. J45372. Retail store, 2" watts model 007MI, serial no. 199265. Retail
store, 2" watts model 007MI, serial no. 206710.
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
7600 SW DARTMOUTH ST, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
FAIL
PLM2012-00080
George Heimos
The following items will be submitted by Guy McClain, from ESI to the Tigard Plumbing
Department for them to review and approve, regarding Walmart's Site Plumbing Final
Inspection. The partial list of corrections is from an e-main sent by Inspector George
Heimos to ESI and KERR Construction on July 3, 2014.
Storm
1. Storm Catch basins: Provide compaction test result approvals for all catch basins, as
per the ADS TECHNICAL NOTE, TN 2.01, September 2008. Minimum Cover traffic
Applications, Table 1 ADS N-12, ASTM F2648, from City of Tigard inspection dated
08/29/13.
Storm Catch Basins: Minimum cover 12”. Compaction material as per Table 2-3 of the
drainage Handbook, Class III material compacted to 90% standard Proctor density.
Provide reports on the following Catch Basins:
14,15,16,17,18,20,21,22,23,24,25,26,27,39,40,41, 43,44,45,46,47,48,50,51 and 59.
Total 25.
6. Provide documentation regarding filter canisters in vaults to verify installation.
7. Provide camera of all storm sewer mains and laterals, except mains from M/H 35 to
M/H 36 and M/H 36 to M/H 37 as highlighted in yellow on site stamped plans, Pg C-2.5.
Water Service.
1. Provide all backflow device test results. Both building and lawn irrigation.
Sanitary Sewer
1. Provide camera of all sanitary sewer laterals on private side from building outside
cleanout to tie-in at public stub, to verify grade and installation of piping for the Walmart
store, Retail #1 and Retail #2.
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
7600 SW DARTMOUTH ST, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
FAIL
PLM2012-00080
George Heimos
Corrections listed below are from an punch list email sent to Kerr Const and ESI on July
7th, 2014
Storm sewer corrections
1. Provide catch basin ADS piping compaction tests results. 310.4
2. Completed
3. Install cleanout fitting and plug missing, #57A. 1101.12
4. Complete grouting on M/H #13/ cut storm pipe that is extended into M/H.
5. Exposé backwater valve cover for Retail Store #2 foundation drainage to storm
location.
6. Provide canister filter installation documentation.
7. Not completed, storm mains and laterals with water running in sewer.
Water service corrections
1. Passed
2. Corrections for Walmart Store backflow vault drain. Provide 2" drain at a minimum
depth of 1' below grade, green tracer wire, extended above grade at both ends of run
and terminate thru curb at parking lot.
3. Not completed. 2" main increased to 3" outside building and brought up thru slab
needs to be 2" for the entire run. Backflow device installation, Pass.
4. Pass
Sanitary Sewer corrections
1. Provide video of all Private Sanitary sewer piping, with water running in sewers.
(Videos have been provided but not viewed or approved.)
2. Pass
3. Pass
4. Tests not completed on Retail #1 & 2, or Walmart store. COT inspector needs to be
present for testing. Test can be either 5lbs of air for 15 min. or
fill with water for 15 min, with no leaks.
5. Pass
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
7600 SW DARTMOUTH ST, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
FAIL
PLM2012-00080
George Heimos
Corrections below are from videos taken by Pacific Int-R-Tek noted on previous
inspection dated, 08/11/14, referenced on stamped and and approved plans Pg C-2.5.
1. Note 4 > Note Flogard Perk. Camera traveled downstream only 30’ on 65’ sewer run,
is something blocking sewer? 718.1/301.4.4
2. Note 5 > Note 4. Back graded sewer, starts at 40’ thru 130’. Provide correction.
718.1/301.4.4
3. Note 6 > Note 5. Back graded sewer at 6 thru 40’ and 53’ thru 59’. Provide correction.
718.1/301.4.4
4. Note 11 > Note 53. Back graded sewer at 0.0’, camera under water. Provide
correction. 718.1/301.4.4
5. Note 24 > Note Flograd. Back graded sewer at 42’ thru 46’. Provide correction.
718.1/301.4.4
6. Note 47 > Note Main. Back graded sewer at 8. thru 11’. Provide correction.
718.1/301.4.4
7. Note 48 > Note 37. Back graded sewer at 5’ thru 9’. Provide correction.
718.1/301.4.4
8. Note 55 > Note 53. Back graded sewer at 67’ thru 69. Provide correction.
718.1/301.4.4
9. Recall inspection when corrections have been completed. Re-inspection required.
103.5.6.1
NOTE: Compaction reports for all storm ADS piping installations provided by PSI
Services Inc. 8032 N. cutter Circle, #480, Portland, Or. 97217, on, 08/06/14, signed Joe
Morrissey, Special Project Manager, and accepted
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
7600 SW DARTMOUTH ST, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2012-00080
George Heimos
NOTE: Videos provided by Pacific Int-R-Tek, (Pipeline Video Report) 2501 NW Division
St. Gresham, OR 97030. For Kerr Construction
Walmart Storm piping corrections as per DVD’s,1of 2 and 2 of 2, from 08/1/14 thru
08/05/14, received at City of Tigard, on 08/06/14.
City of Tigard Plumbing Department reviewed DVD’s from 08/06/14 thru 08/09/14.
1. Note 3 > Note 1 Drain at out fall is lower than Out fall grade. Pipe cannot
discharge water. Provide correction. From 75’ thru 195’.718.1/301.4.4
2. Note 5 > Note 4 Back graded sewer, starts at 40’ thru 130’ Provide correction.
718.1/301.4.4
3. Note 6 > Note 5 Back graded sewer at 6 thru 40’ and 53’ thru 59’. Provide
correction. Re-camera pipe with water running. 718.1/301.4.4
4. Note 7 > Note 6 Pipe separated at 49’, bad camera, needs to be re-camera with
water running, Provide correction, for clarification. 310.4/301.4.4
5. Note 11 > Note 53 Back graded sewer at 0.0’, camera under water. Provide
correction. Re-camera with water running. 718.1 301.4.4
6. Note 24 > Note Flograd Back graded sewer at 42’ thru 46’. Need to check vault for
blockage and re- camera with water running. Provide correction. 718.1 301.4.4
7. Note
47 > Note Main Back graded sewer at 8'. thru 11’. Provide correction. 718.1 301.4.4
8. Note 48 > Note 37. Back graded sewer at 5’ thru 9’. Provide correction. 718.1
301.4.4
9. Note 55 > Note 53. Correct Back graded sewer at 67’ thru 69. 718.1 301.4.4
10. Provide Compaction reports for all ADS piping installations as per manufacturers
installation Instructions (Correction from 7/30/14). 310.4
11. Provide verification that storm filters are installed and clear of debris. 310.4
Lawn irrigation backflow device passed. 11/2" Wilkins model 950XL, serial no. 2743664
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
7600 SW DARTMOUTH ST, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2012-00080
George Heimos
Wet stamped documentation from the Engineer of Record (PacLand) regarding
corrections for the Walmart store was received at the Plumbing Department. Shawn
Nguy P.E. and Bryan Dickerson P.E. provided documentation stating: “it is our opinion
the storm pipes will meet the design requirements to convey the required hydraulic flow
rate for the design storm event.” Final Plumbing passed based on the Engineers
determinations and "Walmart Construction Manager accepted the bellies as
constructed."
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
7600 SW DARTMOUTH ST, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
FAIL
PLM2012-00080
George Heimos
NOTE: The following previous corrections dated 8/5/14, have failed after viewing the
video from Pacific Int-R-Tek the second time and need to be corrected. The following
storm sewers had back grades over 1" in depth and failed at sheets noted on video DVD.
1. Sheet note C-2.5 Note 5 thru Sheet note C-2.5 Note 4
2. Sheet note C-2.5 Note 6 thru Sheet note C-2.5 Note 5
3. Sheet note C-2.5 Note 55 thru Sheet note C-2.5 Note 53
Corrections #1 thru #3 above need to be re-camera with water running in sewer and re-
submitted to the City of Tigard Plumbing Department for viewing and approval.
The following corrections after reviewing on the video DVD, Passed.
Sheet note C-2.5 Note 7 thru Sheet note C-2.5 Note 6
Sheet note C-2.5 Note 11 thru Sheet note C-2.5 Note 53
Sheet note C-2.5 Note 24 thru Sheet note C-2.5 Note Flogard
Sheet note C-2.5 Note 47 thru Sheet note C-2.5 Note Main Note 40
Sheet note C-2.5 Note 48 thru Sheet note C-2.5 Note 37
Violation Summary:
Inspector Contractor