Permit CITY OF TIGARD PLUMBING PERMIT
11111 COMMUNITY DEVELOPMENT Permlt#: PLM2013 00368
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 1,01<P / Date Issued: 10/21/2013
Parcel: 151260000300
Jurisdiction: Tigard
Site address: 9585 SW WASHINGTON SQUARE RD OFFICE
Project: Washington Square Mall Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: S
Project Description: Interior plumbing: Capping(2)sinks and relocating(6)sinks in the food court restroom.l 1/26/13,reprinted to add
repiping of(10)existing water closets.
Contractor: PMSI LLC Owner: PPR WASHINGTON SQUARE LLC
21195 NW EVERGREEN PKWY#204 PO BOX 847
HILLSBORO, OR 97124 CARLSBAD,CA 92018
PHONE: 503-466-2222 PHONE:
FAX: 503-466-2211
FEES
Quantity Description Date Amount
2 ea Fixture/Sewer Cap 10/21/2013 $50.04
Specifics: 6 ea Sink 10/21/2013 $150.12
1 12%State Surcharge- 10/21/2013 $24.02
Type of Use: COM Plumbing
Class of Work: ALT 10 ea Water Closet 11/26/2013 $250.20
Type of Const: 0 12%State Surcharge- 11/26/2013 $30.02
Plumbing
Occupancy Grp:
Stories:
Total $504.40
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
issuan - i 's, suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utif Notification Center. hose are set forth in OAR 952-001-0010 through OAR 9 -11 -1090. You may obtain a copy of the rules
o direct questions to OUNC by c- ng 503. '.1987 or 1.800.332.2344.
ssued By: a r� Permittee Signature: /
Call 503.639.4175 by 7:00 a.m.for the next avail,. = nspection 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.
Nov. 26. 2013 11 :22AM No. 7105 P. 2
Plumbing Permit Applicatio " C IVED
Building Fixtures FOR orrice: USE ONLY
City of Tigard NOV 2 6 2013 :137 (I A6 /3 PermilNe.: '? I3-A'& .'
III
u 13125 SW Hall Blvd,Tigard,OR 97223 plan Review
• 7 Phone: 503.718.2439 Fax: 503.598 Dotedly: Other pennitNo.:
7IGAIt►) Inspection Line: 503.639.4175 ?Ty OFTIGAItD DaleReady/By: turn SeePageafor
Internet: wwtv.ligard-or.gov BUILDING DIVISION. NaifiedfMethod: I®Supplemental Information
TYPE OF WORK PEE' SCHEDULE
❑New construction ❑Demolition For pedal information tire checklist.
Description I Qty I Ea. I Total
®Addition/alteration/replacement ❑Other. New 1-2-fesnily dwellings(includes 100 II.for each utility connection)
CATEGORY OF CON&TRUCT[ON 8FR(1)bath 312.70
❑1-and 2-family dwelling ®Commercial/industrial 8FR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other. Fire sprinkler sq.It.) Page 2 L
JOB SITE INFORMATION AND LOCATION SIN unl lice:
Job site address:9585 SW Washington Square Rd Catch begin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/Z1P:Tigard,OR 97223
Footing drain(no.linear 11: ) Page 2
Suile/bldgJapt.no.: I Project ttetne:Food Court restroom remod Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 1836
Rain drain connector 18.76
Sanitary sewer(no.linear 0.: ) Page 2
Storm sewer(no.linear A.: ) Page 2
Water service(no linear R: ) Page 2 t
Subdivision: I Lot no.: Fixture or Rem:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Add 10 water closets to permit as per inspector {
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER I ❑ TENANT Expansion tank _ 12.51
Name: Endure/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) 1 Pax:( ) lee maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name: Medical gas(value:$ ) Page 2
Primer 12.51
Conlacl name:
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/SiaicJZIP: Solar units(potable water) 62.54
Phone:( ) I Fax::( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
Water dose 10 25.02 250.20
CONTRACTOR
Water heater 37.52
Business name:PMSI LLC
Water piping/DW V 56.29
Address;21195 NW Evergreen Pkwy Suite 204 Other. 25.02
City/State/ZIP:Hillsboro,OR 97124 Subtotal 250.20
Phone:(503)466-2222 oil 12 Fax:(503)466-2211 Minimum permit fee: $72.50
CCD Lie.: ��Q,��y�,, Plumbing Lie.no.:34�34PB Plan review (25%of permit fee)
r Authorized signature' (141t',�,1' Go�4'^'t State surcharge(12°�of permit fee) 30.02
TOTAL PERMIT FEE 280.22
Print name:Lanell bfnson IDale:1038f13 i()S Ms permit application aspires If a permit is not obtained wllhln 1g0 dogs
after It bar been accepted Pa complete.
"Fee methodology set by 1tiLouaty Building Industry Service Donut,
Nov. 26. 2013 11 :22AM No. 7105 P. 3
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-la 100' 50.03 o to 2,000 $121.90
Footing drain-each additional 100' 37,52 2,001 to 3,600 $169.69
3,601 to 7,200 5233.20
Sewer-1st 100' 62.54 7,201 and greater 5327.54
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
Slams&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 Qty. Pee(ea) Total and in $10 000.00,fraction thereof;to
Inspection of existing plumbing or for 510,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$L54 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 525,001.0010$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 90.0011w 550,001,00 end up $742.00 for the fust$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
Quantity byFix Typo Plan Review for Plumbing Installations
Flour Type for keptaeer Plan review is required for an of the following.
Performed: Capped A dad Relocate Y g'
Baptistry/Font Please check all that apply.
Bath Tub/Shower Cl Any new commercial building with water service 2"and
Jectt22i/Vifhirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
• Ve Tlau ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined i,l OA1t918-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defiled in OAR918-780.0040.
Eye Wash
Floor Drain/sink .2" Submit 2 sets of plans with any of the above.
-4" Isometric or Riser Diagram
Car Wash.Drain
Garbage -Domestic-non-food ❑ Isometric or riser diagram is required for new buildings
Disposal -Domostio-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice MachfRefrig.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 Piker *Note: If the fixture work under this permit results in an
Washer-Clothes
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet ( 10 fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
a CITY OF TIGARD PLUMBING PERMIT
1.1 a . COMMUNITY DEVELOPMENT Permit#: PLM2013-00368
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/21/2013
Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9585 SW WASHINGTON SQUARE RD OFFICE
Project: Washington Square Mall Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: S
Project Description: Interior plumbing: Capping(2)sinks and relocating(6)sinks in the food court restroom.
Contractor: PMSI LLC Owner: PPR WASHINGTON SQUARE LLC
21195 NW EVERGREEN PKWY#204 PO BOX 847
HILLSBORO,OR 97124 CARLSBAD,CA 92018
PHONE: 503-466-2222 PHONE:
FAX: 503-466-2211
FEES
Quantity Description Date Amount
2 ea Fixture/Sewer Cap 10/21/2013 $50.04
Specifics: 6 ea Sink 10/21/2013 $150.12
1 12%State Surcharge- 10/21/2013 $24.02
Type of Use: COM Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $224.18
• Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: _ Permittee Signature: ` 1
•
I�
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Oct. 18. 2013 8:45AM No. 7062 P. 1
Plumbing Permit Application 5 ,
Building Fixtures REC EIVED FO orrice USE ONLl'
City of Tigard D ie�BBy JO%1 i 3 Permit 141).: Pte`otvi3-nU344
q 13125 SW hall Blvd,Tigard,OR 9
i = Phone: 503.71$.2439 . Pare: 503.5 3r Plan Review 21 2013 Dates . Other Penni'No.: :LI , 0,001
Inspection Line: 501639.4175 Dale Read/13 Tlads: El See Pa c 2 for
TIGARn gar g CITY OF TIGARD Ready/Ely:
' �f�_ pp g
Internet: WWW.tI d•or, ov tJoiifiedRAerhod: Supplemental
TYPE (2012;1.c, 1 a , PEE* ScIJELIUILE
O New construction ❑Demolition For mint b ormatiou use checklist.
Description Qty- La- Total
El Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 A.for each utility connection) _
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
El 1-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.7$
SFR(3)bath 500.32
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Piro sprinkler( sq.ft.) Page 2
J'OII SITE INFORMATION AND LOCATION S11e utilities:
Job site address:9585 SW Washington Square Rd Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97223 Drywall,leach lint,or trench drain 18.76
Footing drain(no.linear ti.: ) Page 2
Suite/bldg./apt.no.: 1 Project name:Food Court restraint'rernod
Manufactured home tnilitice 50.03
Cross sired/directions to job silo: Manholes 18.76
Rain drain connector 18.76
Salutary sewer(no.linear 1t.: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: Lot no.: Fhrtnre or item:
Tax map/parcel no.: Backllow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25,02
Remove and replace restroom lavatories with new,cut and cop 2locations Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump _ 25.02
❑ PROPERTY OWNER • l ❑ TENANT _ Expansion lank 12.51
Name: Fixture/sewer cap 2 25.02 50.04
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/Stale/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON 1nterreptor/grease trap 25.02
Business name: Medical gas(value:S_) Page 2
Primer 12-51
Contact name:
-
Roof drain(commercial) 12.51
Address; Sink/basindavalory 6 25.02 150.12
City/Stale/ZIP: Solar units(potable water) F 62.54 '
Phone:( ) I Fox::( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
Water closet 25.02
. CONTRACTOR
Water heater 37.52
Business name:PMSI LLC Water piping/DW V 56.29
Address:21195 NW Evergreen Pkvey Suite 204 Other: 25.02
City/Stale/ZIP:Millsboro,OR 97124 Subtotal
Phone:(503)466-2222 ext 12 Fax:(503)466.2211 Minimum permit fee: 572.50 200.16
i Plan review (25%of permit fee)
l CCB Lie.;155256 • Plumbing Lie.no.:34-434P11
Stale surcharge(12%of permit tee) X24 O 02.4-V a
Authorized siguaurg 444-6(..Z W,
f
TOTAL PERMIT FEE )44.'l t
Print name:Lanell ' .binson Date:10/18/13 This permit eppurauon esplres ira permit h not obtained within 180 days
aver n has been accepted as complete.
'Fee methodology set by Tn.County Building Industry Service Board.
Oct. 18. 2013 8:45AM No. 7062 P. 2
Plumbing Permit Application - City of Tigard
Page 2- Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Pee(ea) Toe] Square Footage: Permit Fee:
Pooling drain-1'100' 50.03 0 to 2,000 $121.90 -
Fooling 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 Ibe fast$5,000.00 and$1.52 for
Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof;to
and including$10,000.00.
Inspection of existing plumbing or for S10,001.00 to$25,000.00 $148.50 for the rust$10,000.00 and$1.54 for
which no fee is specifically indicated 90.001hr each additional$100.00 or fraction thereof,to
(minimum charge-1/2 hour) and inoluding$25,000.00.
Inspections°inside 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
Reinspect ion Fees 90.00/hr and including$50,000.00.
Additional plan review for revisions _ " - 90.00/hr $50,001.00 and up 5742.00 for the fast$50,000.00 and$1.20 for
(minimum charge-1/2 hour) -
each addiilional$100.00 or fraction thereof.
Subtotal:
Commercial Fixture'Vpork:
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*.
Qrra>am�ym:tnreTYpa Plan Review for Plumbing Installations
Fixture Type for Reprice'
Work Performed: Capped Added Relocate Platt review is required for any of the following.
Baptistry/Font Please check all that apply.
Bath -1116/Shower ❑ Any new commercial building with water service 2"and
-Jacuzzi/Whirl of greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Then ❑ New exterior plumbing site utilities for any complex strucure
CuspidorAVater Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic C] Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
_3•,
4 Isometric or Riser Diagram
Car%shn Drain ❑ Isometric or riser diagram is required for new buildings
Garbage -Domestic-non-food
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice MachJRofrig rains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sud;dLav -Non-food related 2 6
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note; if the fixture work under this permit results in an
Washer-Clothes
Water Extractor - increase of sewer EDUs,a sewer permit will be issued and
water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures: -
" 4 Accumulative Sewer Tally
t�.: �p Tenant Name: WASHINGTON SQUARE MALL SWR# N/A
a:` Site Address: 9585 SW WASI-IINGTON SQUARE RD P1,M# PLM2013-00368
WAWA
Parcel#: 1S1260000300
Fixture Value Previous Previous Credits Capped Fixture Fixture New New
# value count capped#s value count added# _ added value total#s total values
Baptistry/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
13Vc 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 I-IP) 16 0 0 0 0 0
-Commercial(to 5 HI') 32 0 0 0 0 0
- Industrial(over 5 1-IP) 42 - 0 0 0 0 0
Ice Machine/Refrigerator Drain 1 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:
- I,av/Bar-Non-Food Related - 2 6 12 2 4 0 4 8
- Bradley 5 0 I 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 6 12 I 2 4 0 _ 0 4 _ 8
Current Fixture Value 8 divided by 16= 0.500 Current EDU 1 EDU= $4,800.00
Previous Fixture Value 12 divided by 16= 0.750 Previous EDU
Change -4 divided by 16= -0.250 over (under) S (1,200.00)
Enter EDU Change Here ' -0.250
Notes: ***CREDIT***
Authorized Name/Signature:•BRANDEN TAGGART X2449 Date: 10/21/2013
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\Scwcrl'allyShcct_4800._070113.xlsx
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9585 SW WASHINGTON SQUARE RD OFFICE, 2013 -11 -27 00:00:00
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2013 - 00368
Inspection Type: Result:
399 Plumbing final PASS - No C of 0
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9585 SW WASHINGTON SQUARE RD OFFICE, 2013 -11 -26 00:00:00
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2013 -00368
Inspection Type: Result:
399 Plumbing final FAIL
Comments:
1. Expose floor drain in women's bathroom. 103.5.1.4/103.5.1.3 /315.3
2. Complete all urinal flush valve installations. 310.4
3. Mens left toilet not flushing. 310.4
4. Men's floor drain primer not working. 310.4
5. Add to existing permit repipe on 10 -ea toilets. 103.4.1
Recall when corrections are completed.a
Violation Summary:
Inspector Contractor