Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2014-00228
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/15/2014
T t t `1 k.17 g Parcel: 1 S135BA00102
Jurisdiction: Tigard
Site address: 10206 SW WASHINGTON SQUARE RD
Project: Destination XL Subdivision: OAKBURG Lot: 9
Project Description: Interior plumbing for TI: Replacing(1)drinking fountain,(2)Z'floor sinks,(2)non-food related sinks,(1)
commercial sink,(1)service sink,(2)water closets,and(1)water heater.
Contractor: PMSI LLC Owner: PPR SQUARE TOO LLC
21195 NW EVERGREEN PKWY#204 401 S.WILSHIRE BLVD.
HILLSBORO, OR 97124 SANTA MONICA, CA 90401
PHONE: 503-466-2222 PHONE: 310-899-6437
FAX: 503-466-2211
FEES
Quantity Description Date Amount
1 ea Drinking Fountain 07/15/2014 $25.02
Specifics: 2 ea Floor Drain/Floor Sink/Hub 07/15/2014 $50.04
4 ea Sink 07/15/2014 $100.08
Type of Use: COM 2 ea Water Closet 07/15/2014 $50.04
Class of Work: ALT 1 ea Water Heater 07/15/2014 $37.52
Type of Const: 1 12%State Surcharge- 07/15/2014 $31.52
Occupancy Grp: Plumbing
Stories:
Total $294.22
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: •• ' ee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
From: 07/10/2014 22:04 #150 P.001/002
Plumbing Permit ApplicatiP f,E$VFb
Building Fixtures JUL 1 0 2014 FOR OFFICE USE O\1 1
Received �,q
City of Tigard Permit No..
II
• 13125 SW Hall Blvd.,Tigard,OR 97 Dater By: //i0/1 k pip"D�J1 k-(�
Phone: 503.718.2439 Fax: 503.5 Ye�- I+`^' u Plan Review
e f) Date/B Other Permit No.:/Zr p 9'� le
.'ink. e 4Y'2 {V
Inspection Line: 503.639.4175 i �,? y Date RradyiB t 0 See Page 2 for
TICiA}il) o � g
Internet: www.tigard-or.gov Notified.Method: (�/- Supplemental Information
TYPE OF WORK FEE SCHEDULE
El New construction ❑Demolition For special information use checklist.
- Description ( Qty. j Ea. 1 Total
®Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
❑ 1-and 2-family dwelling ®Commercial/industrial SFR(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.R.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:10206 SW Washington Square Rd Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97223
Footing drain(no linear R.:_l Page 2
Suite/bldg./apt.no.: Project name:DXL Destination XL Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear R.:_) Page 2
Storm sewer(no.linear R.:_-) Page 2
Water service(no.linear R.:_) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Back flow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Dishwasher 25.02 /
Drinking fountain I 25.02 25.02 t/
Ejectors/sump 25.02
PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub 2 25.02 50.04 V
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
0 APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name: Medical gas(value:S_) Page 2
Primer 12.51
Contact name: -
Roof dram(commercial) 12.51
Address: Sink/basin/lavatory 4 25.02 100.08
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02 /
Water closet 2 25.02 50.04 ✓
CONTRACTOR
Water heater 1 37.52 37.52
Business name:PMSI LLC Water P €/
t P m DW V 56.29
Address:21195 NW Evergreen Pkwy Suite 204 Other: 25.02
City/State/ZIP:Hillsboro,OR 97124 Subtotal 262.70
Phone:(503)466-2222 Fax:(503)466-2211 Minimum permit fee: 572.50
CCB Lic.:158286 t/ Plumbing Lic.no.:34-434PB �� Plan review (25%of permit fee)
State surcharge(12%of permit fee) 31.52
Authorized signatu . 1 ' TOTAL PERMIT FEE
Print name:Linen obinson Date:7/10/14 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 Board.
I:Building Peemits PI.Mt1-PemihApp.due 1001/09 440-46161(10 02cOM WEB)
From: 07/10/2014 22:04 #150 P.002/002
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' 50.03 0 to 2,000 $121.90
Footing 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 TOO' 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 $5.001.0(1 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Other Inspections or Fees �' Fee(ea) • - Total each additional$100.00 or fraction thereof,to
P and including.$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.0(and$1.54 for
which no tip'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-OOthr 525,001.00 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,ltr and including$50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 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*.
Quantity by Fixture Type Plan Review:for Plumbing Installations
Fixture Type for Replace/ Plan review is required for any of the following.
Work Performed: •Capped Added Relocate
Baptistry/Font Please check all that apply.
Bath -Tub/Shower ❑ Any new commercial building with water service 2"and
lacuui'Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive-fhru ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR9 18-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic ❑ Any multipurpose fire sprinkler system.
DrinkinLFountaut I ❑ Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" 2 Submit 2 sets of plans with any of the above.
-
Caar r Wash Drain Isometric or Riser Diagram
Garbage Domestic-non-food ❑ Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related 2
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter
Washer-Clothes
*Note: If the fixture work under this permit results in an
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet 2 fees assessed for the sewer increase must be paid before the
Urinal % plumbing permit can be issued.
Other Fixtures: 1 f
C:\Users\lrobinson\Downloads\PLMF-PermitApp(2).doc 2
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
10206 SW WASHINGTON SQUARE RD,
TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
FAIL
PLM2014-00228
George Heimos
1. water pressure exceeds maximum of 80 PSI, PRV required. (88psi) 608.2
2. Correction #2 inspection dated Sept 8th not completed, expose piping in other tenant
spaces above grid for inspection.
3. Recall inspection when corrections have been completed. Re-inspection required.
103.5.6.1
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
10206 SW WASHINGTON SQUARE RD,
TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
FAIL
PLM2014-00228
George Heimos
1. Corrections #1and #2 correction dated sept 8th 2014, not completed. ( clogged main
sanitary sewer to outside and main water service above grid, all pipe in Destination XL
tenant space was covered with pipe insulation. Told plumber on jobsite to leave water
piping not in tenant space exposed for inspection, piping is now covered, uncover.)
2. Work not completed, no inspection made. Recall when ready. 103.5.4
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
10206 SW WASHINGTON SQUARE RD,
TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2014-00228
George Heimos
NOTE Water service for building is on separate permit.
Violation Summary:
Inspector Contractor
George Heimos
From: Lanell Robinson <Iobinson @msi-systems.com>
Sent: Thursday, October 02, 2014 2:19 PM
To: George Heimos
Subject: FW:Apollo Drain
Attachments: 251925.pdf
414:A1/29/7 Pi 41 to
George, please see attached regarding DXL 10206 SW Washington Square Rd
Please forward this to George Heimos with the city of Tigard starting that this is evidence that the SS was jetted
and cleaned on the date noted.
Forwarded message
From: "Chris Kennedy" <ckennedy @marcocontractors.com>
Date: Oct 2, 2014 2:17 PM
Subject: Fwd: Apollo Drain
To: <petem @msi-systems.com>
Cc:
Forwarded message
From: <billing @apollodrain.com>
Date: Tue, Sep 30, 2014 at 4:40 PM
Subject: Apollo Drain
To: CKENNEDY @marcocontractors.com
Good Afternoon,
Attached is invoice 251925 you requested.
Thank you,
Jill McGregor
Accounts Receivable
Apollo Drain & Rooter Services Inc
503.219.88o1503.964.5988
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1
APOLLO DRAIN&ROOTER INC INVOICE
2208 NW BIRDSDALE DR STE 8
GRESHAM OR 97030 t
503-239-8801E t� t�ear 7�1�)9��^��
09/05/14 251925
MARCO CONTRACTERS k?A{d� celRs < +t a}�iaFtaPr s aY1f ialt_.
100 COMMONWEALTH DR
WARRENDALE PA 15086 /O.?okW 4-S 4i6.-re, CHRIS TODD
F4-00 sa 2O
.. ... C I'
COMMERCIAL JET MAIN LINE 195.00
ADDITIONAL HOUR 175.00
ADDITIONAL MAN 190.00
Subtotal 560.00
Tax
Total 560.00
Received 0.00
Balance Due 560.00
Job Site
DXL
10206 SW WASHINGTON SQUARE
PORTLAND OR 97223
Fed Tax ID#93-1311409
CCB#49418&WA LIC#APOLL DR 995MP TERMS Payment Due Upon Service Date
Please detach and return with your payment
Invoice#: 251925
MARCO CONTRACTERS
100 COMMONWEALTH DR Date: 09/05/14
WARRENDALE PA 15086 Balance Due: 560.00
Remit to: APOLLO DRAIN & ROOTER INC
Service at: 10206 SW WASHINGTON SQUARE 2208 NW BIRDSDALE DR STE 8
PORTLAND OR 97223 GRESHAM OR 97030
503-239-8801
CGS 84941E 'WA Lc#APOLLDRORSh'.P NY*C NUMBER 251925
Nartheest 503-252-5693 DATE i� WORK PAYMENT MACHINE USED WARRMITY MI
Saul heast 503-238-5801 q— `f 7 ORDER*_ — _- ... 81 _AUG. _YES p
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Gresham.OR 97M- fa
Vancouver 360.68$-0871 _TRAP f NC CHARGE _ LOCATOR 70.7, 5APJ1E PROBLEM?
Fax 503-689-9668 —OTHER YES_ NO
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ADDRESS: ADDRESS / (. S !' s � _S—.ER _FLOOR DRAIN r PARK'NG LOT DRAIN
CITY: ZIP. CITY: Fibi g., ZIP: f 742-02-3 ...TOILET _URINAL OTHER
PHC'e. PHONE: 'g 44 /._ q CS y C. - _ K TCHEN SINK . GREASE TRAP
1�'7 - - 10-8 a'�y f AMOUNT I ALRHOR E THE WORK TO BE DONE I COMPLETELY
UNUsRSTA1,D ALL THE TERMS AND CON DIT ONS
Al DAGREF TO DAY THE AMC LINT STATED BELL w w-IEN THE JOB IS 1 e[3 6t.• �-e_ - f f O'n .P(-- / S /f ." CRI,^fMAI FSTP4ATE COMPLETED..7 (7 S F 7 S Y0
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SIGNATURE
ACM'CNAL WORK S x....
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4,24iL-/- ACTJA1 TGTA.-j
DAMAGE DOVE7Y NC_
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SUS-TOTAL
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CUSTOMER /AL THORIZED AGENT S SIGNATURE T LEASE PAY PROM THIS INVOICE e!
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FILE COPY