Permit CITY OF TIGARD PLUMBING PERMIT
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3 COMMUNITY DEVELOPMENT Permit#: PLM2015-00283
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/31/2015
T��'Ad Parcel: 2S101BA00101
Jurisdiction: TIGARD
Site address: 7500 SW DARTMOUTH ST
Project: Tigard Retail Center,Retail#2 Subdivision: WEST PORTLAND HEIGHTS Lot:
Project Description: Landlord work for future tenants.Adding(1)clothes washer,(4)3"floor drains,(1)sink,(3)lays,(3)water closets&
(1)water heater.
Contractor: LEED CORPORATION MECHANICAL CONTRACTOR Owner: WAL-MART REAL ESTATE BUSINESS TR
PO BOX 896 BY PROPERTY TAX DEPT STORE 5935-00
BATTLEGROUND,WA 98604 PO BOX 8050
ATTN MS 0555
BENTONVILLE,AR 72716
PHONE: 360-723-0180 PHONE:
FAX: 360-723-0327
FEES
Quantity Description Date Amount
1 ea Clothes Washer 08/28/2015 $25.02
Specifics: 4 ea Floor Drain/Floor Sink/Hub 08/28/2015 $100.08
1 ea Sink 08/28/2015 $25.02
Type of Use: COM 3 ea Lavatories 08/28/2015 $75.06
Class of Work: ALT 3 ea Water Closet 08/28/2015 $75.06
Type of Const: 1 ea Water Heater 08/28/2015 $37.52
Occupancy Grp: 1 12%State Surcharge- 08/28/2015 $40.53
Stories: Plumbing
Total $378.29
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 question ta_n NC by calling 503.232.1987 or 1.800.332.2344.
Issued B / / P. / Permittee Signature:- Y,joe-/!e"—L__
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 (TUE>AUR 26 2016 10:28/ST. 10:28/No. 7600000910 P 2
Plumbing Permit Application ,_
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Building Fixtures `_ � FOR OFFICE USE ONLY
City g 2 5 2 015 Received Z� , a,//1 n1 2^3
Ci of Tigard � Permit No.: � `dv 4�
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13125 SW Hall Blvd.,Tigard,OR Plan Review
Other Permit No.: 1 5
NI I Phone: 503.718.2439 Faz: S. 9 .196D y >� / C�
Inspection Line: 503.639.4f�115'1 1 i Li,._ TIGARD Date/Ready;By: Jana See Page z for
TIGARD Internet www trgard-or g®�I I fl i -j f l/) 1 N Notified/Method`� 0f"r J €e Supplemental Information
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`iai.-',,44-;,' '!. 701 r1A -ri u+ ' .�i i4 ;,,-. .tom:'{a^ -,^ < . v ::�t �i+it a li4s '
,:�' € S e �t r � l.,.'(t i 9, ;'> A: .r_...i!>.rk: titt-i�r.,J'.∎•..,-xili�..,., ��'�=t ,sntrat t.lr.,:3.; {x-rya.7.t . .M. °I a -F-1
®New construction ❑Demolition For special information use checklist.
Descri.tion • . Ea. Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) 1p
a , Fa ZC 'd s 7'" ,7 1,7- r a t4 x. i SFR(I)bath 312.70
h._ ... u... G..L➢ 4,1...1 r said j ;i 1,'1 i
❑ 1-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32 1
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 O
th: er
O Fire sprinkler( sq.ft.) Page 2
Er a r x� - _ Site utilities:
Catch basin or area drain 18.76
Job site address:7500 SW Dartmouth St.
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97223
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name:Walmart Outbuildings TI Manuthctured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: c5 ID I 644co t t'/ Backflow preventer 31.27
(r A� Ci;a t G( i c Ir �ja, er, ,, Backwater valve 12.51
r�` ; i� . tid4c '.4,4'; A -I-,, r4".,1 4 +I1 t,-,t .
Clothes washer 1 25.02 25.02
Install plumbing for new Ti spaces
Dishwasher 25.02
ii \\ Drinking fountain 25.02
LC1VJ)L.Cit'z ) LA-3 (41.4,---11/.1.- NEt,,) X Tit.r2 -.5 Ejectors/sump 25.02
B�` ri �L` 7a � ,;:77,�; y"f1 t^ �e"tt?arg a l ,, 0 Expansion tank 12.51
Name:Wal-Mart Stores,Inc. Fixture/sewer cap 25.02
Floor drain/floor sink/hub 34 4 25.02 100.08
Address:2001 SE 10th St.
Garbage disposal 25.02
City/State/ZIP:Bentonville,AR 72716 Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
RF +'1M.I �yl ...11,. << ,ti q 1. t7r s ::11 Interceptor/grease trap 25.02
Business name:Leed Corporation Mechanical Contractors,Inc. Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Drew Johnson
Roof drain(commercial) 12.51
Address:PO Box 896 Sink/basin/lavatory 1,5 3-L 4 25.02 100.08
City/State/ZIP:Battle Ground,WA 98604 Solar units(potable water) 62.54
Phone:(360)723-0180 Fax::(360)723-0327 Tub/shower/shower pan 12.51
E-mail:drew@leedcorporation.com Urinal 25.02
.,H °� 4;1- �" f 7 -41. r ,1..:;„:„,,r,f r.. ;µms Water closet 3 25.02 75.06
Iii-' l n''h r'111 "'W w Water heater 1 37.52 37.52
Business name:Leed Corporation Mechanical Contractor,Inc. Water piping/DWV 56.29
Address:PO Box 896 Other: 25.02
City/State/ZIP:Battle Ground,WA 98604 Subtotal 337.76
Phone:(360)723-0180 Fax:(360)723-0327 Minimum pennit fee: $72.50
CCB Lic.:181012 , Jµ1 f l 4r Plumbing Lic.no.:PB512 .,t i it Plan review (25%of permit fee)
State surcharge(12%of permit fee) I 40.53
Authorized signature: TOTAL PERMIT FEE .411432:73---
Print name:Drew Johnson Date:08/25/2015 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete. �1
*Fee methodology set by Tri-County Building Industry Service Bjoj�ard.
I:,Building\Pcnnirs\PLMU-PermitApp.doc 10/01/09 440-4616T(10/OJCOM'WEB) --!'L /31%.
FROM <TUE)AUO 25 2015 10:29/5T. 10:28/No.7500000910 P 1
2211 SE Grace.Ave.
Battle Ground,WA 98604
Mailing Address:
P.O. Box 896 Battle Ground, WA 98604
ti fi ,r� f ,l;g`� it �` I ` Phone: 360-723-0180
' �. w. y�At',a; +�1, �� FAX: 360-723-0327
MECHANICAL CONTRACTORS
TO: City of Tigard DATE: 8/25/2015
JOB#: 271
PROJ: Walmart Outbuildings TI
ATT:
WE ARE SENDING REMARKS
• SUBMITTALS
O PLANS
• SPECIFICATiONS
• DRAWINGS
O CHANGE ORDER
O CONTRACT
OTHER Permit Application
COMMENTS:
Please contact me regarding payment.
Thanks,
Drew
PO BOX 896/BATTLE GROUND,WA 98604/PH;(360)723-0180/FX:(360)723-0327