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Permit . n CITY OF TIGARD PLUMBING PERMIT s COMMUNITY DEVELOPMENT Permit#: PLM2016-00172 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/31/2016 Parcel: 2S 112 DA00800 Jurisdiction: TIGARD Site address: 15055 SW SEQUOIA PKWY 100 Project: Pac Star Subdivision: PACIFIC CORPORATE CENTER Lot: 2 Project Description: Cap(1)water closet,relocate(1)water closet&install(1)shower stall. Contractor: DEAN WARREN PLUMBING&REMODELING INC Owner: PACIFIC REALTY ASSOCIATES LP PO BOX 14701 ATTN: N PIVEN PORTLAND, OR 97293 15350 SW SEQUOIA PKWY#300 PORTLAND, OR 97224 PHONE: 503-236-4152 PHONE: FAX: 503-296-2218 FEES Quantity Description Date Amount 1 ea Fixture/Sewer Cap 03/31/2016 $25.02 Specifics: i ea Tub/Shower/Shower Pan 03/31/2016 $12.51 1 ea Water Closet 03/31/2016 $25.02 Type of Use: COM 1 12%State Surcharge- 03/31/2016 $8.70 Class of Work: ALT Plumbing Type of Const: 10 ea Minimum Fee Adjustment- 03/31/2016 $9.95 Plumbing Occupancy Grp: Stories: Total $81.20 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 Not'ficatio 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 di questions to NC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: ,,,i Call 503.639.4175 by 7:00 a.m.for the next available inspet ion 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 Application Building Fixtures RECEIVED City of Tigard Received 1.IIN le Dale/By: 3i /OP a Permit No.: �i'6-.0.6/79- Date/By:SW Hall B.2 39 Tigard,OR `7 //, nom`5 O42 , .93 Plan Review OL ■ Phone: 503.718.2439 Fax: 5031!I 2016 Date/By: Other Permit No.:hu Inspection Line: 503.639.4175 Date Read /B Juris: ® See Page 2 for tI ' Notified/Method: Internet: www.tigard-or.gov CITY OF TIGARD Ready/By: Supplemental Information P ..i.-•,.>!';',,.4.4t;41' . . `f5 s fig S :F w ; 4 3 .. r ,1 .1 Sa-:a.,,,,, x: ; } z= .e „c ❑New construction 0 Demolition For special information use checklist. Description I Qty. I Ea. I Total Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) ', r g3. ' � „ f es r# p - * SFR(1)bath t ,x. �, s ,.c,�.=.z t, . , 1 .-f-;0y10 '4 ,*,..ii. # ei ,,,4, as :, ElI-and 2-family dwelling 4 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building ❑ Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 rr I. t� ..' :.--'1''''''';I 1iieif©f:r- Site utilities: Catch basin or area drain 18.76 Job site address: /J`OSS S ti/ suleuc,,a ,hwy Drywell,leach line,or trench drain 18.76 City/State/ZIP: Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: ie p I Project name: - ' 1"-Iq-12- Manufactured 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.: a S I (gD/�' QQ SQ6 Backflow preventer 31.27 . € r Backwater valve 12.51 .,,,.. b 4 ,... ,: ..:. . te'. .. ..t.' �m Clothes washer 25.02 t"_ ' 'Cj4 5AGu.,.r Dishwasher 25.02 / Q-/Gc- e. 1-- ( -.C Drinking fountain 25.02 Ejectors/sump 25.02 r t 4 t ,_ ' tr,q; Expansion tank 12.51 .,....��.+«�',u!, ,�uy.�°s.. �, ,,.,.e47776' . .., .,a.>x ,..,�.r,�.v 4,. .„ „a.,,..�...�.1♦� a'tc,iSaXa.�#.�;... Name: T Fixture/sewer cap / 25.02 P�c fes-5< Floor drain/floor sink/hub 25.02 Address: / 5 3 sem., S U o,'a P"C( Garbage disposal 25.02 City/State/ZIP: T-0.5,14,4, CA. 9 -7)--.111 Hose bib 25.02 Phone:(r--c• ) j!{-6 j c e Fax:( ) Ice maker 12.51 a 'at o ^11` Iw�( *� Interceptor/grease trap 25.02 « . m _ 4 �� ., .. ",''), _r P ° t.�,w. ) Medical gas(value:$ ) Paget Business name: t+ ,)-rte-l.L,va/A-e,-c(t 1, of /291"d-f Contact name: Primer 12.51 /� Roof drain(commercial) 12.51 Address: '1c /,C JLfx/ Sink/basin/lavatory 25.02 City/State/ZIP: e./,-7--t-. co_ 5 72 c 3 Solar units(potable water) 62.54 Phone:(e )7 go_ 5 y54 Fax: :( ) Tub/shower/shower pan I 12.51 E-mail: Urinal 25.02 `y �J..r x" �$ f�'r.c , nk'-a r N e �x x1 ' Water closet _i 25.02 r� sk z _ �.;,t n. :. _ ,.� m -�, sfi: Water heater 37.52 Business name: Water piping/DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal Phone:( ) Fax:( ) Minimum permit fee: $72.50 7A,4573 Plan review (25%of permit fee) CCB Lic.: j 5!f 4 t'9 Plumbing Lic.no.:).6-73 13/3 Authorized signature: � �-- . /1� State surcharge(12%of permit tee) g;7 ' TOTAL PERMIT FEE 31,E Print name: �� >L Dater-3/-/CThis 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 Permits PLMU-PermitApp.doe 10 01 09 440-4616T(1002'COM WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: 4:. • Footing drain- I" 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 S stems: Water Service-each additional 100' 37.52 . r 'ij"�'_; r �'', , � ��� `ar � rt,fi � au:��,��✓ e,�" gj��r� 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 the first$5,000.00 and$1.52 for ..� %s' '� fns r )7147-0614-41"` each additional$100.00 or fraction thereof,to ' ': <° 4,4e4-44,'..;�' , , .. and including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 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 $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 Reinspection Fees 90.00/hr 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$100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Plan Belle, or um ubi ns ons, . _: Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replace/ Please check all that apply. Work Performed: Capped Added Relocate Baptistry/Font El Any new commercial building with water service 2"and Bath pti Tub/Shower greater,except systems designed and stamped by licensed -Jacuzzi/Whirlpool engineer. ElCar Wash: Each Stall New exterior plumbing site utilities for any complex structure Drive as defined in OAR918-780-0040. EJCuspidor/Water Aspirator Medical gas and vacuum systems for health care facilities. Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system. Domestic El Any complex structure as defined in OAR918-780-0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: -2" , sometriC or Ri$ agram , 0 Isometric or riser diagram is required for new buildings -Car Wash Drain that meet the qualifications above. Garbage -Domestic non-food Disposal: -Domestic food related -Commercial food related -Industrial food related Ice Mach./Refrig.Drains Comments regarding fixture work: Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: -Gang -Stall I Sink: -Lav/Bar non-food related -Bradley -Coin/Serv/Util food related -Service *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and Washer-Clothes fees assessed for the sewer increase must beaid before the Water Extractor p Water Closet-Toilet 1 plumbing permit can be issued. Urinal Other Fixtures: 1:A Building\Permits\PLMF_PennitApp.doc 08/04/2011 2 Accumulative Sewer Tally ■ Tenant Name: Pac Star ***CRl�al"1 S*�* SWR# N/A Site Address: 15055 SW Sequoia Pkwy#100 PINI# 2016-00172 TIGARD Parcel#: 2S 112DA00800 Fixture Value Previous Previous Credits Capped Fixture Fixture New New # value count capped#5 value count added# added value total#s total values Baptiscry/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: -1?ach 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 I?ve 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 11P) 16 0 0 0 0 0 -Commercial(to 5 III') 32 0 0 0 0 0 -Industrial(over 5 I IP) 42 0 0 0 0 0 Ice Machine/Refrigerator Drain 1 0 0 0 0 0 Living Unit 16 0 0 0 0 0 1 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 1 2 1 2 Sink: -I.av/Bar-Non-Food Related 2 0 0 0 0 0 -Bradley 5 0 0 0 0 0 -Cum/Sery/Util-Food Related 3 0 0 0 0 0 Swimming Pool Itilter 1 0 0 0 0 0 Washer-Clothes 6 0 0 0 0 0 Water 1?xtractor 6 0 0 0 0 0 Water Closet-Toilet 6 0 1 6 0 -1 -6 Urinal 6 0 0 0 0 0 Previous I?DU Count 0 0 (;tipped I?DU Credit 0 lO'1'.AI.S 0 0 1 6 1 2 0 -4 Current Fixture Value -4 divided by 16= -0.250 Current FDU 1 EDU= $5,100.00 Previous Fixture Value 0 divided by 16= 0.000 Previous IAA' Change -4 divided by 16= -0.250 over (under) S (1,275.00) Enter EDU Change Here -0.250 " *Round IDUs to the nearest 1/100th: a count ending in.005 shall be rounded up to.01,and a count ending in.014 or less shall be rounded down to.01. Notes: ""CRI:DI"1'S*`* Authorized Name/Signature: Debbie:Adamski Date: 3/31/2016 Building Division Note: The property owner shall retain the ORIGIN Al.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. 1:A Building\Sewer Tally\SewerIallShcct_511n1_U7u115.xlsx 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 15055 SW SEQUOIA PKWY 100, TIGARD, OR, 97224 Commercial - Plumbing 399 Plumbing final PASS - No C of O PLM2016-00172 Chip Barnett Violation Summary: Inspector Contractor