Permit (50) CITY OF TIGARD PLUMBING PERMIT
.114
COMMUNITY DEVELOPMENT Permit#: PLM2016-00317
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/21/2016
Parcel: 1 S 1260000300
Jurisdiction: Tigard
Site address: 9402 SW WASHINGTON SQUARE RD P01
Project: Dicks Sporting Goods Subdivision: None Lot: None
Project Description: Relocate water heater and mop sink. No change in EDU's
Contractor: PORTLAND SERVICE PLUMBING Owner: PPR WASHINGTON SQUARE LLC
8650 SW SORRENTO RD PO BOX 847
BEAVERTON, OR 97008 CARLSBAD, CA 92018
PHONE: 503-312-1562 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Sink 06/21/2016 $25.02
Specifics: 1 ea Water Heater 06/21/2016 $37.52
1 12%State Surcharge- 06/21/2016 $8.70
Type of Use: COM Plumbing
Class of Work: ALT 10 ea Minimum Fee Adjustment- 06/21/2016 $9.96
Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: 'ermittee Signature:
11111.0111.
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Applin t'
Building Fixtures EIVE FOR OFFICE l SI.: 1111.1'
Received / / �^
City of Tigard 1 Date/By: (p �( /$ J7 Permit Na: n� ,� ��l 7
40
.114 RI 13125 SW Hall Blvd.,Tigard,OBI W422 1 2016 dc/
Plan Review{ n ""CO
Phone: 503.718.2439 Fax: 503.598.1960 Other Permit No.:2 -/_�/t/p
gl Date/By:
I I t, \It 1) Inspection Line: 503.639.4119 ayi i'i tA R I) Date Ready/By: lurk: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
El New construction ❑Demolition For special 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)
SFR(1)bath 312.70
1=11-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
El Accessory building El Multi-family
Each additional bath/kitchen 25.02
El Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
:` - Site utilities:
,.
Job site address:2,04°A.'W Washington Square Rd Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:97223
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: l Project name:Dicks'Sporting Goods Manufactured home utilities 50.03
Cross street/directions to job site:SW SCHOLLS FERRY RD 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.:W398482 Backflow preventer 31.27
,.,: Backwater valve 12.51
- _ - d . -- Clothes washer 25.02
Relocation of water heater and mop sink
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
Expansion tank 12.51
Name:DICK'S SPORTING GOODS-CRISPIN C•NKLIN Fixture sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 9402 SW WASHINGTON SQUARE RD
Garbage disposal 25.02
City/State/ZIP:TIGARD/OR/97223 Hose bib 25.02
Phone:(724)273-3591 Fax:( ) Ice maker 12.51
Interceptor/grease trap 25.02
Business name:COLAB ARCHITECTURE Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:ROBBIN GRAY
Roof drain(commercial) 12.51
Address:930 NW 14TH AVE,SUITE 280 Sink/basin/lavatory 1 25.02
City/State/ZIP:PORTLAND Solar units(potable water) 62.54
Phone:(503)416-0151 Fax::( ) Tub/shower/shower pan 12.51
E-mail:ROBBIN@COLABARCHITECTURE.COM Urinal 25.02
Water closet 25.02
. . Water heater / 37.52
Business name: dr uv� c„�.2�1 tC� `�
tC\ P�u nb Water piping/DWV 56.29
Address: - 1)(4' O `3L,LQ"eh o '-d, Other: 25.02
City/State/ZIP: w t1 OC \-1npe) Subtotal
Phone:( l 7 Minimum permit fee: $72.50 7 . Z)
�1j 3\Z., \Stp 2- Fax: 7/
l
CCB Lic.:'-2_,:x) 00� 1/9417 Plumbing Lic.no.: /j 154 a Plan review (25%of permit fee) ��
State surcharge(12%of permit fee) ',7C
Authorized signature: �^ �� TOTAL PERMIT FEE $1,2D
C,..) Date: This permit application expires if a permit is not obtained within 180 days
Print name:
�- o`ob t� "�`I U,2\•k tO after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
______)
I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WIi13)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Su• •ression S stems:
°s p` as ; �. t "fir .
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:reater $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
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
each additional$100.00 or fraction thereof,to
. 1` and includin $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 char_e-1/2 hour) and includin• $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 char:e-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees _ 90.00/hr and includin:$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 char:e-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*.
Quantly by Fixture Type r 7`. C"s �.° K.- .: ,ws:.�6`12
,.;..':,i. '
Fixtureoer faredCopped Added RellarPlan review is required for any of the following.
Work Baptistry/Font Please check all that apply.
Bath Tub/Shower El Any new commercial building with water service 2"and
-Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru El New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
-3"
Car Wash Drain
0 Isometric or riser diagram is required for new buildings h,;
Garbage -Domestic-non-food g 9 g
Disposal -Domestic-food related that meet the •ualifications 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
-Bradley
-Commercial-food related
-Service !
Swimming Pool Filter
Washer-Cloches *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 fees assessed for the sewer increase must be paid before the
Urinal _ plumbing permit can be issued.
Other Fixtures:
C:\Users\colab\Downloads\PLMF_PermitApp.doc 2
Location:
Record Type:
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Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9402 SW WASHINGTON SQUARE RD P01,
TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2016-00317
Don Sylvester
Violation Summary:
Inspector Contractor