Permit (72) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2016-00527
13125 SW Hall Blvd.,Ti Date Issued: 10/19/2016
TI[_ ;\Itf� and OR 97223 503.718.2439 9
Parcel: 2S101 DB00104
Jurisdiction: Tigard
Site address: 7300 SW HUNZIKER RD 110
Project: Spec Space Subdivision: None Lot: None
Project Description: Cap(1)sink
Contractor: WESTERN PLUMBING Owner: HILLTOP BUSINESS CENTER LLC
9460 SW TIGARD AVE SUITE 101 HUNZIKER LLC
TIGARD, OR 97223 9430 NW KAISER RD
PORTLAND, OR 97231
PHONE: 503-639-5296 PHONE:
FAX: 503-684-9015
FEES
Quantity Description Date Amount
1 ea Fixture/Sewer Cap 10/19/2016 $25.02
Specifics: 1 12%State Surcharge- 10/19/2016 $8.70
Plumbing
Type of Use: COM 47 ea Minimum Fee Adjustment 10/19/2016 $47.48
Class of Work: ALT 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 dir „,
ect q OUNC by callingll503.232.1987 or 1.800.332.2344.
Issue By: g� ) ( ),,
Permittee Signature ,
(1� ��L,155// II _iI _eodpl
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.
10/17/2016 08:34 5036849015 WESTERN PLUMBING INC PAGE 01/02
Plumbing Permit Applicu Ei
Building Fixtures t4)l, ()rl lc l I Si ()\i )
City of Tigard 0 C.1 18 2016 1. rived
w )3]25 SW Mall Blvd,,Tigard,OR 9 , , 'atter /6 /f PermitNo.:
1111 -II
ARD
/� •c � l6tviG-oa5�
'~H ' Phone: 503.718.2439 Fax: 50 ow ' ! Xt3i�.tl "lame .few
a eels : Other Permit No.: i,,J/,9_
Inspection Line: 503 639 4175
DIVISION
IS. �N. Iw-e to i . 1 .. ..... ` r h i t 1 See Page
2 for I Internet: www.tigard-or.gov BUILDING oYodimchod Supplemental rato
r,m, awtlYS
�, 16.�aWP':',rTT : rY„ rar . MJ ' ,,' p1t r , ,,,,, ,i',.,:,,,,,,,,,,,,,,,41 A*,
El New ion ❑Demolition
IIII Far special information use checklist
me 17repOther: Description J Qty. L Ea.Vim. Total
1 Addition/alteration/ lacerent ❑
nr ,,i;
New I-2-family dwell! � (includes 100 ft.for each utility connection)
4 i tYti;°1.r rhY, ; ' 77 ; ! t `tc � rf• .
$FR(1)bath312.70
❑ 1-and 2-family dwelling Commercial/industrial SFR(2)bath in 437.78
II
ElAccessory building 0 Multi-family SFR(3)bath 300.32
El Master builder Each additional bath/kitchen 25,02
❑Other Fire sprinkler(. 5 .ft.) _WEI
` 44 ti jAW, ��,,!"!!4 ',iY Nf f,. :,` ';',-"'''';',.4',,' ` -a k` v'"f'T,' "7�. fwd , r m, �l
iMm" , 4 , ,f,i�4 4
w v i KVa '4A r� ,..,,
48„.ua�l,t,...V >vgvi�,A ...-t „? .t� .r, t,r}.?1+' �- ..a'�P.4@J"b!"��r�f �y'��{,� site atlhtlC9:
Job site address: Catch basin or area Grain MIMI
..1► - 1� •a! Drywall,leach line,
City/State/ZIP: t liCn 1A A $ at or trench drain inn
1 Footing drain(no,linear ft.: ) NMI Page 2
Suite/bldg./apt,no.:1(\�'� Project name: . r'����ureNa� .. ,.,�„�,_
�' =+r, Manufactured home utilities 50.03
Cross street/directions to job site: l:✓! o' /1.0 Manholes 18.76
illRain drain connector- 18.76
Sanitary sewer(no.linear ft.:,._-,J Page 2
Storm sewer(no,linear ft.: ) Page 2
Water service(no,linear ft.:,r,,,,,,) Page 2
Subdivision: Lot no.: --..-._
Tax map/parcelNil
As/ a Fixture or Item;
no.: o2 6 QD/b Backflow preventer 11111111111391
1 h( ,a r r�'r� hP�'r rri aiJr 4 Vt. -7,d�� qr,,-,, �i Backwater valve w i,7kk ,A.:4,, +ki,r„al.`Yr,i 1!,...:;:� ,�^� ;�., r r, r,i ed um� .ir.t:.Mw r ?'",t .6,ri,,,>flo+r;'a'jY/,Pr 12.51
Clothes washerMil 25,02
Dishwasher - 11111
25.02
a t-. - 4_• * III Drinking fountain 25.02
1111.11
1111
MEM
° .r. ,,,:',..P!'t1 '.'-.41,;:t''''77';';','" YuEjectors/sump 25.02f ,#� �A° a 7� +, vD ? u 7' ry, � rr ,'? Expansion tank 1 1 ifv0,11a1 rV., 1(t r . :! 8 7,S - ., r r r 4 A ,,:t , Y ,` .. .i mt
Name: Fixturc✓scwer rap 25.02
Address: - Floor drain/floor sink/hub 25.02
Garbage disposal 2$_02
Phone ( ) Hose bib 25.02� ,J.} M� r o- �gIll ice maker 12.51
,7 r•, '� , l"k it, ! ip r 1,r 1'7n 4 $ r
t '�e,S8,�.�11 Pi:..,e.,T''''iaa a},;; 4i..F;.7;, ,1'Jr1V...iH';d,..,,..:',%44.;11,.: c,.Ur at .r+.V rCi"N�., mif rc r', l: Intercepter/ cess trap 28.02 MN
Business name: No Medical gas(value:$ ) Page 2
Contact name: Primer , 12.51
Address;
Roof drain(commercial) 12.51
1111
,,,,_ Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 111111111111
_
Phone ( ) pax;:( ) 111 Tub/shower/shower pan 113111111111111
E-mail: Urinal
rl ■ 25.02
l„�X ,jkk� '''''".?7,'"-.''''',�, ,� � mrt p�'it i j�� �41 y nr .�'"';7'-'';‘,-• WatCr closet 25.02,��mr�l ,wrd.,, au`,.'4'. *.t i?; ia _. 14:'1,a °r �., :;: K ',,';.Llit°v''iit,,:Ai/,, a':' r;.
Water heater
ill
Business name:Western Plumbing.Inc.
water piping/DWY 56.29
Address:9460 SW Tigard Street,Suite 101 Other: 25.02
City/State/ZIP:Tigard,OR 972231111 Subtotal
Phone:(503)639-5296 Fax;(503)684-9015MI Minimum permit fee: $72.50 Nall
CCB Lic.:2439 Plumbing Lic_no.:3429PBIN Plan review (25%of permit fee)
State surcharge(12%of permit fee) is
Authorized signetute: j 411t/ ra,
�J���, •`"., i t A�.
gTOTAL PERMIT FEE , "
Print name: al �, . M Date: y k This permit application a,tplr a if a permit is not obtained within :1 days
alter it has been accepted as wmptete.
*Fee methodology set by Tri-County Building Industry Service Board.
I;utuldizieen»its1PLNIU-PmnitApp,doo 10/0i/09 44C-4616r(1o/02/CvMlw£a)
10/17/2016 08:34 5036849015 WESTERN PLUMBING INC PAGE 02/02
Plumbing Permit Application- City of Tigard
Page 2 Supplemental Information
Fee Schedule: Residential Fire Su
" ` ik .»� ression S stems:
1• J fir},' tf� ,"' ire ea � I
Footmgdrain-l 100' u i .S ;,„,.',... ,,r., ,.,;.:,., ' + ,� . ,. ,.. i. ,... ,. ws.„�`�i.�iiiG
MO 50.03 0 to 2.000 $121.90
Footing drain-each additional 100' 37.52 ME 2,001 to 3,600
T$169,69
Sewer-1st 100' 62.54 3,b91 to 7,300 $233 20
Sewer-each additional 100' 37.52 7 2t71 and greater $327.54
Water Service-1st 100' MIIIISEIMIll
Water Service-each additional 100' 37,52 Medical Gas S stems:
Storm d:Rain Dram•1st I00 • • ,'',;.;!'',',',701,1,
62 54 :^ u,- •'
Storm&Ram Dram each additional 1 QO $1.00 to$5,000.00 Minimum fee$72.50
� � $5,001.00 to$10,000,00 $72.50 for the first SS 000,00 and$1.52 for
.„p, ,;: f' r)tt47 • r, ' is, •r a , ," t ,r 3"- . t
'w w ,,rir,4„' ,, ,1 , . .•ws' ni4,".,..'m .,,:::, , .r„, „( .,r;il''''' each additional$100 00 Or fraction thereof to
Inspection of existing plumbing or for and ineludi, $10,000,00,
which no fee is specifically indicated 90.00/hr11111
$10.001,00 to$25,000,00 eacha$148.50 for the first$10,000.00 and thereof.
for
minimum ch= a l/2 hour) each additional$100,00 or fraction thereof.to
Inspections outside of normal business 90,00/hr and including$25,000.00.
hours(minimum ch; - -2 hours) $25,001.00 to$50000.00 $379.50 for the first$25,000.00 and$1.45 for
Reinspection Fees 90.00/hrNMI each additional$100.00 or fraction thereof,to
and including$50,000.00.
Additional plan review for revisions Ell 90.00/hr IN $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: 1111.1111.1111110
-�-
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurate re a art fixtures could result in increased sewer fees*.
' .' l;'4 re.i>+�Ik� i.,�lg.
a;yN,P1r�kk�i.,S -, , ftp' .A + w �*.nzv 'x'151" 'i..;',',:;,:!'7,:','
,cal r ,
P 1'. til 1� r .a.,.;.,.�1 !.r:b, i ai�{�”���'.; �G a,4�' "r�, Yr , x s
1 pU a G rd A^�
', a ,, ' cigt��° g- ,14 [G' 1 i r a , Ni0 ,s,,.1 , ,,, a i o, Q,4'i. ^ Plan review is required far any of the following,
Baptistry/FontPlease check all that apply.
Bath -Tub/Shower 0 Any new commercial building with water service 2”and
•Jacuxzi/Whiripooi greater,except Systems designed and stamped by licensed
Car Wash -Each Stall engineer.
"Drive Thr 0 Ncw exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR418-780-0040.
Dishwasher -Commercial T' ❑ Medical gas and vacuum systems for health care facilities-
-Domestic ❑ Any multipurpose fire sprinkler system.
Drinkin Fountain 0 Any complex structure as defined in 0A12918-780-0040.
Eye Wash
Floor Drain/sink -2" _ Submit 2 sets of plans with any of the abave.
-3"
-4"
a„i'i r,'-,-,1-:":.;1:-,I,
Car Wash Drain ��,
fi, n 1
_ ' kri � .lir rt,
Garbage Domestio�ton-food Isometric or riser diagram is required for new buildings
Disposal •Domestic-food related that meet the +ualifications above. g
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig-Drains
oil ator Gas station '-- Comments regarding fixture work:
Rec.Vehicle Dump,Station
Shower -Gang
-Stall
Sink/Lav -Non-food related -
-Bradley
-Commercial-food related
-Service
Swimmiit Fool 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 — fees assessed for the sewer increase must be paid before the
-Drina] plumbing permit can be issued.
Other Fixtures'
h tip://www.tigard-or,govicity_haf t/departmerits/ed/docs/i'LMF4PemlitApedoc
Accumulative Sewer Tally
m
1111111 II
Tenant Name: Spec Space SWR# N/A
Site Address: 7300 SW Hunziker Rd#110 PLM# 2016-00527
v R D Parcel#: 2S 101 DB00104
Fixture Value Previous Previous Credits Capped Fixture Fixture New New
# value count capped#s value count added# added value total#s total values
Baptisery/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
Eye 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 HP) 16 0 0 0 0 0
-Commercial(to 5 HP) 32 0 0 0 0 0
-Industrial(over 5 HP) 42 0 0 0 0 0
Ice Machine/Refrigerator Drain 1 0 0 0 0 0
Living Unit 16 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:
-Lav/Bar-Non-Food Related 2 0 1 2 0 -1 -2
-Bradley 5 0 0 0 0 0
-Com/Sery/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 0 0 1 2 0 0 -1 -2
Current Fixture Value -2 divided by 16= -0.125 Current EDU 1 EDU= $5,300.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change -2 divided by 16= -0.125 over (under) $ (689.00)
Enter EDU Change Here -0.130 *
*Round EDUs 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: ***CREDITS***
Authorized Name/Signature: Debbie Adamski Date: 10/19/2016
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:\Building\Sewer Tally\SewerTallySheet_5300_070116.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
7300 SW HUNZIKER RD 110, TIGARD, OR,
97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2016-00527
Don Sylvester
1. Demo and cap off sink - approved
Violation Summary:
Inspector Contractor