Permit (12) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2017-00324
Date Issued: 08/09/2017
T[GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S101CA00200
Jurisdiction: Tigard
Site address: 7920 SW HUNZIKER RD
Project: TerraFirma Subdivision: None Lot: None
Project Description: Adding(1)2"floor drain,(1)primer, (3)shower stalls,(1)sink, (2)urinals&(1)water heater. Replacing/relocating
(3)lays&(3)water closets.
Contractor: CARRIER PLUMBING Owner: WALL STREET INDUSTRIAL LLC
12848 SE STALEY 7900 SW HUNZIKER RD
BORING, OR 97009 TIGARD, OR 97223
PHONE:
PHONE: 658-3818
FAX:
FEES
Quantity Description Date Amount
1 ea Floor Drain/Floor Sink/Hub 08/09/2017 $25.02
Specifics: 1 ea Primer 08/09/2017 $12.51
1 ea Sink 08/09/2017 $25.02
Type of Use: COM 3 ea Lavatories 08/09/2017 $75.06
Class of Work: ALT 3 ea Tub/Shower/Shower Pan 08/09/2017 $37.53
Type of Const: 2 ea Urinal 08/09/2017 $50.04
Occupancy Grp: 3 ea Water Closet 08/09/2017 $75.06
Stories: 1 ea Water Heater 08/09/2017 $37.52
1 12%State Surcharge- 08/09/2017 $40.53
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 r es adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-00 ;.•.. Y. -;"ay obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: /'
Permittee Signature:
��
Call 503.639.4175 by 7:00 a.m.for the next available insp-ction 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 ;, ' p O
City of Tigard RDate/By: 0 ( /7 �i Permit No.: dajolel 7....eQ ?ja
114 No 13125 SW Hall Blvd.,Tigard,OR 1.%\1 Plan Review
l! Phone: 503.718.2439 Fax: 503. 8. 60 Date/By: Other Permit No.: 5/0,Q 09e1f 7-OOp' 3
Inspection Line: 503.639.4175 r�� � ate Ready/By: Juns: ® See Page 2 for
T I(1A R I) Y t , Supplemental Information
Internet: www.tigard-or.gov r` W `x`��q Notified Method: PP
TYPE OF WORK V �A\ r12,,,�V FEE* SCHEDULE
.�� _ For special information use checklist.
❑New construction 0 ' ' on Description Qty. Ea. I Total
.Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 10011.for each utility connection) ��
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70g.
'.i Commercial/industrial SFR(2)bath 437.78
❑ 1-and 2-family dwelling SFR(3)bath 500.32
❑Accessory buildingy
❑Multi-famil Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2 J
JOB SITE INFORMATION AND LOCATION Site utilities: p
3 � / /uA- rrL�� Catch basin or area drain 18.76
Job site address: 7 ZL -f -
Drywell,leach line,or trench drain 18.76 PQ
City/State/ZIP: 7„,..vp 0-'2 Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: ` I Project name:-7 ar-r r/,/L/d,/ 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 5/6` O/3•DD o!..2 Backflow preventer 31.27
,- Backwater valve 12.51
DESCRIPTION OF WORK
x Clothes washer 25.02
4�G" �,� CI 4:43A- 12,,,:,470''t.' 4 FA-A, Dishwasher 25.02
? 'L L../1 7 Drinking fountain 25.02
l Ejectors/sump 25.02
�� p 12.51
0 PROPERTY OWER:4' 1 0 TENANT. Expansion tank
Fixture/sewer cap 25.02
Name:
Floor drain/floor sink/hub 1 25.02 -2_6; x L
Address: Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
Interceptor/grease 25.02
."❑ APPf�CAN'i`N " ;'❑ CONTACT PERSON trap
Medical gas(value:$ ) Page 2
Business name:G2/L-lt�Z pial),/4
Primer / 12.51 /t,.)/
Contact name: 724---:-'
t ,42/2/6 s-z_ Roof drain(commercial) 12.51
Address: / ZtL'(.:zr Jr` 561 ;
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
Sewer-1st 100' 3,601 to 7,200 $23320
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 100' 37.527
Storm&Rain Drain-1st 100' 62.54 Valuation: Permit Fee:
$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
Fee(ea) Total each additional$100.00 or fraction thereof,to
Other Inspections or Fees Q '
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*. 'lalq Review.for 'lum`hing In taLlatiQus ,w
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that a 1
Work Performed: Capped S Added Relocate PP Y•
Baptistry/Font •
0 Any new commercial building with water service 2"and
Bath: Tub/Shower greater,except systems designed and stamped by licensed
-Jacuzzi/Whirlpool engineer.
Car Wash: Each Stall
0 New exterior plumbing site utilities for any complex structure
Drive tall as defined in OAR918-780-0040.
Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities.
Dishwasher: -Commercial ❑ Any multipurpose fire sprinkler system.
Domestic ❑ 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" 1
k: Isometric or Riser I)iagrain
4
0 Isometric or riser diagram is required for new buildings
-Car Wash Drain
Garbage -Domestic non-food that meet the qualifications above.
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 3
Sink: -Lav/Bar non-food related ) 3
-Bradley
-Com/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
Water Extractor fees assessed for the sewer increase must be paid before the
Water Closet-Toilet 3 plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2
_ Tenant Name: TerraFirma Accumulative Sewer Tally SWR# 2017-00263
TI G A R D Site Address: 7920 SW Hunziker St PLM# 2017-00324
Parcel#: 2S 101 CA00200
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 1 2 1 2
-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 3 6 3 6
Sink:
-Lay/Bar-Non-Food Related 2 0 0 1 2 1 2
-Bradley 5 0 0 0 0 0
-Com/Sere/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 2 12 2 12
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 0 0 7 22 7 22
Current Fixture Value 22 divided by 16= 1.375 Current EDU 1 EDU= $5,500.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change 22 divided by 16= 1.375 over (under) $ 7,590.00
Enter EDU Change Here 1.380
*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:
Authorized Name/Signature: Debbie Adamski Date: 8/9/2017 •
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_5500_070117.xlsx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
7920 SW HUNZIKER RD, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2017-00324
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor