Permit CITY OF TIGARD PLUMBING PERMIT
a.. COMMUNITY DEVELOPMENT
Permit#: PLM2017-00341
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/23/2017
f " Parcel: 2S101DC04201
Jurisdiction: Tigard
Site address: 7190 SW FIR LOOP 100
Project: Summit Learning Subdivision: 72ND BUSINESS CENTER Lot: 2
Project Description: Cap(1)mop sink&add(1)break room sink
Contractor: CASCADE PLUMBING CO Owner: VIKING TWINS II LLC
15765 SW 74TH AVE NORTHWOODS WEST LLC
TIGARD, OR 97224 7190 SW FIR LOON
TIGARD, OR 97223
PHONE: 503-289-7095 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Fixture/Sewer Cap 08/23/2017 $25.02
Specifics: 1 ea Sink 08/23/2017 $25.02
1 12%State Surcharge- 08/23/2017 $8.70
Type of Use: COM Plumbing
Class of Work: ALT 22 ea Minimum Fee Adjustment- 08/23/2017 $22.46
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- questions . * NC b .ng 503.232.1987 or 1.800.332.2344.
jiIs- ed By: / Permittee Signature: A" / /
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 Application
Building Fixtures .p FOR OFFICE LSI', O:�Lv
City of Tigard C q E Received </
Date/By: D p�5 f 7 , / Permit No.: A( AV 7• 3
• 0
Itim 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
■ Phone: 503.718.2439 Fax: 503.598.440 G 2 3 2017Date/B y: Other Permit No.:
T I G A K l) Inspection Line: 503.639.4175 Date Ready/By: Juris: H See Page 2 for
Internet: www.tigard-or.gov y Notified Method: Supplemental Information
4 ::.0t: ,.} ., .� ` i. " t °�i d „i < i re ; ,..
•
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❑New construction ❑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 .tA t° Vr� i SFR(1)bath 312.70
❑ 1-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
_' r RI li ii All e A °;r` ,,4 , Site utilities:
Job site address:7190 SW Fir Loop Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard Or 97224
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: /00 I Project name:Summit Learing 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: ) Lot no.: Fixture or item:
Tax map/parcel no.: e /d/ DCG'ol Backflow preventer 31.27
Backwater valve 12.51
Clothes washer 25.02
installing one break sink
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
}�y '-`4''''''' ,A,,,,,%,,,„.:. Expansion tank 12.51
'`;❑` `1' o �' ' ' - ,'a,w A � tiro ),
Name: Fixture/sewer cap '� 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
'4-
4- `'` Interc tor/ ease trap25.02
❑: ONTACt PERSON , ep St
Business name:Cascade Plumbing (,�Lt✓� U�j/ (���j� �1�{�jl/��ij Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Bekka Greer
Roof drain(commercial) 12.51
Address:15765 SW 74th Ave
Sink/basin/lavatory 1 25.02
City/State/ZIP:Tigard OR 97224 Solar units(potable water) 62.54
Phone:(503)289 7095 Fax::(503)2839514 Tub/shower/shower pan 12.51
E-mail:Cascadeplum@yahoo.com Urinal 25.02
Water closet 25.02
CONTRACTOR'
Water heater 37.52
Business name:Same as above Water piping/DWV 56.29
Address: Other: 25.02
City/State/ZIP: Subtotal V"'
Phone:( ) Fax:( ) Minimum permit fee: $72.50 7g .
Plan review (25%of permit fee) -------1
CCB Lie.:204392 /0//7//f Plumbing Lic.no.:PB1528 7///9.0
�1 (((111 State surcharge(12%of permit fee) g.70
Authorized signature: ?...-pA�4 ,. TOTAL PERMIT FEE 8(•e9,6,.....--////"""��V This permit application expires if a permit is not obtained within 180 days
Print name:Bekka Greer Date:8/23/2017 after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:ABuildingAPermitsVPLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
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 greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas Systems
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
Othand 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*.
)Mixture for' tiby ICtlkt l ;�:, 1; ` forl >t mb g t , f.,
Plan review is required for anyof the following.
Work Performed: CapPed Added 9
Baptistry/Font Please check all that apply.
Bath Tub/Shower
D 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 0 New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial 0 Medical gas and vacuum systems for health care facilities.
-Domestic 0 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"
4,' Isometric or Riser Diagram
Car Wash Drain
Garbage Domestic-non-food
0 Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Ref-ig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related I
-Bradley
-Commercial-food related
-Service f
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes
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\Cascade Main\Downloads\PLMF_PermitApp(5).doc 2
Accumulative Sewer Tally
-***CREDITS*** SWR#N/A
Tenant Name: Summit Learni
B
Site Address: 7190 SW Fir Lp#100 PLM# 2017-00341
t c n R D Parcel#: 2S 101 DC04201
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
-4inch 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:
-Lay/Bar-Non-Food Related 2 0 0 1 2 1 2
-Bradley 5 0 0 0 0 0
-Com/Sery/Util-Food Related 3 0 1 3 0 -1 -3
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
0
Capped EDU Credit
TOTALS 0 0 1 3 1 2 0 -1
Current Fixture Value -1 divided by 16= -0.063 Current EDU 1 EDU= $5,500.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change -1 divided by 16= -0.063 over (under) $ (330.00)
Enter EDU Change Here -0.060 *
*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: Debie Adamski Date: 8/23/2017
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:
7190 SW FIR LOOP 100, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2017-00341
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor