Permit (42) CITY OF TIGARD PLUMBING PERMIT
2. COMMUNITY DEVELOPMENT Permit#: PLM2017-00440
Tr GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/14/2017
Parcel: 1 S 1260000300
Jurisdiction: Tigard
Site address: 9321 SW WASHINGTON SQUARE RD 105
Project: Tesla Subdivision: None Lot: None
Project Description: Interior plumbing for TI:Relocating(1)2"floor drain,(1)sink,and(1)water closet; Installing(1)hose bib and(1)
water heater.
Contractor: PMSI LLC Owner: PPR WASHINGTON SQUARE LLC
21195 NW EVERGREEN PKWY#204 PO BOX 847
HILLSBORO, OR 97124 CARLSBAD, CA 92018
PHONE: 503-466-2222 PHONE:
FAX: 503-466-2211
FEES
Quantity Description Date Amount
ea Floor Drain/Floor Sink/Hub 11/08/2017 $25.02
Specifics: 1 ea Hose Bib 11/08/2017 $25.02
1 ea Sink 11/08/2017 $25.02
Type of Use: COM 1 ea Water Closet 11/08/2017 $25.02
Class of Work: ALT 1 ea Water Heater 11/08/2017 $37.52
Type of Const: 1 12%State Surcharge- 11/08/2017 $16.51
Occupancy Grp: Plumbing
Stories:
Total $154.11
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ieiget Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application
Building FixturesFOR OFFICE 1;SE OyLv
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City of Tigard � Received l Permit No.:
• 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: ��,( ('] /0„,i90/� ��
'� Phone: 503.71 S 2439 Fax. 503.598.19 ryJ 9Z\i Plan Review
q By. Other Permit No.'
T1GARD
Inspection 503,639.4175 i+ ,�. 1
Internet: www.tigard-or.gov �� ��� Y o auris pl menta2 for
l Information
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;It_ tAt4 h 04ethod.
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L TYPE OF WO>lx *:" { , �$+
❑New construction \,\„
❑Demo.W\,\„8:1-'� Fors ecirtl in ormation use checklist
Description
Qty. 1 Ea. I 'i'otal
®Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.(br each utility connection)
CATEGORY OF CONSTRUCTION . SFR(I)bath 312.70
0 I-and 2-family dwelling El Commercial/industrial SFR(2)bath 437.78
❑Accessory building ❑Multi-family SFR(3)bath 500.32
❑Master builderEach additional bath/kitchen 25.02
0 Other: Fire sprinkler( sq.Ii.) Page 2
JOB SITE iLNFORMATION AND LOCATION Site utilities:
Job site address:9321 SW Washington Square Road Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97223 Drywell,leach line,or trench drain 18.76
-_..-- Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.:105 Project name:Tesla
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:
'Fax map/parcel no.: Backflow preventer 31 27
DESCRIPTION OF"W o , _ Backwater valve 12.51
Plumbing for'TL Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump
25.02
( PROPERTY OWNER 1 ; .❑"TENANT t Expansion tank 12.51
Name: Fixture/sewer cap 25.02
_.. _ Floor drain/floor sink/hub
Address: 25.02 25.02
Garbage disposal 25.02
City/State/ZIP:
Hose bib 25.02 25.02
Phone:( ) Fax:( ) ice maker 12.51
rr APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:PMSI LLC Medical gas(value:$ ) Page 2
Contact name:Brandy Solana Primer 12.51
Roof drain(commercial) 12.51
Address:21195 NW Evergreen Pkwy.,Ste.204 _
Sink/basin/lavatoty 1 25.02 25.02
City/State/ZIP:Ilillsboro,OR 97124 Solar units(potable water) 62.54
Phone:(503)466-2222 Fax::(503)466-2211 Tub/shower/shower pan 12.51
E-mail:bsolano(nmsi-systems.com Urinai 25.02
i a t C'oNTRAcroi '- Water closet 1 25.02 25.02
f .. Water heater
Business name:MIS!LI.0 1 37.52 37.52
Water piping/DWV 56.29
Address:21195 NW Evergreen Pkwy.,Ste.204 Other 25.02
City/State/ZIP:Hillsboro,OR 97124 Subtotal 137.60
Phone:(503)466-2222 Fax:(503)466-2211 Minimum permit fee: $72.50
CCB Lie.:158286 Plumbing Lie,.no.:34-434PB Plan review (25%of permit fee)
Authorized signature 0
State surcharge(12%of permit fee) 16.51
t5(VO 41 : 7 ik, ' TOTAL PERMIT FEE 154.11
Print name:Brandy Solano Date: 10/18/17 This 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.
tlBuiWing\PermitslPt.MU•PermitApp doe 10/0/09 440-461 STI I0/02ICOM/wEB)
Plumbin2 Permit Application,- City of Tigard
• Page 2 -Supplemental Information
Fget tee SUcthilie(tituOsi e: QtY- FCC.ea). Total SRgeus tial Supp
taF igree:S u p p r„epsesrh:itS,FY ees te:in s: ,
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
7201, 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 11111:4a09 ri,,*-".' ' ' ,' 'Permit Fee:
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
0 Total each additional$100.00 or fraction thereof.to
Qry.
Other Inspections or Fees . Fee 0, ,
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*.
; Quantity by Fixture TYPc ' ,'''1,-Plan Review for Plumbing Installations
,
Fixture Type for RePlace/, Plan review is required for any of the following.
Work Performed: Capped Added Relocate
Please check all that apply.
Baptistry/Font
0 Any new commercial building with water service 2"and
Bath -Tub/Shower
-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 0 Any complex structure as defined in 0AR918-780-0040.
Eye Wash
Floor Drain/sink -2" 1 Submit 2 sets of plans with any of the above.
-3"
lAdmetricifir Riser Diagram% 11;
. „. .. ,
Car Wash Drain
0 Isometric or riser diagram is required for new buildings
Garbage -Domestic-non-tbod
Disposal -Domestic-food related that meet the qualifications 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/l.av -Non-food related
-Bradley
-Commercial-food related
-Service
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 , 1 fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
M:\Job Files\PMSI Jobs\Waiting on Contracts\Tesla Wa.Sq\City of Tigar2 Plumbing Permit App.doc
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9321 SW WASHINGTON SQUARE RD T05,
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2017-00440
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
1 . Nice job!
Violation Summary:
Inspector Contractor