Permit (88) CITY OF TIGARD PLUMBING PERMIT
IN . 'f COMMUNITY DEVELOPMENT Permit#: PLM2018-00008
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/04/2018
T[ 9 Parcel: 1 S 136C D00100
Jurisdiction:
Site address: 11701 SW PACIFIC HVVY
Project: Starbucks Subdivision: None Lot: None
Project Description: Interior plumbing for TI: Capping(9)4"floor drains;Adding(1)commercial dishwasher,(10)3"floor drains,and(7)
sinks; Relocating(1)ice machine, (2)sinks,(1)sink,and(2)Water closets; Installing(1)water heater,and water
piping/DWV.
Contractor: SAKRISSON PLUMBING Owner: PACIFIC CROSSROADS PROPERTIES IN
PO BOX 821 RIDGEFIELD WA 98642 BY WYSE INVESTMENT SERVICES CO
RIDGEFIELD,WA 98642 1501 SW TAYLOR ST STE 100
PORTLAND, OR 97205
PHONE: 503-440-7540 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Dishwasher 01/04/2018 $25.02
Specifics: g ea Fixture/Sewer Cap 01/04/2018 $225.18
10 ea Floor Drain/Floor Sink/Hub 01/04/2018 $250.20
Type of Use: COM 1 ea Ice Maker 01/04/2018 $12.51
Class of Work: ALT 1 ea Water Piping/DWV 01/04/2018 $56.29
Type of Const: 2 ea Water Closet 01/04/2018 $50.04
Occupancy Grp: 1 ea Water Heater 01/04/2018 $37.52
Stories: 1 12%State Surcharge- 01/04/2018 $78.81
Plumbing
Total $735.57
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:L/f Cea
•ermi ee Signature:
f
Call 503.639.4175 by 7:00 a.m.for the next available inspection d te.
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.
PIumbing Permit Application 1 i, is 'i/
Building Fixtures FOR OFFICE t SE 0\11
City of Tigard � TM;tc . � �.Gni.-ed ,
.. ,, 9
13125 SW Hall B1vd.,Tigard,OR 9721,"i.:4,..1,-,--;?,,\A,
a c24.: a a r Date By: /�j l 177_
permiti„...., „,,,,,,,,,.,...,..„,,,,,,,,_,,,,4,,,,,,,,,
r Plan Rcv + L 1-1
Phone: 503.718 2439 Fax: 503.598:.1960 Other Pmnit No. '
111
DatoBy: '
TI G A R D Inspection Line: 503.639.4175 i r, Dale Ready/By: .hos Ea See Page for
Internet: w- w.tigard-or.gov 4 C l Ll- ,' 76 Notified/Metnod: Supplemental Information
TYPE OF WORK t ( FEE* SC."f1DTJI,F
���-✓,, ykp '<itxr%0
❑few construction 0 t Adlirtfon _w, For special infornrution use checklist
Additionlalterationlreplacemem [ �,,1` 5., ^s° h ik i Description I Qty 1 Ea I Total
New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70.
Q 1-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
CI Accessory building 0 Multi-family SFR(3)bath 500.32
❑Master builder Each additional bath/kitchen 25.02
0 Other Fire sprinkler( sq.TO Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 11701 SW PACIFIC HWY Catch basin or area drain 18.76
City/State/ZIP: TIGARQ,OR 97223 I7ty!+ell,leach line,or trench drain 18.76
Footing drain(no.lineat ft.: )' Page 2
Suite/bldg.lapt.no.: Project name: STARBUCKS-PACIFIC&78TH Manufactured home utilities 50.03
Cross street/directions/0.10h site: PACIFIC HWY W.&SW DARTMOUTH ST. Manholes 18.76
Rain drain connector 18,76
Sanitary sewer(no.linear fi.: ) Page 2
Storm sewer(no,linear ft.:_)' Page 2
Waterservice(so,linear ft.:__,) Page 2
Subdivision 1S138CD00100 1 Lot no. Fixture or item:
Tax map/parcel;no.: Backllowpreventer 31,27
DESCRIPTION OF WORK Backwater valve 12.51
Conversion of the former Arby's into a Starbucks Coffee Shop WI outdoor seating and drive-thru Clothes washer 251°2
facilities. Scone of work includes.removal of exterior facade and replaced w/new.Removal of Dishwasher / '' 25.02 25,02
entire interior,replace w/new partition walls&finishes.New equipment,HVAC&accessible
restmoms. Drinking fountain 25.02.
Ejectors/sump 25.02
0 PROPERTY OWNER I ® TENANT Expansion tank i 12,51
Name: STARBUCKS COFFEE COMPANY Fixture/sewer cap 9 25.02 225.18
Floor drain/floor sink/hub /' 10 25.02 250.20
Address: 2401 UTAH AVE SOUTH,SUITE 800,MS MD-9Garbage disposal 25.02
City/State/ZIP: SEATTLE,WA 98134-1435 Hose bib 25.02
Kon Blanchette
Phone:
( ) 503-572-4345 Fax:( ) Ice maker / 1 12.51 12.51
9 APPLICANT C:A1+lT CONTACT PERSON Interceptor/grease trap 25.02
Business name:GPD ENGINEERING&ARCHITECTURE PROFESSIONAL CORPORATION Medical gas(value:$ ) Page 2
Primer 12.5I
Contact name: HALEY BECKER
Roof drain(commercial) . 1251
Address: 520 SOUTH MAIN ST.SUITE 520 Sink/basin/lavatory- 25.02
City/State/ZIT' AKORN,OH 44311 Solar units(potable water) 62.54
Phone:( 330) 572-3611 Fax::( 330) 572-2101 Tub/shower/shower pan 12.51
E-mail: hbecker(gpdgmup.com Urinal 25.02
Water closet r/ 225;02 50.04
CONTRACTOR
�+ Water heater ' 1 37.52 37.52
Business name: c�P'KS -1 CS O iJ ..W M.a it)0" Water pipmg/DWY ✓ 1 5629 56.29
Address: 1'p '�tl t t I Other.
o� - 25.02 t
City/State/ZIP: �O(TE I SLY) f LA)/t- t $t9tt2- Subtotal 6556.75
Phone:(N3 ) 440�� ')210 Fax:( ) Minimum permit fee: $72.50
CCB Lie.: tPlan review (25%of permit fee) re .
( Co t Plumbing Lie.no.: S a
�� State surcharge(12%of permit fee) ,Yj 1 J
Authorized signature: ;� TOTAL PERMIT FEE 35,5E
Print name: Hon Blanchette Date: 0 , This permit application expires it:a permit is not obtained within 180 days
/,� after it has been accepted as complete.
*Fee methodology set by Tn-County Building Industry Service Board.
l Model nyh3'ermss,Pl,LrU-PernstApp doc 10101109 4 a.46r6T(1o10?ICL avwE&)
•
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Su' s ression S stems:
tea_ ,
d; . a .' i 4
Footing drain-Is`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 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
i . i each additional$100.00 or fraction thereof,to
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 char:e-1/2 hour and including$25,000.00.
Inspections outside of normal business 390.00/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 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 charle-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*.
,��h��(� � T r? Planreview is required for any of the following.
-Baptistry/FontPlease check all that apply.
Bath Tub/Shower
0 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 1 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 OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
3„ 10
Car Wash Drain
0 Isometric or riser diagram is required for new buildings
Garbage -Domestic-non-food q g
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/Lav -Non-food related 2
-Bradley
-Commercial-food related 7
-Service 1
Swimming Pool 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 2 fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
O:\2016\2016355\20_Tigard Marketplace_Tigard OR\Due Diligence\Site purvey Report\Reference docs\PLMF_PermitApp.doc
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11701 SW PACIFIC HWY, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2018-00008
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
1 . Correction's are complete, plumbing final approved.
Violation Summary:
Inspector Contractor