Loading...
Permit CITY OF TIGARD PLUMBING PERMIT ` COMMUNITY DEVELOPMENT Permit#: PLM2017-00313 Date Issued: 07/31/2017 T i C;A p.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S 1260000300 Site address: 9504 SW WASHINGTON SQUARE RD J02 Jurisdiction: Tigard Project: Tumi SubProject Description: Interior plumbing for TI:Adding(1)2"floor drain,(1)sink,and(1)water closet;Installingivision: None Lot: None heater. ( )primer and(1)water Contractor: R A WARNER PLUMBING PO BOX 820785 Owner: PPR WASHINGTON SQUARE LLC VANCOUVER,WA 98682 PO BOX 847 CARLSBAD, CA 92018 PHONE: 360-772-2490 PHONE: FAX: 360-263-5354 FEES Quantity Description Date Amount 1 ea Floor Drain/Floor Sink/Hub 07/31/2017 $25.02 Specifics: 1 ea Primer 07/31/2017 $12.51 ' Type of Use: COM 1 ea Sink 07/31/2017 $25.02 Class of Work: ALT 1 ea Water Closet 07/31/2017 $25.02 Type of Const 1 ea Water Heater 07/31/2017 $37.52 Occupancy Grp: 1 12%State Surcharge- 07/31/2017 $15.01 Stories: Plumbing I Total $140.10 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 the e ru Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-00'0 follow Youth may lobtainoat copy of the mules I or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: ` �_� ..44,....100.- .• .ee Signature: L. AI Call 503.639.4175 by 7:00 a.m.for the next available inspec on d te. This permit card shall be kept In a conspicuous place on the job site until ••m.,,tion of the p eject. Approved plans are required on the job site at the time of each pection. Plumbing Permit Application / Building Fixtures City of Tigard Received 13125 SW Hall Blvd.,Tigard OR 97223 f �� Date/By: 7/3///? Qui-w-^ Permit No.: ,p�c, 7,6(0313 e Phone: 503.718.2439 Fax: 503.59C Plan Review r/�� / Inspection Line: 503.639.4175 Date/ByOther Permit No. TIC A l2i..1Page 2 for Internet www tigard or.gov Zpl� ql Notified/Method: - .,.T3t'PE 0)F WOY;K �.��"'�' ,. •�< .Date Ready/By: 7uris:/ � �PP►emeotallnf�mation j 1:2New construction0 D t' Di`'fc`0� 4 For sreeia/inforiaarion use checklist ❑Addition/alteration/replacement , 0 t.:0 V 1,7 D ripdon Total New 1-2-family dwellings(includes 100 ft.for each utility connection)_ ' ' ' 'CATEGOA`Y.OF CONSTRUCT O1!i 312.70 £ . SFR(1)bath 0 1-and 2-family dwelling Cm omercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 ❑Master builder 0 Other: 108 SITE Fire sprinkler( sq.ft.) Page 2 INFORMATION AND LOCATION '. -, g �g Site utilities: Job site address: 55-0/4 VaJ�, SI C 5 'It: f' - Catch basin or area drain 18.76 City/State/ZIP: Q �p� ©e :72b , 3 Drywell,leach line,or trench drain 18.76 ` Footing drain(no.linear ft.:- _) Page 2 Suite/bldg./apt.no.: Project name: i Manufactured home Cross street/directions to job site: utilities 50.03 jj ll }} Manholes 18.76 W k i I ttit,i'r.A. S t�r re mM t Rain drain connector 18.76 U Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Subdivision: Water service(no.linear ft.:- ) Page 2 I Lot no.: Fixture or item: fax map/parcel no.: Backflow preventer 1 s 31.27 A* GAJ.•o-��, �„ ' -' DESCRIPTION O r . -� , , Backwater valve 12.51 X10 y4 re 0 v Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 PRO)'E)<t +1yElt' :> tEjectors/sump 25.02 T,7,Ii- j �_ r:e [ TTNA'�rr '1.',;;4; Expansion tank 12.51 Name: - Fixture/sewer cap 25.02 Address: Floor drain/floor sink/hub 7 1 25.02 ?, Cityress:/ZIP: Garbage disposal 25.02 v Phone:( ) Hose bib 25.02 Fax ( ) Ice maker _ 12.51 0 AF)hi�CANX, f' r " z',,,e- � - s ..ft ,:,-,A1,100,A1,100,44,� !NOD!: ,� Ad� Interceptor/gtrase trap - Business name: 25.02 Medical gas(value:$ ) Page 2 SA, 63lnJ1,Erp CLA.1n43 Contact name: JCti1Mc Primer r 12.51 ii- 57/ f� 0. Address: Y o �O( 4.6,3 Roof drain(commercial) 12.51 City/State/ZiP: t / Sink/basin/lavatory i 25.02 c' 0�,ra71�45. LAI )4 rg‘�� Solar units(potable water) 62.54 Phone:( -11,72 2t.efo Fax::(7(> E mazl p // p9 ) �l0 �f�3J Tub/shower/shower pan 12.51 Urinal 25.02 �'' �,y� f, ,•..t .�O �Gt1r � 71 25.02 Business name: Q /1 u3,,,.„4.,... �� Cv Water heater 37.52 3 7„ 7 , t,4 u Water piprng/DWV 56.29 Address: 16 otk C Other:City/State/ZIP: ^111 ( °Agtea-a- Subtotal / jC(j_ Phone:cat.., ) a3,?-4.2-2y g. I Fax:(3c° )2(o-(1731 Minimum permit fee: $72.50 CCB Lie.: 1513A Plumbing Lic.no.: 3.7 -S 1 2( Plan review (25%ofpennit fee) Authorized ignature: i' 1 State surcharge(12%of permit fee) /c,C4 TOTAL PERMIT FEE /40, () II Print namOr J�f t W� q (/Ya-1) Date:aJ� 1 This permit application expires if a permit k not obtained within 180 days / ` after It has been accepted as complete. 'Fee methodology set by Tri-County BBptiding Industiy Service Board. 1:1BidldinglPnmitslPLMU-Pamilppp.doe 10/01/09 t,�JcL�Ivr-k f 3 Ito) ‘t.) 440-0616T(10/02/COM/wF-g) $ 3, 6oc:i( Plumbing Permit Application - City of Tigard Page 2- Supplemental Information Fee Schedule: »F � al Fire Suppression Systems: Residential ate utilities ttiy ' ;lee(1). Total Ski 'r g ' r iit Fee Footing drain-1°100' A 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 Sewer-each additional 100' 7,201 and greater $327.54 37.52 Water Service-1st 100' 62.54 Water Service-each additional 100' Medical Gas Systems: 37.52 Storm&Rain Drain-lst 100' 62.54 ValllSti41I1: Permit Fee: Stoma&Rain Drain-each additional 100' $1.00 to$5,000.00 -Minimum fee$72.50 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for Other Inspection§or reei C'sa) 'r tai 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 (minimum charge-1/2 hour) each additional$100.00 or fraction thereof,to Inspections outside of normal business 90.00/hr and including$25,000.00. hours(minimum charge 2 hours) $25,001.00 to$50,000.00 $379.50 for the fast$25,000.00 and$1.45 for 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 $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for (minimum charge-1/2 hour) each additional$100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Plan=lteview for Flumbing;Iistallatno>I _{ _; 'S Fixture'Type for �QuanHtvby lRirture,Typg- Plan review is required for any of the following. work Performed: Capped Aaded R Please check all that apply. Baptistry/Font 0 Any new commercial building with water service 2"and Bath Tub/Shower greater,except systems designed and stamped by licensed -Jacuzzi/Whirlpool engineer. Car Wash: Each Stall 0 New exterior plumbing site utilities for any complex structure Drive Tluu as defined in OAR918-780-0040. Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities. Dishwasher: Commercial - 0 Any multipurpose fire sprinkler system. Domestic 0 Any complex structure as defined in OAR918-780-0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: -2" _3„ � � _3„ ' I$Qit tetlric Or Riser-Diagram -Car Wash Drain - 0 Isometric or riser diagram is required for new buildings 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 Sink: -Lav/Bar non-food related j -Bradley Com/Serv/Util food related -Service Swimming Pool Filter *Note: If the fixture work under this permit results in an Washer-Clothes increase of sewer EDUs,a sewer permit will be issued and Water Extractor fees assessed for the sewer increase must be paid before the Water Closet-Toilet / plumbing permit can be issued. Urinal Other Fixtures: I:\Building\Permits\PLMF_PetmitApp.doc 08/04/2011 2 Accumulative Sewer Tally 2 Tenant Name: Tumi Site Address: 9504 SW Washington Square Rd SWR# N/A-EDU CREDIT T I G n R D PLM# 2017-00248 Parcel#: IS 1260000300 Fixture Value Previous Previous Credits Capped Fixture Fixture ew New # value count ca..ed#s value count added# added value total#s total values Ba.tise /Font 4 0 0 0 0 0 Bath: -Tub/Shower 4 0 0 0 0 0 - acuzzi/Whirl.ool 4 0 0 0 0 0 Car Wash: -Each Stall 6 0 0 0 0 0 -Drive throu:h 16 0 - 0 0 0 0 Cus.idor/Water As.irator 1 0 0 0 0 0 Dishwasher: -Commercial 4 0 - 0 0 0 0 -Domestic 2 0 - 0 0 0 0 Drinkin:Fountain 1 0 0 0 0 0 E e Wash 1 0 0 0 0 0 Floor Drain/Sink: -2 inch 2 04 8 0 -8 -3inch 5 0 0 0 0 0 -4 inch 6 0 0 0 0 -Car Wash 6 0 0 0 0 0 0 0 0 Garbage Disposal: -Domestic(to 3/4 HP) 16 0 I 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 -Stall 2 0 0 0 0 0 Sink: 0 0 0 0 -Lav/Bar-Non-Food Related 2 0 -Bradley 5 0 0 0 0 0 0 0 0 -Com/Sery/Util-Food Related 3 0 0 2 6 0 -2 Swimming Pool Filter 1 -6 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 Urinal 6 0 0 0 0 0 0 0 0 Previous EDU Count 0 0 Capped EDU Credit 0 TOTALS 0 0 0 6 14 0 0 -6 Current Fixture Value -14 divided b 16 -14 Y = 0.875 Current EDU 1 EDU= $5,300.00 Previous Fixture Value 0 divided by 16= 0.000 Previous EDU Change -14 divided by 16= -0.875 -.-,, over (under) $ (4,664.00) Enter EDU Change Here -0.880 * *Round EDUs to the nearest 1/100th: a count ending in.005 shall be rounde up to.01,and a count ending in.014 or less shall be rounded down to.01. Notes: EDU Credit Only-9/6/17 credits applied to SWR2017-00242,Dadamski Authorized Name/Signature: Dianna Howse Date: 6/22/2017 Building Division ote: 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 IIIAccumulative Sewer Tally • s Tenant Name: TUMID(6,-/A/41._ TIGARD Site Address: 9504 SW WASHINGTON SQUARE RD SWR# 2017-00242 Parcel#: 1 S 12600000 03PLM# 2017-00313 Fixture Value Previous Previous Credits Capped Fixture Fixture ew New # value count ca..ed#s value count added# added value total#s total values Bastise /Font 4 0 0 0 Bath: -Tub/Shower 4 0 0 0 0 0 - acuzzi/Whirl.00l 4 0 0 0 0 0 Car Wash: -Each Stall 6 0 0 0 0 0 -Drive throu:h 16 0 0 0 0 0 Cos•idor/WaterAs•irator 1 0 0 0 0 0 Dishwasher: -Commercial 4 0 0 0 0 0 -Domestic 2 0 0 0 0 0 Drinkin_Fountain 1 0 0 E e Wash 1 0 0 0 0 0 0 0 0 Floor Drain/Sink: -2 inch 2 10 20 0 -3 inch 5 0 00 0 1 2 0 0 -4 inch 6 0 0 0 0 0 -Car Wash 6 0 0 0 0 0 Garba•e Dis.osal: 0 0 -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 - Ice Machine/Refri•erator Drain 0 0 0 0 - 1 0 0 0 Livin_Unit 16 0 0 0 0 0 Oil Se. Gas Station 6 0 0 0 0 0 Rec.Vehicle Dum• station 16 0 0 0 0 0 Shower: -Gan• .Der head 1 0 0 0 -Stall 2 0 0 0 0 0 Sink: -Lav/Bar-Non-Food Related 2 0 - -Braille 0 1 2 1 2 5 0 0 -Com/Sery/Util-Food Related 3 0 0 0 0 0 0 Swimmin• Pool Filter 1 0 0 0 0 0 Washer-Clothes 6 0 0 0 0 0 Water Extractor 6 0 0 0 0 0 0 1 6 1 0 1 Water Closet-Toilet 6 60 Urinal 6 0 0 0 0 0 0 Previous EDU Count_ 0 Capped EDU Credit 0 TOTALS 0 0 0 0 0 3 10 Current Fixture Value 10 divided b 16 3 10 Y = 0.625 Current EDU 1 EDU= Previous Fixture Value 0 divided b 16= $5,500.00 Y 0.000 Previous EDU Change 10 divided by 16= 0.625 over (under) $ 3,465.00 Enter EDU Change Here 0.630 * *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: BRANDEN TAGGART X2449 Date: 7/31/2017 Building Division ote: 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: 9504 SW WASHINGTON SQUARE RD J02, TIGARD, OR, 97223 Record Type: Record ID: Commercial - Plumbing PLM2017-00313 Inspection Type: Inspector: 399 Plumbing final Don Sylvester Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor CITY OF TIGARD PLUMBING PERMIT iiri 1 COMMUNITY DEVELOPMENT Permit#: PLM2017-00313 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/31/2017 TIGARD 9 Parcel: 1S1260000300 Jurisdiction: Tigard Site address: 9504 SW WASHINGTON SQUARE RD J02 Project: Tumi Subdivision: None Lot: None Project Description: Interior plumbing for TI:Adding(1)2"floor drain,(1)sink,and(1)water closet; Installing(1)primer and(1)water heater. Contractor: R A WARNER PLUMBING Owner: PPR WASHINGTON SQUARE LLC PO BOX 820785 PO BOX 847 VANCOUVER,WA 98682 CARLSBAD, CA 92018 PHONE: 360-772-2490 PHONE: FAX: 360-263-5354 FEES Quantity Description Date Amount 1 ea Floor Drain/Floor Sink/Hub 07/31/2017 $25.02 Specifics: 1 ea Primer 07/31/2017 $12.51 1 ea Sink 07/31/2017 $25.02 Type of Use: COM 1 ea Water Closet 07/31/2017 $25.02 Class of Work: ALT 1 ea Water Heater 07/31/2017 $37.52 Type of Const: 1 12%State Surcharge- 07/31/2017 $15.01 Occupancy Grp: Plumbing Stories: Total $140.10 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 952-001-0091 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: - •••.eeSignature: Call 503.639.4175 by 7:00 a.m.for the next available inspec on d.te. This permit card shall be kept in a conspicuous place on the job site until on -tion of the p •ject. Approved plans are required on the job site at the time of each'trt'spection. Plumbing Permit Application l (0 _i - t 6 ABuilding Fixtures - `' FOR OFFICE USE om.1 City of Tigard Received f 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: 3 Permit No.: A/_/1/) ,�� 1C 114 Plan Review�� //� '' / 'r xL 7 ll�il✓ Phone: 503.718.2439 Fax: 503.5911 " T Inspection Line: 503.639.4175j°' Date/By: Other Permit No. !_/f )�i 7._I�L�1� TI G A R D Date Ready/By: Juris: I H See PageLL2lfoor Internet: www.tigard-or.gov A. ���� J Notified/Method: Supplemental Information TYPE OF WORK .'„ SCHEDULE FEE*' New construction 01- 11kI� ❑D 1 o 1\1L�``� For special information use checklist ❑Addition/alteration/replacement � Description ❑ �� Qty. I Ea. Total New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION 4 SFR(1)bath 312.70 ❑ 1-and 2-family dwelling commercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 ❑Master builder Each additional bath/kitchen 25.02 ❑Other: Fire sprinkler( sq.ft.) Page 2 • JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 5504 0,,,,L S e 5_ Catch basin or area drain 18.76 (� 6""� -it-3-02 City/State/ZIP: YOB'�rAn ©� � � Drywell,leach line,or trench drain 18.76 Suite/bldg./apt.no.: Project name: ` Footing drain(no.linear ft.: ) Page 2 J(A 1 Manufactured home utilities 50.03 Cross street/directions to job site: OA" y Manholes 18.76 W A 5 vI -l 1--CAN t� C mat t� Rain drain connector 18.76 l Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.:_) Page 2 Subdivision: Water service(no.linear ft.: ) Page 2 Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DE$ RIP'TIO1V P. SV,,,, ac water va ve B k 1 12.51 r act( I 400- r>°5 o OM Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 0 w;PROI'ERTY_oi " , ,„ ❑ Expansion tank 12.51 Name: Fixture/sewer cap 25.02 Address: Floor drain/floor sink/hub / i 25.02 ) }„ r City/State/ZIP: Garbage disposal 25.02 Phone:( ) Hose bib 25.02 Fax ( ) Ice maker 12.51 APPLICANT x ' .. ❑",,CQNT4C ' PERSON r" ' Interceptor/grease trap 25.02 Business name: �/� / ry�^*er �� ��` Medical gas(value:$ ) Page 2 Contact name: 1� V-� M`� Primer 12.51 f y 3et, JM" J2. Address: ��� Roof drain(commercial) 12.51 l Sink/basin/lavatory :-/ 25.02 City/State/ZIP: C 1�ct 5• (A C) �5 L. rec3‘ Solar units(potable water) 62.54 Phone:() _7,72,1 t.. d Fax::(3 C� ) 2/0_q7S Tub/shower/shower pan 12.51 E-mail: ��rtie IUrinal F /u,„,Zr 0 ;WI: 6 25.02 CO CTOI Water closet I 25.02 4 41 Business name:" f ,' Water heater ' 37.52 �4 Lc - �(A.L✓l14ln (v • 0, 7� le tat `c 3 (I Water piping/DWV 56.29 Address: J City/State/ZIP: t.K 1"�J Co-VA el&�- Other: 25.02 Phone: .� �lY _ Subtotal 1� l�S�c � C ) WZ 2(fy, Fax:(j(" )2(a-Y 735 Minimum permit fee: $72.50 CCB Lic.: 1591�3. Plumbing Lic.no.: 3'7 -Sz1 �� Plan review (25%of permit fee) Authorized signature: 1 l 1 State surcharge(12%of permit fee) f y,`1 TOTAL PERMIT FEE/ d/10 i V Print nam This permitP �a il Wk. a UYLt t,� I Date: f Zt I application expires if a ermit is not obtained within 180 days J /✓1 after it has been accepted as complete. *Fee methodology set by Tri-County B ilding Industry Service Board. I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) (C+ tr-(c + 3it0 y,♦ Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities . Qty. Fee(ea) Total t Square Footage: Permit Fee: 50.03 0 to 2,000 $121.90 Footing drain-15S 100' 2,001 to 3,600 $169.69 Footing drain-each additional 100' 37.52 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 Valuation: 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 each additional$100.00 or fraction thereof,to Other Inspections or, : Fee(ea) Total FeesQty, 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. 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for Additional plan review for revisions each additional$100.00 or fraction thereof. (minimum charge-1/2 hour) Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to �.tai � accurately report fixtures could result in increased sewer fees*. Plan Review for Plumbing Ius atiol s Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replace/ Please check all that apply. Work Performed: Capped Added Relocate 0 Any new commercial building with water service 2"and Baptistry/Font greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool 0 New exterior plumbing site utilities for any complex structure Car Wash: -Each Stall as defined in OAR918-780-0040. -Drive Thru 0 Medical gas and vacuum systems for health care facilities. Cuspidor/Water Aspirator 0 Any multipurpose fire sprinkler system. Dishwasher: -Commercial ❑ Any complex structure as defined in OAR918-780-0040. -Domestic Drinking Fountain Submit 2 sets of plans with any of the above. Eye Wash l Floor Drain/sink: -2" -3" -Isometric or Riser Diagram 4>' 0 Isometric or riser diagram is required for new buildings -Car Wash Drain that meet the qualifications above. Garbage -Domestic non-food Disposal: -Domestic food related -Commercial food related -Industrial food related Comments regarding fixture work: Ice Mach./Refrig.Drains Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -Lav/Bar non-food related i -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 fees assessed for the sewer increase must be paid before the Water Extractor plumbing permit can be issued. Water Closet-Toilet Urinal Other Fixtures: I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2 Accumulative Sewer TallyIII --SC's r`7 a Tenant Name: TUMI-Revision 1 S #-29.14-96`24k2^ REVISED TIGARD Site Address: 9504 SW WASHINGTON SQUARE RD PLM# 2017-00313 Parcel#: 1S1260000300 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 -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/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 1 6 1 6 Urinal 6 0 0 0 0 0 Previous EDU Count 0 0 Capped EDU Credit 0.88 14.08 TOTALS 0 0 0 0 3 10 3 -4.08 Current Fixture Value -4.08 divided by 16= -0.255 Current EDU 1 EDU= $5,500.00 Previous Fixture Value 0 divided by 16= 0.000 Previous EDU Change -4.08 divided by 16= -0.255 over (under) $ (1,430.00) Enter EDU Change Here -0.260 * *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: 9/6/17,.88 sewer credits from PLM2017-00248 applied,.26 credit balance remaining. Dadamski Authorized Name/Signature: BRANDEN TAGGART X2449 Date: 9/6/2017 Building Division rote: 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