Permit (108) CITY OF TIGARD PLUMBING PERMIT
' 1 COMMUNITY DEVELOPMENT Permit#: PLM2018-00140
T I c;A It D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/11/2018
Parcel: 2S101DA00104
Jurisdiction: Tigard
Site address: 13333 SW 68TH PKWY
Project: Triangle Pointe Subdivision: VARNS ACRES
Project Description: Plumbing site utilities for parking modifications and construction of a Lot: 9
80 ft.of sanitary sewer,and 1,306 ft.of storm sewer. building pad:(15)catch basins,(4)manholes,
Contractor: DEACON CONSTRUCTION LLC Owner:
TRIANGLE POINTE TWO LLC
901 NE GLISAN ST STE 100 901 NE GLISAN ST, STE 100
PORTLAND, OR 97232 PORTLAND, OR 97232
PHONE: 503-297-8791 PHONE:
FAX:
FEES
Quantity Description Date Amount
15 ea Catch Basin or Area Drain 04/11/2018 $281.40
Specifics: 4 ea Manholes 04/11/2018
$75.04
80 If Sanitary Sewer 04/11/2018
Type of Use: COM $62.54
Class of Work: ALT 1306 If Storm Sewer 04/11/2018 $550.30
Type of Const: 1 Plan Review 04/11/2018 $242.32
1 12%State Surcharge- 04/11/2018 $116.31
Occupancy Grp: Plumbing
Stories:
Total $1,327.91
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. 400 'say obtain a copy of the rules
or direct questions to OUNC by calling 503.2832.1987 or 1.800.332.2344.
Issued By: �� 1 ll
.1l't .XO`",1 Permittee Signature: A
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application
_ _____
Site Utilities RECEIVE _ ____. . FOR OFFICE USE ONLY
City of Tigard Received
.1111 'I 13125 SW Hall Blvd.,Tigard,OR 97223 �q ��� Date/By: "�i1//c ,(� -1s6rmit No '--e62.,/y'0'0
2'. " Phone: 503.718.2439 Fax: 503.598.1960 Plan Review _`li 7,.;1
Inspection Line: 503.639.4175 OF
y Date/By:te �} l un g:Other Permit No f gc 2 for 6j�.�
TIGARb P CITY ;3t :ii ,' r
Internet: www ttgard or gov `��� Date Ready/By:
r� � ;"� Jurts
1 12�1i l f'I '1 a Notlficd/Mcthod E'1 e Inf
* F ' 'fir r 3 f� lil`� i /+.'r�� I.„,_Supplemental Information
N .:. ,.v � ,.":, . i _-.,.;. TYPE OF WORK a � 'f-•:;'
E »:. FEE* SCHEDULE 4 z� e l
1''s^ `f*b : : r �....,.:�. � ,..�w�.l :"�,.{;t*��$ ° f R"'R�V� �"��� �#�v r v�
0 New construction = ;: ,_ . : « ,.
Demolition For special information use checklist.
®Addition/alteration/re lacementDescription Total
P 0 l Qty. Ea.
New 1-2-family dwellings(includes 100 ft.for each utility connection)
.< ir {.„ :V ,,CATEGORY OF CONSTR CTIOJ ' >
: .�,,. ,:..,<�.i :-:..� ttaSFR(I)bath 312.70
❑ 1-and 2-family dwelling [g)Commercial/industrial SFR(2)bath
o Accessory buildingSFR(3)bath 437.78
0 Multi-family 500.32
❑Master builderEach additional bath/kitchen
0 Other 25.02
q ;: Fire sprinkler( sq.ft.) Page 2
' , . g.: 4 JOB SITE?INFORMATION;nAND�LOCATION,, h, Site utilities:
Job site address:13333 SW 68th Parkway Catch basin or area drain 15 18.76
281.40
Drywall,leach line,or trench drain 18.76
City/State/ZIP:Tigard, Oregon 97223
Suite/bldg./apt.no.: Project name: Footing drain(no.linear ft.:_) Page 2
Triangle Pointe Parking Manufactured home utilities
Cross street/directions to job site: 4 50.03 7S d4
Manholes 18.76 .4.8e.
Exit 293 from 1-5 S. Continue on SW 68th Ave. Rain drain connector 18.76
to SW 68th Parkway Sanitary sewer(no.linear ft.:
$iL) IX Page 2 62.54
Storm sewer(no.linear ft.: )6 H 444e. Page 2 152.75
Subdivision: Water service(no.linear ft.: ) Page 2 550.30)
1 Lot no.:2300/104 Fixture or item:
Tax map/parcel no.:2S 101 DA00104, 2S 101 DA02300 Backflow preventer
31.27
.:.` ' DESCRIPTION OF''11 ORK> A Backwater valve
12.51
Parking modifications Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump
(21 PROPERTY O%VNER 25.02
� ❑ TTrNANT ,�r � Expansion tank 12.51
Name:Triangle Pointe, LLC and Triangle Pointe Two, LLC Fixture/sewer cap 25.02
Address: 901 NE Glisan St. Floor drain/floor sink/hub 25.02
City/State/ZIP: Portland, Oregon 97232 Garbage disposal 25.02
Hose bib 25.02
Phone:(503)297-8791 Fax ( )
� Ice maker 12.51
r x , n: ,�..,,Q APDL CANT l r,CONTACT PERSON Interceptor/grease trap 25.02
Business name: Mackenzie Medical gas(value:$ ) Page 2
Contact name: Bailey Smoke Primer 12.51
Address:1515 SE Water Ave., Suite 100 Roof drain(commercial) 12.51
Sink/basin/lavatory 25.02
City/State/ZIP: Portland, Oregon 97214
Solar units(potable water) 62.54
Phone:(503)224-9560 I Fax::( 503)228-1285 Tub/shower/shosverpan 12.51
E-mail: bsmoke@mcknze.com Urinal 25.02
-s .' 3 , Water closet
25.02? - N.�. k ,CONTRACTOR"
Business name:Deacon Water heater 37.52
Water piping/DWV 56.29
Address: 901 NE Glisan St.
Other: 25.02
City/State/ZIP: Portland, Oregon 97232 cm,as
Subtotal
Phone:( 503)297-8791 Fax:( ) Minimum permit fee: $72.50
CCB Lic.: 212549 Plumbing� Lic.no.:
Q42.32 Plan review (25%of permit fee) 2 .6<
Authorized signature: 0 ! art C\ ✓ 1'tt' 16.31 State surcharge(12%of permit fee) �1.(1/a.$E
l- l 27. 91 TOTAL PERMIT FEE 1.-
I Print name: Bailey`S-moke Date: 3/28/2018 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.
I:\nuilding`'..Permits'PLMU-PermitApp.doc 10.01/09
410-46 16T(10/021COMtWl3n)
Plumbing Permit Application - City of Tigard
•
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Su
Site LIt'Illties r Suppression Systems:
Q Y r. .(ea) Total
Square:Foota e.,..;47,-,::::4 ;'Permit:-.Fees
Footing drain-I"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' 62.54 3,601 to 7,200 $233.20
62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service- I st 100' 62.54
Water Service-each additional 100' 37.52 Medical Gas Systems:
Storm&Ram Drain 1st 100 Valuation � �`,
62.54 62.54 Minim
Fee .'
Storm&Ram Drain each additional 1 UO't3 41.948. 37 52 $i.00 to$5,000.00 Minimum fee$72 SU
399 21487.9 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Other InSpeCtlonS:Or,,Fees;. X,/St,
Fee(ea) Total each additional$100.00 or fraction thereof,to
Inspection of existing plumbing or for and including$10,000.00.
$10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 fbr
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 first$25,000.00 and$1.45 fbr
each additional$d 00.00 or fraction thereof,to
Reinspection Fees 90.00/hr
Additional plan review for revisions 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
(minimum charge-1/2 hour) each additional$100.00 or fraction thereof
Subtotal: 61,1.$.1
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 Type Plan Review for Plumbing Installations
,-FixtuteT efor , ,, _.
YPr_ � Replace./
� `
%York Performed. .k Capped waded Relocate Plan review is required for ally of the following.
Baptistry/Font Please 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/1VaterAsptrator as defined in OAR918-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic
0 Any multipurpose fire sprinkler system.
Drinking Fountain
Eye Wash 0 Ally complex structure as defined in OAR918-780-0040.
Floor Drain/sink -2"
3>. Submit 2 sets of plans with any of the above.
Car Wash Drain N;.ISome tric or;Riser;:Diagram
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./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial-food related
-Service
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 fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
I:\Building\Permits\PLMU PertnitApp.doc 2
Transmittal for 2150559.00: Dianna Howse (Community Development) at City of Tigard Page 1 of 1
MACKENZIE
1515 SE Water Ave.Suite 100•Portland OR 97214 MA9 201
PO Box 14310•Portland OR 97293
TEL:503.224.9560•NET:MCKNZE.COM•FAX:503.228.1285 (T
Letter of Transmittal
61876-1
Date: March 29, 2018 Project Number: 2150559.00
To: City of Tigard
13125 SW Hall Blvd
Tigard, OR 97223-8199
Attention: Dianna Howse (Community Development)
Project Name: Triangle Parking
Enclosed:
Quantity Medium Description
Comment
1 Original Plumbing permit application
2 Bond Full Plumbing plans
2 Color Basin Map (proposed)
Photocopy
Remarks:
Signed: Samuel Roberts
Transmitted
Via: Delivery PM
If enclosures are not as noted, kindly notify us at once.
http://www.grpmackweb.com/gm/transmittal/preview_transmittal.php?dbFetch=l&transm... 3/29/2018
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13333 SW 68TH PKWY, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2018-00140
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
1 . Site utilities ( storm and San. Located in parking lot) - Approved
2. Note: remove filter bags from catch basin's.
Violation Summary:
Inspector Contractor