Permit (92) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2018-00247
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/22/2018
T I'�� °L� g Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9499 SW WASHINGTON SQUARE RD A01
Project: VR Cafe Subdivision: None Lot: None
Project Description: Plumbing fixtures for new tenant: CAP(1)non-food sink,ADD(1)ice machine, (1)2"floor sink,(1)non-food sink
for hand washing,(1)3-compartment food related sink and(1)espresso machine.
Contractor: SUPERIOR PIPE AND DRAIN Owner: PPR WASHINGTON SQUARE LLC
9770 SW SHADY LN PO BOX 847
TIGARD, OR 97223 CARLSBAD, CA 92018
PHONE: 971-246-4271 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Fixture/Sewer Cap 05/22/2018 $25.02
Specifics: 1 ea Floor Drain/Floor Sink/Hub 05/22/2018 $25.02
1 ea Ice Maker 05/22/2018 $12.51
Type of Use: COM 2 ea Sink 05/22/2018 $50.04
Class of Work: ALT 25 Misc Other Fee 05/22/2018 $25.02
Type of Const: 1 12%State Surcharge- 05/22/2018 $16.51
Occupancy Grp: Plumbing
Stories:
Total $154.12
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 ttoo/OUNC by calling 503.232.1987 or 1.800.332.2344.
<( /
Issued By: / - Permittee Si.• 6 �
� 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 Applicatio l
Site Utilities I 0itl( 1 I Ll ()\,I.ti
City of Tigard Received
13125 SW Hall Blvd.,Tigard,OR 97223 MAY 2 2111 Plan Re Date/By: `s iola /LP ° Permit NyP���� -Da.2 y7
ti Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
Date/By Other Permit Ng 'J O 67/ -,00,/%4.--,
_
Inspection Line: 503.639.4175
CITY OF i i f�Ag�
11 f'J i tT B f Date Ready/By: orris: 0 See Page 2 for
Internet: www.tigard-0i.gov } j ��j i(� Notified/Method. Supplemental Information
IJ1NG i.rY YISIO
TYPE OF W FEE* SCNEAUI.E
0 New construction ❑Demolition For special information use checklist
Description
(El-Addition/alteration/replacement ❑Other: py Ea. Total
New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ 1-and 2-family dwellingCommercial/industrial SFR(2)bath 437.78 pr
0 Accessory building ❑Multi-family SFR(3)bath 500.32
❑Master builderEach additional bath/kitchen 25.02
0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: C i ' '9 e i / Catch basin or area drain
i / ) 0 lit' -N 1)�I'"t- o-) ,i 18.76
City/State/ZIP: /2 ar `% l G f� � I�rYwell,leach line,or trench drain 18.76
, F Footing drain(no.linear ft.:_) Page 2 1
Suite/bldg./apt.no.:4_6s, 1 Project name: VI-, 61.( Manufactured home utilities 50.03
Cross street/directions to job site: ---- j�ey j� `in Manholes
r� Y 18.76
(le td' T Rain drain connector 18,76
n
,C,tG' _��j 1c';i,-'TZ-1 �.V C!" Lt / k el-.� Sanitary sewer(no.linear ft.:_) p 2
[ • Storm sewer(no.linear ft.: ) Page 2
., Water service(no.linear ft.: ) Page 2
Subdivision: L Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25,02
/ft7t el
�^
Dishwasher 23,02
/CI ( j1')Gr /6'k- -' Drinking fountain 23.02
(r�T 7k2 p 5'/1/& Ejectors/sump 25.02 w
0 PROPERTY OWNER 0 TENANT Expansion tank 12.51
Name: Fixture/sewer cap 25.02 5. 0,=.2...
Address: Floor drain/floor sink/hub 25.02 .0 0-e_
City/State/ZIP:
Garbage disposal 25.02
Hose bib 25.02
Phone:( ) Fax;( ) Ice maker
f 12.51 ,Z.. r.
0 CONTACT PERSON Interceptor/grease trap 25.02
ess name: IfaLC l c /,„?L,O i. n Medical gas(value:$ ) _ 2
/ / Gs'� `� c '�lt.�
Primer
12.51
Contact name: CL t'1CZ-�' �.�°
/ Roof drain(commercial) 12,51
Address: -7?C S L^- .(li.ii`'/ (.�L,`'- 7 I
Sink/basin/lavatory 0.2 25.02 5-0 Of
City/State/ZIP: t Z` .
/ " / 5% Solar units(potable water) 62.54
-
Phone:(')7/), _q 4-7,72-7/ * Fax::( ) Tub/shower/shower pan 12.51
E-mail: )e '!r`I Cr'Ce �C' E y/C,t,-I-2,e G Yt�'c',et ., n -I--- Urinal 25.02
�
CONTRACTO Water closet 25.02
/ Water heater 37.52
I Business name:
Water piping/DWV 56,29
n Address: Other:
c^�f-t- /z 1 25.02 Z.S. �`
City/State/ZIP: j Subtotal /(Z.y./
Phone:( ) Fax ( ) -77//2-C2_.? Minimum permit fee: $72.50 /�-
y� Plan review (25/o of permit fee) �/ ,
7, I
CCB Lie.: -/ L/'r 3/4,/,,,,„Plumbing Lic.no.:✓ � £L"'/ s
Authorized signatur'
State surcharge(12%of permit fee)
TOTAL PERMIT FEEir
Print name: ?j/L.• Date: 27 /4/ This permit application expires if a permit is not obtained within i D days
I after it has been accepted as complete. /54/. i
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doe 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:
Site Utilities Qt', Fee(as) Total Square Footage: Permit Fee:
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 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
Other Inspections or Fees Qty. Fee(ea) o Total 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 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*.
Quantlty by Fixture Type Plan Review for Plumbing Installations
Fixhire Type Plan review is required for anyof the following.
Work Performed: capped Added Relocate 9
Baptistry/Font Please check all that apply.
❑ Any new commercial building with water service 2"and
Bath -Tub/Shower
dacuzziower pool " greater,except systems designed and stamped by licensed
.,
Car Wash -Each Stall engineer.
-Drive Thru 111 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 ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" . l' V. r3 Submit 2 sets of plans with any of the above.
T. 1-
- Isometric or Riser Diagram
Car Wash Drain ,
`
Garbage Domestic-non-food ❑ 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./R.efrig.Drains
Oil Separator(Gas Station) Co ments regarding fixture work:
Rec.Vehicle Dump Station /V( -,5-/.wry / -;_CO //)/s-/�-/tie-A?" ft,i-v'/C_
Shower -Gang 12)ff'L'f/ toev /2.z<'L�-,-E%2 / e�c/L7
Sink/Lav -Non-food related fi r= ��`v r to/7'664T i,/ /14tCc7- G----
-Bradley _ ies i(2 11..9-C ttrA/‘ i AM IV ii-'c9Z11 // nL '-
EI i,,' i
-Commercial-food related r R (`65- 7- ,4/'--9,A ,t/7t> Z v° G -fZ. S iA/lc_
-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.
Other Fixtures: "
C:\Users\Suzanne\Downloads\PLMU PermitApp.doc 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9499 SW WASHINGTON SQUARE RD A01 ,
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2018-00247
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor