Permit (93) CITY OF TIGARD PLUMBING PERMIT
INI2 COMMUNITY DEVELOPMENT Permit#: PLM2018 00249
T t GA i?D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/23/2018
Parcel: 1 S 1260000300
Jurisdiction: Tigard
Site address: 9473 SW WASHINGTON SQUARE RD A08
Project: Jamba/Cinnabon Subdivision: None Lot: None
Project Description: ADD(1)2"floor sink and(1)3"floor sink;RELOCATE(1)2"floor sink and(1)grease interceptor
Contractor: PLUMBING CONCEPTS INC Owner: PPR WASHINGTON SQUARE LLC
PO BOX 1068 PO BOX 847
CLACKAMAS, OR 97015 CARLSBAD, CA 92018
PHONE: 503-658-5232 PHONE:
FAX: 503-658-5232
FEES
Quantity Description Date Amount
3 ea Floor Drain/Floor Sink/Hub 05/23/2018 $75.06
Specifics: 1 ea Interceptor/Grease Trap 05/23/2018 $25.02
Type of Use: COM 1 12%State Surcharge- 05/23/2018 $12.01
Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $112.09
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: ;. Permittee Signature:
I I 6j/ti pz-/ ('( 771,\ /
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 Fixtures E(;ENED
FOR OFFICE USE ONL1
City of Tigard MAY 2 3 2018.74 RDeactee/iBveyd:..5,Ag „f1
aied0(194- Permit No/941-Xpoicf-.7)(962.V.9
14 13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.5980re OF TIGARD Plan Review
Other Permi64W/Ze9exf,-O01913
BUIs 1,,,i,k Date/By:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: Juris. Vi See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK '''...„„ % :. ,FEE, ScREDUtefi
LIDING DIVI LPN
CI New construction 0 Demolition For special information use checklist.
Description I Qty. I Ea. I Total
( .Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
''' ` SFR(11 bath 312.70
CATEGORY OF CONSTRUCTION .-• 1:--;: :i:z9,' , bath 312.70
0 1-and 2-family dwelling Commercial/mdustnal SFR(2)bath
SFR(3)bath 500.32
0 Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
;?5:: •ti,6,, 0B SIT. INFORMATION AND LOCATION -..,,‘, Site utilities: -
Catch basin or area drain 18.76
Job site address: 7"-/73 s Lk.) (A.)pck,„4_5-to A ' 1 Drywell,leach line,or trench drain 18.76
City/State/ZIP:
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: 1 Project name:
:-.. --A r-kbilk /&r4 IN PrbOrNi Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
UL\1Pk. ki VC.J.-6 A 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: I Lot no.: Fixture or item:
Backflow preventer 31.27
Tax map/parcel no.:
Backwater valve 12.51
DEkitwooiv
oN iRK .
- - -,.- -.- ' Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER El TENANT Expansion.-..,, E sion tank 12.51
.'':-41;i; 4 'o..,•-•014,.4
Fixture/sewer cap 25.02
Name:
- Floor drain/floor sink/hub 325.02 75,efr,
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
El4i6i( -1-C-',- ' '' ..74' 0 CONTACT PERSON Interceptor/grease trap i 25.02 P-3, 0.2,...
7 1:'...W- -' P. .0,
o
Business : e -L;-----
Med Medical gas(value:$ ) Page 2
ov efri
Primer 12.51
Cf5rA edi`erep, z.ce,74-40
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02
nam :
City/State/ZIP:
Fax::( ) Solar units(potable water) 62.54
Phone:( ) Tub/shower/shower pan 12.51
A."3 / J Urinal 25.02
E-1110L-70/t-L 44- /1 Ce1/1% 25.02
Water heater 37.52
-r---)
Business name: -t I 0,_..x. b ( .......7 (i7 1-N 1(2-6-CC+S .-1-16.-- Water piping/DWV 56.29
Address: pc,-) ---:-. ..)x K.) „,..,BOther: 25.02
City/State/ZIP:City/State/ZIP: /,' ,&di ..___e_ -- 70 V / Subtotal /00,Of
Minimum permit fee: $72.50
Phone:(„4-53)(c>S33 S"--2 2 Fax:( )
Plan review (25%of permit fee)
CCB Lic.: 1 7 s73 7 Plumbing Lic.no.: 3 _2_1-33:13
State surcharge(12%of permit fee) /..1,, 0/
Authorized signature: TOTAL PERMIT FEE A
Print name: .) __,._<__c& 2.A,,,,, 1...,j 1 0 Date: 4723///3 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.
1.\Building\Permits\PLMU-PerrnitApp doc 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:
'Re Uti•lities r qty• Fey ) ' Tonal S4towtf0o* e: -Permit -gee;
Footing drain-ls`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
lv-Storm&Rain Drain-1st 100' 62.54 Valuation , Permit Fee:
$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
Fee euoYal '' each additional$100.00 or fraction thereof,to
Cher Ins a 6 s Fees Qty. _° (e
�w ?Ti : 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*. Plan.'°„ !'K.:41i C.`. umbing Inst.T.:ationS
Quantity by Fixture TypePlan review is required for any of the following.
Future Type for Reply ' Please check all that apply.
Work Performed: Capped Added Reigate
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
Car Wash: -Each Stall ❑ New exterior plumbing site utilities for any complex structure
Drive as defined in OAR918-780-0040.
I:Cuspidor/Water Aspirator 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 Drai sink: -2" �:.
3" ! `b.:- gid, r. •serPtag.ram
0 Isometric or riser diagram is required for new buildings
-Car Wash Drain
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
-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
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9473 SW WASHINGTON SQUARE RD A08, June 25, 2018 at 9:13:29 AM
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2018-00249
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor