Permit (9) CITY OF TIGARD PLUMBING PERMIT
INI2 COMMUNITY DEVELOPMENT Permit#: PLM2018 00286
Date Issued: 06/13/2018
T I(;ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 15135BD00100
Jurisdiction: Tigard
Site address: 9600 SW OAK ST, STE#200
Project: Cascade Management Subdivision: ASHBROOK FARM Lot: 5
Project Description: Plumbing fixtures for TI: CAP(2)dishwashers and(4)break room sinks;ADD(2)dishwashers,(2)break room
sinks,(2)garbage disposals,(2)ice makers,(2)primers,(2)water heaters and(2)hub drains for water heaters.
Contractor: JAMES ROOD PLUMBING INC Owner: PLAZA WEST OWNER LLC
125 S 1ST AVE#542 BY CHIEF FINANCIAL OFFICER
HILLSBORO, OR 97123 680 FIFTH AVE 20TH FL
NEW YORK, NY 10019
PHONE:
PHONE: 503-547-0491
FAX: 503-547-0492
FEES
Quantity Description Date Amount
2 ea Dishwasher 06/13/2018 $50.04
Specifics: 6 ea Fixture/Sewer Cap 06/13/2018 $150.12
2 ea Floor Drain/Floor Sink/Hub 06/13/2018 $50.04
Type of Use: COM 2 ea Garbage Disposal 06/13/2018 $50.04
Class of Work: ALT 2 ea Ice Maker 06/13/2018 $25.02
Type of Const: 2 ea Primer 06/13/2018 $25.02
Occupancy Grp: 2 ea Sink 06/13/2018 $50.04
Stories: 2 ea Water Heater 06/13/2018 $75.04
1 12%State Surcharge- 06/13/2018 $57.04
Plumbing
Total $532.40
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.
c —
Issued By: 404 A Permittee Signature: eiivr /9-70/01.,./(../ c,
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.
Pfumbin2 Permit,A DPIiC2tii"t �\�
Building Fixtures �"t
Received yet_/`!ad/44 4viir2F�
City 0)F Hall
BI J L N 1 1 20'18 Date/By:GA.3 (d Permit N
IN ■ 13125 SW Mall Blvd Tigard,OR 97223 Plan Review
Ill
Phone: 503.718-2439 Fax: 503.5Jli OF IGARD Date/BY; oilier Penhiit No.:
Inspection Line: 503-639.4175 BUILDING DIVISION Date Ready/By
T1GA1 D urs. I �eoi lInformat2 for ion
Internet: www.ttgard•or.gav , . ,.......
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Otltled/1�I
Demolition r secialinformationuse checklist
❑New construction _ Description E Qty. E Ea. I Total
a Addition/alteration/replacement ❑Other. New 1-2.-family dwellings(includes 100 ft.for each utility connection)
�C iu:': 1Y k':r:r;,!..r ,.r,�k+:ry4 wf,; •rSYL9 Jlidll,a _v, e:Lyi:;t"r `.';My�j'i5=:i. ai .''' _SFR(1)bath I 312.70
:;li �n,'�91,:,« 11gf efn retti,o `9 6 ' '1'1�° y
,..I"lii�lf"a' :?. . ..vi+,t+ i �w t. ?k? �,,.� t•C. 1!1411 iH!�'.• `'4�1
E] 1-and 2-family dwelling I Commercial/industrial
SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building El Multi-family Each additional bath/kitchen 25.02
.
ElMaster builder ❑Other: Fire sprinkler( sq.ft.) Page 2
=' :',:;,r;!;•!-;�.:_, j•y,,: ;a''' i : �� ;,i: �1 ,riir�'��ii(4;1'!;i ';alt :; t utilities:
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... ,,.. :�:;,. �..-.''' � �ii ��� a. � q:at::.;!;i r�'a14 �R_; Site
� 1I� yyryry
.,:,;r(�?...:, .;..i. r: uy�,:,'!� !7`��� ,. :e.,;. ,��•�. !r�;�ii;l::p{.).Tglq'�x'31a{'ittli'r�iue"!�,�-i;$swr..,". a drain 8,76
5' i"rl s,: I nr Catch basin or are I
Job site address: sop j, oat t-
Orywell,leach line,or trench drain 16.76
City/State/ZIP: ' 1 tz s ,. 0 t✓- 4 7,x.-2 7 Footing drain(no.linear ft.:_) Page 2
al 1dg./apps.no.:moo I Project name:ascoote se )S Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
r
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft:_) f Page 2
Water service(no.linear ft.; ) I Page 2
Subdivision: l Lot no.: Fixture or item: . -
Backflow preventer31.27
Tax map/parcel n0-: •
,:.//..... .2 ,'•- -
AulT'!
.i.l.'' 12.51
1, .,� l ':;' „ ?yi1,.11rr:• S � � ' Y ,, :k:,,r• i�1ts:e: ^ dii=na1 , Backwater valve
, -
.!�,. .:;..i. ,{i' ;,;r{(; S5i-J1 '-� . •. u,. d'iL4.0, 1i :�I x �nFx4atf-Irlt{ clothes washer 2$.02
ti► C r Each aaid. ddit ,y
fi3cai..o& ', an 13,051 tC j Drinking fountain N 25.02
Ejectors/sump 25.02
...,,,,...,..-.;Me., ..,,- - r..,, ftin !r 4, , 5 Expansion tank 12.51 /5e, (.7-
, ,.„;;;,;
�
na- .' ti' u Fixto eewer Cap (40 jor 25.02 !w'��' $If
t.
Name:
Floor drain/floor sits ub )-- 25.02 .ro.aii
Address. Garbage disposal „' '� Z. 25.02 ,c,)-v./City/State/ZI P: l-lose bib 1�1�er 25.02
Phone:( ) Fax:( ) Ice maker ?j 1231 a.5.0
I
.lig
r,i;:74;1iie. 3 ;y11 1i'i;,t$iii1i vn:a17t1 it ' n'dt ►;. , Y�::1: 9 '•th[41. Interceptor/grease trap
2502
Medicalgas(value;$ )
Page 2
Business name:
Primer 12.51 25-..0
Contact name: - 12.51
Roof drain(commerciaq
Address: Sink/basin/tavatory a- 25.02 ,
City/State/ZIP: �- Solar units(potable water) 62.54 Se 41
1
Phone:( ) ( Fax::( ) Tub/shower/shower pan 12.51
_Urinal 25,02
E-mail: Is" ►'27G /A.fl•-• W a A x rµI r 6-f/'v�. Water closet M 25,02
:a;;n.,gli! i',,res';��,.,.i..,ft.: prn ...1h ?',trr^'':M3Sa!',? 191g fl -..icE., .irA?: ri -
1{%i:':' " 1.1.y, .:1.i' ::7�d'i f :+.a' ',4b N: •'141au1.,.i '"+ ', ,t i.`�,•r,:
4� �'s,`�Ff{• ' ��:. ,�Ir'` +• ,. �%, �:a 'els-,:,�;:�!�:r :Yl,r�kS4^>:a��r:Nl:i�.f..r lt,,,r water heater � 37.52 �S.��
.�i4';a;i,�;lr'"�!�;�a!„1;, i':i:,h`(:11 i';i;.i,.{"':o$a f� +,d
Business name: i b. .. • • •••t . Water piping/DWv 56.29
Address: ,, �.r - ' _ y Other: 25.02 y
Subtotal City/State/ZIP: ,'lb .-a .-y 0 y„ ,' ,")# Minimum permit fee: $72.50
Phone:(cS� ) 77 -"a 9 9 Fax:(Sb ) 5y7p t94/92i
Plan review (25%of permit fee)
CCB Lic.: ia. `7r Plumbing Lic.no.: �� State surcharge(12%of permit fee) 52,0t
, �'.Authorized Signature: „,,,. 53�,',
TOTAL PERMIT FEE re
r ,r/ This permit application expires if a permit is not obtained within 180 days
Print name: 1P�A�elIC Date: after a has here accepted as complete,
*Fee methodology set by Tri-County Building Industry Service Board.
Bil3uurling1PermicaLMt1-PermitAppdoc 10/01/09 440'4616T(10102/COM./'E5)
Plumbing Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Su es Systems:
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�� �'.l;f 1 ,40.1}4. . �!� _ �tid, .n1M .L�,151-� , t, ,... 1; _. a,t k�:-:3.
Footing drain-1°100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 30600 $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 1, M .M i 1 .r f,y , x y y iY y'v it
Storm&Rain Dram-1st 100' 62.54 $1.00 to$ 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
;�f ,{p a u each additional$100.00 or fraction thereof,to
r.,1.titlii'1i�'ki •'' ;?.',, 'I' ":+"�t6r! � `JN3li•'i'i L-Ljn' 1�=> ' �`:
�.IN�GR° �,�; RHY'LT ^� .�..:r".Z� ` ,,,. i :��i ���� ��,kl p,� •,�* and incluain:$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
jminimum char, e-1/2 hour) _ i 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.
Additlonat plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
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
accurately report fixtures could resultincreasedsewer fees*. r:„
in "
id`• ,tl tttl`B!, .nl I' iw ` •' e j " P ur5{� 'yam, f l } ' t C I E •' IC''ix.
., ,i.„.*:ri g�t .. ^,''- �f �'t :`I- ', i1�.� i,s 11 r I w i�s I ,`I II ,„
Ir. '1..11• „�.4 t.^:k '4 W,1111M „pa.�1E�a.eGR'rr S.n. iM
^ -,; ii ' < ,':; ;,� .. p;° Re a ofthe following.
-:�►xtut•.r.:fi'yp�ittl>I �.�,! ,',;., '�I�: �:,,a.„y,'•`4i - '� 1��r""`; Plan review is required for any g-
i' �bt .I:. ,(print _�,,.,..' Ti'..,.. 1? , ....L.�.�.. ....c3`.-.1.,,
;.W �l�pi;r •s�i::�:r:,-_a,l Rl.i:�l` ,ii.�.,1.. ...lad.., ; , ..�..�:•;.
Santis !Font Please check all that apply.
❑ Any new commercial building with water service 2"and
Bath -Tub/Shower
- i/whirlpool greater,except systems designed and stamped by licensed
-Car Wash -Each Stall engineer.
-Drive Thru ❑ 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.
Drinkin_Fountain ❑ Any complex structure as defined in OAR918-780-0040.
_e Wash -
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
-3" `` '/ {Ili cls ,11 '",-Y.� • .;-.0,•,-.,p'! ,,. u { , •,.,�tix_ F;,.
-Qn M/_ i W {.'� ° ��� . ,,,, 7e,u I .:1f s 1•.P 4T.,;;.. i1 JB 1-: 1'j,iiw -! } .e,.
Car Wash Drain p j5 4 _
Garbage -Domestic-non-food ❑ isometric or riser diagram is required for new buildings
�� A;�
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related .
-Industrial-food related - _,
Ice Mach-/Refri_.Drains
Oil Se.arator Gas Station Comments regarding fixture work:
Rec.Vehicle Dump StationA4d, as &i,iv _.s puha 9
Shower -Gang - ke0
-Stall _ J
Sink/Lav -Non-food related 14 ,
-Bradley -. _
-Commercial-food related _
-Service
5wimmi-Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes
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\iim\Downloads\PLMF_PerrnitApp(24).doc 2
= Tenant Name: Cascadeulativ'PIe Sew
ccumulative Sewer Tally SWR# N/A
T 1 G n K D Site Address: 9600 SW Oak St,Suite 200 PLM# 2018-00286
Parcel#: 1 S135BD00100
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 2 4 2 4 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 0 0 0
-3 inch 5 0 0 0 0 0
-4 inch 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 4 8 2 4 -2 -4
-Bradley 5 0 0 0 0 0
-Com/Sery/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 0 0 0
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 6 12 4 8 -2 -4
Current Fixture Value -4 divided by 16= -0.250 Current EDU 1 EDU= $5,500.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change -4 divided by 16= -0.250 over (under) $ (1,375.00)
Enter EDU Change Here -0.250 *
*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: ***EDU CREDIT***
Authorized Name/Signature: Dianna Howse Date: 6/13/2018
Building Division
Note: 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:
9600 SW OAK ST STE 200, TIGARD, OR, 97223 October 31 , 2018 at
12:07:04 PM
Record Type: Record ID:
Commercial - Plumbing PLM2018-00286
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor