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Permit (112) CITY OF TIGARD PLUMBING PERMIT ,1114 . ' COMMUNITY DEVELOPMENT Permit#: PLM2018-00487 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/17/2018 Parcel: 2S103DD01100 Jurisdiction: Tigard Site address: 13939 SW PACIFIC HWY Project: Providence Retail Clinic Subdivision: None Lot: None Project Description: ADD(2)service sinks for new tenant. Contractor: ADVANCED TECHNOLOGY GROUP Owner: WALGREEN CO#5780 455 SE 2ND AVE PO BOX 901 HILLSBORO, OR 97123 DEERFIELD, IL 60015 PHONE: 503-693-9202 PHONE: FAX: 503-640-4333 FEES Quantity Description Date Amount 2 ea Sink 10/17/2018 $50.04 Specifics: 22 Minimum Fee Adjustment- 10/17/2018 $22.46 Plumbing Type of Use: COM 9 12%State Surcharge- 10/17/2018 $8.70 Plumbing Class of Work: ALT 1 ea Investigation Fee 10/17/2018 $90.00 Type of Const: 1 ea Investigation 12%State 10/17/2018 $10.80 Occupancy Grp: Surcharge Stories: Total $182.00 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. Yo 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: , / A . L. di ' Call 503.639.4175 by 7:00 a.m.for the next available insp-ction date. This permit card shall be kept in a conspicuous place on the job site u it completion of the project. Approved plans are required on the job site at the time of each inspection. Plumbing Permit Application Building FixturesFOR OFFICE USE ONLY City of Tigard R -l'il Ili ik Q s �` Date y::/'6 ",. ff Permit N9pl.H 7/rf�Qd If7 lig • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ,/_" Phone: 503.718.2439 Fax: 503.598.1960 p ,,2�I � (plate/By: ateBy: Other Permi /� /�e � Inspection Line: 503.639.4175 I j[ 1, 1 �.U I`Date Ready/By: Duds: Bf See Page 2 for �° TIGAItHg Internet: www.tigard-or.gov Notified/Method: Supplemental Information l ebhIlI1I TYPE `y OiR .- CT ti g A rAl4 '!'9' �iplEEE* S , otiP' '''' - � U , I�INII+gIIIPIJ ,4.. - ,„,,„,,,,a„„,,,,,.,,. : , , wY q14. . - fu : . � 1- ❑ ❑ �r�y �r i For special information use checklist. New construction Der itiD PING DA 1.,,t h,.'9. ^ Description I Qty. I Ea. I Total ®Addition/alteration/replacementi" III Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) � 11 j( 11W:. O GO1t"Y OF CONSTRUCTION _ jjdli) SFR(1)bath 312.70 ❑ 1-and 2-family dwelling Z Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building ❑Multi-family Each additional bath/kitchen 25.02 ❑Master builder ['Other: Fire sprinkler( sq.ft.) Page 2 a�,a,;;' 4 w.E'�-- iii i ,-.�- °� i )1 1OB',`SITE INFO.IRMA'plON-AND 1.O AtIOI 05:' ' Site utilities: Job site address: 13939 SW Pacific Highway Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard/Oregon/97223 ?1/t tt /41)14 at w. Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name,; ' Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 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: Tax map/parcel no.: Backflow preventer 31.27 11•1101"--;''''''''' - p ' DE-'''''''''''''''4"''''' }iiiTQN OF WOo�� ,,,;-,i,11111,9,19$-,',.'- Backwater valve 12.51 tW o „ F. : ii''' Clothes washer 25.02 Installation of new two new sinks rZitki Dishwasher 25.02 I I I -.4:0P f'� ' - 1L_,/ //ii pz r"I Drinking fountain 25.02 /" f Ejectors/sump 25.02 RI Ir :I'ROPERT.' QWNER '�� ?. :. - L ❑ TE° ;NT I1,1II�1N1. Expansion tank 12.51 Name:Providence Health&Services-OR Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25,02 Address:4400 NE Halsey,Building 2,Suite 190 Garbage disposal 25.02 City/State/ZIP:Portland/OR/97213 Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 ` 2( APPrT ANT` -'W3-,4):4,,,,,..i . - ,�Iti❑. oNTAtT PERS - Interceptor/grease trap 25.02 Business name:Advanced Technology Group,Inc. Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:Michael Hudson Roof drain(commercial) 12.51 Address:455 SE 2"d Avenue Sink/basin/lavatory 2 25.02 50.04 City/State/ZIP:Hillsbobo/OR/97123 Solar units(potable water) 62.54 Phone:(503)545-0249 Fax::(503)640-4333 Tub/shower/shower pan 12.51 E-mail: michaelh@atgweb.com Urinal 25.02 P, ' igH 2 1,6ONT1 ACTOReW �rnfN Water closet 25.02 ,ogo,1 . - 991 ! 4Cu�. .,,,,94.,6,-,.- � P-- .., � A Water heater 37.52 Business name:Advanced Technology Group,Inc. Water piping/DWV 56.29 Address:455 SE 2"d Avenue Other: 25.02 City/State/ZIP:Hillsboro/OR/97123 Subtotal 50.04 Phone:(503)693-9209 Fax:(503)640-4333 Minimum permit fee: $72.50 702,Spry CCB Lic.:130364 Plumbing Lic.no.:34-399PB /N����6.fini �� 41 State surcharge(12%of permit fee) cp. -70 Authorized signature: TOTAL PERMIT FEE /17¢2,Gre Print name:Michael Hudson Date:10/11/18 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. C\Building\Permits\PLMU-PermitApp.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: Site Utilities = Qty. Fee ca) Total Sgjiarc eet ge.R nidi' i''' Permit Fee: R n 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 ' . � � ��y:�� b„��� u�;" •+ Val latlOr : PermitF; i g01�u 6 tii dou 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 -77 Other Ins ections'or Fees Qty, Fee(ea) Total each additional$100.00 or fraction thereof,to h 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: Other Fixtures: 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 Fixture Type for Replace! ' Plan Re 0fClP111 IngiIniti d 1UnS WarkFerformed• Capped AddedRelocate :! Baptistry/Font Plan review is required for any of the following. Bath Tub/Shower Please check all that apply. Jacuzzi/Whirlpool ❑ Any new commercial building with water service 2"and Car Wash -Each Stall greater,except systems designed and stamped by licensed -Drive Thru engineer. Cuspidor/Water Aspirator ❑ New exterior plumbing site utilities for any complex structure Dishwasher -Commercial as defined in OAR918-780-0040. -Domestic ❑ Medical gas and vacuum systems for health care facilities. Drinking Fountain ❑ Any multipurpose fire sprinkler system. Eye Wash ❑ Any complex structure as defined in OAR918-780-0040. Floor Drain/sink -2" 3" Submit 2 sets of plans with any of the above. -4" Car Wash Drain °; d�'i6 v9�� `�i�i�i���� {-r Garbage -Domestic-non-food I'IC flr RIset 1 1'"d Disposal Domestic-food related ❑ Isometric or riser diagram is required for new buildings -Commercial-food related that meet the qualifications above. -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Rec.Vehicle Dump Station Comments regarding fixture work: Shower -Gang ATG's scope of work was the installation of two clinic sinks -Stall Sink/Lay -Non-food related 2 and faucets.All other plumbing work was performed by -Bradley by others. -Commercial-food related -Service Swimming Pool Filter Washer-Clothes *Note: If the fixture work under this permit results in an Water Extractor Water Closet-Toilet increase of sewer EDUs,a sewer permit will be issued and Urinal fees assessed for the sewer increase must be paid before the \\atg-nas\FDrive\ATG Job Folder\_MRH Jobs\_In Progress\MRH180070_2Valsh_Providence Express_051118\17- Permits\PLMFPermit 101118.doc Dianna Howse From: Branden Taggart Sent: Thursday, October 11, 2018 11:34 AM To: Don Sylvester Cc: #Building Permit Technicians;Walter Barnett Subject: Providence Retail Clinic: PLM2018-00301 - 13939 SW Pacific Hwy Attachments: Branden Taggart.vcf Hi Don, I spoke with Michael Hudson from Advanced Technology Group regarding the interior plumbing work at the Providence Retail Clinic for(2) new sinks that were added, and this work was in fact completed without a permit. I will be adding an investigative fee of$100.80 to their permit once we process it. The remaining work that you noted at the plumbing final inspection for PLM2018-00301,for(2)water heaters and (1) hub drain,was completed by Cascade Plumbing. I just wanted to let you know that a second plumbing contractor was involved. Thanks, Branden Taggart * City of Tigard Mr Senior Permit Technician Community Development tQ 13125 SW mall Blvd Tigard,OR 97223 (503}718-2449 brandent tigard-or.gov DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained by the City of Tigard in compliance with the Oregon Administrative Rules"City General Records Retention Schedule." 1 Branden Taggart From: Branden Taggart Sent: Thursday, October 11, 2018 11:19 AM To: 'Michael Hudson' Cc: #Building Permit Technicians Subject: RE: Building permit application: Providence Retail Clinic - 13939 SW Pacific Hwy. Attachments: Branden Taggart2.vcf Thank you, Michael. Please allow 2-3 business days for processing. We will contact you when the fees are ready to be paid online. The fees will be as follows: Plumbing permit: $81.20 Sewer permit: $1,412.50 Investigative fee for work without permit: $100.80 Total: $1,594.50 Thank you, Branden Taggart q. City of Tigard II a° Senior Permit Technician Community Development MARA 13125 SW Hall Blvd Tigard„OR 97223 (503}718-2449 brandent@tigard-or.gov From: Michael Hudson [mailto:michaelh@atgweb.com] Sent:Thursday, October 11, 2018 10:53 AM To: Branden Taggart<brandent@tigard-or.gov> Cc:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Subject: RE: Building permit application: Providence Retail Clinic- 13939 SW Pacific Hwy. Branden, Here is the revised, signed, application, thanks. Best Regards, Michael Hudson, PMP Project Manager 455 SE 2nd Avenue, Hillsboro, OR 97123 M. 503.545.0249 michaelh a(�atoweb.com atgweb.com 1 From: Branden Taggart<brandent@tigard-or.Rov> Sent:Thursday, October 11, 2018 10:37 AM To: Michael Hudson <michaelh@atgweb.com> Cc:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Subject: RE: Building permit application: Providence Retail Clinic- 13939 SW Pacific Hwy. Hi Michael, Thank you for the application. However, per our conversation, (1) hub drain and (2) water heaters will also need to be added to the scope of work—if your company installed them. If Cascade Plumbing installed these fixtures,then you do not need to add them to this permit. As previously stated, we need you to complete the Commercial Fixture Work section on the second page. Lastly,we will need you to sign the permit application before we can proceed. I will be adding an investigation fee for work without a permit, and this fee will be $100.80. Please let me know if you have questions. Thanks, Branden Taggart it City of Tigard lo �" Senior Pernit Technician Community Development TIGARD 13125 SW Hall Blvd Trgard,OR 97223 (5031718-2449 bra ndent r-,tigard-or.gov From: Michael Hudson [mailto:michaelh@atgweb.com] Sent:Thursday, October 11, 2018 10:24 AM To:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Subject: Building permit application Brandon, Attached is the plumbing permit application for the Tigard Express Care Clinic I called you about.ATG's scope included installation of two each clinic sinks and the faucets, we did not do anything with hub drains.All other plumbing work was performed by others (see PLM2018-00301). Please let me know if there are other questions,thanks. Best Regards, , Michael Hudson, PMP I Project Manager 455 SE 2nd Avenue, Hillsboro, OR 97123 M: 503.545.0249 michaelh(a,atgweb.com atgweb.com /4\`1 1., G ,._, ,„, .. 2 . -- DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requemhad, e-mail may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained by the City of Tigard in compliance with the Oregon Administrative Rules"City General Records Retention Schedule." 3 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13939 SW PACIFIC HWY, TIGARD, OR, 97223 October 18, 2018 at 9:26:11 AM Record Type: Record ID: Commercial - Plumbing PLM2018-00487 Inspection Type: Inspector: 399 Plumbing final Aaron Cillo-Gobel Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor