Permit (56) CITY OF TIGARD PLUMBING PERMIT
"1111
COMMUNITY DEVELOPMENT Permit#: PLM2019-00118
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/21/2019
Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9573 SW WASHINGTON SQUARE RD B06
Project: Abercrombie&Fitch Subdivision: None Lot: None
Project Description: Interior plumbing for TI: Relocating (1)2"floor drain, (2)sinks,and (1)water closet; Installing (1)water heater.
Contractor: PMSI LLC Owner: PPR WASHINGTON SQUARE LLC
21195 NW EVERGREEN PKWY#204 PO BOX 847
HILLSBORO, OR 97124 CARLSBAD, CA 92018
PHONE: 503-466-2222 PHONE:
FAX: 503-466-2211
FEES
Quantity Description Date Amount
1 ea Floor Drain/Floor Sink/Hub 03/21/2019 $25.02
Specifics: 1 ea Sink 03/21/2019 $25.02
1 ea Lavatories 03/21/2019 $25.02
Type of Use: COM 1 ea Water Closet 03/21/2019 $25.02
Class of Work: ALT 1 ea Water Heater 03/21/2019 $37.52
Type of Const: 1 12%State Surcharge- 03/21/2019 $16.51
Occupancy Grp: Plumbing
Stories:
Total $154.11
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 • . - 2344.
Issued By: � Permittee Signature: l
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 +wFOR OFFICE* USE (NL}'
City of Tigard RECEIVED ReceivedetePermitNo.:
v 13125 SW Hall Blvd.,Tigard,OR 97223 y 3 a,//l /tee icy ,_eV/if/
It g Plan Review _
Other Permit No y,►.��-��
6 Phone 503.718 2439 Fax 503.598R�(� 1 2019 Date/By: �r�ly �/a'e'er''
TIC ARL) Inspection lin : 5(13.639.4175 ^ 9 DateReady/By: )oris: itii See Page 2 for
Internet: www.tigard-or.gov
CITY OF TIGARD Nonfed/Method. �j �, Supplemental information� � sclrEDULr:
TYPE °P`' 1LD1NG�DIVISION :.
❑New construction 0 Demolition For special information use checklist.
Description I Qty. ( Ea. I Total
►: Addition/alteration/replacement 0 Other: New I-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ 1-and 2-family dwelling A Commercial/industrial
SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02
0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:9573 SW Washington Square Rd. Catch basin or area drain I8.76
Drywell,leach line,or trench drain 18.76
City/State/ZI1': Portland,OR 97223
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.:306 Project name:Abercrombie&Fitch 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.: ) l'age 2
Water service(no.linear ft.:,) Page 2
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Plumbing for TI Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERT%" OWNER 0 TENANT Expansion tank 12.51
Fixture/sewer cap 25.02
Name:
Floor drain/floor sink/hub 1 25.02 25.02
Address: Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
C,4 APPLICANT 0 CONTACT PERSON ."- Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name:PNIS1 LLC
Primer 12.51
Contact name:Brandy Solano Roof drain(commercial) 12.51
Address:21195 NW Evergreen Pkwy.,Ste.204 Sink/basin/lavatory 2 25.02 50.04
City/State/"LIP:Hillsboro,OR 97124 Solar units(potable water) 62.54
Phone:(503)466-2222 Fax::(503)466-2211 Tub/shower/shower pan 12.51
---- Urinal 25.02
E-mail:bsolano u?msi-systems.com
Water closet 1 25.02 25.02
CONTRACTOR Water heater I 37.52 37.52
Business name:PN'S! LLC Waterpiping/DWV 56.29
Address:21195 NW Evergreen Pkwy.,Ste.204 Other: _ 25.02
City/State/ZIP:Ilillsboro,OR 97124 Subtotal 137.60
Phone:(503)466-2222 Fax:(503)466-2211 Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB I._ic.: 158286 Plumbing Lie.no.:34-434PB o
State surcharge(12%of permit fee) 16.51
Authorized signature: qt' S`ry ) TOTAL PERMIT FEE 154.11
(eft This permit application expires if a permit is not obtained within 180 days
C Print name:Brandy Solano Date:3/18/19 after it has been accepted as complete.
"Fee methodology set by Tri-County Building Industry Service Board.
1'\nuildin5d'ermils\PLM1.TPermitApp.doe 10/01./10 440-4616T(t0/02/COM/WEt).
Iw.
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(es) Total Square Footage: ,,'' Permit Fee:
-
Footing dram-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 IOU' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52
Valuation;
'14 Permit Fee:
'‘,1' '
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 n* each additional$100.00 or fraction thereof,to
Fee(e" 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 S50.000.00 $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 fir 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*.
Quantity by Fixture Type Plan Reiriew"for,Plimbing Installations',
,
Fixture Type for Replace/ Plan review is required for any of the following.
Work Performed: Calved Added _ Relocate Please check all that apply.
Baptistry/Font „ 0 Any new commercial building with water service 2"and
Bath -Tub/Shower , greater,except systems designed and stamped by licensed
-Jacuzzi/Whirlpool
Car Wash -I,mch Stallengineer.
0 New exterior plumbing site utilities for any complex structure
-Drive Thru
Cuspidor/Water Aspirator as defined in(MI(918-780-0040.
Dishwasher -Commercial 0 Medical gas and vacuum systems for health care facilities.
.....,
-Domestic 0 Any multipurpose fire sprinkler system.
" 0 Any complex structure as defined in 0AR9 I 8-780-0040.
Drinking Fountain -
Fe Wash -
Floor Drain/sink -2" I Submit 2 sets of plans with any of the above.
-
-,i',, ,•:''.,1e Isometric oritisei-Diagrant,:
Car Wash Drain 0 Isometric or riser diagram is required for new buildings
Garbage -Domestic-non-lbod
Disposal -Domestic-food related .. that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator t(Ias Station). Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related I
-Bradley
-Commercial-food related
-Sereice I
Swimming Pool Filter °Note: If the fixture work under this permit results in an
Washer-Clothes increase of sewer EDUs,a sewer permit will be issued and
Water Extractor
Water Closet-Toilet I fees assessed for the sewer increase must be paid before the
Urinalplumbing permit can be issued.
,
Other Fixtures:
M:\Joh Files\VMSI Jobs\20181 -Abercrombie& Fitch-WA SQ Ivlall\Cit2of Tigard Plumbing Permit App.doc
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9573 SW WASHINGTON SQUARE RD B06,
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2019-00118
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor