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Permit (38) CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit#: PLM2019-00125 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 s 4 Date Issued: 03/27/2019 Parcel: 1S1260000300 Jurisdiction: Tigard Site address: 9753 SW WASHINGTON SQUARE RD D02 Project: 85C Bakery Subdivision: None Lot: None Project Description: Landlord work Interior plumbing: Capping(9)2"floor drains/sinks, (2)sinks,and (1)water closet and(2)water heaters; Installing 30 ft.of water service and(1)water meter. 3/29/19: REPRINTED to include(1)capped clothes washer. Contractor: MODERN PLUMBING Owner: PPR WASHINGTON SQUARE LLC 11120 SW INDUSTRIAL WAY PO BOX 847 TUALATIN, OR 97062 CARLSBAD, CA 92018 PHONE: 503-691-6166 PHONE: FAX: 503-691-6771 FEES Quantity Description Date Amount 30 If Water Service 03/27/2019 $62.54 Specifics: 14 ea Fixture/Sewer Cap 03/27/2019 $350.28 25 Misc Other Fee 03/27/2019 $25.02 Type of Use: COM 1 12%State Surcharge- 03/27/2019 $52.54 Class of Work: ALT Plumbing Type of Const: Occupancy Grp: Stories: Total $490.38 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: 'ermi ee Signature: /� ..G' GSC ���/ :07/ Call 503.639.4175 by 7:00 a.m.for the next available inspection date. "_`o 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. oh CITY OF TIGARD PLUMBING PERMIT . COMMUNITY DEVELOPMENT Permit#: PLM2019-00125 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/27/2019 TIGARD 9 Parcel: 1S1260000300 Jurisdiction: Tigard Site address: 9753 SW WASHINGTON SQUARE RD D02 Project: 85C Bakery Subdivision: None Lot: None Project Description: Interior plumbing for a new bakery:Capping(9)3"floor drains/sinks, (2)sinks,and(1)water closet, and(2)water heaters; Installing 30 ft.of water service and(1)water meter. Contractor: MODERN PLUMBING Owner: PPR WASHINGTON SQUARE LLC 11120 SW INDUSTRIAL WAY PO BOX 847 TUALATIN, OR 97062 CARLSBAD, CA 92018 PHONE: 503-691-6166 PHONE: FAX: 503-691-6771 FEES Quantity Description Date Amount 30 If Water Service 03/27/2019 $62.54 Specifics: 14 ea Fixture/Sewer Cap 03/27/2019 $350.28 25 Misc Other Fee 03/27/2019 $25.02 Type of Use: COM 1 12%State Surcharge- 03/27/2019 $52.54 Class of Work: ALT Plumbing Type of Const: Occupancy Grp: Stories: Total $490.38 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: 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 Biilding Fixtures FOR OFFICE USE ONLY Received > City of Tigard ,y,/ f Permit No.: L-- ` 11111 14 g H I V �1 ate/ evie 3 'l'✓/r ( %7✓T 9 2J9 U i 5 13125 SW Hall Blvd.,Tigard,OR 97223 • Phone: 503.718.2439 Fax: 503.598.1960 DateBy: Other Permit No.: 6:416;),c)/L 0.4)9.7 T 1 c n R D Inspection Line: 503.639.4175 Date ReadyBy: Juris: ® See Page 2 for Internet: www.tigard-or.gov MAR 2 6 2019 Notified/Method: -c. Supplemental Information 0 New construction ❑aluilliDING DIVISION 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) *E t t SFR(1)bath 312.70 ❑1-and 2-family dwelling ®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 t S t ! t t F Site utilities: Job site address: ' SW WASHINGTON SQ,SPACE DOl Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:TIGARD,OR 97223 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name:85C BAKERY CAFE 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.:30') 1 Page 2 & $1/ Subdivision: Lot no.: Fixture or item: Backflowreventer 31.27 Tax map/parcel no.: 5-. 1 .,1 "N�p. p Backwater valve 12.51 F' Clothes washer 25.02 LANDLORD WORK-INSTALL 1-1/2" COPPER WATER LINE TO SPACE Dishwasher 25.02 FROM MAIN IN CEILING. SUPPLY AND INSTALL WATER METER. CAP Drinking fountain 25.02 OFF EXISTING WASTE PIPING Ejectors/sump 25.02 Expansion tank 12.51 Fixture/sewer cap R5 25.02 37. Name: Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 I Interceptor/grease trap 25.02 Business name:MODERN PLUMBING CO Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:DON GEORGE Roof drain(commercial) 12.51 Address:11120 SW INDUSTRIAL WAY,BLDG 9-3 Sink/basin/lavatory 25.02 City/State/ZIP:TUALATIN,OR 97062 Solar units(potable water) 62.54 Phone:(503)691-6166 Fax::(503)691-6771 Tub/shower/shower pan 12.51 E-mail:DON@MODERNPLUMBING.US Urinal 25.02 Water closet 25.02 t A ` Water heater 37.52 Business name:MODERN PLUMBING Water piping/DWV 56.29 Address:11120 SW INDUSTRIAL WAY,BLDG 9-3 Other:WATER METER 1 25.02 25.02 City/State/ZIP:TUALATIN,OR 97062 Subtotal „74, Phone:(503)691-6166 Fax:(503)691-6771 Minimum permit fee: $72.50 CCB Lic.:87906 Plumbing Lic.no:34-250PB Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: 01 TOTAL PERMIT FE , ' , (�"i) Printname:DON GEOKIiNif '////C Date:3/26/19 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 I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) J Accumulative Sewer Tally II . Tenant Name: SWR# TIGARD Site Address: 9753 SW Washington Square Rd D02 PLM# Parcel#: 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 0 0 0 0 Drinking Fountain 1 0 0 0 0 0 Eye Wash 1 0 0 0 0 0 Floor Drain/Sink: -2 inch 2 9 0 9 (0 0 0 0 0 I g -3 inch 5 0 0 0 0 0 -4inch 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: -Lav/Bar-Non-Food Related 2 7 0 1 l!�`r 0 0 0 0 -Bradley 5 0 0 0 0 0 -Com/ServkM .Food-Related 3 1 0 1 (3) 0 0 0 0 3 Swimming Pool Filter 1 0 0 0 0 0 Washer-Clothes 6 1 0 1 ( ) 0 0 0 0 (, Water Extractor 6 0 0 0 0 0 r Water Closet-Toilet 6 1 0 1 /14 0 0 0 0 (p Urinal 6 0 0 0 0 0 Previous EDU Count 19 0 0 Capped EDU Credit 19 3s- 0 TOTALS 0 0 0 0 0 0 0 0 Current Fixture Value 0 divided by 16= 0.000 Current EDU 1 EDU= $5,650.00 Previous Fixture Value 0 divided by 16= 0.000 Previous EDU a, t/e,vti,6 Change 0 divided by 16= 0.000 over (under) $ - 4 Enter EDU Change Here 0.000 * *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: 1 Restroom with 1 toilet and 1 lay; 6 other hand sinks(non-food); 1 utility sink(non-food); 9 floor sinks; 1 dishwasher Authorized Name/Signature: Date: 03.04.19 Building Division IN ote: 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_070118.xlsx 111 Accumulative Sewer Tally C Tenant Name: 85C BAKERY SWR# N/A TI G n R n Site Address: 9585 SW WASHINGTON SQUARE RD PLM# 2019-00125 REVISED Parcel#: 1 S 1260000300 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 16 0 0 0 0 0 Drive through Cuspidor/Water Aspirator 1 0 0 0 0 0 Dishwasher: -Commercial 4 0 0 0 0 0 -Domestic 2 0 0 0 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 9 18 0 -9 -18 -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: -Lav/Bar-Non-Food Related 2 0 1 2 0 4 -2 -Bradley 5 0 0 0 0 0 -Com/Sere/Util-Food Related 3 0 1 3 0 -1 -3 Swimming Pool Filter 1 0 0 0 0 0 Washer-Clothes 6 0 1 6 0 -1 -6 Water Extractor 6 0 0 0 0 0 Water Closet-Toilet 6 0 1 6 0 -1 -6 Urinal 6 0 0 0 0 0 Previous EDU Count 0 0 Capped EDU Credit 0 TOTALS 0 0 13 35 0 0 -13 -35 Current Fixture Value -35 divided by 16= -2.188 Current EDU 1 EDU= $5,650.00 Previous Fixture Value 0 divided by 16= 0.000 Previous EDU Change -35 divided by 16= -2.188 over (under) $ (12,373.50) Enter EDU Change Here -2.190 * *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: ***CREDIT*** 3/29/19 CHANGED FLOOR DRAINS/SINKS FROM 3"TO 2"AND ADDED(1)CAPPED CLOTHES WASHER. Authorized Name/Signature: BRANDEN TAGGART X2449 Date: 3/27/2019 Building Division IN ote: 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_070118.xlsx