Permit (68) 11111 {
CITY OF TIGARD PLUMBING PERMIT
' ' COMMUNITY DEVELOPMENT Permit#: PLM2019-00238
1
=
T I r'RL 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/10/2019
2S115BA02600
' Jurisdiction: Tigard
Site address: 16230 SW PACIFIC HWY 140
Project: Spec Space Subdivision: 2004-015 PARTITION PLAT Lot: 2
Project Description: Landlord interior plumbing prior to TI:Capping(5)2"floor drains/sinks,(2)3"floor drains/sinks,(7)sinks,and(1)
water closet.
Contractor: GRIDLINE PLUMBING Owner: SN PROPERTIES PARTNERSHIP
14844 SW 109TH AVE 1121 SW SALMON ST
TIGARD, OR 97224 PORTLAND, OR 97205
PHONE: 971-275-6167 PHONE: 503-450-0806
FAX:
FEES
Quantity Description Date Amount
15 ea Fixture/Sewer Cap 06/10/2019 $375.30
Specifics: 1 12%State Surcharge- 06/10/2019 $45.04
Plumbing
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $420.34
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: -e
ern
•
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.
CITY OF TIGARD PLUMBING PERMIT
' COMMUNITY DEVELOPMENT Permit#: PLM2019-00238
TL RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/10/2019
Parcel: 2S 115BA02600
Jurisdiction: Tigard
Site address:
Project: Spec Space Subdivision: 2004-015 PARTITION PLAT Lot: 2
Project Description: Landlord interior plumbing prior to TI: Capping(5)2"floor drains/sinks, (2)3"floor drains/sinks,(7)sinks,and(1)
water closet.
Contractor: GRIDLINE PLUMBING Owner: SN PROPERTIES PARTNERSHIP
14844 SW 109TH AVE 1121 SW SALMON ST
TIGARD, OR 97224 PORTLAND, OR 97205
PHONE: 971-275-6167 PHONE: 503-450-0806
FAX:
FEES
Quantity Description Date Amount
15 ea Fixture/Sewer Cap 06/10/2019 $375.30
Specifics: 1 12%State Surcharge- 06/10/2019 $45.04
Plumbing
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $420.34
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 1- 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 oi,-in a copy of the rules
or direct questions to OUNC by calling 503.232. 2.2344.
Issued By: Permittee Signature: e CI Irr/4*
Call 503.639.4175 by 7:00 a.m.for the next available i ,%cti, 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 FOR OFFICE LSE Oyl.v
Cityof Tigard Received //�� _ �
g v�a Date/By: it)J�cJ '�y Permit No.: �LM�I cJ'�' c3
li � 13125 SW Hall Blvd.,Tigard,OR 97223 �` �✓""/l
_ �°G Plan Review
Phone: 503.718.2439 Fax: 503.598 �'�VDate/By: Other Permit No. /AQy7,1t _ ,
Inspection Line: 503.639.4175
T 1 C.A R 1) 4 a Za\g Date Ready/By: Juns gi See Page 2 for
Internet: www.tigard-or.gov k\,,M Notified/Method: Supplemental Information
❑New construction 0 Den; G,D,vls� {�1 For special information use checklist
N Description Qty. I Ea. Total
Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ I-and 2-family dwelling Iiiii .is is- cial/industrial SFR(2)bath 437.78
buildingSFR(3)bath 500.32
❑Accessory 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE.INFORMATION AND LOCATION ' Site utilities:
Job site address: ` Catch basin or area drain 18.76
/ ,Z 30
� � ��` Drywell,leach line,or trench drain 18.76
City/State/ZIP: 7,---)6 _-- y 7'.7 7
dFooting drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.:
Project 1 „ .-
/ name: /f / �� Manufactured home utilities 50.03
Cross street/directions to job site: _j - ,S/ C. anholes 18.76
7- /'�Dr�. �/� 3 1/ 5-- /./ " Rain drain connector 18.76
✓ �?%/ . S /� Sanitary sewer(no.linear ft.: ) Page 2
_ c^.C.� Storm sewer(no.linear ft.:_) Page 2
r///7//4 S Water service(no.linear ft.:_) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: 157 ( j (;+1 Backflow preventer 31.27
Backwater valve 12.51
': :i," t' ION O sr '
,+ Clothes washer 25.02
L� 1 �.: - / v71Z siii? k- ' 1d6 r - Dishwasher 25.02
r/ r
(/1/I11/ i/i S . Drinking fountain 25.02
Ejectors/sump 25.02
w t. t t + 4' I �, . Expansion tank 12.51
Name: Fixture/sewer cap A.3 25.02 '3 75 3•C
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
0 t "'`. ; 0 CONTACT PERsox Interceptor/greasetrap _ 25.02
Medical gas(value:$ ) Page 2
Business name:
Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
t s Water closet 25.02
tea. -
''''' : >` „'...'1'. .. ' `' ' Water heater 37.52
Business name: "� �p � ��//� Water i in DWV 56.29
�Lp i P P P�3,,,
iAddress: /9 `� Other: 25.02 f
City/State/ZIP: / r GjG�I / 977/-1/ Subtotal -�j�j .
Phone:(7 /) .7-5 .- �/1 Fax:( ) Minimum permit fee: $72.50
CCB Lic.: 7 9�(/ Plumbing Lic.no.: W9��! Plan review (25%of permit fee)
State surcharge(12%of permit fee) 115-el
Authorized signature: i TOTAL PERMIT FE di,?0,3d/
Print name: C / Un tiCI�iC Date: /,-/' 9 This permit application expires if a permit is not obtained within 180 days!!
after it has been accepted as complete.
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I:\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 �' ' Qy. FO.(ea) Total Square Footage: Permit Fee:
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 " <'
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
O r Inspections or Fees '" Qty* Fee(ea) " To each includingi $10,l$100.00. or fraction thereof,to
and $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 . 'Nati'Review for PlumJ.lnig Installations
Quantity by Fixttt Type Plan review is required for any of the following.
Fixture Type for Please check all that apply.
Work Performed:, CaPPed Added Relocate
Baptistry/Font
0 Any new commercial building with water service 2"and
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.
hm
Cuspidor/Water Aspirator 0 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 Drain/sink: -2"
3" iSt?Mph f'Rniarillin . '.
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 Z plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
Accumulative Sewer Tally
■
s Tenant Name: SPEC SPACE SWR# N/A
T i c;n►t D Site Address: 16230 SW PACIFIC HWY PLM# 2019-00238
Parcel#: 2S 1 15BA02600
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 0 5 10 0 -5 -10
-3 inch 5 0 2 10 0 -2 -10
-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 0 5 10 0 -5 -10
-Bradley 5 0 0 0 0 0
-Com/Sery/Util-Food Related 3 0 2 6 0 -2 -6
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 1 6 0 -1 -6
Urinal 6 0 0 0 0 0
Previous EDU Countr 0 0
Capped EDU Credit 0
TOTALS 0 0 15 42 0 0 -15 -42
Current Fixture Value -42 divided by 16= -2.625 Current EDU 1 EDU= $5,650.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change -42 divided by 16= -2.625 over (under) $ (14,859.50)
Enter EDU Change Here -2.630 *
*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:
Authorized Name/Signature: BRANDEN TAGGART X2449 Date: 6/10/2019
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_070118.xlsx
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
16230 SW PACIFIC HWY 140, TIGARD, June 11 , 2019 at 1 :35:14 PM
OR, 97224
Record Type: Record ID:
Commercial - Plumbing PLM2019-00238
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor