Permit CITY OF TIGARD PLUMBING PERMIT
m: COMMUNITY DEVELOPMENT Permit#: PLM2020-00515
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/29/2020
Parcel: 2S101AD03500
Jurisdiction: Tigard
Site address: 6600 SW HAMPTON ST
Project: PacTrust Subdivision: WEST PORTLAND HEIGHTS Lot: None
Project Description: 400 ft.of water service.
Contractor: WESTERN PLUMBING Owner: PACIFIC REALTY ASSOCIATES
9460 SW TIGARD AVE SUITE 101 ATTN: N PIVEN
TIGARD, OR 97223 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-639-5296 PHONE:
FAX: 503-684-9015
FEES
Quantity Description Date Amount
400 If Water Service 12/29/2020 $175.10
Specifics: 1 12%State Surcharge- 12/29/2020 $21.01
Plumbing
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $196,11
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 or 1.800.332.2344.
Issued By:A01 -7P Permit[ee 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 AppliclI CEIVED E- 12/15120
Site Utilities I I)14 (Ill If,- I `.I. OBI.,
2020 Received
DEC 1 5
City of Tigard DatelBy l �aZj/dZ.0 Permit No.: It r )ge"A, (c"
• 13125 SW Hall Blvd..Tigard.OR 97223 plan Resiew /'"
r,'II • Phone: 503.718.2439 Far503. p1iiy6@F TIGARD Dale/By: Other Permit No..
Inspection Line: 503.639.4175 i3UILDING DIVISION Dale Ready/By: ur 0 Seep e2for
'f iiAli.i1
Internet: irww.tigard-ocgos' Notified/Method: Suppkmental Information
TYPE OF WORK FEE" SCHEDULE
❑New construction ❑Demolition For special information use checklist.
Description I Qty. I Ea. I Total
VI Addition/alteration/replacement ['Other: New I-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ I-and 2-family dwelling Ilg Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
O Master builder 0 Other: Fire sprinkler(_sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:Work) `Ne f,�t 7q� S Catch basin or area drain 18.76
�� ^ '"- Doting leach line.or trench drain 6
City/State/'LIP: L
Footing drain(no.linear R.: ) Page 2
Suite/bldg./apt.no.: Project name: /k,�i-s-S' - _ 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.i / Page 2 115 7y: t6
Water service(no.linear R.: (41) Page 2 /-2,-;-: lc
Subdivision: Lol no.: Fixture or item:
'fax map/parcel no.: Backtlow preventer 31.27
Backwater valve 12.51
DESCRIPTION OF WORK
n\(� Clothes washer 25.02
-
`N(Z tX (.Ol�l dt '..A 1k ,Y aca vvtSL, Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER { 0 TENANT Expansion tank 12.51
Fixture/sewer cap 25.02
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
t 1 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name 1�11 )(x(t �m �yt(� 1$ Medical gas(value:$ ) Page 2
r� J� x
1 Primer 12.51
Contact name'.O r yx�� - t/��� Roof drain(commercial) 12.51
Address: Cidtk JCS -S \"t. `SLL ‘0, Sink/basin/lavatory 25.02
City/State/ZI'. q , lilt� p4-la Solar units(potable water) 62.54
1 O -gj.i^1-1 Tub/shower/shower pan 12.51
Phnnc'l ) k .I"I Pax: :l )
I:-mail:/+Q.t1 ..( ) 3ynr("�ItyyS y\C \\C Nyyn Urinal 25.02
c^ \""`�- `\J Water closet 25.02
` CONTRACTOR Water heater 37.52
Business name1\�@Q yc�y�b it N\rne s Water piping/DWV 56.29
Address: / `r'r r�,' rn 1 ! A^Lr�9 1 el' . - u •I Other: 25.02
City/State/ZlP:"� , •��ol d'J Subtotal 7} IC
Phone:( )ti�r�( (p Fax:( I
Minimum permit fee: $72.50
���qPlumbing �� ^� Plan review (25%of permit fee)
C'C'B i.ic.: c/`f 4 Lic.no.. 1/
s State surcharge(12%of permit fee) �,d)
Authorized signature: 11 TOTAL PERMIT FEE , 0('(Ir,ii
Print name s YV t� Det¢:I a+15126 This permit application
it has been accepted as complete.rmit is not obtained within 180 days
J-� •Fee methodology set by Tri-County Building Industry Service Board.
I'llnddm8Wermds`PLMi.'PermeApp doe tlll)i vrr 44N61t,TI 10,o2POxl WEB)
Plumbing Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee: •
Footing drain-I" 100' 50.03 0 to 2,000 $121 90
Footingdrain-each additional 100' 37.52 2A01 to 3.600 S 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-tst 100' % 62.54 iio Ts Medical Gas Systems:
Water Service-each additional 100' 13 37.52 11rxC44, Valuation: Permit Fee:
Storm&Rain Drain-I sl 100' 62.54 $I.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 ' Fee(ea) Total each additional$100.00 or fraction thereof to
and including$10.000.00.
Inspection of existing plumbing or for $lftu l0(1 to$25000.00 $148.50 for the first$I0.000.IN1 and$1.54 for
rohtch 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 $25001.00 to$50.000.00 $379.50 for the first$25.000.00 and S I.45 for
hours(minimum charge-2 hours) each additional S100.00 or fraction thereof.to
Reinspection Fees 90 00fir and including$50.000.00.
Additional plan review for revisions 90.00/hr $50.00100 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: M,1C:b
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*. �� "•.
Quaandq by Fixture Type Plan Review for Plumbing IttstallaltoaS
Fixture Type for Replace/ Plan review is required for any of the following.
Work Performed: Capped Added Relocate
Baptistry/Font Please check all that apply.
Bath Tub/Shower ❑ Any new commercial building with water service 2--and
-Jacuzzi/Whirlpool greater.except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru D 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.
Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040.
Use Wash
Floor Drain/sink -T" Submit 2 sets of plans with any of the above.
-3"
Isometric or Riser Diagram
Car Wash Drain
Garbage -Domestic-non-food ❑ Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach/Rcirig.Drains •
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/lav -Non-food related
-Bradley
-Commercial-food related •
-Service
Swimming 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
I:\Building\Permits\PLM tl_PemtitApp.doc 2
Branden Taggart
From: Branden Taggart
Sent: Tuesday, December 29, 2020 8:08 AM
To: 'Dana@westernplumbinginc.com'
Subject: PacTrust Water Service Permit: PLM2020-00515 - 6600 SW Hampton St.
Attachments: Invoice.pdf
Hi Dana,
The water service Plumbing permit for PacTrust, located at 6600 SW Hampton Street, is ready to issue now. The balance
due is$196.11, and I have attached an invoice above for you to reference. The permit fees can be paid online through
our website: https://aca.accela.com/tigard/Default.aspx. From there, click on the Building tab, enter the permit
number(PLM2020-00515) in the Record Number field, and click Search. Once paid, please notify us at
TigardBuildingPermits@tigard-or.gov, and we will email the permit paperwork to you.
Thank you,
Branden Taggart
III a City of Tigard
11;« Senior Permit Technician
Community Development
TIGA. D
13125 SW Hall Blvd
Tigard, OR 97223
(5031718-2449
brandent@tigard-or.gov
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