Permit ,, CITY OF TIGARD PLUMBING PERMIT
''! le . COMMUNITY DEVELOPMENT Permit #: PLM2011 -00253
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/09/2011
Parcel: 2S101AD03100
Jurisdiction: Tigard
Site address: 6950 SW HAMPTON ST 320
Project: PCC Hampton Square Subdivision: WEST PORTLAND HEIGHTS Lot: PTS 1 -8
Project Description: Interior plumbing: Replacing existing break room sink.
Contractor: BEAVERTON PLUMBING INC Owner: WESTON INVESTMENT CO
13980 SW TV HWY 2154 NE BROADWAY
BEAVERTON, OR 97005 PORTLAND, OR 97232
PHONE: 503 - 643 -7619 PHONE.
FAX: 503 - 643 -7620
FEES
Quantity Description Date Amount
1 ea Lavatories 08/09/2011 $25.02
Specifics: 1 12% State Surcharge - 08/09/2011 $8.70
Plumbing
Type of Use: COM 47 ea Minimum Fee Adjustment - 08/09/2011 $47.48
Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
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: 'ermittee Signature: �—
L_ %/ �i 4,.. ;cLL s�
Call 503.639. 5 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.
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Plum bing 'ermit Application
Building Fixtures it 11 �� 1 ill: i►i 11(' 1 i. �;1: 0.1.‘ City Of Tigard rteceived
• y G P Nn.; r. ��
■ 13125 SW Hall Blvd„ Tigard, OK 972 ' (� 8 Date /lir; p �J 14i /fir / I��'�� 3
�
R , Phone: 503.718.2439 Fax: 503.598.. 1 92 50" 0 2 D nian B` etaBy: Other Permit No.:
Inspection Line: 503.639.4175
I ` Date Ready/By: Juris: el See Page 2 ror
Internet: www.tigard or.gov CITY OF TIGA D Notified/Method:
_` Sup .lcmcntalInformation
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0 ff M! +�09i : t iO!1W�in! 1 , hi nt d ;t V� � � { a l t,. ,y i d ' � �. .te . . (S'�l .x ", i V i' " a ; ern i r, ulN ,J 4'.4.? � 2! I k j1 r ;' ,
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❑ New construction ❑ Demolition For special Infornrarion use checklist
Description I Qty. I Ea. I Total
® Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
'X I " s 11'' ill @I I Vier ' 4ll11al': aiII0S ' riblt, ' ';; 8Fk (1) both I J 312.70
1 -and 2-family dwelling SFR (2) bath 437.78
El y ng ® Commercial/industrial
SFR (3) bath 500.32
❑ Accessory building ❑ Multi - family Each additional bath/kitchen 2$.02
❑ Master builder ❑ Other:
Fire sprinkler ( _ sq. ft.) Page 2
r ;� , , 1 rT mmi pl � �I�JI� I' p i ���� r
�IIIGig� I �� li d � . v ', } r � ' ' t ,r I I i , � It. Il li! I III I ' ' y N ryl' �� , , ' Site utilities:
Job site address: 6950 SW HAMPTON ST. Catch basin or area drain 18.76
Drywall, leach line, or trench drain 18.76
City /State/ZIP: TIGARD, OREGON 97223
Footing drain (no. linear ll.: ) Page 2
Suite/btdgJapt. no.: 320 Project name: HAMPTON SQUARE Ott, Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear ft.: ) Paige 2
Storm sewer (no. linear It; _) Page 2
Water service (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31,27
1 ,i . „ Backwater valve 12..51
G'lntbo s wa sher 25,02
REPLACE EXISTING BREAK ROOM SINK
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
g a I ' "'r '1 EI AN E Expansion tank 12,51
Name: AMERICAN PROPERTY MANAGEMENT Fixture/sewer cap 25.02
Floor drain /floor sink/hub 25.02
Address: 2154 NE BROADWAY
Garbage disposal 25.02
City /State/ZIP: PORTLAND, OREGON 97212 Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12,51
9 A, u lllf Ill,`4 i �Nllitf ° I�Ii! " In
y k q tare optor /grease trap 25.02
w l 1 . i • ' ._u �, N, "n. ,, :. i,lll + 'i'�tld
Bu-ei M e di ca l gas (va $ ___..... Page 2
nexx name: BEAVERTON PLUMBING,
Primer 12.51
Contact name: CASEY S'I'EPHENS
Roof drain (commercial) 12.51 •
Address: 13980 SW TUALATIN VALLEY HWY Sink /basin/lavatory 1 25.02
City /State/ZIP: BEAVERTON, OREGON 97005 Solar units (potable water) 62,54
Phone: (503) 643.7619 Fax: : (503) 643.7620 'tub/shower /shower pan 12.51
E -mail: ISIue(1)beavertonplumbing.eom Urinal 25.02
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II '.i "PiJil'I, djl, f nr lViil W�PII 96 Water Cl09et I , 25.02
Water heater 37.52
Business name: BEAVERTON PLUMBING, INC Water piping/MY 56.29
Address: 139130 SW TUALATIN VALLEY HWY Other: 25.02
City /State/ZIP: BEAVERTON, OREGON 97005 Subtotal
Phone: (503) 643.7619 Fax: (503) 643.7620 Minimum permit fee: $72,50 72.50
CCB Lic.: 12889 Plumbing Lie. no.: 34-4PB Plan review (25% of permit fee)
Authorized signature: l �I1 � State surcharge T (12% L ERM PERMIT PE 8.70
��' `�.�R_SLC . 1 TOTAL PEC2Ml'1' FEE 81-20
Print name: SUSAN DEAN Date: 8/8/2011 This permit application expires if a permit is not obtained within ISO days
otter it has been accepted us complete.
"Pee methodology set by Tri -County Building industry Service Board.
19 a141ldan5U 'crnilte\PLMU- Paradulpp.duc 10101/09 440-4616T(10 /02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2- Supplemental Information
Fee Schedule: Residential Fire Suppression Sstenis:
4 itinr*FootArgr.
Footing drain - 1" 100 50.03 L 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 Sistems:
Water Service - each additional 100' 37.52
Storm 1k 1-fain Drain - 1st 100' 62.54
$1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 37 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 tbr
" !p
,'.!!'n?,171+7101MgilifkkriNileVri each additional $100.00 or fractim thereof, to
and including $10,000,00.
Inspection of existing plumbing or for $10,001.00 to $25,060:00 $14850 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
Reinspeetion Fees 90.00/hr and including $50,000.00.
Additional plan review fitr 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
Plan review i
*tiiii.Pertermeti: is required for any of the following. "
Baptistry/Font Please check all that apply.
0
Bath -Tub/Shower Any now commercial building with water service 2" and
-Jacuy4i/Whirlpool greater, except systems designed and stamped by licensed
- Car Wash -Each Stall engineer.
_Drive 0 New exterior plumbing site utilities for any complex structure
as defined in OAR91R-780-0040.
Cuspidor/Water Aspirator
Dish washer - Commercial Medical gas and vacuum systems for health care facilities.
-Domestic 0 Any multipurpose fire sprinkler system.
Drinking Fountain Li Any complex structure as defined in OAR918-780-0040.
Eye Wash
-
Floor Drain/sink - 2" Submit 2 sets of plans with any of the above.
Car Wash Drain
Garbage -Domeatio-non-food
0 isometric or riser diagram is required for new buildings
that meet the qualifications above.
Disposal -Domestic-food related
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig. Drains
Oil Separator (Gas Station) Comments regarding fixture work:
Rec. Vehicle Dump Station
Shower -Gang
- Stall 1
Sitilc/Lav -Non-food related
- Bradley
-
-Commercial-food related
-Service
Swimming Fool Filter
*Note: If the fixture work under this permit Washer - Clothes t results in an
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:
http://www.ligtu-d-or.gov/city,,.hall/dcpartncnts/cd/docs/PLMF-PcnnitApi2doc