Permit CITY OF TIGARD PLUMBING PERMIT
1111 COMMUNITY DEVELOPMENT Permit #: PLM2013 00231
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/18/2013
Parcel: 2S 101 AC01600
Jurisdiction: Tigard
Site address: 7100 SW HAMPTON ST 130
Project: Mainlander Cafe Subdivision: BEVELAND NO.2 Lot: 18 -19, P
Project Description: Add (1) 3 compartment sink, (1) prep sink, (1) hand sink, (1) floor sink (1) grease trap & (1) ejector pump.
Contractor: DETEMPLE COMPANY INC Owner: NEIMEYER, JOHN
1951 NW OVERTON ST 15 82ND DR STE 210
PORTLAND, OR 97209 GLADSTONE, OR 97027
PHONE: 503 - 227 -2641 PHONE:
FAX: 503 - 274 -7686
FEES
Quantity Description Date Amount
1 ea Ejectors /Sump 07/18/2013 $25.02
Specifics: 1 ea Floor Drain /Floor Sink/Hub 07/18/2013 $25.02
1 ea Interceptor /Grease Trap 07/18/2013 $25.02
Type of Use: COM 3 ea Sink 07/18/2013 $75.06
Class of Work: ALT 1 12% State Surcharge - 07/18/2013 $18.01
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $168.13
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct ques ' NC by calling 503.232.1987 or 1.800.332.2344.
Issued B : •, Permittee Sign re: �[�J
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
JUL /03 /2013 /WED 02:42 PM FAX No, P. 002
Plumbing Permit AppliL; 41''. Site Utilities - .. �� FOR Orrlc ;r. US ONLY
City of Tigard i (JI 3 2013 Date/13 : 2 5 / 3 eJ/ /c/ 5-o0; 5/
' 1 � 2 I Pe No.: I
a 131 SW Hall iilv Tigaz OR 9 3
i ll
° Phone: 503,718.2434 Fax: �.�Q$ I ,� • ,�D Plan Review L h2 946-x/57
" p ( Date/By: Other Permit No • a
T i GARD Inspection Line 503 639 417 Dale Rend /9
1ntemet WWW tigald oC go ; Y Y /LA.: S See Page 2 for
�1 i l� A'� is Notified/method; Su lemcutniinform
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, New �,., - yti -_-� a,4�� +_�.. � .a s , �2_- ,1: �� ri � ;�,, , � ^, u _ .. rr Vii, six' :Z
construction ❑ Demolition For special in1ormotion use checklist.
Description I Q(Y. I Ea. I Total
® Addition/alteration/replacement ❑ Other; New 1 - 2- family dvvellings� includes 100 It for each utility connection)
z . �.
kf'G zt_Zi� U5 df= u. ^n � , ?,� * ` SFR(1)bath 31270
❑ 1- and 2- family dwelling E Commercial /industrial SFR (2) bath 437.78
1=1 Accessory building ❑ Multi - family SF'It (3) bath 500.32
❑ Master builder Each additional bath /kitchen 25.02
❑ Other: •
[ , s c E' ryW, y,t T Fire sprinkler ( sq. ft.) Page 2
r •A l k " ,, •4j flKil t xse ti . r N14 i �W - d.° - t � r. - 4 Site u -
Job site address: 7100 SW Hampton Catch basin or area drain 18.76
City /State /ZTP: - Tigard OR 97223
Drywell, leach line, or trench drain 18.76
Footing drain (no. linear ft.: ) Page 2
Suite /bldg. /apt. no.: 130 I Project name: 4 44-7,4--7i,-/ Manufactured home utilities 50:03
Cross street/directions to jab site: aH. fezi- 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.: ) Page 2
Subdivision: Lot no,; Fixture or item;
Tax map /parcel no.: , 6/0 / 4 C.1 ® //RO0 Bacicflow prevc» ter 31.27
`� i s Backwatcrvalvc
•∎• ' 7- d G !in zgi s • i y6.i e,� , ^ r x K t . ` 12.51
rn . _ �szo��: --- •- �'re..i. z:_�_ %, . Clothes washer 25.42
Add 3 compartment sink, prep sink, hand sick, floor chain, grease trap, and
Dishwasher 25.02
ejector for cafe remodel Drinking fountain 25.02
Ejectors /sump 1 25.02 25.02
-, it - '
f , :1 _ ✓ 6. :3 a [ , = f ��,`ti `rr +a- �x p 12.51
Ex an
Name: Mainlander Investments Fixniro /sewer cap 25.02
Address: 310 SW 4"', Suite 512 Floor drain/floor suck /hub 1 25.02 25.02
Garbage disposal _ 25,02
City /State /ZIP: Portland OR 97205 !lose bib 25.02
• Phone: (503)650 -9500 Fax: ( ) Ice maker 12.51
c' � �Ea� ` 1 �F� .
t , ` etiT ' 3 i`+ 7 i g2 t Interceptor/ grease
e d,, � ,tzr--r ..nom -�. ,: } ' " rr7 �.. B trap • 1 25.02 2t.02
Business name: DeTemple Company, Inc. Medical gas (value: $ �) Page 2
Contact name; David Pile
Primer 12.51
Roof drain (commercial) 12.51
Address: 1951 NW Overton St Slick /basiNlavato
ry 3 25,02 75.06
City /State/ZIP: Portland OR 97209 Solar units (potable water) 62.54
Phone: (503) 227 -2641 Fax; : (503) 274 -7686 Tub /shower /shower pan 12.51
. E -mail: j- prabucki @detemple.com Urinal 25.02
c. x s. ue--- wr °tips Water closet 2
9k - _ ... 4 +, ° i t r fr3 1 T {� # , ' 5.02 • 1 _ - - ._, � � W . �. „ -. •� 5- -: -- Water heater 37.52
Business name: Same as Applicant Water piping/DWV 56.29
Address: Other:
25.02
City /State /ZIP: Subtotal 150.12
Phone: ( ) Fax ( ) Minimum permit fee: $72.50
CCB Lic.: 2510 412-V Plan review (25% of permit fee)
Plumbing Lie. no.: 26 -25P13 1 11114
State surcharge (12% of permit fee) 18.01
Authorized signature: TOTAL. PERMIT FEE 168.13 ) ,VI
Print name: " - , of u Date: 07/03/13 This permit application expires if a permit is not obtained Within t80 days
nttor it has been accepted as complete.
"Fee methodoleby set by Tri- County Building Industry Service hoard.
1:113ui lding \Permits \PLM U- Per,n;LAph Aoo I 40 i /09 440- 4616T(1 n/021CUM /WEB)
JUL/03/2013 /WED 03:22 PM FAX No, P.001
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Su • • ression S stems:
T
-�,� •+e� ip [I Il i ,,5l . ,_. 6iy a : , .tX 7 i, ! l[ " fit 1 t l i, _ � } r an j 4 k . .f r
,..... "` z _. --. .. _urn - 1,... � .] - - __ 1 - - .. . .. , , . ,'r�
....:
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 00 $23320 •
Sewer - 1st 100' 62.54 7.201 and - -eater $327.54
Sewer - each additional 100• 37.52
Water Service - 1st 100' 62.54
Medical Gas S stems:
Water Service - each additiona1100' 37.52
�r u[ � C pj.t.. Oi F � j rl v .� ! + ' Z �
Storm & Rain Drain - 1st 100' 62,54 . •z. .: _ -<--- - - - -,_, i
$1.00 to $5,040.00 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
,,,;,, _,:., J ,w : " i - + . ,yN -..:._ I E .N. ii �... µ„ - each and including $10 000.00.
00.00 or fraction thereof, to
and includng $10
Inspection of existing plumbing or for : 510,001,00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
which no fcc is specifically indicated 90.00/hr each additional $100.00 or fraction thereof, to
(minimum chat :e -12 hour and includin • $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 char. e - 2 hours each additional $100.00 or fraction thereof, to
Reinspection Fees _ 90.00/hr 111111 and includin • $50 000.00.
_ _ _Additional plan review for revisions 90.00 /br III. $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
(minimum eh: e -12 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 *.
}, A SJ .t La3j 1(d ;. ri J - l , 1 , J iG J... ."'v ✓1
9l a f.. 4 2 } ar I i • r j l °�t i i i l' i u , J
Plan review is required for any of the following.
+
;M1 , r i� ; t Y ,r r aL _L }� a'ai fl
k
B -.t;s /Font
==
Please check all that apply.
Bath -Tub /Shower - -- ❑ Any new commercial building with water service 2" and
- Jacuzzi/Whirl. . .1 _ -- greater, except systems designed and stamped by licensed
Car Wash -Each Stall - -- engineer.
- Drive Thm - -- ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water As .irator - -_ as defined in OAR918- 780 -0040.
Dishwasher - Commercial ❑ Medical gas and vacuum systems for health care facilities.
- Domestic -_=MI ❑ Any multipurpose fire sprinkler system.
Drinking Fountain 111111111111 -- ❑ Any complex structure as defined in OAR918 -780 -0040.
E e Wash IMIIIIIIIIIM
Floor Drain/sink - 2" - EN_- Submit 2 sets of plans with any of the above.
3„ - - -_
y �� J1 ,
Car Wash Drain -�� . : ti i _ t - - - s s w . . { . 2 f�U ° ^:.:::.L-.. ,: { M ? , . 1 , ' : / _J 1 � ?_ .. .,. -- ._ ---
Garbage -Domestic-non-food
OMNI • Isometric or riser diagram is required for new buildings
Disposal - Domestic -food related that meet the . uali rCations above.
- Commercial -food related M
- Industrial -food related - --
Ice Macb./l.efii_. Drain - --
Oil Separator Gas Station Comments regarding fixture work:
Rec. Vehicle Dump Station
Shower -Gang 1111111111111111111111111111
-Stall - -- -
Sink/Lav - Non -food related (
-Bradley - --
. - Commercial -food related - 2.
-Service - --
Swirnmin • Pool Filter - --
Washer - Clothes *Note: If the fixture work under this permit results in an
Water Extractor - increase of sewer I;DUs, 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: - -
C: \Users \dpyle \Desktop \Plumbing Permit Apps\PLMF- PermitApp.doc 2
Accumulative Sewer Tally
' Tenant Name: Commerce Plaza Deli * *CREDI'T'S ** SWR # N/A
Site Address: 7100 SW I Iampton #130 PLM # 2013 -00231
Parcel #: 2S1 01 AC01600
Fixture Value Previous Previous Credits Capped Fixture Fixture New New
# value count capped #s \ alue 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 0 0 0 0
- 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
Oil Sep (Gas Station) 6 0 0 0 0 0
Rec. Vehicle Dump station 16 0 0 0 0 (I
Shower: - Gang (per head) 1 0 0 0 0 0
- Stall 2 0 0 0 0 0
Sink:
- Lay/Bar - Non-Food Related 2 0 0 0 0 0
- Bradley 5 0 0 0 0 0
- Com /Sery /Util - Food Related 3 0 0 3 9 3 9
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 (I 0 0 0
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0.75 12
TOTALS 0 0 0 0 3 9 3 -3
Current Fixture Value -3 divided by 16 = -0.188 Current EDU 1 EDU = $4,800.00
Previous Fixture Value 0 divided by 16 = 0.000 Previous EDU
Change -3 divided by 16 = -0.188 over (under) $ (912.00)
Enter EDU Change Here -0.190
Notes: Per CWS Rates & Charges: 2" floor sink not included in calculation as the 3- compartment sink drains into it
7/18/13, credits from PLM2013 -00237 applied to this permit. Credit balance of .19 available for future
Authorized Name /Signature: Debbie Adamski Date: 7/8/2013
Building Division
N ote: The property owner shall retain the ORIGINAL sewer tally record. If credits exist, this document will serve as a voucher which must be
r ote:
to the City of Tigard Building Division to redeem credits towards future system development charges.
I: \Building \Sewer Tally \SewerTallySheet_4800._0701 l3.xlsx
JUL /03 /2013/WED 02:41 PM FAX No. P.001
DI TENIPLE PLUMBING- HEATING -AIR CONDITIONING-BOILERS
Since 1895
• COMPANY,INC "t510 •
www detemple.com Honeywell Building Control Specialist
24 HR EMERGENCY SERVICE
Fax
TO: Permits FROM: Julie Prabucki
FAX: 503 -598 -1960 PAGES: 3
PHONE: 503 - 718 -2439 DATE: July 3, 2013
RE: Permit Application
❑ Urgent a For Review ❑ As Requested ❑ Please Reply ❑ Please Recycle
Comments: Following this cover sheet, please find a permit application and credit card
authorization form,
Please fax the permit back (503 - 274-7686) or email it to j.prabucki @detemple.com.
If you need anything additional, please let me know.
Thank you,
Julie Prabucki
Construction Administrator
DeTem pie Company
D: 503 -471 -5272 F
O: 503 - 227 -2641
F: 503 -274 -7686
Coast Service Area
Portland O„ fficed: Salem Officai: Astoria to Maaaanitn -. ,Neba/enz to Tillamoole
503/227 -2641 • FAX: 503/274 -7686 503/585 -7567 - FAX: 1-503/274-7686 503/738-4313- FAX: 503/738 -5662 503/436-1750- FAX: 503/738 -5662
• Mailing Address For All Offices:1951 N.W. Overton 5t. • Portland, OR 91209