Permit (78) ., CITY OF TIGARD PLUMBING PERMIT
1 . a COMMUNITY DEVELOPMENT
Permit*: PLM2017-00391
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/27/2017
Parcel: 2S101AD03500
Jurisdiction: Tigard
Site address: 6600 SW HAMPTON ST
Project: Farmers Insurance Subdivision: WEST PORTLAND HEIGHTS Lot: None
Project Description: Replace existing plumbing fixtures for tenant improvement: (1)backflow preventer,(1)dishwasher,(2)drinking
fountains,(1)expansion tank,(3)2"floor drains,(1)garbage disposal,(1)ice maker,(2)primers,(13)non-food
related sinks,(19)water closets,(2)tub/shower,(2)urinals,(1)water heater.
Contractor: BEAVERTON PLUMBING INC Owner: PACIFIC REALTY ASSOCIATES
13980 SW TV HWY ATTN: N PIVEN
BEAVERTON, OR 97005 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-643-7619 PHONE:
FAX: 503-643-7620
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 09/27/2017 $31.27
Specifics: 1 ea Dishwasher 09/27/2017 $25.02
2 ea Drinking Fountain 09/27/2017 $50.04
Type of Use: COM 1 ea Expansion Tank 09/27/2017 $12.51
Class of Work: ALT 3 ea Floor Drain/Floor Sink/Hub 09/27/2017 $75.06
Type of Const: 1 ea Garbage Disposal 09/27/2017 $25.02
Occupancy Grp: 1 ea Ice Maker 09/27/2017 $12.51
Stories: 2 ea Primer 09/27/2017 $25.02
2 ea Sink 09/27/2017 $50.04
11 ea Lavatories 09/27/2017 $275.22
2 ea Tub/Shower/Shower Pan 09/27/2017 $25.02
2 ea Urinal 09/27/2017 $50.04
19 ea Water Closet 09/27/2017 $475.38
1 ea Water Heater 09/27/2017 $37.52
1 12%State Surcharge- 09/27/2017 $140.36
Plumbing
Total $1,310.03
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.
dal
Issued By: 400— 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.
' From:Beaverton Plumbing 5036437620 09/25/2017 11:33 #360 P.001/002
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Plumbin• Permit A s s licatio 1
Building Fixtures (JE
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WTI and p 2 b 7 Received 1,/,,2 7/'7 ��CI'/ Permit No�/i&0 i•7-/�° ?i
a 33125 SW Flalt Blvd,T'igard.OK 972 Plan Review ..
It Phone: 503.718 2439 Fax: 503.5,9,8,1,9p0,-.„ r11"x Date/By. Other Permit tia/'i:c►/7
htspecnan Line.: 503 639.4175 (al I - i 1-� Date Ready/By. --� ions Cn See Page 2 for
TIGARb g eczi "1!�J F'ho',,\, Information
Internet: yyu�yv.tigard-or.gov 33,IH �I��-1 �dlV1n y Notifted'7Nathod: Supplemental
. TYPE OF WORK I FEE* SCHEDULE ,
Demolition For special information use checklist.
❑New construction-- 0 j Description Qty. 1 Ea I Total
l
0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
• CATEGORY OF CONSTRUCTION ] SFR(I)bath I 312.70
❑ I-and 2-family dwelling ® ! SFR(2)bath 437.78 Commercial/industrial i
SFR(3)bath 500.32
❑Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other: ` Fire sprinkler 1_•sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Catch basin or area drain 1 18.76
Job site address:6600 SW IIAMPTON STREET { (-µ
Drywell,leach line,or trench drain I 18.76
City/State/ZIP:TIGARD,OREGON -
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name:FARMERS INSURANCE-Tl Manufactured home utilities 1 50.03
Cross street/directions to job site: Manholes ___ 18.76 --
i
W Rain drain connector 18.76
Sanitary sewer(no.linear 1t.: ) Page 2
Storm sewer(no.linear fl.: ) I Page 2
Water service(no.linear It.: 1 Page 2
Subdivision: Lot no.: Fixture or item:
- _- Backflow preventer 1 31.27 31.27
Tax map/parcel no.:__
o.:
Backwater valve 12.51
DESCRIPTION OF WORK --
Clothes washer 25.02
COMPLETE REMODEL OF COMMERCIAL BUILDING Dishwasher 1 25.02 25.02
Drinking fountain 2 25.02 50.04
____._-_.___-__ Ejectors/sump 25.02
0 PROPERTY OWNER 0 TENANT. • Expansion tank 1 12.51 12.51
- Fixture/sewer cap 25.02
Name:
Floor drain/floor sink/hub3 25.02 75.06
Address: - Garbage disposal 1 25 02 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 1 12.51 12.51
® APPLICANT ►� CONTACT PERSON Interceptor/grease trap 25.02 --
Medical gas(value:$_) Page 2
Business name:BEAVERTON PLUMBING INC
_ Primer 2 1251 25.02
Contact name:JACKIE STEWART •
Roof dram(commercial) 12.51
Address:13980 SW TUALATIN VALLEY HW'Y __ Sink/basin/lavatory Ii 1-4-VS" 13 25.02 325.26
City/State/ZIP:BEAVERTON,OREGON �_ Solar units(potable s&cr ' C`�r7 62.54
Phone:(503)643-7619 X106 Fax::(503)643-7620 Tub/shower/shower pan 2 12.51 ! 25.02
Urinal 2 25.02 50.04
E-mail:jackie(upbeavertonplumbing.com
Water closet 19 25.02 I 475.38
CONTRACTORWater heater 1 37.52 37.52
Business name:BEAVERTON PLUMBING INC 3 Water piping/DWV 56.29
Address:13980 SW TUALATIN VALLEY HWY Other: j 25.02
i City/State/ZIP:BEAVERTON,OREGON 97005 Subtotal 1169.67
i503 643-7620 Minimum permit fee: $72.50
Fax:
Phone:(503)643-7619 X106 (- )
l Plan review (25%of permit fee)
1 CCB I_:ic.:12889 I Plumbing Lic.no.:34-4PB - -- o,
State surcharge(12ro ol'pemtit fee) 140.36
Authorized signalyr L S(a!L, ,u,1 TOTAL PERMIT FEED 1310.03
(uejinc �J I Date:09/22/2017 I This permit application expires if a permit is not obtained within 180 days
Print name:Jacque Stewart after it has been accepted as complete-
-" ^Fee methodology set by'Tri-County Building Industry Service Board.
i"•D_dldinaJ'errouts`PLMLI-PerutrApp doe I0%01!09 441f-461GT(10102.'COWwES)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information Begaudbn PLurnb.L'9 r ''
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qt). Fee(ea) Tota! 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
Valuation: Permit Fee:
Storm&Rain Drain-1st 100' 62.54 $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 fast$5,000.00 and$1.52 for
Other Inspections or Fees Qty. Fee(ea) Trani each additional$100.00 or fraction thereof,to
}� and including$10,000.00.
Inspection of existing plumbing or for S10,001.00 to$25,000.00 $145.50 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*.
Quantity by Fixture Type Plan Review for Plumbing Installations
Fixture Type for Repl"r`f
Work Performed: Capped Added Relocate Plan Plan review is required for anyof the following.
Baptistry/Font Please check all that apply.
Bath -Tub/Shower 0 Any new commercial building with water service 2"and
JacrtzzilWhirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thou 0 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 / 0 Any multipurpose fire sprinkler system.
Drinking Fountain __ r 0 Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" 3 Submit 2 sets of plans with any of the above.
-3„
Isometric or Riser Piogram
Car Wash Drain 0 Isometric or riser diagram is required for new buildings
Garbage -Domestic-non-food
Disposal -Domestic-food related / that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains /
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station e-
Shower -Gang
-Stall ...,... _
Sink/Lav -Non-food related /3
-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 _ /,q if fees assessed for the sewer increase must be paid before the
Urinal / plumbing permit can be issued.
Other Fixtures:
http://www.tigard-or.gov/document_center/Building/PLMF_PermitApp.dtg ifrrt 'f�
60(
I
Plumbing Permit Applicatialho
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Jt i_ c'.�s/r 7 ` ,
Building Fixtures
tt' Cityof Tigard SEP 2 7 ?01 Received
Date/By: Permit No.:
' " 13125 SW Hall Blvd.,Tigard,OR 97223
.' Phone: 503.718.2439 Fax: 503.59 :'F Plan Review
p q�p�� 1 (.'f-+' '^1' � Date/By: Other Permit No.:
Inspection Line: 503.639.4175 1''I 1 , v" r l ;fit D e
T1GXI.:Cl �jj 4 ft�sl, t ateReady/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov till...0! E ..)t V$ .,", `' Notified/Method, Supplemental Information
TIPE OF WORK FEE` SCHEDULE
0 New construction ❑Demolition For special information use checklist
Description I Qty. I. Ea. I Total
fr Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY' OF CONSTRUCTION SFR(1)bath 312.70
❑ 1-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
o Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AM) LOCATION Site utilities:
Job site address:6600 SW HAMPTON STREET Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:TIGARD,OREGON
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: 1 Project name:FARMERS INSURANCE-TI Manufactured home utilities 50.03
I Cross street/direetions 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 t: ) Page 2 _
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 1 31.27 31.27
I DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
COMPLETE REMODEL OF COMMERCIAL BUILDING Dishwasher 1 25.02 25.02
Drinking fountain 2 25.02 50.04
Ejectors/sump 25.02
0 PROPERT'F OWNER ❑ TENANT Expansion tank 1 12.51 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sirk/hub 3 25.02 75.06
Address:
Garbage disposal 1 25.02 25.02
City/State/LIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 1 12.51 12.51
:1 APPLICANT 10 CONTACT PERSON Interceptor/grease trap 25.02
Business name:BEAVERTON PLUMBING INC Medical gas(value:$ ) Page 2
Primer 2 12.51 25.02
Contact name:JACKIE STEWART
Roof drain(commercial) 12,51
Address:13980 SW TUALATIN VALLEY HWY Sink/basin/lavatory 13 25.02 325.26
City/State/ZIP:BEAVERTON,OREGON Solar units(potable water) 62.54
Phone:(503)643-7619 X106 Fax: :(503)643-7620 Tub/shower/shower pan 2 12.51 25.02
E-mail:jackie®beavertonplumbing.com Urinal 2 25.02.. 50.04
CONTRACTOR - Water closet 19 25.02 475.38
. Water heater 1 37.52 37.52
Business name:BEAVERTON PLUMBING INC
Waterpip 1 m WV 56.29
Address:13980 SW TUALATIN VALLEY IIWY Other: 25.02
City/State/ZIP:BEAVERTON,OREGON 97005 Subtotal 1169.67
Phone:(503)643-7619 X106 Fax:(503)643-7620 Minimum permit fee: $72.50
CCB Lic.:12889 Plumbing Lic.no.:34-4PB Plan review (25%of permit fee) -
State surcharge(12%of permit fee) 140.36
Authorized signal,.p 1 �e414.1.1.1,,t TOTAL PERMIT FEE 1310.03
Print name:Jacq rte Stewart Date:09/22/2017 1 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.
I:Iauildlog\Penmitsl5LMtJ-Per,utApp.doc 10/01/09 440-4616T(10/07JCOMIWEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
6600 SW HAMPTON ST, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2017-00391
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
1 . Correction 's are complete, plumbing final approved.
2. 2" Watts RP device, model LF009M2QT, serial # 088942, for bldg. supply, located in
mechanical room- approved with test
Violation Summary:
Inspector Contractor