Permit (118) CITY OF TIGARD PLUMBING PERMIT
: ■' COMMUNITY DEVELOPMENT Permit#: PLM2018-00451
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/03/2018
T l c A r f7 g Parcel: 2S101 BA00500
Jurisdiction:
Site address: 7600 SW DARTMOUTH ST
Project: Walmart Subdivision: HERMOSO PARK Lot: 8
Project Description: Moving backflow preventer 20 ft.
Contractor: DETEMPLE COMPANY INC Owner: WAL-MART REAL ESTATE BUSINESS TR
5636 NE HASSALO STREET BY PROPERTY TAX DEPT STORE 5935-00
PORTLAND, OR 97213 PO BOX 8050
ATTN MS 0555 1
BENTONVILLE,AR 72716
PHONE: 503-227-2641 PHONE:
FAX: 503-274-7686
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 10/01/2018 $31.27
0
Specifics: 1 12%State Surcharge- 10/01/2018 $8.70
Plumbing
T f 41 ea Minimum Fee Adjustment- 10/01/2018 $41.23
ype o Use• COM
Plumbing
Class of Work: OTR
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: ,004Permittee Signature:
-I Sze �Lv�'/5/�,
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.
09/25/2018 14 : 20 From : 5032747686 DeTemple Co Inc Page : 2/2
Plumbing Permit Application
Building Fixtures SE ONL}
Ci Of Tigard � .A.1 R-eceived Perm'I4///61.01,./V
,,.e ,�'
74
■ 13125 SW Hall Blvd.,Tigard,OR 97223 DateBy: Q �! /�J ' �v(�'�/s"� ����
Phone 503.7I8.2439 Plan Review
Fax: 503.598.1960,E p 2 5 2 0 1 8 Date/By: Other Permit No.:
T I G A R n Inspection.Line: 503.639.4175 Date Ready`By: Awls 63 See Page 2 for
Internet www.tigard-or.gov py yy citified/Method. Supplemental Information
;; TYPE 01? WQitt� t d a�l tM1 0 01. t . a ikri tiatDCit
❑New construction �y tr t' 1 Far special information use checklist
Description I Ow. I Ea. I Total
®Addition/alteration/replacement ❑Other: New I-2-family dwellings(includes 100 ft.for each utility connection)
t 'RGORY O COFT ,TE IC`i'TON` t ` SFR(1)bath. 312.70
11 1-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
❑Accessory buildingSFR(3)bath 500.32
0 Mufti-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
JOT/ SITE IN)FORMATION';AND ]LOCATION Site utilities:
Job site address:7600 SW Dartmouth St Catch basin or arra drain 18.76 `
City/State/ZIP:Tigard,Or 97223 Drywell,leaeh line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name:Walmart 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 ft,: ) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 1 31.27 31.27
DESCRIPI'ozip OF WORK;
Backwater valve 12.51
Clothes washer 25.02
move backflow 2ft
Dishwasher 25:02
Drinking fountain 25.02
Ejectors/sump 25.02
Wil.WilettiiiiiiiikiiiikfAiiiialsommisonsorigifigawnseaspi, Expansion tank 12.51
Name: Fixture/sewer cap 25.02
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
ApL(ANiCONTACTRSON 1nterceptorrgreasetrap 25.02
Business name:DeTemple Company Medical gas(value:S _) Page 2
Primer 12.51
Contact name:Suzanne Postula
Roof drain(commercial) 12.51
Address:5636 NE Hassalo St Sink%basin/lavatory 25.02
City/State/ZIP:97213 Solar units(potable water) 62.54
Phone:(503)471-5267 Fax::( ) Tub/shower/shower pan 12,51
E-mail:s.postulal@detempie.eom Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name:same as above
Water piping/DWV 56.29
Address: Other: 25.02
City/State/ZIP: Subtotal
Phone:( ) Fax.( ) Minimum permit.fee: $72.50 72.50
Plan review (25%of permit fee)
CCB Lic.:2510 Plumbing Lie,no.:26-25PI3 -
State surcharge(12%of permit fee) 8.70
rS f
Authorized signature: ) f,1,L {E_s',(eL, 'o,, ;� 4_j x,,•,J TOTAL PERMIT FEE 81.20
Print name:Suzanne Postula Date:9/25/2018 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:Building-Petmils PLMII.PerrnitApp.dne 10 01'09 440.46167(10.0:COM WEB)
09/25/2018 14 : 20 From : 5032747686 DeTemple Co Inc Page : 1,2
FAX COVER SHEET
To: Permitting From: SUZANNE POSTULA
Company: City of Tigard Company: DETEMPLE
5035981960 503-471-5267
Fax: Phone:
Date: 9/25/2018 Pages w/cover: 2
Subject:
Plumbing Permit Application
Comments:
7600 SW Dartmouth St
Thank you.
Suzanne Fbstula
s.postulal gdetemple.com
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
7600 SW DARTMOUTH ST, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2018-00451
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
1 . 3/4" SVP back flow device, Watts LF08PCQT , serial #02475, for fish tank at NW front
corner of Bldg.- Approved with test
Violation Summary:
Inspector Contractor