Permit p CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2013 -00237
T [ G ARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/18/2013
Parcel: 2S101AC01600
Jurisdiction: Tigard
Site address: 7100 SW HAMPTON ST 111
Project: Spec Space Subdivision: BEVELAND NO.2 Lot: 18 -19, P
Project Description: Capping (2) 2" floor drains, (1) hand sink & (2) food prep sinks.
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
5 ea Fixture /Sewer Cap 07/18/2013 $125.10
Specifics: 1 12% State Surcharge - 07/18/2013 $15.01
Plumbing
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $140.11
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 • _ - . - - . OUNC by calling 503.232.1987 or 1.800.332.2344.
Issue By: / � 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.
JUL /10/2013/WED 01:08 PM FAX No, P. 002/004
Plumbing Permit App ; ' t IV
Site Utilities FOR OFFICE USE ONLY
City of Tigard JUL 10 2013 Received - eg y+ � N9.ol 3 -0 X32_
p Date /13y: 7 �! / 5 Permit No.: p O
r 13125 SW Hall Blvd., Tiga o i9GARD
Phone: 503.718.2439 rt,l Plan Review
Date/By: Other Permit Nn.:
TIGARD Inspection Line: 503.63�1 DING MINN Date Ready /By: lutis El See Page 2 for
Internet www tigard or�dd�L Notified/Method: Supplemental Information
. _ I - .•, .- „ , ,,, _
t , i is v+ uti - , - - I . . -= M q - ' `' +' ' ` t -t 7 -r n
❑ New construction ❑ Demolition For special information use checklist.
Description I Qty. 1 Ea. I Total
Addition/alteration/replacement ❑ Other: New 1- 2 - family dwellings (includes 10011. for each utility connection)
^ a''' r I'' a e a yr"' 70-N, n.: �+r. a [ o 7 � r ' kc. SFR (1) bath • 312.70 -
❑ 1- and 2- family dwelling ® Commercial /industrial SFR (2) bath 437.78
1=1 Accessory building ❑ Multi - family SFR (3) bath 500,32
❑ Master builder Each additional bath /kitchen 25.02
❑ Other:
: _ Fire sprinkler (_ sq. ft.) Page 2
• . r a : � t l" y id n i VO rlal IFi +Ir a's i, Sit u
Job site address: 7100 SW Hampton
Catch basin or area drain 18.76
City /State /Z1P: Tigard OR 97223
Urywell, leach line, or trench drain 18.76
Footing drain (no. linear ft,: „ ) Page 2
Suite /bldg. /apt. no.: ill Project name: I t - a{
i fttntlet617emadet 6
/� - - Manufactured home utilities -50.03
Cross street /directions to job site: 0- 0 K M t le-E. `''LMX rt---D£c./ Manholes 18
Rain drain connector 18.76
Sanitary sewer (no. linear ft.: _ ) Page 2
Storm sewer (n linear ft,: _ Page 2
Water service (no. linear ft.; _) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map /parcel no.; 6 9 /o/ R-C O /600 Backflow preventer 31.27
� r • pr,,�, :F Backwater e
.sea° " T i t w '--- valve
�!,: :, _ x s,.l . ; f t>� -tat / st � ' � 12.5]
�' ti wt `` Clothes washer 25.02
Cap off existing fixtures in Suite 111
Dishwasher 25.02
Drinking fountain 25.02
Ejectors /sump 25.02
T 3 . ' u7T-- SL ( T
ii.,...,. - re3+.- - r - . tom, t ' _ • "r -' l ''''' _� Expansion tank 12.51
Name: Mainlander Investments Fixture /sewer cap 6 25 t0
Address: Suite 512, 310 SW 4th
Floor drain /floor sink /hub 25.02
Garbage disposal 25.02
City/State/ .1P: Portland OR 97205 Hose bib 25.02
Phone: (503)650-9500 [ 9 Fax; ( ) Ice maker 12.51
F� fl , k �' V-' 4 i � 1 t l r 2 V � - « � - N :.. Y ff �i� f �1 1 �.
! %ci,7 - '.^. � 4. � ?. .,1 " .' �v vt' _ r y tilt. Interceptor /grease trap 25.02
Business name: DeTemplc Company, Inc. Medical gas (value: S ) Page 2
Contact name: David Pile
Primer 12.51
Roof drain (commercial) 12,51
Address; 1951 NW Overton St y Sink/basin/lavatory 25.02
City/State /ZTP: Portland OR 97209 Solar units (potable water) 62.54
Phone: (503) 227 -2641 I Fax; : (503) 274 -7686 Tub /shower /shower pan 12.51
E-mail: j.prabuckl @detemple.com Urinal 25.02
a �* ' ere a , ° ` = = Water closet 25.02
1244= :• ..., �` ,..... c� '�_,Yaar i4r: r � Wate i . heater 37.52
Business name: Same as Applicant Water piping/DWV 56.29
Address; Other:
25.02
City /State /ZTP: Subtotal /2.5.i°
Phone; ( ) Fax- ( ) Minimum permit fee: $72,50 �-
CCB Lie.: 2510 - Plumbing Lie, no.: 26.25PB Plan review (25 % of permit fee)
State surcharge (12% of permit fee) ! 5 1 !
Authorized signature; TOTAL PERMIT FEE i [/0.! 1
Print name: Julie Prab ,' r Date: 07/10/13 This permit application expires it a permit is not obtained within 180 days
after it has been accepted as complete.
'Pee methodology set by Tri County Building Industry Service Board.
1:1 9ulleing \Pe'sitnwLMU- PermitApp.doc I0iGi/09 440. 15161'(10 /02/coM/wei3)
JUL /10 /2013 /WED 01:08 PM FAX No, P.003/004
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
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Fee Schedule: Residential Fire Su . ' ression S stems:
L_ t n: c =- �-�" -
i p ✓� ' , :: 'a {:' -iY7,, , lin" EM.ri V a ` i�C,i pi t': -Ilird
Footing drain - i" 100' 50.03 0 to 2,000 _ $121.90
Footing drain - each additional 100' 37.52 2,001 to 3,600 $169,69
Sewer - 1st 100' 62,54
3.601 to 7,200 $233.20
70i and greater $327.54
Sewer - each additional 100' 37.52
Wafer Service - 1st 100' 62,54 Medical Gas S stems:
Water Service - each additional 100' 37,52 ,-
Stoim & Ra St 1 00'
m Drain - I 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 first $5,000.00 and $1.52 for
F ii , T7fit o a d i1, `S r tt ' -E,LialTil i1 7 each additional $100.00 or fraction thereof, to
Inspection of existing plumbing or for _ and including $10,000.00.
$10.001.00 to $25,000.00 $I48.50 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 charger 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/lu $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
(minimum charge - /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*.
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t ll � >C I �� r. ' ' 3 re F N a,! =1t' SPRY b`-. s ` lr ,idCd L- l i P lan review 9 E �7 Tr E .4G Et«7�.- .��
� �, G `Xa�.�, P i a t � o _,...
,,,. l _ t' l• a .= A -t , r, s - w is required for any of the following.
Baptistry/Font Please check all that apply.
Bath - Tub /Shower 11 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 ❑ New exterior plumbing site utilities for any complex structure
Cuspidor /Water Aspirator as defined in OAR91 8-780-0040.
Dishwasher - Commercial ❑ Medical gas and vacuum systems for health care facilities.
- Domestic ❑ Any multipurpose tire sprinkler system,
Drinking Fountain ❑ Any complex structure as defined in 0AR918 -780 -0040,
Eye Wash
Floor Drain /sink - 2" 2 Submit 2 sets of plans with any of the above.
- -
'g : .' 4 l F, .. i ge �nEK• E 1 1 E �,\ , r If _
Car Wash Drain -- a .5.‘411.±,7=- bGO.
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. /Rcfrig. Drains
Oil Separator (Gas Station) Comments regarding fixture work:
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lay - Non -food related 1
- Bradley
- Commercial- food related _
-Service
- -
Swimming Pool Filter
Washer - Clothes *Note: If the fixture work under this permit 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: W
httpahvww.tigard- or.gov /city_ha] l/ departments /cd /does /PLMU -perm itAp2,doc
II I I Accumulative Sewer Tally
v
T enant Nano: Spec Space "CREDITS' f JI S iL SWK # N /A.
Site Address: 7100 SW Hampton, Suite 1 l 1 ` PI .N1 # 2013 -00237
TIGARD
Parcel #: 2S101AC01600
Fixture Value Previous Previous Credits Capped Fixture Fixture New New
# value count capped #s value 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
Eve Wash 1 0 0 0 0 0
Floor Drain /Sink: - 2 inch 2 0 2 4 0 -2 -4
- 3 inch 5 0 0 0 0 0
- 4inch 6 0 0 0 0 0- _ - _
- Car Wash 6 0 0 0 0 0
Garbage Disposal:
- Domestic (to 3/4 I -IP) 16 0 0 0 0 0
- Commercial (to 5 1 -IP) 32 0 0 0 0 0
- Industrial (over 5 l -IP) 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 0
Shower: - Gang (per head) 1 0 0 0 0 0
- Stall 2 0 0 0 0 0
Sink:
- Lav /Bar - Non -Food Related 2 0 1 2 0 -1 -2
- Bradley 5 0 0 0 0 0
- Com /Sery /Util - Food Related 3 0 2 6 0 -2 -6
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 0 0 0 0
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
TO'T'ALS 0 0 5 12 0 0 -5 -12
Current Fixture Value -12 divided by 16 = -0.750 Current [DU 1 EDU = $4,800.00
Previous Fixture Value 0 divided by 16 = 0.000 Previous [DU
Change -12 divided by 16 = -0.750 over (under) S (3,600.00)
Enter EDU Change Here -0.750
Notes: `"" " 7 /1 8/13, credits applied to SWR2013 -00157
Authorized Name /Signature: Debbie Adamski Date: 7/15/2013
Building Division
IN V ote: The property owner shall retain the ORIGINAL sewer tally record. 1 f credits exist, this document will serve as a voucher which must be
ubmitted to the City of Tigard Building Division to redeem credits towards future system development charges.
r
1: \Building \Sewer'I'ally \Sewer I'allySheet_4H1111._I17111 I3.xlsx
Accumulative Sewer Tally
v
1 11111 _ . Tenant Name: Spec Space " "Citl::Dl "1'S ** SWR # N/A
Site Address: 7100 SW Hampton, Suite 111 PI ,IM # 2013 -00237
TIGAIiD
Parcel #: 2S101AC01600
Fixture Value Previous Previous Credits Capped ' I Fixture New New
# value count capped #s value 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
Lye Wash 1 0 0 0 0 0
Floor Drain /Sink: - 2 inch 2 0 2 4 0 -2 -4
- 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 1 -IP) 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 0
Shower: - Gang (per head) 1 0 0 0 0 0
- Stall 2 0 0 0 0 0
Sink:
- I.av /Bar - Non -Food Related 2 0 1 2 0 -1 -2
- Bradley 5 0 0 0 0 0
- Com /Serv/Util - Food Related 3 0 2 6 0 -2 -6
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 0 0 0 0
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 5 12 0 0 -5 -12
Current Fixture Value -12 divided by 16 = -0.750 Current [DU 1 EDU = $4,800.00
Previous Fixture Value 0 divided by 16 = 0.000 Previous EDU
Change -12 divided by 16 = -0.750 over (under) S (3,600.00)
Enter EDU Change Here' -0.750 '
Notes: "*CREDITS'"
Authorized Name /Signature: .Debbie Adamski Date:'. 7/15/2013
Building Division
Note: The property owner shall retain the ORIGINAL sewer tally record. If credits exist, this document will serve as a voucher which must be
submitted to the City of Tigard Building Division to redeem credits towards future system development charges.
I: \ Building \Sewer Tally \S& u t 1,_117U1 13.xlsx
JUL /10 /2013 /WED 01:08 PM FAX No, P.001 /004
D PLUMBING- HEATING -AIR CONDITIONING- BOILERS
Since 1895
COMPANY,INC "`S'° •
www.detemple.com Honeywell Building Control Specialist
24 HR EMERGENCY SERVICE
Fax
TO: Permits FROM: Julie Prabucki
FAX; 503-598-1960 PAGES: 'f
PHONE: 503 - 718 -2439 DATE: July 10, 2013
RE: Permit Application
O Urgent 0 For Review ❑ As Requested 0 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
De1 Company
D:. 503 -471 -5272 F
0: 603- 227 -2641
F: 503 -274 -7686
•
Coast Service Area
Portland Off ices: Salem Offices: Adtar a to Ma=anita. Ne4alem, to Tllanwok:
503/227 -2641 • FAX: 503/274 -7686 503/585 -7567 • FAX: 1-503/274-7686 503/738 -4313 • FAX: 503/138 -5662 503/436.1750 - FAX: 503/7385662
Moiling Address For All Offices:1951 0.W. Overton St. • Portland, OR 97209