Permit (21) ,, CITY OF TIGARD PLUMBING PERMIT
1 COMMUNITY DEVELOPMENT Permit#: PLM2016-00099
Tfi ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/01/2016
Parcel: 2S 101 AC01600
Jurisdiction: Tigard
Site address: 7150 HAMPTON ST 201
Project: EBS Associates Subdivision: None Lot: None
Project Description: Capping(1)kitchen break room sink and adding(1)bar sink.
Contractor: DIRECT PLUMBING LLC Owner: NEIMEYER, JOHN
PO BOX 4247 15 82ND DR STE 210
TUALATIN, OR 97062 GLADSTONE, OR 97027
PHONE: 503-548-3448 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Fixture/Sewer Cap 03/01/2016 $25.02
Specifics: 1 ea Sink 03/01/2016 $25.02
1 12%State Surcharge- 03/01/2016 $8.70
Type of Use: COM Plumbing
Class of Work: ALT 22 ea Minimum Fee Adjustment- 03/01/2016 $22.46
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You •..y obtain a copy of.the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: �" Permi ee i : I
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application
Building Fixtures RECEIVE
Cityof Tigard Received
Date/By: iiia ^ ,� Permit Nod616;
-0
0
0(79
4 NM 13125 SW Hall Blvd.,Tigard,OR 97223�,�1 pp 1 2016 Plan Review /�
. ■ Phone: 503.718.2439 Fax: 503.598.19MAR Date/By: Other Permit No.: /b�1.tR,90 i co-ceca„$
I I i A 1.t) inspection Line: 503.639.4175 � D Date Ready/By: Juris: See Page 2 for
Internet: www.tigard-or.gov CITY Q t a s Notified/Method: Supplemental Information
❑New construction ❑Demolition For special information use checklist
�{, Description Qty. Ea. I Total
ICI,Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
r W ,'I'x M' SFR(1)bath 1r
437.78
0 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath
buildingSFR(3)bath 500.32
0 Accessory 0 Multi-family
Each additional bath/kitchen 25.02
0 Master builder 0 Other
b �� 4 r Fire sprinkler( sq.ft.)
.1 ..4ale x ;.,,,,,:;',.. .,-4...,,,,cI 54.-;',A,1;.,,46,„ . . Site utilities:
Job site address: 7( ----0 �� -.fr- . J�, Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: \ \C. _D O`Q�
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: 490/ Project name: E,66 f46eare i 14-re S 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.: Backtlow preventer 31.27
r; 4a t Backwater valve 12.51
i ..y..(, \.. ..,. - . Clothes washer 25.02
/
C-fC' C7k) �F 5 1 `C J Dishwasher 25.02
E.:?)/ t tJ1-. J Drinking fountain 25.02
Ejectors/sump 25.02
', w: A•s a r Expansion tank 12.51
Name: Fixture/sewer cap / 25.02 ,9-5;
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
t r lw"[Ax Interceptor/grease trap 25.02
Business name: �tQ ,� r �k�(�
Medical gas(value:$ ) Page 2
Contact name: �-` _ Primer 12.51
' "xrk ,t' ">� 001.- Roof drain(commercial) 12.51
A
Address: a mC `�-----t
Sink/basin/lavatory
-
25.02 �'�
City/State/ZIP: � N (:),(2_ c� _ Solar units(potable water) Il 62.54
1
Phone: ) .c� Fax: :( ) Tub/shower/shower pan 12.51
E-mailiD ttQ_,cr.PL .JK�estt,YG �C 6;• \ Urinal 25.02
, e.�r d Water closet
x v :5.1-4241•7"-- ( � 25.02
' �.- ., ' r , + . ,a .::`,..61;t"- -,-,:,,,,,,0444,44:14;(06,. r, K
Water heater 37.52
Business name: t+t€ Ra 4' OV(
Water piping/DWV 56.29
Address: Other: 25.02
City/State/ZIP: Subtotal
Minimum permit fee: $72.50 7a,•5th
Phone:( ) Fax:( )
Plan review (25%of permit fee) ,---'----•
CCB Lie.: 195::4)-1: Plumbing Li o.: -4-77
State surcharge(12%of permit fee) 7.74)
Authorized signature: ! TOTAL PERMIT FEE g /.ea.&
/ fiG
This permit application expires if a permit is not obtained within 180 days
Print name: -.__' ` j� T Dater i
F i� ogles it has been accepted acomplete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:Building Permits,PLMU-PermitApp.doc 1001,09 440-4616T(10'02%COM'WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Su' t ression S stems:
-1:;("<<54 9 'w'ta ' 0, :' 'NV
fro> s ' Ira
i ...
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' 37.52k f r ¢
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 first$5,000.00 and$1.52 for
each additional$100.00 or fraction thereof,to
a °g) ,.'„ ° ia ° 'x.> p and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 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*. 0w, Q _us, lat1 ;
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate
❑ Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
-Jacuzzi/Whirlpool engineer.
1=1Car Wash: Each Stall New exterior plumbing site utilities for any complex structure
Drive as defined in OAR918-780-0040.
1=1Cuspidor/Water Aspirator Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial 1=1 Any multipurpose fire sprinkler system.
-Domestic ❑ Any complex structure as defined in OAR918-780-0040.
Drinking Fountain
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink: -2"
4 ❑ Isometric or riser diagram is required for new buildings
-Car Wash Drain
Garbage Domestic non-food that meet the qualifications above.
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
Ice Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -Lav/Bar non-food related / /
-Bradley
-Com/Serv/Util food related
-Service *Note: If the fixture work under this permit results in an
Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and
Washer-Clothes fees assessed for the sewer increase must be paid before the
Water Extractor
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
1:ABuilding\Permits\PLM F_PennitApp.doc 08/04/2011 2
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
7150 SW HAMPTON ST 201, TIGARD, OR,
97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2016-00099
Chip Barnett
Violation Summary:
Inspector Contractor