Permit (172) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2018-00412
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/04/2018
T f[ A.i ' 9 Parcel: 2S 101 AD00400
Jurisdiction: Tigard
Site address: 6665 SW HAMPTON ST
Project: Hampton Oaks Subdivision: WEST PORTLAND HEIGHTS Lot: 31
Project Description: CAP(2)urinals,RELOCATE(2)lays and(4)water closets,ADD(2)lays.
Contractor: NORTHWEST CENTRAL PLUMBING CO INC Owner: HAMPTON OAKS LLC
2870 SE 75TH AVE#206 6665 SW HAMPTON ST, STE 200
HILLSBORO,OR 97123 PORTLAND, OR 97223
PHONE: 503-642-2067 PHONE:
FAX: 503-642-5954
FEES
Quantity Description Date Amount
2 ea Fixture/Sewer Cap 09/04/2018 $50.04
Specifics: 4 ea Lavatories 09/04/2018 $100.08
4 ea Water Closet 09/04/2018 $100.08
Type of Use: COM 1 12%State Surcharge- 09/04/2018 $30.02
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $280.22
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: l//i -� � �— Permittee Signature: 1,/4 /CI
r �0
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. �/ //(�J�
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.
6B/24/2018 11 :24 From: 5036425954 Local Plumbing Co . Page : 2,2
Plumbing Permit Application-City of Tigard
Page 2-Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site UtIktae,9 QLy- Res OM 'tsrtyit Square FoQ.tage'2 F Permit Fee:
Footing drain-1'100' 50.03 0 to 2,000 $121:90 _
Footing drain•each additional 100' 37.52 2,001 to3;600 $169.69
3,601 to 7,200 5733.20
Sewer-1st 100' 62.54 7,201 and
Sewer-each additional 100' 37,52 greater $327.54
Water Service•1st 100' 62.54 Medical Cas Sxstems•
Water Service-each additional 100' 37.52 ' 91u t DA: r Permit Pee ��T T
Storm&Rain Drain-1st 100' 62.54 51.00 to S5,000.00 Minimum 5=572.50
Storm&Rain Drain•each additional 100' .37,52III $5,001.00 to$10,000.00 $72.50 for the first 55,000.00 and$1.52 for
Other Ipspeetlons or Fees Qty, Fee(es} each additional$100.00 or fraction thereof,to
and including S10,000.00.
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 fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereon to
(minimum chew-1/2 hour) and including$25,000.00.
inspections outside of normal business 90.00/hr 525,001.00 to$50,000.00 $379.50 for the fust 525,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00Au and including 550,000.00.
Additional plan review for revisions 90.00/in 550,001,00 and up 5742.00 for tho first$50,000.00 and 51.20 for
(minimum charge-12 hour) each additional$100.00 cc fraction th"ereof.
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*.
Gentility,bs.l4sture Type Plan Revme y for Plumbing Installations
wyture fype for ' Replaw
Work Performed: ebpprd Added lte3o.ate Plan review is required for any of the following.
Daptislry/Ftrht Please check all that apply.
Rath -Tub/Shower 0 Any new commercial building with water service 2"and
•Jacurri/Whirlpool - greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru ❑ New exterior plumbing site utilities for any complex strucinre
Cuspidor/Water Aspirator as defined in OAR9I8-780-0040.
Dishwasher -Commercial 0 Medical gas and vacuum systems for health care facilities.
-Domestic 0 My multipurpose fire sprinkler system.
Drinking Fountain 0 Any complex strarturc as defined in 0AR9111-780.0040.
Eye Wash
Floor Drain/sink -2.' Submit 2-sets of plans with any of the above.
-4. Isap;l,,etric or Riser Dia r'4m
CRI wash Drain .
Garbage -Domestic.non-fond ❑ Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food retaed
Ice Mach.,ttefrig,Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall - ,
Sink/Lav -Non-food related
-Aradlc}' _.
-Conunereial-food related
-Service
5witnmigg 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
WaterClo:et-Toilet 4 fees assessed for the sewer increase must be paid before the
Urinal 2 _ plumbing permit can be issued.
Outer Fixtures: ti
P:\0.LOCAL Iiids',Harhro'2018 Rids\7.23.18 C56I85 6665 SW Hamptol2Fire damage\Tigard_PLMF-PesmitApp(2).doc
Accumulative Sewer Tally
llC Tenant Name: Hampton Oaks SWR# N/A
Site Address: 6665 SW Hampton St PLM# 2018-00412
TIGARD
Parcel#: 2S101AD00400
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
Eye Wash 1 0 0 0 0 0
Floor Drain/Sink: -2 inch 2 0 0 0 0 0
-3inch 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
Living Unit 16 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 0 2 4 2 4
-Bradley 5 0 0 0 0 0
-Com/Sery/Util-Food Related 3 0 0 0 0 0
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 2 12 0 -2 -12
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 2 12 2 4 0 -8
Current Fixture Value -8 divided by 16= -0.500 Current EDU 1 EDU= $5,650.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change -8 divided by 16= -0.500 over (under) $ (2,825.00)
Enter EDU Change Here -0.500 *
*Round EDUs to the nearest 1/100th: a count ending in.005 shall be rounded up to.01,and a count ending in.014 or less shall be rounded down to.01.
Notes: ***CREDITS***
Authorized Name/Signature: Dianna Howse Date: 9/4/2018
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\SewerTallySheet_5500_070117.xlsx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
6665 SW HAMPTON ST, TIGARD, OR, 97223 March 7, 2019 at 11 :13:47 AM
Record Type: Record ID:
Commercial - Plumbing PLM2018-00412
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor