Permit (4) 114
CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT
Permit#: PLM2020-00297
Date Issued: 7/31/2020
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 1060
Project: Old Republic Subdivision: METZGER,TOWN OF Lot: 9
Project Description: ADD (1)dishwasher, (1)2"floor drain, (1)sink,(1)primer and(1)water heater.
Contractor: POWER PLUMBING CO Owner: LINCOLN CENTER LLC
PO BOX 19418 BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97280 235 MONTGOMERY ST, 16TH FLOOR
SAN FRANCISCO, CA 94104
PHONE: 503-244-1900 PHONE:
FAX: 503-244-8825
FEES
Quantity Description Date Amount
1 ea Dishwasher 07/31/2020 $25.02
Specifics: 1 ea Floor Drain/Floor Sink/Hub 07/31/2020 $25.02
1 ea Primer 07/31/2020 $12.51
Type of Use: COM 1 ea Sink 07/31/2020 $25.02
Class of Work: ALT 1 ea Water Heater 07/31/2020 $37.52
Type of Const: 1 12%State Surcharge- 07/31/2020 $15.01
Occupancy Grp: Plumbing
Stories:
Total $140.10
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
Issued By: j/t:7)-�. Permittee Signature: rt./f
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the joh site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application
Building Fixtures RECE ' �
t IORR twt.teE t'St O'sI,Y
Received-, `/�
City of Tigard 0 202D Date/try < /ze 4 D PemntNpa-420.20(DOoZ9/
1,11 • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan pens `-'
Phone: 503.718.2439 Fax' 503 598.196G1 1- ` Other Permit,N�' n
Date/By: War.�� "00137
_ Inspection Line: 503.639.4175 -y ;� Date Read /B hint: 0 See Poe 2 for
I I 6,4 RL) (-'E�1/ (°/- 11"A tL/ y= o / / g
Internet w�svv.tigard-or .. - - ttifiedrM11mhad:7/3Q/ Supplemental Information
TYPE OF WORK 014/L t_i.i. T/t FEE* SCHEDULE LF
--- For special infornwlion use checklist.
❑New construction 0 Demolition
Description I Qty. I Ea. 1 Total
®Addition/alteration/replacement 0 Other. New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ I-and 2-family dwelling 0 Comm SFR(2)bath 437.7$
❑Accessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler(_sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Catch basin or area drain 18.76
Job site address: 10260 SW GREENBURG RD
Drywell,leach line,or trench drain 18.76
City/Slate/ZIP:TIGARD, OR 97223 p� q Footing drain(no.linear ft.:_) Paget
Suite/bldg./apt.no.:1060 Project name:20-233 0Lb l€.t✓1 U_ L-!C.... 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: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
-_ DESCRIPTION OF \\'ORK. Backwater valve 12.51
Clothes washer 25.02
OLD REPUBLIC T.I. SUITE 1060 Dishwasher 1 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER 0 TENANT Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub 1 25.02
Address:
Garbage disposal 25.02
City/State/ZIP. Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name:POWER PLUMBING CO. Medical gas(value.$_) Page 2
Primer 1 12.51
Contact name: MIKE WARREN Roof drain(commercial) 1251
Address: P.O. BOX 19418 Sitlle/basin/lavatory 1 25.02
City/State/ZIP: PORTLAND, OR 97280-9418 Solar units(potable water) 62.54
Phone:( 503-244-1900 Fax: :( 5031-244-8825 Tub/shower/shower pan 12.51 .
E-mail'SERVICE@POWERPLUMBINGCO.COM Urinal 25.02
Water closet 25.02
COtiI"RACTOR
Water heater 1 37.52
Business name:POWER PLUMBING CO. Water piping/DWV 5629
Address:6611 SW MULTNOMAH BLVD Other: 25.02
City/State/ZIP:PORTLAND, OR 97223 Subtotal
Phone:( 503-244-1900 Fax:( 503)-244-8825 Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lic.:52378 Plumbing Lic.no.: 34-150PB
State surcharge(12n/n of permit tee)
Authorized signature: j-,/ (" i,.�r TOTAL PERMIT FEE
Print name:KRISTIE RAMWELL /Ca Date:7-20-2020 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
°Fee methodology set by'Fri-County Braiding Industry Service Board.
I.':HvadingTelmits/PLMU-PennilAppdue 10.'O1409 440.4616T(IOrO2'C'O5BWEB)
'Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression stems:
Site Utilities Qty. Fee(ea) Total S uare Footagci Permit Fee:
Footing drum- I" 100' 50,03 0to2,000 $121.90
Footing drain-each additional 100' 37,52 2,001 to 3,400 $1o9.69
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-Ist 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52 Valuation:. Permit Fee'
Storm&Rain Drain- 1st 100' 62.54 ----
$1.00to$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
Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
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*. Plan Review for Plumbing Installations
Quantity by Fixture Type Plan review is required for any of the following.
Fixture'fype for Replace/ Please check all that apply.
Work Performed:. Capped Added Relocate
Baptistry/FontElAny new commercial building with water service 2"and
Bath: -'rub/Showergreater,except systems designed and stamped by licensed
-Jacuzzi/Whirl pool engineer.
Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure
-Drive as defined in OAR918-780-0040.
Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities.
Dishwasher: -Commercial 0 Any multipurpose fire sprinkler system.
-Domestic 0 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" t
3" Isometric or Riser Diagram
❑ Isometric or riser diagram is required for new buildings
-Car Wash Drain that meet the qualifications above.
Garbage -Domestic non-food
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
lee Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station) ALL FIXTURES NEW
Rec.Vehicle Dump Station PLEASE CALL MIKE WARREN WITH QUESTIONS 503-936-5929
Shower: -Gang
-Stall
Sink: -Lav/Bar non-food related
-Bradley
-Com/SendUtil 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
Water Extractor fees assessed for the sewer increase must be paid before the
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
l:lBuilding\Permits\PLMF_PermitApp.doe 08/04/2011 2