Permit CITY OF TIGARD PLUMBING PERMIT
■ COMMUNITY DEVELOPMENT Permit#: PLM2020-00501
Date Issued: 12/17/2020
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 1S135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 101
Project: Spec Space Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Interior plumbing landlord work prior to TI: Relocating(1)dishwasher,(1)2"hub drain,and(1)sink; Installing(1)
primer and(1)sink.
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 12/17/2020 $25.02
Specifics: 1 ea Floor Drain/Floor Sink/Hub 12/17/2020 $25.02
ea Primer 12/17/2020 $12.51
Type of Use: COM 1 ea Sink 12/17/2020 $25.02
Class of Work: ALT 1 ea Water Heater 12/17/2020 $37.52
Type of Const: 1 12%State Surcharge- 12/17/2020 $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
or direct questions to,OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: G ! 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.
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Plumbing Permit Application
Building Fixtures REIV 3^City of Tigard Received
/ - Permit No.: ,_^ y'�
t 13125 SW Hall BM.,Tigard,OR 97223 DaterBy: F� i 7 UV -`7rr /0U'�/��a�-a l
Plan Review
' a:,. Phone: 503.718.2439 Fax: 503.598 199F.r 1 i m n Date/By: Other Permit No./{r_n') cle).-/0*,
Tic.;AR(7
Inspection Line. 503.639.4175 ��"�1` for Date Ready/By: hair HI See Page 2 for
Internet usvu tigird-or_goP \otificdlvietirod: Supplemental Information
K
TYPE OF, C ...
FEE* SCITEDUt.E
❑New Construction ❑ Demolition For special in urmado/I use checklist
Description Ea. Total
Q(Y
®AddiGatUalteration/replacement El Other New I-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION '1.i € t ,_ * SFR(I)bath 312.70
❑ 1-and 2-fancily dwelling ®Comnlerci /indusD 4r.
t SFR(2)bath 437.78
El Accessory building 0 Multi-fami
(� SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Muster builder El Other: Fire sprinkler(_sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
I Job site address: 10220 SW GREENBURG RD Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/Stale/ZIP:TIGARD, OR 97223
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.:101 Project name:20-303 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 31.27
DESCRIPTION OF WORK Backwater valve 12.51
TENANT IMPROVEMENT, VACANT SPACE PREP Clothes washer 25.02
__ Dishwasher 1 25,02 of .dr_
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 27;.L,,
Address:
City/State/ZIP: Garbage disposal 25.02
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:$ ) Page2
Contact name: MIKE WARREN Primer 1 12.51 J�,5�
Roof drain(commercial) 12.51
Address: P.O. BOX 19418 Sink/basin/lavatory 1 25.02
City/State/ZIP: pORTLAND, OR 97280-9418 Solar units(potable water) 62.54 ��
Phone:( 503-244-1900 Fax::( 503-244-8825 Tub/shower/shower pan 12.51
E-mail:SERVICE@POWERPLUMBINGCO.COM Urinal 25.02
s `T CONTRACTOR^ Water closet 25.02
:,s` Water heater 1 37.52 17 .5-j,
Business name:POWER PLUMBING CO. pt•
Water piping/DWV 56.29
Address:6611 SW MULTNOMAH BLVD Other: 25.02
City/State/ZIP:PORTLAND, OR 97223 Subtotal 1) ,Lf
Phone.( 503-244-1900 Fax:( 503-244-8825 Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lie..
52378 Plumbing Lic.no.: 34-150PB State ct•tief surcharge(12°/a of
66 g permitfee) 13 .
Authorized signature �-�/ TOTAL PERMIT
FE
Print name:KRISTIE BRAM WELL Date:1 -2-2020 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
"Fee methodology set byTri-County Building Industry Service Board.
i./EnUIdIn6'PermiuPLMU-PermitApp.doe 1091/09 44O-4616T(10iO2/COMAVEBi
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Total Square Footage: _ Permit Fee:
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
7,201 and greater $327,54
Sewer-each additional 100' 37.52
Water Service- 1st 100' 62.54
Water Service-each additional 100' 37.52 Medical Gas Systems:
Storm&Rain Drain-1st 100' 62.54 valuation:. Minim
Permit Fee:
$l.(X)to$5,000.00 um 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$100.00 or fraction thereof,to
Inspection of existing plumbing or for and including$I first$10,000.0000
which no fee is specifically indicated 90.00/hr $10,001.00 to$25,000.00 $14850 for the orfraction
and$1.54 for
(minimum charge—1/2 hour) each additional$100.00 or fraction thereof,to
Inspections outside of normal business 90,00/hr and including thefirst$25,0 0.00.
hours(minimum charge—2 hours) $25,001.00 to$50,000.00 each a 0 for first$25,000.00 and$1.45 for
Reinspection Fees 90.00Por each additional$100.00 or fraction thereof,10
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 Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate
Baptistry/Font ❑ Any new commercial building with water service 2"and
Bath: Tub Shower greater,except systems designed and stamped by licensed
-Jacuzzi/Whirlpool engineer.
Car Wash Each Stall 0 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 ❑ Any multipurpose fire sprinkler system.
-Domestic t 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" f ln L41J
3 Isometric or Riselt Diagram
Car Wash Drain ❑ Isometric or riser diagram is required for new buildings
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 PLEASE CALL MIKE WARREN WITH QUESTIONS 503-936-5929
Shower: -Gang
Stall ALL FIXTURES PULL AND REPLACE
Sink. -LavBar non-food related t
-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
Water Extractor fees assessed for the sewer increase must be paid before the
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
L1Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
Plumbing Permit Annlica r LCEI, e RJ n E - 12121Zp
Building Fixtures V I t)R t,rl ICII t S ()NIA
City of Tigard DEC 2 2020 Received
Ifi • 13125 SW Hall Blvd.,Tigard,OR 97223
Date/By: Permit No.:
Plan Rev Phone: 503.718.2439 Fax: 50 5 1 "ryry` rIGAR] Date/By:
Other Permit No.:
1 11 Inspection Line: 503.639 417t J I L n ING ®IUISIQDate Ready/By:Internet www.tigard-orgov Notified/Method: j g1 ESu pSpele mPaegneta 2l lfonrf ormarion
TYPE OF WORK FEE* SCHEDULE
O New construction ❑Demolition For special information use checklist
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(I)bath 312.70
❑ I-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
❑Accessory building ❑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:
Job site address: 10220 SW GREENBURG RD Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:TIGARD, OR 97223
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.:1 O1 I Project name:20-303 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 WORK Backwater valve 12.51
Clothes washer 25.02
TENANT IMPROVEMENT, VACANT SPACE PREP Dishwasher 1 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
0 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
' 0 APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
• Business name:POWER PLUMBING CO. Medical gas(value:$_) Page 2
• Contact name: MIKE WARREN Primer 1 2.51
Roof drain(commercial) 12.51
Address: P.O. BOX 19418 Sink/basin/lavatory 1 25.02
City/State/ZIP: PORTLAND, OR 97280-9418 Solar units(potable water) 62.54
Phone:( 503-244-1900 Fax::( 503-244-8825 Tub/shower/shower pan 12.51
E-mail:SERVICE@POWERPLUMBINGCO.COM Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 1 37.52
Business name:POWER PLUMBING CO. Water piping/DWV 56.29
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 Lie.:52378 Plumbing Lic.no.: 34-150PB
State surcharge(12%of permit fee)
Authorized signature‘..1
I�e_ TOTAI.PERMIT FEE
Print name:KRISTIE BRAMWELL Date:1 -2-2020 This permit application expires if a permit is not obtained within ISO days
after it has been accepted as complete.
'Fee methodology set by Tri-County Building Industry Service Board.
I.\BuildingRermitsPLMU-Per;nit App do< 10'01/09 4404616T(10/02/COMJWEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee:
Footing drain-l' 100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100- 37,52 2,001to3,600 $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' 37.52
Valuation: Permit Fee:
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
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$10,000.00 and$I.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 S50,000.00.
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 Future Type Plan review is required for any of the following.
Fixture Type for Replaee/ 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.
Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure
Drive as defined in OAR918-780-0040.
Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher Commercial ID 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"
3" Isometric or Riser Diagram
0 Isometric or riser diagram is required for new buildings
-Car Wash Drain that meet the qualifications above. S
Garbage -Domestic non-food q
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 PLEASE CALL MIKE WARREN WITH QUESTIONS 503-936-5929
Shower: -Gang ALL FIXTURES PULL AND REPLACE
-Stall
Sink: -LavBar 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
Water Extractor fees assessed for the sewer increase must be paid before the
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
I:1Building\Permits\PLMF_PermitApp.doc 08/04/2011 2