Permit CITY OF TIGARD PLUMBING PERMIT
'.• COMMUNITY DEVELOPMENT Permit#: PLM2021-00061
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 2/16/2021
Parcel: 1S135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 700
Project: Integrated Healthcare Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Interior plumbing: Capping(1)sink.
Contractor: POWER PLUMBING CO Owner: LINCOLN CENTER LLC
PO BOX 19418 BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97280 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503-244-1900 PHONE:
FAX: 503-244-8825
FEES
Quantity Description Date Amount
1 ea Fixture/Sewer Cap 02/12/2021 $25.02
Specifics: 1 12%State Surcharge- 02/12/2021 $8.70
Plumbing
Type of Use: COM 47 ea Minimum Fee Adjustment- 02/12/2021 $47.48
Plumbing
Class of Work: ALT
Type of Const:
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 may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: 40v5"zir....."...2.0. .. _- Permittee Signature:
.-","" psi:
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 ApplicationECC
RECEIVED fVE®
Building Fixtures ft)R OI 1 It I. ( s(. (1�1 )
City of Tigard FEB 03 2021 Fuzz, /L,i/�-/ ,'� permit No,: n�N l ,, t
.t, 41 13125 SW Hall Blvd.,Tigard,OR 97223 } J' Q OJ l
I, Phone: 503.718.2439 Fax: $03 59 Plan Review
CAW OF TIGARD oate;6,-: �/ , outer Permit No �,Q )JP J� 3j
Inspection Line: 503.639.4175tel or
Ii.. y k l: BUILDING DIVISIONpate Reaay-6y: Q lung a see axe for
Internet: www.tigard-or.gov Notified"Method: r%sa t u 1 / 'J'"�/, pp
al
Supplemental Information
TYPE OF WORK laml 6.3f^1F t 1 rt-Pt FEE" SCHEDULE
❑Newconstruction ❑Demolition For special information
Description I Qty. J Ea. I Total
®Addition/alteration/replacement 0 Other: New I-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ I-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND'LOCATION Site utilities:
Job site address: 10200 SW GREENBURG RD Catch basin or area drain 18.76 1
Drywell,leach line,or trench drain 18.76
City/State/ZIP:TIGARD, OR 97223 Footing drain(no.linear ft. _) Page 2
Suite/bldg./apt.no.:700 I Project name: -Ttiic� eJ s �k.."e' Manufactured home utilities 50.03
Cross streeUdirections to job site: V Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:_) Page 2
/
Subdivision: 6 5-/3.5, gad I Lot no.: Fixture or item:
Tax map/parcel no.: gad
Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
INTEGRATED HEALTHCARE/ SOLUTIONS LLC T.I. Dishwasher 25.02
p
t.rf P ( l) 1-eh. Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Fixture/sewer cap 1 25.02 NR Name:
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: I-lose bib 25.02
Phone:( ) I Fax:( ) Ice maker 12.51
0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:POWER PLUMBING CO. Medical gas(value:$_) Page'_
' Primer Contact name. MIKE WARREN 1
Roof drain(commercial) 1251
Address. P.O. BOX 19418 Sink/basin/lavatory 25.02 i
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 1251
E-mail:SERVICE@POWERPLUMBINGCO.COM Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:POWER PLUMBING CO. Water piping/DWY 56.29
Address:6611 SW MULTNOMAH BLVD Other: 25.02
City/State/ZIP:PORTLAND, OR 97223 Subtotal ;--.U).
Phone:( 503-244-1900 Fax:( 503)-244-8825 Minimum pennit fee: $72.50 -7A.,0
Plan review (25%of permit fee)
CCB Lie.:52378 Plumbing Lie.no.: 34-150PB
State surcharge(12%of permit fee) ir.. -7
Authorized signature: kt.e, &.a.t..e a TOTAL PERMIT FEE K(_t>`r)
Print name:KRISTI BRAM WELL Date:2-3-2021 This permit application expires if a permit is not obtained nit n 0 days
after it has been accepted as complete.
"Fee methodology set by Tri-County Building Industry Service Board.
I nuitdmg\Permns'PLUU.PernntApp doe 1001 t09 440-4616T110'02'COM;xvE61
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 2,001to3,600 $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- Ist 100' 62.54 Medical Gas Systems:
Water Service-each additional 100- 3752
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
p and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 S 148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/br 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 S25,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional S100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including S50,000.00.
Additional plan review for revisions 90.00/hr S50,001.00 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 mice/ Please check all that apply.
Work Performed: Capped Added Relocate
Baptistry/Font ❑ Any new commercial building with water service 2"and
greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
engineer.
-Jacuzzi/Whirlpool
Stall ❑ New exterior plumbing site utilities for any complex structure
Car Wash: -Each as defined in OAR918-780-0040.
-Drive Thr
Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher Commercial ❑ 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'
Isometric or Riser Diagram
❑ 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 PLEASE CALL MIKE WARREN WITH QUESTIONS 503-936-5929
Shower: -Gang CAP LAV IN MOTHERS ROOM
-Stall oar
Sink: -LavBar non-food related i
-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:\13uilding\Permits\PLMF_PermitApp.doc 08/04/2011 2
Accumulative Sewer Tally
i al
m Tenant Namc: INTEGRATED HEALTHCARE SWR# N/A
TIGARD Site Address: 10200 SW GREENBURG RD 700 PLM# 2021-00061
Parcel#: 1 S 135AB00900
Fixture Value Previous Previous Credits Capped Fixture Fixture New New
# value count capped#s value count added# added value total#s total values
Baptistry/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
-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 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 1 2 0 -1 -2
-Bradley 5 0 0 0 0 0
-Com/Serv/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 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 1 2 0 0 -1 -2
Current Fixture Value -2 divided by 16= -0.125 Current EDU 1 EDU= $5,800.00
Previous Fixture Value 0 divided by 16_ 0.000 Previous EDU
Change -2 divided by 16= -0.125 over (under) $ (754.00)
Enter EDU Change Here -0.130 *
*Round F,DUs 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: ***CREDIT***
Authorized Name/Signature: BRANDF.N TAGGART X2449 Date: 2/11/2021
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\SewerTally\Sewer TallySheet_5800_070119.xlsx
Branden Taggart
From: Branden Taggart
Sent: Tuesday, February 16, 2021 8:07 AM
To: Kristie Bramwell
Subject: RE: Integrated Healthcare Permit: PLM2021-00061 - 10200 SW Greenburg Rd.
Attachments: Permit.pdf
Hi Kristie,
have issued the Plumbing permit, and the permit paperwork is attached above. You may now schedule inspections
online through our website: http://inspections.tigard-or.gov/WebOnlinelnspections. I will be mailing the blue Clean
Water Services Sewer Use Information Card for you to complete and return to them.
Also, please provide the owner of the property with the attached sewer tally credit. The sewer tally must be retained
and submitted as a voucher in order to redeem the credits towards future usage.
Thank you,
Branden Taggart
11111 a. City of Tigard
a,3„: Senior Permit Technician
Community Development
TIGARD
13125 SW Hall Bivd
Tigard, OR 97223
(503)718-2449
brandent@trgard-or.gov
From: Kristie Bramwell <service@powerplumbingco.com>
Sent: Friday, February 12, 2021 8:43 AM
To: Branden Taggart<brandent@tigard-or.gov>
Subject: RE: Integrated Healthcare Permit: PLM2021-00061- 10200 SW Greenburg Rd.
Warning!This message was sent from outside your organization and we are unable to Allow sender I Block sender
verify the sender.
Just paid, thanks!
Kristie Bramwell I service(Jpowerplumbinaco.com
Service Department I Power Plumbing Co.
0 503.244.1900 I F 503.244.8825
(( Power Plumbing Co.
From: Branden Taggart [mailto:brandent@tigard-or.gov]
Sent:Thursday, February 11, 2021 5:16 PM
1
To: Kristie Bramwell<service@powerplumbingco.com>
Subject: Integrated Healthcare Permit: PLM2021-00061- 10200 SW Greenburg Rd.
Hi Kristie,
The Plumbing permit for Integrated Healthcare is ready to issue now. The balance due is$81.20, and I have attached
invoices above for you to reference. The fees can be paid online through our
website: https://aca.accela.com/TIGARD/Default.aspx. From there, click on the Building tab, enter the permit numbers
in the Record Number field, and click Search. Once paid online, please notify us at tigardbuildingpermits@tigard-or.gov,
and I will issue this permit and email you the permit paperwork.
Thanks,
Branden Taggart
e City of Tigard
3 ■ :.. Senior Permit Technician
._. Community Development
13125 SW Hall Blvd
Tigard, OR 97223
(503}718-2449
brandent@t[gard-or.gov
DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail
may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained
by the City of Tigard in compliance with the Oregon Administrative Rules"City General Records Retention Schedule."
2