Permit 114 CITY OF TIGARD PLUMBING PERMIT
` COMMUNITY DEVELOPMENT Permit#: PLM2021-00373
D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 9/2/2021
T[�'"� g Parcel: 1S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 300
Project: Spec Space Subdivision: METZGER,TOWN OF Lot: 9
Project Description: CAP(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 Fixture/Sewer Cap 09/02/2021 $25.02
Specifics: 1 12%State Surcharge- 09/02/2021 $8.70
Plumbing
Type of Use: COM 47 ea Minimum Fee Adjustment- 09/02/2021 $47.48
Class of Work: ALT Plumbing
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
Issued By: a.,,,,,,e„ Permittee Signature: y
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 Atmlic CElV'E ,. Z,\ _ E-
Building Fixtures
City of Tigard A!<G U Zr27 I Received
9!f/2/ AQO Permit NPL-N 21 ZI -' 10 3 73
1 • 13125 SW Hall Blvd.,Tigard,OR 973 Plan Review
l • Phone: 503.718.2439 Fax: 503.548 9 0�TIGARDDate/By: Other Permit No.:
Inspection Line: 503.639.4175 DING DIVISION H seepage 2 tor
I I G 11 R D 01 I I I Date Ready/By: 1 1 )„ds
Internet: www.tigard-orgovKotifiedMlethod /t J�-/ (..a Supplemental information
TYPE OF WORKCrWit_ / cr g FEE* SCHEDULE
❑New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. I Total
®Addition/alteration/replacement ❑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 ElCommercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ❑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: 10260 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 II:_) Page 2
Suite/bldg./apt.no.:300 I Project name:21-470 S 1>C-�-e_. S y'e -' 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
VSP SUITE 300, LINCOLN TOWER Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Name: Fixture/sewer cap 1 25.02
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
❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name.POWER PLUMBING CO. Medical gas(value:$ ) Page 2
Primer 12.51
Contact name: MIKE WARREN
Roof drain(commercial) 12.51
Address: P.O. BOX 19418 Sink/basin/lavatory 25.02
City/State/ZIP: PORTLAND, OR 97280-9418 Solar units(potable water) 62.54
Phone:( 503-244-1900 Fax::( 503`244-8825 Tubishower/shower pan 12.51
E-mail.SERVICE@POWERPLUMBINGCO.COM Urinal 25.02
• CONTRACTOR
closet 25.02
Water heater 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'( 503L244-8825 Minimum permit fee: $72.50 7 Z_ 5O
CCB Lie.:52378 /���Plluu/"mbing Lic.no.: 34-150PB Plan review (25%of permit fee)
j / 0 e "-' ` ez Statesurcharge(12%of permit fee) ,.. 2741
,
Authorized signature: .�--(Y.i�,a"i TOTAL PERMIT FEE y0
Print name:KRISTIE BRAMWELL Date:8-34-2021 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I.\Building'\Permin\PLMU-PermitApp.doe 10,01!09 440-4616T(M0'SICOM'WEB)
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-1°100' 50.03 0to2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 10 7,200 $233.20
Sever-let 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 Valua r:..
Storm&Rain Drain-1st 100' 62.54
hon: Permit Fee:
$1.00 to$5,000.00 Minimum fee S72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to S10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Other Inspections or Fees Qty. Fee tea) Total each additional$100.00 or fraction thereof,to
and including S 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 S 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 S379.50 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 850,001.00 and up $742.00 for the first S50,000.00 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 ❑ Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
-Jacuzzi/Whirlpoolengineer.
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 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"
3" Isometric or Riser Diagram
4 ❑ 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
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
Sink: dav/Bar non-food related 1
-Bradley
-Com/Serv/Util food related
-Service *Note: If the fixture work under this permit results in an
Swimming Pool Finer increase of sewer EDl)s 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:
1:113uilding\Permits\PLMF_PermitApp.doc 08/04/2011 2
m Accumulative Sewer Tally
1111 Tenant Name: Spec Space SWR# N/A
Site Address: 10260 SW Greenburg Rd,300 PLM# 2021-00373
ncnxD Parcel#: 1S135AB03400
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: -"1'ub/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= $6,085.00
Previous Fixture Value 0 divided by 16_ 0.000 Previous EDU
Change -2 divided by 16= -0.125 over (under) $ (791.05)
Enter EDU Change Here -0.130 *
*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.Ol.
Notes: .13 EDU CREDITS
Authorized Name/Signature: Dianna Omelas Date: 9/1/2021
Building Division
sote: The property owner shall retain the ORIGINAL sewer tally record. If credits exist,this document will serve as a voucher which must be
ubmitted to the City of Tigard Building Division to redeem credits towards future system development charges.
I:\Building\Sewer Tally\SewerTallyShect_6085_07012l.xlsx