Permit CITY OF TIGARD PLUMBING PERMIT
2. . COMMUNITY DEVELOPMENT Permit#: PLM2021-00371
Date Issued: 9/2/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 1S135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 125
Project: Fitness Center Subdivision: METZGER,TOWN OF Lot: 9
Project Description: ADD(1)drinking fountain and relocate(6)shower stalls.
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 Drinking Fountain 09/02/2021 $25.02
Specifics: 6 ea Tub/Shower/Shower Pan 09/02/2021 $75.06
1 12%State Surcharge- 09/02/2021 $12.01
Type of Use: COM Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $112.09
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: ze
/!li l �' Permittee Signature: CA,• f j �J7� 1-77LAda
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 Applicat CEIVED e-cat‘ci 12-
Building Fixtures AU6 1 9 2021 Fort orrlci•: Fsi: ()Nil
City of Tigard 11TY OF TIGANL Received
7 'i/2/ 'ti P`rmitN`f t,ti UZI-0037/
13125 SW Hall Blvd.,Tigard,OR 97425 Plan Revie
Phone: 503.718.2439 Fax: 503.1UN DING DIVISION Date By: Other Permit�:w)/aid"71 "D(�a xr
Inspection Line: 503.639.4175 Date Reed/B r ® Sre Page 2 for (/t
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Internet. s1�+w.tigard-or.gov NoligedlMe[ttod� / ` 1 L-7 Supplemental Information
TYPE OF WORK UM*I l., ST/ 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(1)bath 312.70
❑ 1-and 2-family dwelling ®Commercial/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:
lob site address: 10220 SW GREENBURG RD Catch basin or area drain 18.76
City/State/ZIP:TIGARD, OR 97223 Drywall,leach line,or trench drain 18.76
Footing drain(no linear ft.:_) Page
Suite/bldg./apt.no.:125 I Project name:21-460 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 FITNESS CENTER REMODEL SUITE 125, 3 LINCOLN Dishwasher washer 25.02
Dishwasher 25.02
Drinking fountain 1 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Name: Fixture/sewer cap 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 0 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 Tub/shower/shower pan 6 12.51
E-mail:SERVICE@POWERPLUMBINGCO.COM Urinal 25 02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:POWER PLUMBING CO. Water piping/DWV 5629
Address:6611 SW MULTNOMAH BLVD Other: 2502
City/State/ZIP:PORTLAND, OR 97223 Subtotal Idt) . D?
Phone:( 503-244-1900 Fax'( 5031-244-8825 Minimum permit fee: $72.50
CCB Lic.:52378 Plumbing Lic.no.: 34-150PB Plan review (25%of permit fee)
State surcharge(12%of permit fee) I Za 0 j
Authorized signature:�fr-e. if c-�le TOTAL PERMIT FEE II 2 l
e
Print name:KRISTI BRAMWELL Date:8-19-21 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.
1:18mldingtPermits\PLMU-PermitApp doe 1001(09 440-46161-(101o2/COMiNE8)
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 0 to 2,000 $121 90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
Serer-1st 100 62.54 3,601 to7,2 $233.20
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$1.54 for
which no fee is specifically indicated 90.00/hr
(minimum charge-1/2 hour) each additional$100.00 fraction thereof,to
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$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 Fixture Type Plan review is required fbr any of the follow ing.
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
engineer.
-Jacuzzi/Whirlpool
ElCar Wash: Each Stall New exterior plumbing site utilities for any complex structure
Dr ve Thm as defined in OAR9I8-780-0040.
Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities.
Dishwasher -Commercial 0 Any multipurpose fire sprinkler system.
Domestic El 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
El 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 Mack/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 6
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 fees assessed for the sewer increase must be paid before the
Water Extractor
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
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