Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2021-00322
Date Issued: 8/12/2021
T f G MID D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S135A601003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 380
Project: Spec Space Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Interior plumbing for TI: Replacing(1)dishwasher,(1)2"floor drain,and(1)sink;Installing(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 07/28/2021 $25.02
Specifics: 1 ea Floor Drain/Floor Sink/Hub 07/28/2021 $25.02
1 ea Primer 07/28/2021 $12.51
Type of Use: COM 1 ea Sink 07/28/2021 $25.02
Class of Work: ALT 1 ea Water Heater 07/28/2021 $37.52
Type of Const: 1 12%State Surcharge- 07/28/2021 $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: /n Permittee Signature: pers0717- 61
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 ApplicatiRECEIVED 6' -
Building Fixtures tOR 0111( 1: 1 tit. O\l 1
JUL 19 2021 Received
City of Tigard tt�By. 7,0„),7 2, __ Permit No.:f 7-J_p03.�,
13125 SW Hall Blvd.,Tigard,OR 97 2 �OF TIGARD Plan Review L
O ' Phone: 503.718.2439 Fax: 503.5 Date/By: OrherPennitNo.: >N�l� P91_�/
Inspection Line: 503.639.4175ING DIVISION Date Read B ��f� 0 age 2 orl " F TIGARD Internet: www.tigard-orgov Notified/Method: 7/"1.1/4i / -' 1 1(a} Supplemental Information
TYPE OF WORK 0 Elena
r',[o J K„ FEE" SCHEDULE
0 New construction 0 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 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory buildingSFR(3)bath 500.32
❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 10300 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.:380 I Project name:21-438
JaC�G ...yam Manufactured home utilities 50.03
Cross street/directions to job site: (7 I� Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear It:_) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.:_) Page 2
.� ubdivision: Lot no.: Fixture or item:
1....s....
w Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
• Clothes washer 25.02
L.VSP SUITE 380, 1 LINCOLN TENANT IMPROVEMENT Dishwasher 1 25.02 V2_
, Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER ' ❑ TENANT Expansion tank 12.51
Name_ Fixture/sewer cap 25.02
Floor drain/floor sink/hub 1 25.02 .9-'`0)-
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:POWER PLUMBING CO. Medical gas(value:$_) Page 2
Primer 1 12.51 Ov.5)
Contact name: MIKE WARREN
Roof drain(commercial) 12.51
Address: P.O. BOX 19418 sink/basin/lavatory 1 25.02 2S,v),,
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
Water closet 25.02
CONTRACTOR
Water heater 1 37.52 ti 7,5 -
Businessname:POWER PLUMBING CO. Waterpiping/DWv 56.29
Address:6611 SW MULTNOMAH BLVD Other: 25.02
City/State/ZIP:PORTLAND, OR 97223 Subtotal 40.5-,4/7
Phone:( 503-244-1900 Fax:( 503-244-8825 Minimum permit fee: $72.50
CCB Lie.:52378 Plumbing Lic.no.: 34-150PB Plan review (25%of permit fee)
State surcharge(12%of permit fee) -- jT C)I
Authorized signature: 1 /„r,�Z�,- j��� / TOTAL PERMIT FE /ttd i J
Print name:KRISTIE BRAMWELL Date:7-19-2021 This permit application expires if a permit is not obtained hie 180 days
after it has been accepted as complete.
•Fee methodology sct by Tri-County Building Industry Service Board.
11Building5nmitslPLMU-Petn,aApp.doc 10/01/09 440-4616T(101021COMM1VEB)
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' 3,601 to 7,200 $233.20
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
Storm&Rain Drain-1st 100' 62.54 Valuation: Permit Fee:
$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 5100.00 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 or 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$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 $742.60 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
Quantii 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 Rdewte
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.
El Wash: -Each Stall New exterior plumbing site utilities for any complex structure
as defined in OAR918-780-0040.
Cuspidor/Water Aspirator CIMedical 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" ram Isometric or Riser Diagram
Car Drain 0 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
Sink: -Lav/Bar 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
washer-clothes increase of sewer EDUs,a sewer permit will be issued and
Water Ex act x fees assessed for the sewer increase must be paid before the
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
I:1Building\Petmits'PLMF_PermitApp.doc 08/04/2011 2