Permit CITY OF TIGARD PLUMBING PERMIT
s COMMUNITY DEVELOPMENT Permit#: PLM2021 00484
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/1/2021
Parcel: 1 S135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 545
Project: Gallagher Basset Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Interior plumbing for TI:ADDING(1)DOMESTIC DISHWASHER;(1)FLOOR DRAIN;(1)PRIMER;(1)
BREAKROOM SINK;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 11/30/2021 $25.02
Specifics: 1 ea Floor Drain/Floor Sink/Hub 11/30/2021 $25.02
1 ea Primer 11/30/2021 $12.51
Type of Use: COM 1 ea Sink 11/30/2021 $25.02
Class of Work: ALT 1 ea Water Heater 11/30/2021 $37.52
Type of Const: 1 12%State Surcharge- 11/30/2021 $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: Permittee Signature: SA /-
`j�
` Call 503.639.4175 by 7:00 a.m.for the next available inspection date. CC''��
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 ApplicatiiiECEIVED .. -,. o 0
Building Fixtures NOV 8 2011FOR (]ruler: usl': O l.V
Received // /� �/
City of Tigard DarelBy: L 0 fi�‘�dZ(.1li'obY��,
r Phone SW Hall.239 Tigard,
OR 9na�lTY OF TIGNH� Plan Rccicvc Ag /-0Da-/7
Phone: 503.718.2439 43. Fax: 503.59$1lR¢(}-�ING DIVISION Date/By: r
TIGARD Inspection Line: 503.639.4175 Date Ready/By: Ef See Page 2 for
Internet: wwht'.ligard-or.gov Norifled�te hod: /�/�� Supplemental Information
TYPE OF WORK I TEE* SCHEDULE
❑New construction 0 Demolition For special information use checklist
Description I Qty. I Ea. I Total
®Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
0 1-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
0 Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 10220 SW GREENBURG RD Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:TIGARD, OR 97223
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.:545 I Project name:21-6O4 trp J/i i,tor Manufactured home utilities 50.03
Cross street/directions to job site: 4 A 53 7 Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(ro.linear ft.:_) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
• Clothes washer 25.02
GALLAGHER BASSETT T.I. (/J V1411 r-/ Dishwasher 1 25.02
.U1 ROCOI d/�rt+i7/ (I) /Qp'i ter/ (/) brc*kroow si'a,� Drinking fountain 25.02
4 Rd (/) ( I i h e,k.'• Ejectors/sump 25.02
0 PROPERTY OWNER ' jc ❑ TENANT Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub 1 25.02
Address: Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
0 APPLICANT ❑ CONTACT PERSON. Interceptor/grease trap 25.02
Business name:POWER PLUMBING CO. Medical gas(value:$ ) Page 2
Printer 1 12.51
Contact name: MIKE WARREN Roof drain(cotroncrcial) 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
- - - Water closet 25.02
CONTRACTOR
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 pennit fee: $72.50
CCB Lie.:52378 Plumbing Lic.no.: 34-150PB Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: • to t-- a,G,1 TOTAL PERMIT FEE
Print name:KRISTIE RAMWELL J Date: 1-8-21 This permit application expires if a permit is not obtained within 190 days
after it has been accepted as complete.
''Fee methodology set by Td-County Building Industry Service Board.
I:1Bulding\Pesnilt9PLMU-PernutAp.doe 10VI/09 440.4616T(10,02.COMAYEB)
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
3,601 to 7,200 $233.20
Sewer- 1st 100' 62.54 7,201 and greater $327.54
Seger-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 Qr>. 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 each additional$100.00 or fraction thereof,to
(minimum charge-I/2 hour) and including$25,000.00.
Inspections outside of normal business 90.00/r $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 $742.00 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
Quantt •by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace Please check all th•tt 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
•lacuui/Whirlpool engineer.
Car Wash: -Each Stall ❑ New exterior plumbing site utilities for any complex structure
-Drive Thru as defined in OAR918-780-0040.
Cuspidor/IVateraspirator ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher: Coirator ial ❑ Any multipurpose fire sprinkler system.
Domestic f ID 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" 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: -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
Washer•Clothes increase of sewer EDUs,a sewer permit will be issued and
Water Extractor fees assessed for the sewer increase must be paid before the
WaterCloset-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
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