Permit CITY OF TIGARD PLUMBING PERMIT
■_. COMMUNITY DEVELOPMENT Permit#: PLM2022-00185
T I GAP.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 5/19/2022
Parcel: 1 S 135AB 01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 400
Project: KPA Tenant Improvement Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Interior Plumbing: Relocation of:(1)dishwasher,(1)2"floor drain,(1)lay sink and new installation of(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 05/19/2022 $25.02
Specifics: 1 ea Floor Drain/Floor Sink/Hub 05/19/2022 $25.02
1 ea Primer 05/19/2022 $12.51
Type of Use: COM 1 ea Sink 05/19/2022 $25.02
Class of Work: ALT 1 ea Water Heater 05/19/2022 $37.52
Type of Const: 1 12%State Surcharge- 05/19/2022 $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: ✓ 5 rl! Permittee Signature:
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 ApplicatI iECEI V ED
Building Fixtures APR 2 9 2022
City of Tigard �I Received / Pennil No.:
■ 13125 SW Hall Qlvd.,Tigard,OR 9728riTY OI• [IGARD Date/By: /'�5 /c�l<}-, } Pzr'l aoad --oDi 5
�19a►NG DIVISION PlenRy'tw
Phone: 503.718.2439 Fax: 503.5 I pg�g Other Permit No.:
i i l ^µt) Inspection Line: 503.619.4175 Nate Ready/By: i @I See Page 2 for
Internet: www.tigard-or.gov Notified/Method: J((-5 Supplemental information
TYPE OF WORK FEE* SCHEDULE
❑New construction ❑Demolition For special information use checklis/.
Description I Qty. I lia. I ' Total
®Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for cacti utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
0 1-and 2-family dwelling 2)Commercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler(_sq.R.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 10220 SW GREENBURG RD Catch basin or area drain 18.76
City/StaterLIP:TIGARD, OR97223 Dtywell,leach line,a trench drain 18.76
Footing drain(no.linear II.: ) Page 2
Suite/bldg.apt.no.:400 I Project name:22-584 Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear II.:_) Page 2
- Stonn sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backfow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
KPA TENANT IMPROVEMENT Dishwasher 1 25.02 0
Drinking fountain 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 1 25.02 ray as,
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
❑ APPLICANT 0 CONTACT PERSON Inlerceptor/grease trap 25.02
Business name:POWER PLUMBING CO. Medical gas(value:S_) Page 2
Primer 1 12.51 1 I 51
Contact name: MIKE WARREN Roof drain(commercial) 12.5I
' Address: P.O. BOX 19418 Sinkibasin/lavatory 1 25.02 'Lj C',
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 57 CI
Business name;POWER PLUMBING CO. Waterpiping/DWY 56.29
Address:6611 SW MULTNOMAH BLVD Other: 25.02
City/State/ZIP:PORTLAND, OR 97223 Subtotal
Phone:( 503-244-1900 Fax:( 503L Minimum permit fee: $72.50 244-8825 la 5,°1
cal Lie.:52378 Plumbing Lic.no.: 34-150P6 Plan review (25%of permit fee)
��---yy'' State surcharge %of per fee) (�e
Authorized signature: fr.?„/� G4"n TOTAL PERMIT
mit FEE y4 ,j0
Print name:KRISTIE B WELL ��yy�� Date:4-29-22 This permit application expires if a permit Is not obtained within ISO days
after it has been accepted as complete.
•Fee methodology set by Tri•County Building Industry Service Board.
I:IBuildinglPen is'PLMU•PrrmiiApp.doc 1001/0 440-4616T(10/02/Cf1MtWE8)
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-1 st 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 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 aeach ndincdiitinnnal$11 g 00000orfractionthereof,to
.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-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 525,000.00 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 S50,000.00 and$1.20 for
(minimum charge-112 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: trapped Added Relocate
Baptistry/Pont 0 Any new commercial building with water service 2"and
greater,except systems designed and stamped by licensed
Bath: -Tub/Shower engineer.
-Jacuzzi/Whirlpool
Car Wash: Each Stall 0 New exterior plumbing site utilities for any complex structure
Drive Thru as defined in OAR918-780-0040.
CuspidodWaterAsirator 0 Medical gas and vacuum systems for health care facilities.
Dishwasher: -Commercial ❑ Any multipurpose fire sprinkler system.
-Domestic t ❑ 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" 0 Isometric or riser diagram is required for new buildings
-Car Wash Drain
Garbage Domestic non-rood 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
-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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