Permit lig CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2022-00166
T t A 111 T) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 5/5/2022
6
Parcel: 1 S 135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD
Project: Lincoln Center Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Replace 3/4"backflow in 13th floor mechanical room.
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 Backflow Preventer 05/05/2022 $31.27
Specifics: 1 12%State Surcharge- 05/05/2022 $8.70
Plumbing
Type of Use: COM 41 ea Minimum Fee Adjustment- 05/05/2022 $41.23
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: / /U(-11) Cly C/mil/ Permittee Signature: C'1
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.
D
Plumbing Permit Application C I /EGO
Building Fixtures APR 1 v 2022 FOR Orrl('l•: I Sr: (Ll.\
City of Tigard Received
t l I Y OF TIGARD Date/By "I /D/1 permit No.: jLf11..Odj 0Q a
III • 13125 SW Hall Blvd.,Tigard,OR 9722 D�
Plan Re,;ew:
R• Phone: 503.718.2439 Fax: 503.598410.DING DIVISION Date/BY Other Permit No..
Inspection I me: 503 639 4175 ——
f t C i A R 1) Date Ready/By:: n 0 See Page 2 for
Internet. www tigurd-or.gos Notified/Method: G Supplemental Information
TYPE OF WORK FEE* SCHEDULE
----------------- ---
❑New construction 0 Demolition For special information use checklist
Description I Qty. [ Ea. 1 Total
®Addition/alteration/replacement ❑Other New I-2-family dwellings(includes 100 ft for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
0 1-and 2-family dwelling EaCommerc;allindustr;al SFR(2)bath 337.78
0 Accessory building 0 Multi-family SFR(3)bath 500.32
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 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 ft.:_) Page 2
Suite/bldg./apt.no.: Project name.22-573
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: Lot no: Fixture or item:
Tax map/parcel no: Backflow preventer 1 31.27
DESCRIPTION OF WORK Backwater valve 12 51
Clothes washer 25.02
REPLACE 3/4" BACKFLOW 13TH FL MECHANICAL ROOM Dishwasher 2502
Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER L 0 TENANT Expansion tank 12.51
Fixture/sewer cap 25.02
Name:
—' — 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
0 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(comnicrcial) 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 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 56.29
Address:6611 SW MULTNOMAH BLVD Other: 2502
City/State/ZIP:PORTLAND, OR 97223 Subtotal
Phone:I 503-244-1900 f Fax 1503l 244_8825 _ Minimum permit fee: S72 50
CCB Lic:52378 Plumbing lie no.. 34-150PB Plan review (25%of permit fee)
// State surcharge(12%of permit fee)
Authorized signature: j1l1/�7_ Clie4A-t.�'Q — TOTAL.PERMIT FEE ST ,
Print name.KRISTIE BRAMWELL!!!! (tom Date 4-1 3-2022 This permit application expires if a permit is not°Maine(',+;thin 188 days
after it has been accepted as complete.
•Fee methodology set by Tri-Counry Building Industry Service Board.
!j I'\BuildingiPerntits\TEND-PermnApp.mice itFot/o9 440-46I6Tt 10ro2/C'OM/WFB)
3
i
Plumbing Application A lication - City Tigard
Ti and
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee:
Footing drain-1"I00 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
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$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-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$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
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
Baptista/Pont ❑ Any new commercial building with water service 2"and
greater,except systems designed and stamped by licensed
Bath' -Tub/Shower
-Jacuzzi/Whirlpool engineer.
Car Wash Each Stall ❑ 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 lire 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
❑ 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: lithe 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:
I:1Building\Permits\PI.MF_PermitApp.doc 08/04/2011 2