Permit CITY OF TIGARD PLUMBING PERMIT
_ ■ Permit#: PLM2022-00458
COMMUNITY DEVELOPMENT
T I G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/9/2022
Parcel: 1 S 135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD
Project: Lincoln Center Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Interior plumbing for lobby restrooms:Capping(1)2"floor drain/sink,(3)sinks, (1)water closet,(1)urinal,and(1)
grease interceptor;Adding (1)2"floor drain/sink and(1)sink; Installing(1)ice maker,(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
7 ea Fixture/Sewer Cap 11/09/2022 $175.14
Specifics: 1 ea Floor Drain/Floor Sink/Hub 11/09/2022 $25.02
1 ea Ice Maker 11/09/2022 $12.51
Type of Use: COM 1 ea Primer 11/09/2022 $12.51
Class of Work: ALT 1 ea Sink 11/09/2022 $25.02
Type of Const: 1 ea Water Heater 11/09/2022 $37.52
Occupancy Grp: 1 12%State Surcharge- 11/09/2022 $34.53
Stories: Plumbing
Total $322.25
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: /
-47
2>VIat„ (4.ge
Call 503.639.4175 by 7:00 a.m.for the next available inspection ddat__e.
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 Application.
Building Fixtures Hf C / AyyFOR OFFICE, usE ONLY 1 �y/r r �J
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City of Tigard SEP 0 6 2022 Des;y 6{ g zl Y/lJ t'"n"t No.:p[� n0 " tN Id,A
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■ 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
ill R Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.:
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date ReadyBy: lurk: El See Page 2 for
Internet: www.ligard-or.gov FUMING DIVISION Notified/Method: �/ //� Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑New construction 0 Demolition For special information use checklist
Description I Qty. I Ea. I Total
®Addition/alteralion/replacement ❑Other: New I-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
CI1-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
0 Master builder ❑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
City/State/ZIP:TIGARD,OR 97223 Drywall,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name:22-661 L h/rdi j (e r 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.: 1 5 ( / 0)47 i)O Backflowpreventer I 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
LINCOLN TOWER LOBBY UPGRADES T.I. Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER I 0 TENANT Expansion tank 12.5I
Fixture/sewer cap 7 25.02
Name:
Floor drain/floor sink/hub 1 25.02
Address: Garbage disposal 25.02
City/State/ZIP: _ Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 1 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name:POWER PLUMBING CO. Medical gas(value:$_) Page 2
Primer 1 12.51
Contact name: MIKE WARREN Roof drain(commercial) 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/show+erpan 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 stibtatal '..
Phone:( 503-244-1900 Fax:( 503-244-8825 Minimum permit fee: $72.50 ,.
CCB Lie.:52378 Plumbing Lic.no.: 34-150P6 Plan review(25%of permit fee)
1 State surcharge(12%of permit fee)
Authorized signature: K-e" (cy&ti.LZ2,4 e TOTAL PERMIT FEE 24)-a,
Print name:KRISTl BRAMWELL Date:11-8-2022 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.
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Plumbing Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(en) 'total Squpre.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 end 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(es) Total each additional$100.00 or fraction thereof,to
p and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first S10,000.00 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'I'ype for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate
Baptistry/FontElAny new commercial building with water service 2"and
greater,except systems designed and stamped by licensed
Bath: -Tub/Shower engineer.
-Jecuszi/Whirlpool
Car Wash: -Each Stall ❑ New exterior plumbing site utilities for any complex structure
-Drive Tam as defined in OAR9 I 8-7S0-0040.
Cuspidor/Water Aspirator ❑ Medical 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 t
3" Isometric or Riser Diagram
0 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: -Lav/Bar non-food related 3
-Bradley
-Com/Serv/Util food related
-Service *Note: Tithe 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 t plumbing permit can be issued.
Urinal t
Other Fixtures:GREASE INTERCEPTOR
1:1Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
Accumulative Sewer Tally
i Tenant Name: LINCOLN CENTER SWR# N/A
T G n x D Site Address: 10260 SW GREENBURG RD PLM# 2022-00458
Parcel#: 1S135AB03400
Fixture Previous Previous Credits Capped Fixture Fixture New New
# value count capped#s value count added# added value total#s total values
Baptisery/Font 4 0 0
0 0 0
Bath: -Tub/Shower 4 0 0 0 0 0
-Jacuzzi/Whirlpool 4 0 0 0 0 0
Car Wash: -Each Stall 6 0 0 0 0 0
-Drive through 16 0 0 0 0 0
Cuspidor/Water Aspirator 1 0 0 0 0 0
Dishwasher: -Commercial 4 0 0 0 0 0
-Domestic 2 0 0 0 0 0
Drinking Fountain 1 0 0 0 0 0
Eye Wash 1 0 0 0 0 0
Floor Drain/Sink: -2 inch 2 0 1 2 1 2 0 0
-3inch 5 0 0 0 0 0
-4 inch 6 0 0 0 0 0
-Car Wash 6 0 0 0 0 0
Garbage Disposal:
-Domestic(to 3/4 HP) 16 0 0 0 0 0
-Commercial(to 5 I IP) 32 0 0 0 0 0
-Industrial(over 5 I IP) 42 0 0 0 0 0
Ice Machine/Refrigerator Drain 1 0 0 0 0 0
Living Unit 16 0 0 0 0 0
Oil Sep(Gas Station) 6 0 0 0 0 0
Rec.Vehicle Dump station 16 0 0 0 0 0
Shower. -Gang(per head) 1 0 0 0 0 0
-Stall 2 0 0 0 0 0
Sink:
-Lav/Bar-Non-Food Related 2 0 3 6 1 2 -2 -4
-Bradley 5 0 0 0 0
0
-Com/Scrv/Util-Food Related 3 0 0 0 0 0
Swimming Pool Filter 1 0 0 0 0 0
Washer-Clothes 6 0 0 0 0 0
Water Extractor 6 0 0 0 0 0
Water Closet-Toilet 6 0 1 6 0 -1 -6
Urinal 6 0 1 6 0 -1 -6
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 6 20 2 4 -4 -16
Current Fixture Value -16 divided by 16= -1.000 Current EDU 1 EDU= $6,625.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change -16 divided by 16= -1.000 over (under) $ (6,625.00)
Enter EDU Change Here -1.000 *
*Round EDUs to the nearest 1/100th: a count ending in.005 shall be rounded up to.01,and a count ending in.014 or less shall be rounded down to.01.
Notes: ***CREDIT***
Authorized Name/Signature: BRANDEN TAGGART X2449 Date: 11/8/2022
Building Division
Note: The property owner shall retain the ORIGINAL sewer tally record. If credits exist,this document will serve as a voucher which must be
submitted to the City of Tigard Building Division to redeem credits towards future system development charges.
I:\Building\Sewer'Fatly\SewerTallySheet_6625_070122.xlsx