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Permit (4) CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT71 Permit#: PLM2022 00404 Date Issued: 10/5/2022 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S135AB00900 Jurisdiction: Tigard Site address: 10200 SW GREENBURG RD 200 Project: Spec Space Subdivision: METZGER,TOWN OF Lot: 9 Project Description: Landlord work prior to TI:Capping(1)dishwasher, (1)2"floor drain,and(1)sink. Contractor: POWER PLUMBING CO Owner: LINCOLN CENTER LLC PO BOX 19418 BY SHORENSTEIN PROPERTIES LLC PORTLAND, OR 97280 555 CALIFORNIA ST 49TH FL SAN FRANCISCO, CA 94104 PHONE: 503-244-1900 PHONE: FAX: 503-244-8825 FEES Quantity Description Date Amount 3 ea Fixture/Sewer Cap 10/05/2022 $75.06 Specifics: 1 12%State Surcharge- 10/05/2022 $9.01 Plumbing Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $84.07 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 l 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 e Issued By: 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 Application '7 . .. i2_ti Building Fixtures RECEIVER I/()R OFFICE USE ONLY CityTigard al•d Received 2 q�gq rennitNo.: n 13125 SW Hall Blvd.,Tigard,OR 97223 JUN 9 LY2L Date/By: l o ).L . fi. )a_Ur)Liel Plan Review /� �� Phone: 503.718.2439 Fax: 503.598.1960 �/(�g Other Permit No.: / - Date/By: �3L�/• Inspection Line: 503.639.4175 Date Ready/By: tuns: B! See Page 2 for TIGARD p ,IT`(OF TIGARD id/Vie Internet: www.tigard-or.gov yy�,� Notified/Method: �,�) 6 Supplemental Information TYPE OF `rVORPN `"� FEE* SCHEDULE ❑New construction ❑Demolition For special i/tforutntiort use checklist.T Description I Qty. 1 Ea. ( 'total ®Addition/alteration/re lacentent 0 Other: pNew 1-2-familydwellings(includes 100 ft.for each utilityconnection) g CATEGORY OF CONSTRUCTION - ,,,..,rri. SFR(I)bath 312.70 ❑ 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 ❑Accessory buildingMulti-family- SFR(3)bath 500.32 0 ------ - - 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: 10200 SW GREENBURG DR 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.:200 I Project name:22-630 Sp.ec.% SA,�,r-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 liens: Tax map/parcel no.: Backtlow preventer 31.27 DESCRIPTION OF WORK Backwater valve t2 51 2_ Clothes washer 25.02 VSP SUITE 200, 5 LINCOLN Dishwasher -. 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 0 PROPERTY OWNER l ❑ TENANT Expansion tank 12.51 Name: Fixture/sewer cap 3 25.02 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 ❑ APPLICANT 0 '.CONTACP 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(commercial) 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 Pltone:( 503-244-1900 Fax::( 5031.244-8825 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. WaterpipinglDWV 56.29 Address:6611 SW MULTNOMAH BLVD Other: - 25.02 City/State/ZIP:PORTLAND, OR 97223 Subtotal Phone:( 503-244-1900 Fax:( 5031244-8825 Minimum permit fee: $72.50 - - CCB Lie.:52378 Plumbing Lic.no.: 34-150PB Plan review(25%ofpermit fee) w> State surcharge(12%of permit fee) 1,4,Authorized signature: ! .a TOTAL PERMIT FEE Print name:KRISTIE BRAMWELL tut Date:7-29-2022 This permit application expires if a permit is not obtained within ISO days after it has been accepted as complete. *Fee methodology set byTri-County Building Industry Service Board. I:\tluitding\Permits\PLMU-PernillApp.doe 10/01/09 4,10-1616T(t0/02/COMUWE©) Pu^\2022-COLLCM • 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' 62.54 3,601 to 7,200 $233.20 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 each additional$100.00 or fraction thereof,to l3 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 Replore/ Please check all that apply. Work Performed: Capped Added Relocate Baptistry/Font ElAny new commercial building with water service 2"and greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jactini/Whirlpool Car Wash: -Each ❑ New exterior plumbing site utilities for any complex structure Stall as defined in OAR918-780-0040. -DrivCuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities. ❑ Any multipurpose fire sprinkler system. Dishwasher: -Commercial Domestic 1 ❑ 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" 1 -3" Isometric or Riser Diagram 4,. ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain 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 1 -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: I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 Accumulative Sewer Tally 111111 Tenant Name: SPEC SPACE SWR# N/A Site Address: 10200 SW GR1?ENBURG RD SU11'1?200 PLM# 2022-00404 1 ( ARt) Parcel#: 1 S 135AB00900 Fixture Value 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 1 2 0 -1 -2 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 0 -1 -2 -3 inch 5 0 0 0 0 0 -4inch 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 HP) 32 0 0 0 0 0 -Industrial(over 5 HP) 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: -Lay/Bar-Non-Food Related 2 0 1 2 0 -1 -2 -Bradley 5 0 0 0 0 0 -Com/Serv/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 0 0 0 0 Urinal 6 0 0 0 0 0 Previous EDU Count 0 0 Capped EDU Credit 0 TOTALS 0 0 3 6 0 0 -3 -6 Current Fixture Value -6 divided by 16= -0.375 Current EDU 1 EDU= $6,625.00 Previous Fixture Value 0 divided by 16= 0.000 Previous EDU Change -6 divided by 16= -0.375 over (under) $ (2,517.50) Enter EDU Change Here -0.380 * *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: Authorized Name/Signature: BRANDEN TAGGART X2449 Date: 10/5/2022 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 Tally\SewerTallySheet_6625_070122.xlsx