Permit CITY OF TIGARD PLUMBING PERMIT
• COMMUNITY'DEVELOPMENT Permit #: PLM2010 -00013
T l G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 01/12/2010
Parcel: 1 S135AB01003
Jurisdiction: Tigard
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Site address:_, 10300 SW GREENBURG RD 590
Subdivision: Lot: 0
Project: ID Expert •
Project Description: Replace existing d /w, floor drain (same size), garbage disposal, sink, and w /h.
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Owner: FEES
LINCOLN CENTER LLC Quantity Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
CALIFORNIA ST 49TH FL 1 ea Dishwasher 01/12/2010 $25.02
PHONE: 1 ea Floor Drain/Floor Sink/Hub 01/12/2010 $25.02
1 ea Garbage Disposal 01/12/2010 $25.02
1 ea Sink 01/12/2010 $25.02
Contractor: 1 ea Water Heater 01/12/2010 $37.52
POWER PLUMBING CO 1 12% State Surcharge - 01/12/2010 $16.51
PO BOX 19418 Plumbing
PORTLAND, OR 97280 •
PHONE: 503 - 244 =1900 . •
FAX: 503 - 244 -8825 •
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Type'of Use: COM
Class of Work: - ALT Type of Const:
Occupancy Grp:
Stories:
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Total .$154.11
Required Items and Reports (Conditions)
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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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
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Issued By: •� 1 \` , ' 1 Permittee Signature:
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Call 503.639.4175 by 7 :00 a.m. for an inspection that business day.
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.
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111111 11/201't/MON J9:43 AM POWER PLUMBING FAX No, 503 244 8825 P. 001
1 v .
Plumbing Permit Application
CEIVE
Buildin Fixtures ,
FOR OFFICE USE ONLY
City of Tigard R J Permit No.��p20I0 0001S
111 - 131 SW Hall Blvd., Tigard, OR 97223 JAN 11 201 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 �+ TIGARD Date/By: Collier Permit No.: 6 Co CCS
T IG i) inspection Line; 503.639.4175 CITY 1 �/ OF i?ate Ready/By: .1u : FA See Page 22 for
Internet; www.tigard -or gov 1 DIVISI 1 I1�ettaedmethoe ;75,, Supplemental Irtformadon
�+- e' d f , (. . ? .'r a t ch ti ' - , 11- M r r � f, �C .: 1 T �� - 1f F 6 ,-, 1, - . 1 7-:--7 N, y C'I I 1 7 � ',. 5- #• " +,' y , ,,tyy~,.�! :
y vt.7 . 5:4 a 1y� �,',�,+t ,, l.„. ` n .i� .f I 3 � „ -85.3 ' ,p . 1 p 1 ]v�r�_.__ � :�; � ;.-1-, L. :.,,1, -,
El New construction ❑ Demolition
For special information use checklist
Description I Qty. I Ea. I Total
r1 Addition/alteration/replacement O Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
aT i S T ,.r - 7 v 4 T' - 1 ti fT n I� S ` r .� v. ,.. 1 ,
: N .z r.:: tc fs- it�vlZ;j7o)-t.:1- .7.. .1 I�Cst C i`Iti c riFE l ` x-c r °, 5FR(1)bath I 31270 I
_ r _. ,1 -- , _ ._, t -. , z. �, ,r s :� _. _.� t _ �s , SFR (2) bath
437.78
❑ 1- and 2- family dwelling ❑ Commercial/industrial
SFR (3) bath 500.32
❑ Accessory building ❑ Multi- family Each additional bath/kitchen 25.02
ID Master �builder ❑Other: - Fire sprinkler ( sq. ft) Page 2
r i) 3) 3. 1` - L r. n Y , , i, r1 r t l d
t r ? ,` t c :Tel rWJ'i i(t. "=� c,•c���rc Pt :. E' `.'K Site utilities ,
I � :�'f -� .: c. � � . .�r � " _�. �JS-A .,_ .. c, 1 ..� : p , : vitC..:.:L . .,,
Job site address: i WC Si,) ( ..y , pure) ' , Catch basin or area drain 18.76
Drywall, leach line, or trench drain 18.76
City/State/ZIP: • / 1 •e 3 -)-
Ili Footing drain (no. linear ft.: ____) Page 2
. ldgJapt- no.. 2All . h . Project name: P r A ` Manufactured home utilities 50.03
Cross sheet/dire . ons to job site: Manholes 18.76
L D �. A-+ L�`N r 0 Rain drain connector 18.76
• ' l Sanitary sewer (no. linear R: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Water service (no. linear ft.: 1 Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map /parcel no.: Sack(low prevents 31.27
31.27
;s[-I ., r r , , 1 s =��, '� - - firTRFA Backwater valve 12.51
z. ,x7t.z.:2 r . Ca kill a.. . ^- + 1fi �f'el t c e• F 4 . `'n
iij,rx fY c�. a 4 #9 .4a..t�2't4� Wu I?�s6?' y :K i E. �'i z.+�. Cloth
�,�....:. � �r..,....` ._. Clothes washer 25.02
M I.�- S V _� ( V _ Dishwasher � Fja
reply i IDifk ` Lida o f . r / Drinking fountain 25.02
U ( I r Ejectors /sump 25.02
�-" t tfnl --:y rlvc .� 41.-I rti` 0..a. , J, 1-i =-
� %tL �G 1 1 l .. �! . am y1.4 �w S :F �'iV]ta r,kai Ci r T1 , it �!' -: bxpansion tank 12.51
" � Fixture/sewer cap 25.02
r
•L e r !/ r
Floor draitUfloorsink/hub I 25.02 1
Address: Garbage disposal I 25.02 2_
City/State/ZIP: Hose bib 25.02
Phone: 603) 2 • Fax ( ) Ice maker 12.51
m� --ic s/ , irls`•4 y iii :� � 1 9 } F: - Ni l .l t sv 4 , N I ` t _ ? i Interceptor /grease trap 25.02
Business name: • _ . p tom" Medical gas (value: $ ) Page 2
;I-0k^ h Roof 12.51
Contact name: _ V Roof drain (commercial) 12.51
Address: (0 I I . .t f (4 /l4J\ Qj) vd Sink/basinfavatory I 25.02 2.5 6 L
City/State/ZIP: T M 1 62.54
) i o� �-� Solar units (potable water)
Phone: ' • ) 'ati - GO Fax :: (5:8) . ,..e. 2, Tub /shower /shower pan 12.51
Urinal 25.02
E-mail:
(' l , r x y Y F- x ✓t1 ? ,-_-,, i i„ .. ,. ,; ,. aT'c I �-r T � 1 Water closet 25.02 5.31 ►; t� t a..N. .:,=1,`:k': . 4 r .)i . i t ' °. .•1, u,s.,,,..14.1...,;3 . I r . Water heater I 37.52 37 d-
w ! ... / _ Water pipingfDWV 56.29
Address: I • ;`) q b Other. 25.02
City /State/ZIP: PIP& (y C,`7 Subtotal 13 57 66
Phone: (505) ,,A.1_9 t OV 603) a Minimum permit fee: $72.50.
Fax:
Plan review (25% of permit fee)
CCB Lic.: Pl Lic. no.: 4, P p? State lurch 5
�. surcharge (12/° of permi fee ) 1
Authorized signature: TOTAL PERMIT FEE 1 4. ( (
�/ r ( _
c n This p ermit appliatlon expires if a permit is not obtained within 180 days
I Print name: K ` J `t,I 1 Date: I I I 1 after It has been accepted as comptet
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*Pee methodology set by Tri- County Building Industry Service Board.
0.13vilding1PmnitalMt1- PemitAp0.doe 10/01/09 440.4616Tt 0)021CO
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