Permit , ` f CITY OF TIGAR® PLUMBING PERMIT
` COMMUNITY DEVELOPMENT Permit #: PLM2010 -00209
1GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/25/2010
... .." Parcel: 1S135AB01006
Jurisdiction: Tigard
Site address: 10500 SW GREENBURG RD 100
Subdivision: LINCOLN PLAZA Lot: 0
Project: Beal Bank
Project Description: Replace existing water closet and lavatory; install new water heater.
Owner: FEES
LINCOLN CENTER LLC Quantity Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
CALIFORNIA ST 49TH FL 1 ea Lavatories 06/25/2010 $25.02
PHONE: 1 ea Water Closet 06/25/2010 $25.02
1 ea Water Heater 06/25/2010 $37.52
1 12% State Surcharge - 06/25/2010 $10.51
Contractor: Plumbing
WEST COAST CENTRAL PLUMBING LLC
12714 SE MAJESTIC LN
HAPPY VALLEY, OR 97086
PHONE: 503 - 298 -0435
FAX: 503 - 855 -3264
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Total $98.07
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
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.
Issued By: /(V"S";72g774...r-S-"r----- Permittee Signature: /
Cali 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.
06/25/2010 07:11 50359131960 CITY OF TIGARD PAGE @2/03
Plumbing Permit Applicat ' ' i .
JUN 2 5 2010 1'0I2 OFFICE I ",tit <)ti►.,V
t City Tigard Pcr No.: 2^ /f D°� • t 3125 SW W Hall Blvd.. Tigard, OR 9 z /�� /�
Da Y PC�/�� "
� �
n Phone: 501 639.4171 Fax: 503 r f + C a• 1st r ' 1 ' ' ��r i ��' Review aerntu Q
u/ o?0 /Q ��� �
1. r c; ,t N I") Inspection Line: 503.639.4175 of . i 111 ■ J DexJa (>Hr Date Rudy/By: r ? ® See Pepe 2 for
[ nemet Www.tigtrd -orgov Notified/Method: Pi SU pplement I Intone anon
�'•.n .?• !!���,�.�'� s: ' &I`,44 , (,L -�,« y • ;�;�- �``�� , �;.
, e.-N- t : ' n " "-:�;! , ri se`'e-'e �•, �-•�•
:: y,i,, ; fC. N'fi'•. ' I /'Fw 4: :it'' r .4.4 �K-.. . 2Y •' ,. i . r.. `�La s''' '",'- 11,5.5' ' -- h ■
❑ New construction ❑ Demolition Fe:especial information use eheekl;.rr,
17cscriptwon 1 Qty. ] 6a. i Total
pt Addition /alteration/replacement ❑ Other. New .t- 2- tinnily dwcilings (incitldcs 100 It for each ati)ity connection)
k ec ti 'R; ^ x• , .,- ::E: 'iii o' :'tr4•a •.: . ; :,H!r' 03: SFR. (l) bath 312.70
❑ ) • and 2- family dwelling pj Commercial /industrial 5FR (2) bath 437.78
Accessory building SFR (3) bath 500.32
❑ ry g ❑ Multi family
Each additional bath/kitchen 25.62
❑ Master builder ❑ Other:
Fitt sprinkler( sq. ft w ) Page 2
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Job site address: C atc h b as i n or area drain 18,76
�if,(tb h tzet 1t 5cx Ol'�f Griff Ztti • � [00 Drywall. leach line. or trench drain 18.76
City/StatclZLP: : ? q -• Footing drain (no. linear tt :_) Paget
mt IC .�D ldg, /apt. no.: J 1 P roject name:
Mane fkaared home utilities SD.03
Cross street/directions to job �� sac: 03. ' - l t A. r•� Manholes 18.76
/� Rein drain connector 16.76
01r-P etkk>1 .
Sanitary sewer (nn, linear R,: -) R age 2
Storm sewer (no. linear ft.: Page 2
_
Water service (no. linear R.: ) Pagc 2
Subdivision: 1 Lot no.: Fixtvre or item:
-
Tax mup/pareel rm -: Backflaw preverter 31,27
< •: ?.. •;,.. ' n,
; r: ..r _ :� " $nckwatervalve 12.51
' I Clothes WASIIer 25.42
Ra 1 1 L 4 ,sr IhA re ip1.f j � } h� t-
' ti A Dlahwniher 25.02
kv N( ' F Xi h tC'7S� vSh.\,l ti ) ( Drinking fountain 25.02
Ejectors/sump 25.02
( x ` h e AA-tr. p _
: ` tr3irfi•::1 ��y i ;"''.'l lfAi�.t _•,'?X. �.c n ion tank 12.51
.�i•rZ: .. :...c;.. �.. .- �- .-- '�+�.� ' �c- "i�rY',•.i1��~M •_' ia? ';; �:Yil�ii "��...r ,- tlit.i ir� �_.` }:� E
p a
Name: Fixture/sew er cap 25,02
Flo drain /floor sink /hub 25.02
Address:
Garbage disposal 25.02
City1State2lP: Hass bib 25.02
Phone: ( ) Fax: ( y p ) lee maker 12.51
�(,;�
. ?,�;1 .r' - i,:' rs is :: -.i :' , tl 4 � n " .
�. g • r .P.7.�� ;:.L ; >.,. •,�, g, { ;i° Tilt' %: Interceptor/grease trap 25.02
Business name: m 'd"in Medical gas (value: S ) Page 2
ire
t►.el er. lr t . _a. •a a. Primer 12.51
Contact name: Ky t5 c` LLlf r�x- 4
Address:
A a i Roof drain (commercial) -
�� 1 i / !v` r ' ir.. 1 t. - Sinklbasinllavotor 25.02
City/State/ZIP: w � h. �� as-, o ,-
City /Slate
TA a, . , 7 b V e - Solar units (potable water) 62.54
Phone: ( • • , Mg
�.,."' _ • Tu b /shower /sbnwor pan 12.51
E - mail: Urinal 25.02
'•+,.g,.• w I .' 25.02 .134-
: `` w.• •:[•:,i'''' : yK ; . .•.: ',, w: Alert OSet
•r K_- ' c�a'o .; .- 11 - f1-77 q i . .._. ' ':a .::. . ....'•.-.. •r
y Wrucnc�axr " 37.52
Business name: �� '
a /.r i t 4 . Waterpiping/DwV 56.29
Address: itT1JL1 ' a�� L. •,. ' •, ,. • 4 Other. 25.02
City /Stxte/ZIP: ■ 4 n, Itiii.orinf, Subtotal
Phone: ( 1 ) . 11 . 1:._ . ►f► : _ Mininn+m permit rte: 572.50 j' . i 0• r 5
l Plumbing Lie, no.: .�
,� Plan review (25% of permit fee)
�' 4 State surc (12% of permit fs 1 4 7 /0 .5
Authorized signature: 1 e TOTAL PE
RMiT FEE
�}�1 �� T his pe esItnpernkis ;nM..ithin O
liiY i� eh a _ a ' . Dtrtc: L1 jL'� other a has been acto r nv t„nnlex. C{ I
'Fee methodology teP by Tri •Crony Balding Industry Sarvioe r1atrd,
ig ka lLitgotssiiir!PLMU- etrmilAePdoc 01O1t09 alma 6157110m2COMIWPBi
Z'd 179Z£ 5ulgwnld DOM e£9:90 0l• 9Z unr
.' ' ": :r ..'.'Qu'
.1 .... - .
ant ity byIFlsttrre):Wdrgperfortned .
� '..
'Plevlouu
.''!asTi eir t .
R
` tfiiittitar -
Baptistry/Font
.37.52
Bath - Tub/Shower
- Jacuzzi/Whirlpool
Sewer- 1st 100'
5327.54
62.54
5742.00 for the first 550,000.00 and 51.20 for
each additional 5100.00 or fraction thereof.
Sewer - each additional 100'
Car Wash -Each Stall
-Drive Tbru
Water Srrvicc - 1st 100'
62.54
Water Service • each additional 100'
Cuspidor/Water Aspirator
Storm & Rain Drain • 1st 100'
62.54
Dishwasher - Commercial
- Domestic
Storm & Rain Drain - each additional 10
37.52
r0'
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Inspection of existing plumbing or for
which no fee is specifically indicated
(minimum charge- 1/2 hour)
Drinking Fountain
90.00/hr
Inspections outside of normal business
hours [minimum charge - 2 hours)
90.00/hr
Eye A'ash
Reinspection Fees
90.00/hr
Floor T)rainisink -2"
• 3"
- 4"
Car wash Drain
90.001hr
Subtotal:
Garbage - Domestic
Disposal -Commercial
•Tdustrial
Ice Mach/Refrip. Drains
Oil Separator (Gas Station)
Roc, Vehicle Dump Station
Shower -Gang
-Stall
Sink - BnrlLavatory
- Bradley
- Commercial
- Service
Swimming Pool Filter
Washer - Clothes
Water Extractor
Water Closet - Toilet
Urinot
Other Fixtures:
g 1 !LJZJ.12K4'ii.!..cr ..A `Wi ?J .'
Footing drain - i" 100'
rR,
L"Ffi'
50.03
"•
Footing drain -each addition' 100'
5169.69
.37.52
$233.20
Sewer- 1st 100'
5327.54
62.54
5742.00 for the first 550,000.00 and 51.20 for
each additional 5100.00 or fraction thereof.
Sewer - each additional 100'
37.52
Water Srrvicc - 1st 100'
62.54
Water Service • each additional 100'
3732
Storm & Rain Drain • 1st 100'
62.54
Storm & Rain Drain - each additional 10
37.52
r0'
�
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y�
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^
Inspection of existing plumbing or for
which no fee is specifically indicated
(minimum charge- 1/2 hour)
90.00/hr
Inspections outside of normal business
hours [minimum charge - 2 hours)
90.00/hr
Reinspection Fees
90.00/hr
Additional plan review 0 r revisions
(minimum charge- 112 hour)
90.001hr
Subtotal:
•i i ,� a -• . ti
• -'e.d:s.... .tLc4
'r0- •' i - ' 1 :I '. +r`.' ,; • r :
rS.= .. ..h1%: - .Mira Al i. alr_•4:
0 to 2,000
5121.90
2,001 to 3,600
5169.69
3.601 to 7,200
$233.20
7,201 and greater
5327.54
•4 hS r
i:l ry , :. •:;ra yr !!..i„
51.00 to 15,43 CD
Minimum fee 572.50
55.001.00 to 510,000.00
572.50 fbr the first 55,000.00 and 51.52 for
each additional 5100.00 or fraction thereof, to
and including 510,000.00.
510,001.00 ti, 525,000.00
5148.50 far the first $10,000.00 and 51.54 fbr
each additional 5100.00 or fraction thereof. to
end including $25,000.00.
525.001.00 to 550.000.00
5379.50 for the first 525,000.00 and 51.45 fir
each additional 5100.00 or fraction thereof. to
and inc'uding 550,000.00.
550,001.00 and up
5742.00 for the first 550,000.00 and 51.20 for
each additional 5100.00 or fraction thereof.
65/25/2010 07:11 5035981960
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental information
Fee Schedule:
Commercial Fixture Work:
Are you capping, adding or replacing fixtures? if "yes",
please indicate work performed by fixture. Failure to
accurately report fixture: could result in increased sewer fees
1:15ui IdieglP cmiits\PLM F•ParmitApp.doc
E•d
179ZE
CITY OF TIGARD
Residential Fire Sut►pression Systems:
PAGE 03/03
Medical as Systems:
Plan review is required far any of the following.
Please check all that apply.
❑ Any new commercial building with water service 2" and
greater, except systems designed and stamped by licensed
engineer.
❑ New exterior plumbing site uti lilies for any complex structure
as defined in OAR918 -750 -0040,
❑ Medi cal gas and vacuum systems for health care feel] ities.
❑ Any multipurpose Fire sprinkler system.
❑ Any complex structure as defined in OAR918- 780.0040.
Submit 2 sets of plans with any of the above.
❑ IsornetTic or riser diagram is required for new buildings
that meet the qualifications above.
Comments regarding fixture work:
*Note: If the Fixture work under this permit results in an
increase of sewer EDUs, a sewer permit will be issued end
fees assessed for the sewer increase must be paid before the
plumbing permit can be issued.
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