Permit - CITY OF TIGARD PLUMBING PERMIT
' - 2 COMMUNITY DEVELOPMENT Permit #: PLM2010 -00230
TIGARD' 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/21/2010
Parcel: 1S135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 120
Subdivision: LINCOLN ONE Lot: 0
Project: Genex
Project Description: Replace existing plumbing fixtures. No change in EDU count.
Owner: FEES
LINCOLN CENTER LLC Quantity Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
CALIFORNIA ST 49TH FL 1 ea Floor Drain /Floor Sink/Hub 07/21/2010 $25.02
PHONE: 1 ea Primer 07/21/2010 $12.51
1 ea Sink 07/21/2010 $25.02
1 ea Water Heater 07/21/2010 $37.52
Contractor: 1 12% State Surcharge - 07/21/2010 $12.01
POWER PLUMBING CO Plumbing
PO BOX 19418
PORTLAND, OR 97280
PHONE: 503 - 244 -1900
FAX: 503 - 244 -8825
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Total $112.08
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.
. 4z6 Q ...___
Issued By: Permittee Signature:
fJ7i//',
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.
JUL /16 /2010 /FRI 01:22 PM POINER PLUMBING FAX No,503 244 8825 P. 001
Plumbing Permi A ppIicatiou C.4C711
Building Fixtures ti Ci �� r�%,°. FOlt OF FI C E . USE ONLY .
City of Tigard 1 :8 > p ,, •
ail/ /0 . Permit N9117. O0nn
13125 SW Hell Blvd., Tigard, OR 97223 \\.\'" c, oS36
e
Phone: 503.639.4171 Fax 503.598.1960 �`S� Review �^
c - Dates : Other Permit No / 409 j //�
TIGARD Jni e iom ww tlgard drgov75 � �y \ c " Date Ready/By: F►'; Page 2 for pt
`\ Notified/Method Supplemental information
.' .:7-7,71,.71; .. 1 r { ,.t 1) ,� ,',4 pp it�a o �p f # j • ... 1 : """""')
t ,.' -,.... Y: _.. . rr1,. ..:;x •5,,: , ` . Y ZT.,, V ;del. � 3. _ .,. ,-,, � �' � : D ; i: :: { :_ ;: i�r ty ' f � a.
:....- ..n_». .� � • �a.� 7�Y'r .. f fY E i IJS{1 tIL1 .. �q t�sr f�'^
.�.Ne..i rrr wt: ..J....,. .2'e' �rr::., , ... .:7 � rt. r� . ...,e.:i! i •
In New construction ❑ Demolition For speciallnformarion use checklist
Description 1 Qty. 1 Ea. Total
► Addition/alteration/replacement ❑ Other New 1 -2- family dwellings (includes 100 ft, for each utility connection)
r r r ,^ ref v -,--,
%47- ,* •V• :i.:.? : .;PF °.,.', u� ►1,f 9�► 1..--5- 6 ,x"4(' :' lt , Jr t:. .t1 SFR (1) bath 312.70
El 1- and 2- family dwelling Commercial/industrial SFR (2) bath_ 437.78
❑ Acc* ssory building ❑ Multi - family SFR (3)' - 500.32
E ach additional bath/kitchen 25.02
Q Master builder ❑ Other. Fite s rinkler -
? ti s s r: , ,2 • - - n-- P ( sq, R) Page 2
f({ v. �7z.!' ,e,�{ ,,, ti :!t 0 d�' 0 �j1 �P_� +' t G`;,Vi A 4, y � Site ut 11111 e 8 : • C.w r'' .._ c a. aau'T -.r.. �'u� >.C.:� "�A X13, ir' 'ti7'e:..0si�_a.:.e:�., w`.� ° ,: _+s>•"a
Job site address V DO . ' /.i • 2 rMIIIII Catch basin or area drain 18.76
Drywell, leach line, or trench drain 18.76
City /State/ZIP: , ,D-� / �
� 1 (Al 4 Footing drain (no. linear ft: ) Page 2
Suit idg. /apt. no.: 12.0 Project name:
Manufactured home utilities 50.03
Cross street/directions to job site: Manholes
,-_ 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear fl.; _ ) Page 2
Storm sewer (no. linear ft.: P age 2
water service (no. linear ft.:' ) Page 2
Subdivision: Lot no,: Fixture or item: -
•
Tax map /parcel no.: • Backflow preventer 3127
; ,'' �i ,,y}f r. �r� 11Y� I a { yr� :' tirifi 77 I �� * •Jy r; Backwater valve 12.51
av L i r.LG aiii ct.`.L.A -,., ' .., ?_ 1 '? r, c,.•'42. �1 a �Uy --
�/ I p Q �/ Clothes washer 25.02
f Q `�''� - °�- r ' 4 C ' `� � .a.A r r.i Dishwasher 25.02
i ► �i Drinking fountain , 25.02
Ejectors/sump 25.02
i=. 4;s�F .:!'�'�;L e �srr4 Mr„ .' ii r N e 1l -t '-'^s iT 72 Expansion tank 12,51
- -• - w->s.u. ........ W 2.51
Name: Fixture 25.02
Address:
-'-" -- Floor drain/floor si ub 25.02 O2.-
-- Garbage disposal 25.02
City /State/ZIP: Hose bib -
_ 25.02
Phone; ( ) Fax: ( ) Ice maker 12.51
{{1^ 'lnr^MLI L7r --7W.•• ,r'�' ` `y 1s q ... �'.� `� Y Q.AI 4''Z; In
11M +�, tSra. " ` = �: "`�l�.�c '' �: *` ..,�..- .0 ` r �. , 4 �,,, ;,j DricePtor /grease trap 25.02
Business name: / , ° � 1 Medical as (value: S ) Page 2
Contact name: '`A Primer 12.51 }) 5 ► ,
,.J r ��
Address: � i Al � Roof drain (commercial) 12.51
�S " ry Sin asin/lavatory / 25.02 2. 02
City/State/ZIP: Ej l ,, / 6 -/ • ! �, Solar units (potable water) 62.54
Phone: 6 a4 " q. )4906 Fax: : /6) ,41Qz, Tub /shower /shower pan 12.51
E -mail: Urinal 25.02
• M M1 i . 1 ' :r ; ., P � _,,+fir v, E +r Water closet 25.02
,�.r tt 774-0g,,..7 r.1Xlitl�iJlifl' }' n h +. �1i Z ,
r ''4 . "_•F '. f e. i . 1 ' -
( A m / 37.52 37 52-
Business name: . j Water piping/DWV 56.29
Address: Other
IF 25.02
City /Stete/ZIP: _ Subtotal MC) 01
Phone: ( ) Fax: ( ) Minimum permit fee: $72.50
CCB Lie -: i, Plumbing Lic. no.: .. & p i, - Plan review (25% of permit fee)
.
Authorized signature: State surcharge (12% of permit fee) 1Z 0 I , /
TOTAL PERMIT FEE 1 1 0 $ f'
P rint name: R LS j J1 � Date: -7 L! (OJ /,1 V Thia permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete
`Fee methodology act by Tri- County Building Industry Service Board.
1; 11lmlding \P°rrnIMPLMli- 1 10/01/09 440 -4616T(10 /04/COM/W28)
JUL /16 /2010 /FRI 01:22 PM POWER PLUMBING FAX No, 503 244 8825 P.002
Piumbine Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Su i . ression S stems:
S C. Y' ` �j1 Y ( tz v i. , f } ^ .,., + y (t_ f z` ' 4 ^^T 1 - � sngj� jiy5 , _ ,. , k.1 , .,..- ,
F a'-!+ 1( " Ln >L.r .. :. -: T .,.. r.0 w ^Y } y ;.k 4' Y1' 1.... Lk :. -9 '. S`i.tr� ..4^,4 �
r ` ��K_3 4 , y 1 1 1 f � �. `{
Footing drain -1 100' 50.03 0 to 2 000 $121.90
Footing drain - each additional 100' MIMI 37.52 2 001 to 3,600 $169.69
3 601 to 700 3.20
Sewer - 1st 100' 62.54 MN 7,201 and eater ' g 2 7.54
Sewer - each additional 100'
Water Service • 1st 100' 62.54 Medical Gas S stems:
Water Service - each additional 100' 1 Z t L G 1 i ri , o � � ..
& Rain Drain -1st 100' 62.54 ° ' k 1; s.L n i mu m fee c 7.�; :: ru. :: � � s..�. `
Storm
=� $
= $5,001.00 ,00 to $5,000.00 to $1 0 ,0 00.00 $72.50 for the Minimum first
Storm & Ra 5
m Dram -each additional 100 5 to $ I,0 first 55,000.00 and 51.52 for
a ' ,� ' � "' q 't ' +. " : ' y '.�'^ ^'^ 'iG ,� �` �. "r f fi r• ,
. c-;+ h 1 �-(' tiv 'Zy?rf t 6.77 ° ' ,-,,., �. X7 ' `; each additional $100.00 or fraction the
G.� ac, �, n, + rcof to
" �°'�` ' E and including $10,000.00.
Inspection of existing plumbing or for $10,001.00 to $25,000.00 5148.50 for the first $10,000.00 and $1,54 for
which no fee is specifically indicated 90.00/hr
(minimum ch ::c -1/2 hour each additional $100.00 or friction thereof, to
and including $25,000.00.
Inspections outside of normal business 1111 90.00/hr $25,001.00 to $50, 000,00 $379.50 for the first $25,000.00 and $1.45 for
hours (minimum ch -2 hours) each additional $100.00 or fraction thereof; to
Reinspection Fees MI 90.00/4 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 $120 for
minimum char a -1/2 our - _ cach additional $100.00 or fraction thereof
Subtotal: ME__
Commercial Fixture Work:
Are you capping, adding or replacing fixtures? If "yes ", <, 2ljr. 1 , .d21 g .., F . F q i r : N
please indicate work performed by fixture. Failure to Plan review is required for any of the following.
accurately report fixtures could result in increased sewer fees *. Please check all that apply.
c and o:; :ii' ,tit im �+� tip ifillt�l V Fixtuee War ormed ', 1:1 Any new commercial building with water service
Y 2" •
! h , ;t. , t ,t J r r -.: d, i greater, t
;� j , o ...^ � , _ � . except systems designed and stamped by licensed
;-1r a�; tzi engineer.
5 /Font ❑ New exterior plumbing site utilities for any complex structure •
Path Tub /Shower _1 - i/Mi as defined in OAR918- 780 -0040.
- Jacuai/Whirl, .01 - - --
Car Wash -Each Stall 11111.M ❑ Medical gas and vacuum systems for health care facilities.
-Drive Thru 1=1 Any multipurpose fire sprinkler system.
C • idor/water A . irator 0 Y complex structure as defined in OAR918- 780 -0040,
Dishwasher - Commci ial - -�
- Domestic NM _ Submit l sets of plans with any of the above.
Drinkin_ Fountain -MIMI��
E=IMMIIIIMII MM. �� }n•,rr1 r x; t , ,..b' i � oo r-c �wr t 1.7.zt
Floor Drain/sink 2" • Isometric or riser diagram is required for new buildings
3" =� �= that meet the qualifications above.
Car Wash Drain NM= MIN
Garbage - Domestic -MOM
Disposal - Commercial NOM Milli •
- Industrial IMIll Commen s regarding fix re work:
Ice Mach. /Refri_. Drains j - 1 I4. IA
Oil .arator Gas Station) -`-
Rec. Vehicle Dum, Station IMIN w
Shower -Gang . .-
-Stall MEM! ME `
Sink - Bar/Lavatory M t'
-Le
- Commercial Mil *Note: lithe fixture work under this permit results in an
- Service �
Washer increase of sewer EDUs, a sewer permit will be issued and
sr • Clothes �
n_ Pool Filter fees assessed for the sewer increase must be paid before the
Washer _ - �
Water Extractor plumbing permit can be issued.
Water Closet - Toilet _M�_
Urinal MIMI .1.101111.= .
Other Fixtures: !7!U r 111111111M -M IM
•
http : / /www.tigard- or.gov /city_hal /depart meths /cd/docs/PLMF- PermitApedoc