Permit CITY OF TIGARD PLUMBING PERMIT
Permit #: PLM2011 -00330
COMMUNITY DEVELOPMENT Date Issued: 11/03/2011
T1Gi°iR 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 1S13 00
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG R 1 150
Project: Corvel Subdivision: METZGER, TOWN OF Lot: 9
Project Description: Interior plumbing: Dishwasher replacement.
11/23/2011: REPRINTED with correct suite address.
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:
PHONE: 503 - 244 -1900
FAX: 503 - 244 -8825
FEES
Quantity Description Date Amount
1 ea Dishwasher 11/03/2011 $25.02
Specifics: 1 12% State Surcharge - 11/03/2011 $8.70
Plumbing
47 ea Minimum Fee Adjustment - 11/03/2011 $47.48
Type of Use: COM Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
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
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: DA/ 97 °,9 L j c' -jam p vz�
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.
CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2011 -00330
Date Issued: 11/03/2011
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 parcel: 1S135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 180
Project: Corvel Subdivision: METZGER, TOWN OF Lot: 9
Project Description: Interior plumbing: Dishwasher replacement
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
1 ea Dishwasher 11/03/2011 $25.02
Specifics: 1 12% State Surcharge - 11/03/2011 $8.70
Plumbing
47 ea Minimum Fee Adjustment - 11/03/2011 $47.48
Type of Use: COM Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $81 20
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
or direct questions to OUNC by calling 503 232 1987 or 1.800 332.2344
Issued By: 4111 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.
NOV /02/2011/WED 09:14 AM POMEA PLUMBING FAX No, 503 244 8825 P. 001
PP ,nbin I Applicat g �� j �
Branding Fixtures VV 0 ,�•� FOR OFFICE tISE ONL City of Tigalyd - � c� ti
1 _ a 13125 SW Hall Blvd,, Tigard, OR 97223 o Pi
Phone: 503.639.4171 Fax: 503.595.1960 .,\O es ' ' eview
Other Permit No.: Eiza
� s_le/�Y:
TIGARD inspection Line 503_639 .4175 1 Date Road /t3 H
I b ardor ov O ∎.) X y' See e Pant l Information
nternet www
-�•, g g G Notlfiea/Method: I t
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a. ;{� � �j� DP mahpn
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❑ New construction [] Demolitio�i For special irrfonna lox use checklist.
NZ Descri.tion
MEI / t Ea. Total
' dd /alteration /replacement 0 Other: New 1- 2-family dwellings (includes 100 ft � Y ty ( for each utility epnneotion)
v. � ^'[�fg"�'�17i�i X niq � ��l w"+ t �ol' li' , � , � � ii "I�Ox"}1 f�lti�if�w��r� s n r� n �� -,
R,T5i,mr,}o,Tgi! a r„ : , , 14ei sW ffi ;'l��lv'' MI � 0 � )��t t ^r P:2P7 , SFR (1 bath
1 ,-:;. i_ ∎.:0 ,.ii._._,,. ,,,z y .i t, ,,«, ?...- -_ ,_._ �.1_ ". ) 312.70
1- and 2- family dwelling Ommercial /industrial SFR (2) bath 111111EM�
0 Accessory building ❑ Multi-family SFR (3) bath 500,32
Each additional'bath/kitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.)
( 5'cz';r6?r F?.ui,3.: s 7 a . uu stir Lh r � ;;•v -;, a r �?� µ^r . ry',+ �` Page 2
((f{' ry diy � D 1 , , lt 1 lryp. O Z�i6 111 4 i:', :' BwICe N:y\�] ti t" wr ?4: Site utilitie :
L':2UJa.}a 7 ,Sou .� i riao.',s1xaaty' _r);r .2 t'- :7,;'t. ;!:.� "+ 1�'A1 t 1 i :i-ki K+ 'L b
Job site address: 1QZ�0 O r�eUy Catch basin or area drain MIZIMIII
City/State/ZIP: / State/ZIP: 61 '�3
l r Drywell, leach l or trench dram 18,76 MIN
Footing drain (no, linear ft: • ) Page 2 NMI
uite/dg. /apt_ no,: I 5 Project name: irrV J y Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
MN - - --- -- .- -. -. ---- . - - - . -- - ___ -- ---- ----- ------- ---- .--- - - °.... , .„ Raindrainconnector.. . 18.76 _
Sanitary sewer (no. linear ft.: ) - Pa 2
Storm sewer ( linear ft.; ) Page 2
---- (
Water service (no. linear ft.: ) Page 2
Subdivision: - I Lot no.: Fixture or item:
Tax map /parcel no.: Backflow preventer 31.27
�,'a*, m r"'i'a'*1;7t! . Y .. au "y; t a an, ,i^} Backwater valve
.� � g � t r �` o ti 6 � srr, r,,M t�•at�v , 12.51
0 At r Clothes washer 25.02 ME
I A .) 1 - 7 �- . . / •'� - D i shwasher E' 25.02 0
I .l1 e. _ .. , I 0 J� Drinking fountain 25.02
Ejectors /sump 25.02
,. zip: 7'J1 ? !a P` c� �i7F- t � ligi ;." r `,ti , ,2, ,rlrkit l' t s,n' P t t` ",�. '-t'j Ex anion tank 12,51
q.. i ::- .*�t1Ki4 :nii iiw' i ;;c� esk` it tin: ;rIky ,.1grakS,. �w+x' Y, d.74- , 4 -:,:t - i'itrw±t7:' p -
Name: Fixture /sewer cap 25.02
Address:
• Floor drain /floor sink/hub 25.02
Garbage disposal -
25.02
City /State /ZIP: Hose bib
25.02
Phone: ( ) Fax ( ) Ice maker
G t ;r +� n F 41�, .Mt« *rtS"'"'t"""- '"y-n y to 12.51
�,}: i �� %` Intercepr /grease ire
,..la,. _.�+ n�d.$iPF� }U � �1J.�,� r�4M� S3�ili,1 i3��, � � p 6 � ` ' , M1 ��e L•�'3 � Q ' pfd � �'��� R ZS.O2
Business name: I A t Medical gas (value: $ ) NM Page 2
Contact name: Primer
Roof drain (commercial) 12.51
Address. p • / q I Sink/basin/lavatory 25.02
City / State/ZIP: '0 4, A - 7 )io+- Solar units (potable water) 62.54
Phone: (55x6) - _lc Fax: : ( 6 j) 1/44 . 1 3 Tub /shower /shower pan 12.51
Urinal
25.02
E-mail:
T H � } ' i 1 reF iX�.fei+�rin. V +0 r p' . 9 ` fin' t o+ Water closet 25.02
li t5.' it WA !)a`�. 'tit. a ' rAATLA:Ati °u Ell
'� nq �� � Water heater 1111. 37.52
Business name; .Q�/ I °LIAJn 1 /] Water piping/DWV 56.29
Address: S`' .1_ - ��"'�}
4 r "' t Other: 25.02
City /State/ZIP: Subtotal 2,5 0
Phone: ( ) N lI _ Minimum permit fee: $72.50 IV 50
CCB Lie.: 5p.,3-7 A Plumbing Lie. no.: A 60-P16 16 Plan review (25orb of permit fee)
State surcharge (12% of permit fee) M
Authorized signature: TOTAL PERMIT FEE FS=
Print name: ` l r / enS�l Date: ( am This permit application expires if a permit is not obtained within 180 days
+ ( after It has been accepted as complete
"Fee methodology set by Tri Couoly Building Industry Service I3Gard.
-
I tfl¢ ildinx \Pormit6W1,MV PennhApp,doi I0 /009 446 -06161 - 0mo /COM/wES)
■
NOV/02/2011/WED 09:14 AM POWER PLUMBING FAX No, 503 244 8825 P.002
Pl, mbjna Permit Application - City of Tigard
Ptige 2 - Supplemental Information
Fee Schedule Residential Fire Su ression S stems:
l 7 C x,',, : q : x r, +. ;Gl; q ;�:_• t++..rt
l'. �.1.1i .; 6a S T 7 e. > ,,; '•a 1' �.� 7 7 , x! is f �j�t:Yl e r };y �]r N. l T .7„ 7 " ) 13,,1, , 2 :J t . ,�4 '' 75 ,,t T.: ;-..
1 ` :..3_ . '.o-rv1 ^t` .n•.�. { . rl ti ° � r i vl 7:� � �"3' �T F � � i�li � 1 yn < 1 i4
k ,
Footing drain -1 100' 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' MI 37.52 _ -
WaterService - 1st 100' 62.54 Medical Gas S stems:
Water Service - each additional 100' 1111111 ^u^ r rr
Storm & Rain Drain - 1st 100' .11111 62 „54
$ I.00 to $5,000.0. $7
2 00 Minimum fee $72 SO
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
[['" 1 iI f rl ' iw� ,� „ x In i h 4 CW' each additional $100.00 or fraction thereof, to
k:) ` aSi G tN l � t t..S i � it 1 a e fir . ,. 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 oh - :c -1/2 hour) and including $25,000.00.
Inspections outside of normal business MI 90,00/hr - $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
hours minimum chard - 2 hours) each additional $100.00 or fraction thereof, to
Reinspection Fees _ 90.00/hr and including $50,000.00.
Additional plan review hr revisions 90 00/hr IIII $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
(minimum char_e -1/2 hour each additional $100.00 or fraction thereof.
Subtotal:
Commercial Fixture Work:
Are you capping, adding or replacing fixtures? If "yes ", T 7. -
+ 'I ¢ii� t fr - 1V- s
�; _I_t it s
please indicate work performed by fixture. Failure to Plan review is required for any of the following.
accurately report fixtures could result in increased sewer fees. Please check all that apply.
at ` : i$ a s'11'Ivi `1i 1 l t rm fink per o > ii r 0 Any new commercial building with water service 2" and
}
',i : 't, 7 r U
"�. ' y greater, except systems designed and stamped by licensed
��" f
engineer.
Baptistry /Font ❑ New exterior plumbing site utilities for any complex structure
Bath -Tub/Shower as defined in OAR918- 780 -0040.
-Jacuzzi/whirlpool ❑ Medical gas and vacuum systems for health care facilities.
Car wash -Each Stall
-Drive Tlsru ❑ Any multipurpose fire sprinkler system.
Cuspidor/Water Aspirator ❑ Any complex structure as defined in OAR918- 780 -0040.
Dishwasher - Commercial
- Domestic Submit a sets of plans with any of the above,
Drinking Fountain
" Eye Wash - s4.,txa'^v >Ii� �' �TG ?).;�1''[t slr rt
Floor Drain/sink - 2" Isometric or riser diagram is required for new buildings
-3"
qualifications meet the ualifications above.
.4"
Car Wash Drain _
Garbage - Domestic
Disposal - Commercial
Industrial mer Comments regarding fixture work:
Ice Mach /Rcfrig. Drains
Oil Separator (Gas Station) -
Rec. Vehicle Dump Station
Shower -Gang
- Stall
Sink - Bar/Lavatory
- Bradley
- Commercial -. *Note: If the fixture work under this permit results in an
service increase of sewer EDUs, a sewer permit will be issued and
Swimming Pool Filter fees assessed for the sewer increase must be aid before the
Washer - Clothes plumbing permit can be issued. p
Water Extractor
Water Closet - Toilet
Urinal
Other Fixtures:
http://www.tigard-or.govkity