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Permit . CITY OF TIGARD PLUMBING PERMIT - I DEVELOPMENT SERVICES PERMIT #: PLM2006 -00422 � � 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/14/2006 PARCEL: 1 S135AB -03400 SITE ADDRESS: 10260 SW GREENBURG RD 200 ZONING: C -P SUBDIVISION: LINCOLN CENTER /LINCOLN TOWER LOT: 014 JURISDICTION: TIG Project Description: Replace (1) Breakroom sink. CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 1 URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES EQUITY OFFICE PROPERTIES TRUST ONE SW COLUMBIA ST #300 Description Date Amount PORTLAND, OR 97258 [PLUMB] Permit Fee 9/13/2006 $72.50 [TAX] 8% State Surcha 9/13/2006 $5.80 Phone : Total $78.30 Contractor: MCKINSTRY CO 5400 NE COLUMBIA BLVD PORTLAND, OR 97218 REQUIRED ITEMS AND REPORTS Contact # : PRI 331 -0234 FAX 503 -331 -6906 Reg #: LIC 40981 PLM 37 -22PB This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952- 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344. Issued By: Permittee Signature: 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. 1 4 =� � , j 1 l � ' 4 • • • - ow . _ ■ 5. 11 - I m Plumbing Permit 'Ai pl ic ati o r i FOR OFFICE USE ONLY City of Tigard CEP DateB d • h.../ O '� / Permit No. 4,0,4, pO V.2. 13125 SW Hall Blvd., Tigard, OR 97223 2UU6 Plan Review Phone: 503.639.4171 Fax: 503.598.1.960 pi t � ?' Date /By: Other Permit I‘1Qf (� '� p p,' j9 24- Hour Inspection 39. ection Line: 503.64l75�/ m `j f g _ p ..i Pi !L �1 � V 1L�1' 11�s' � t. I Date Ready /By: Jr See Page 2 for Internet: www.ci.tigard.or.us - � F Try Yr , , , 7 ,,, y e;.,_ Notified /Method: Q 0 Supplemental Information 1 � 1.:;17"4,77.11w:--W �... >..- ,.,,. , tT > ,: F � _ ..,.. - :` `� . F.EE SCI3EDII LE�: -:<- >.�:- :,:..`;� %:�. � � T YPEOF WORK -: -> -.'x', � , < � ,.,_�.... _ -.. mss �=t ❑ New construction For special information use checklist. ❑ Demolition Description Qty. I Ea. Total Z Addition/alteration /replacement ❑ Other: New 1 dwellings (includes 100 ft. for each utility connection) r ;;4..:: :"CATEG ©RY,OF.,a- .CONSTRUCTsION S FR 1 bath 24920 ❑ 1- and 2- family dwelling ® Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi- family SFR (3) bath 399.00 Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: .., ,- Fire c ( sq. ft.) Page INEORiV1AfiION AND ="LOCATION W _;, �._: ., -- e ,- .,M,.- ,;•„,;;,;- . . -. � - , .,.„'�,� �;� _ _o > , e. -, ..,, Site utilities OP Job site address: 10260 SW Greenburg Road Catch basin or area drain 16.60 City/State /ZIP: Tigard, OR 97223 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: 200 Project name: Ascentium Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no.: valve , , 1 - < .;3�t z �.:;�.� Absorption 16 60 ' t:,,. DESCRIPTION; =,`W®RK -' ,' . % ;.. j . ,,; ..... , •; •; : ' ... •: : ., %,.,:::,-, .... . ... . .... . .�,�, .,_, .. . ..... - . x..... Backflow preventer Page 2 Furnish and instsall breakroom sink and faucet and associated plumbing. Backwater valve 16.60 Replaces sink that used to exist in that location. '1' .- c' '--' - -t Mel4`' -'r`d i Clothes washer 16.60 � " 9 442 Dishwasher 16.60 Vie:„ ,; ,,,."r.o, -,., '. Drinking fountain 16.60 ~ " R "'P . f 1WNER:� ,,��- ; .,, a , :�, �: ~TE1V _ . .,- f��.e•, �,..�,�.. ��; > m33,.>d . ,� s .. �,,� . . , _ _. �>.. ``' °>` Ejectors/sump 16.60 Name: Expansion tank 16.60 Address: Fixture /sewer cap 16.60 City /State /ZIP: Floor drain/floor sink/hub 16.60 Phone: ( ) Fax: ( ) Garbage disposal 16.60 ;,r,3, Hose t : ® Af'R ' ,1t %sa , , 'i; ; t ®, i tt PERSON.: „„ . n Business name: McKinstry Co. Interceptor /grease trap 16.60 Contact name: Jason Carver Medical gas (value: $ ) Page 2 Address: 12021 NE Airport Way, Suite G Primer 16.60 City/State /ZIP: Portland, OR 97220 Roof drain (commercial) 16.60 Phone: (503) 331.2461 Fax: : (503) 331 - 6906 Sink/basin/lavatory 1 16.60 Tub /shower /shower pan 16.60 E - mail: jasonc @mckinstry.com Urinal 16.60 rig3, :. ,•�Y� :"- f •aye. Water closet 16.60 v -'�: CON•TRAG�TCIR ,, �. �,,.;,: �.� ,am : _ ter: Business name: McKinstry Co. Water heater 16.60 Address: 12021 NE Airport Way, Suite G Other: City/State /ZIP: Portland, OR 97220 Subtotal Minimum permit fee: $72.50 Phone: (503) 331 - 2461 Fax: (503) 331 - 6906 Residential backflow minimum permit fee: $36.25 k. CCB Lie.: 40981 Plumbing Lic. no.: 37 - 22PB Plan review (25% of p ermit fee) 4 State surcharge (8% of permit fee) Authorized signature: TOTAL PERMIT FEE ) <6. . Y Print name: Jason C er Date: 9/11/06 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-County Building Industry Service Board. i:\Building \Permits \PLM- PermtApp.doc 06/05 440.46 16T( I 0 /02 /COM/WEB) Building Division T 1 A R Request for Permit Action or Refund TO: CITY OF TIGARD Permit System Administrator 13125 SW Hall Blvd., Tigard, OR 97223 • Phone: 503.718.2430 Fax: 503.598.1960 www.tigard - or.gov FROM: ❑ Owner ❑ Applicant ❑ Contractor 114 City Staff (check one) REFUND TO: Name: / �//�� (Business or Individual) 4 0 N L— Ts u K D V 0 1 0 Mailing Address: City /State /Zip: 7 ,T ' / 4/c 9�VU �� Phone No.: • /% PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1): 5 CANCEL PERMIT APPLICATION. REFUND PERMIT FEES (attach receipt, if available). ❑ REMOVE CONTRACTOR FROM PERMIT (do not cancel permit). C 49//// Permit #: Le - 0 . X0 /'L c2006 CO yam Site Address or Parcel #: o'> c S W G �Z�C (� lJ�j�[ -� 4t7„.6 Project Name: k.S'C et U r e- ' Subdivision Name: Lot #: EXPLANATION: - 1 W_ r_0 1Z. Qk L t tv f D Q2. M Ate, r-12.0 rY1 Qat" N6.11) Signature: �e -,Gt cam- �c% ; Date: 1 ` f . 0(, Print Name: p,- e-p,-Ia(N. M S e1A)E -e- -L - j Refund Policy 1. The Building Official may authorize the refund of: a) any fee which was erroneously paid or collected. b) not more than 80 percent of the permit fee for issued permits prior to any inspection requests. c) not more than 80 percent of plan review fee when an application is canceled before any plan review effort has been expended. 2. Refunds will be returned to the original Payer in the same method in which payment was received. .FOR OFFICE USE ONLY Rte to Sys Admin: Date Qier7 , , By e Rte to Bldg Admin: Date By Refund Processed: Date / By Invoice Processed: Date By Permit Canceled: Date ? fy p 4, Bylr, Parcel Tag Added: Date By Receipt # Date Method Amount $ I:\ Building \Forms \RegPermitAction - Bldg.doc Rev 05/24/06 Accumulative Sewer Tally Parcel # 1S135AB -03400 Tenant Nam: Ascentium This SWR# 2006 -00220 Site Address: 10260 SW Greenburg Rd. #200 This PLM# 2006 -00422 Fixture Value Previous Previous Credits Capped Fixture Fixture New New # value capped off value added added total total count off #s count # value #s 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 0 0 0 0 Drinking Fountain 1 0 0 0 Eye Wash 1 0 0 oN 0 0 Floor Drain /Sink - 2 inch 2 0 0 0 0 0 - 3 inch 5 0 \.. 0 0 0 0 - 4 inch 6 0 0 0 0 0 - Car Wash Drn 6 0 SO - 0 0 0 Garbage Disposal - Domestic (to 3/4 HP) 16 0 0 0 1 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 Oil Sep (Gas Station) 6 0 0 0 0 0 Rec. Vehicle Dump station 16 0 0 \ 0 0 Shower - Gang (per head) 1 0 0 0 0 - Stall 2 I 0 0 l• N,,,}H 0 0 0 Sink - Bar /Lavatory 2 0 0 0 0 0 - Bradley 5 0 0 0 / 0 0 - Commercial 3 0 0 1 3 1 3 - Service 3 0 0 / 0 0 Swimming Pool Filter 1 0 0/ 0 0 Washer - Clothes 6 0 0 0. 0 0 Water Extractor 6 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 o TOTALS 0 0 '0 . __t 1 3 1 3 Current Fixture Value 3 divided by 16 = 0.2 Current EDU 1 EDU = $ 2,700 Previous Fixture Value 0 divided by 16 = 0.0 Previous EDU Change 3 divided by 16 = 0.2 over (under) $ 540.00 Enter EDU Change Here 0.2 Notes: Authorized Name /Signature: Barbara Butler Date: 9/13/2006 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.xls 7/1/06 CITY OF ��nn m ��m nn�w��mm�� 'BUILDING DIVISION '��UKUU '' ~�~,"~~~°"""~~ ~°"°"~,.~~"~ PERK�|T PLkA2OO�O[422 ' 13125 SW Hall Blvd., Tigard, OR 07223� DATE ISSUED: EV14/I000 Phone: (503) 630~4171 ' Inspection Requests (24 Hrs.): (503) 630'4175 INSPECTION WORKSHEET FOR DATE: 10/20/2006 TIME: 7:01Ak8 PAGE: 1 SITE ADDRESS: 10260 SW GREENBURG RD 200 CLASS OF WORK SUBDIVISION: LINCOLN CENTER/LINCOLN TOWER LOT #: 014 TYPE OF USE: PROJECT NAME: ASCENTIUIvi DESCRIPTION: (1) new breakroom sink, OWNER: EQUITY OFFICE PROPER11ES TRUST, PHONE #: CONTRACTOR: KACKJNSTRYCO PHONE #: 331'O234 Inspection Request Scheduled For: Date: 10V2012008 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 038698-01 503-780-3222 � Corrections/Comments/Instructions: C&ASS PARTIAL APPROVAL 0 CANCEL NO ACCESS El FAIL ri CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: //) / `�~Oate: ���� �� �� Phone#: (5O3) 718' C/ ' � -- CITY OF TIGARD BUILDING DIVISION _ PERMIT #: PLM2006M0 422 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/14/2006 Phone: (503) 639 -4171 .' �II��11I Inspection Requests (24 Hrs.): (503) 639 -4175 111. INSPECTION WORKSHEET FOR DATE: 9/2012006 TIME: 7:01AM PAGE: 16 SITE ADDRESS: 10260 SW GREENBURG RD 200 CLASS OF WORK: SUBDIVISION: LINCOLN CENTERILINCOLN TOWER LOT #: 01,E TYPE OF USE: PROJECT NAME: ASCENTIUM DESCRIPTION: I (1) new breakroom sink. OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #: CONTRACTOR: MCKINSTRY CO PHONE #: 331 -0234 Inspection Request Scheduled For: Date: 9120/2006 Pour Time: , Code # Inspection Description Confirm # Contact # Message 320 Piumbing rough -in 036874 -01 206 - 256.3693 N Corrections/Comments/Instructions: • `fll—PASS I I PARTIAL APPROVAL ❑ CANCEL ( I NO ACCESS n FAIL I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED .el i Inspector: ` Date: l Phone #: (503) 718-