Permit CITY OF TIGARD PLUMBING PERMIT
' • COMMUNITY DEVELOPMENT Permit#: PLM2013-00343
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/02/2013
Parcel: 1 S 135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 750
Project: Axium Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Interior plumbing:Adding(1)service sink,(1)floor hub,(1)primer,and(1)water heater.
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 Floor Drain/Floor Sink/Hub 10/02/2013 $25.02,
Specifics: 1 ea Primer 10/02/2013 $12.51
1 ea Sink 10/02/2013 $25.02
Type of Use: COM 1 ea Water Heater 10/02/2013 $37.52
Class of Work: ALT 1 12%State Surcharge- 10/02/2013 $12.01
Type of Const: Plumbing
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 952-001-0090. 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: /
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.
SEP/30/2013/MON 01 :07 PM POWER PLUMBING FAX No, 503 244 8825 P. 001/003
•
Plumbing Permit Application • ` to • -poi "7
Building Fixtures [FOR e(ah1FJr1. ;USE :ONLL+ .
Received
Tigard Permit No.' 3 dr3
City of l Blvd Plan Re. E� 3 �7'7� /t/11 d o/ 0
IN . u 13125 SW Hall Blvd.,Tigard,OR 7223 p ® 2Q\3 Plan Review Other Permit No.: !, - •
- Phone: 503.718.2439 Fax: 503.598.1iit Date/By: ( ,'
Inspection Line: 503.639.4175 ��® Date Beady/By: s'1 see rage z rot
Tlt ILD Notified/Method; �� Supplementallnformation
Internee www,tiglvd or.gov � � �IG . ,r�E • ' n:
t 1 h. : rr 'An P ;c- 7:2: +'P! v ;Jr ,',!j'-�s•' ,: .:+ '+. ;/19'1!1 t',1:NJ1ti 1F :'y'1•`f. :d^ 7...�.�.
i..',rs , ,7i $i*'J,, Erttazi" ,a;j ��y� .sv y�' :�•L '•� f- (y ,v.,.::::,,-;.:..• •:�• ,rr,., ..
3 xr.� i.'}ai�� .-;r..f�L i^.f�"Il i:ii 1l�SLe:.,tur."•.. .. • + '�,?�
New construction 1111 D emolition
- For special information use checklist
['
Description �� Ea. Total
r^ •ddttion/ttheranonheplaoement
Other: New 1-2-(amity dwellings(includes 100 ft.for each utility connection)
b.`! 4.y aq�ynt cti, �i ApLS'W''�:15. " sw''.',:!,,',/,:.,•`a�., SFR(1)bath 312.70
M{ :•.,: c:. i.ol r ee1a� a.1 ut,r.•yrlic r- ' ,`r:
n ..t, 4� ,; -,,c2 SFR(2)bath 437.78
E'1-and 2-family dwelling 1.1 ommercial/industrial SFR(3)bath 500.32
O Accessory building ❑Multi-family Each additional bath/kitchen 25.02
LI Master builder 0 Other Fire sprinkler( sq.ft.) Page 2
:"1 ;; . ` `+4 27\tRe Cjl;m�(�r7io^ ; G17 r: J ` Site'utilities:
r /` Catch basin orarca drain 18.76
Job site address: I t0_0 O S ' '.A -
�7 Drywall,leach line,or trench drain 18.76
City/State2lP- !� 1 I % Footing drain(no.linear ft.: ) Page 2
Sui • • dgiapt no.: 1 • Project name: AI Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connecmr 18.76
Sanitary sewer(no.linear ft,: Page 2
- Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: I Lot no.: -Fixture or item:
Ballow preventer I • 3127
Tax maplparcel Ito
r ''-17 z1 27'7 -'17 {-r"%7s. 4•-si f r•'.�ela.�i-� T7 cZ tih-441 L F�7_ }N Backwater valve
12.51
2- a.T. 1 . g+ 4 Y--i2... i.:',).!,LT:4 .-?1, C•1 i :. CiOuC5 washer 25.02
• lA QM-!,i`; / 1 Dishwasher -25:02 l-
Drinldng fountain 25.02•• Ejectors/sump 25.02
{{! .a-. ,rqr,+! . t ''•,4o':,,,y .•..,v •.4,27. t't.; Expansion tank 12-51
!i•.:y�•. -., i, - yy;- . ...�•6`N7j,yisu.•�. ;�< , -.1f t1:A'.,-' •.,n"�R59 iy"
is
«r> atk. X'G� FlxtuttJsewercap 25.02
Name: Floor drain/floor sin ub 25.02 5 02-
'� Address: Garbage disposal 25.02 -
City/State/ZIP: r Hose bib • 25.02
Phone:( ) Fax:( ) Ice maker 12.51
r �,��I y"°.R' ;s''1•s���yks :c';"i �' C;:+F. Interaeptor/greasetrap 25.02
IX(� x�;�-i�,•°n.a'�'T ��w�� .,i��T t '.- +..�r�•5�t+n(� .'...:.;..n.•..:-`,,.rfN�i��'y;; Medical gas(value:S - ) Page 2 ��,-
Business name: / „ �I_/,L��j Primer <L� "
'-' Contact name: ,,I 111!�1J •..,f drain(commercial) 12.51
Address: % f Sinit/b 'in/lavatory . 25.02 MU
City/State/7Th °T /'1-` ONI f /.-t1 .ar units(potable water) 62.54
) 12,51
Phone:( ) J ., _ ICI O Fax::( ) o°p if-19 Tub/shower/shower pan
Urinal 25.02
E-mail: r ` - Water closet 25.02
; J p
�'� �s��, i �� �W �� .
' 6:1-1•";* ''' r le,''- Water heater
Business name: I,I�. a+ rikI water piping i wV 56.29
Address:
4 I Other: 25.02 -
-'] Subtotal 00 el
City/State/ZlP: 15)C (�, Minimum permit fee: 572.50
• M Fax:( •) i •
Phone:( ) Plan review (25%of permit fee)
Plumbing Lie.no.: GIL State surcharge(12%of permit fee) - b
• Authorized signature: .,,Milt`-4e/
50 r • TOTAL PERMIT FEE 1)
This permit application expires if a permit is not obtained within 18O days
{_Print name: Date. after it hes been accepted as complete
*Fee methodology set by Tri-County Building lndusty Service Board
f
la tuilding WenoittIPf.Mt1,Pe'mitApp.dac 10/01109 40-4616T(10/02/COMNJFa)
•
SEP/30/2013/M0N 01 :07 PM POWER PLUMBING FAX No. 503 244 8825 P. 002/003
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Plumbing Permit Application - City of Tigard
Page 2- Supplemental information
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Fee Schedule: Residential Fire Su# .ression Systems•
. ,:74, ,,, •o-S ! " d' y .°'�. T,l.,. •� V t t\ n, l .r' "v st,t�; 'a 9 yV�s
',,...:;,:,,,,71,7;7„...t.1 ,?, 11.4 k .�,-' •,a,.,,4a.,y� •,.,,y,:,.il. .P- �'.G ;:441.2',.s...., ':.Yr 1 G%s:.a.,.,• il.: -iMF �'. ' a,.,..+„xmfi1.::'..ai:,E. �?'` :Arr. ` ' - -
- -Footing drain-1-100' �(. 50.03 0 to 2,000 $121.90 -
�2 001 to 3,600 $169.69
Footing drain-each additional 100' 37.52 3 601 to 7,200 $233.20 •
Sewer-1st 100' 62.54 7,201 and greater . $327.54
Sewer-each additional 100' 37.52
-
W Service-1st I00' 62.54 Medical Gas S stems:
each additional 100' 37.52 ". .:,'.''''t-,:‘,74.1:, -,a3 ;i N - .--Ai nj ;�:i , tY
Water Service \'�'4.11,1,,,,11::en t1�.•,_ ... `,��,. ,�.r�w.. . ,ry� -
62.54 .-.
S Rain Drain-1st 100' $1.00 to$5,000.001 Minimum fee$72.50 _,
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 fbr the first$5.000.00 and$1.52 for
�7,,,•_ "?t'7 7'- rI!•fit77't'35 3's , , each additional$100.00 or fraction thereof,to
(%,i - 'hS 1 b3,rdr1-t,A'r r,x a r ,: k <A,�• and including$10,000.00.
Inspection of existing plumbing or for 510,001.00 to$25,000.00 $148.50 fbr the first 510,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
(minimum charge--1/2 hour) and including$25,000.00.
Inspections outside of normal business 90.00/hr 525,001.00 to$50,000.00 $379.50 for the first 525,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Rcinspection Fees 90.00/hr and including$50,000.00.
Additional plan review for revisions 90,00/hr $50,001.00 and up $742.00 for the fast$50,000.00 and$1.20 for
each additional$100.00 or fraction thereof
(minimum charge-1/2 hour),
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate.work performed by fixture. Failure to
accurately.
qt re s ort fixtur
es could result increased fees*.s
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� e,'.,:s '��}« ij '�'fi.x t}.r `�t +{"�:>��" Plan review is required for any the following.
- ' �br5ite� : ,,3 d .'a; pjF. r.;'!,.9-8dd??i 14.411 1
Please check all that apply.
• Baptistry/Font ❑ Any new commercial building with water service 2"and
Bath Tub/Shower greater,except systems designed and stamped by licensed
-Jata,ai/VVhi .001 engineer.
Car Wash -Each 'rlu' - ❑ New exterior plumbing site utilities for any complex structure Thru as defined in OAR9I8 780-0040.
D ',i usher Aspirator 0 Medical gas and vacuum systems for health care facilities.
Dishwasher -Commercial
.Domestic ❑ Any multipurpose fire sprinkler system.
Drinkin•Fountain ❑ Any complex structure as defined in OAR918-780-0040.
Eye W
Floor Drain/sink -2" Submit 2 sets of plans with any of the above
car wash Drain - ❑ Isometric or riser diagram is required for new buildings
Garbage -Domestic-non-fend that meet the qualifications above.
Disposal -Domestic-food related
-Commercial-food related
-industrial-food related
Ice MarhJRefiig.Drains
Oil Separator(Gas Station Comments regarding fixture work:
Rec.Vehicle Dorn,Station •
Shower -Gang,
-Stall -Sinlc/l.ry -Non-foodtelated
-Bradley
. -Commercial-food related
-Service I .
swimmin•Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes increase of sewer ED>(Js,a sewer permit will be issued and
Water Closet-Extractor fees assessed for the sewer increase must be paid before the
Water Closet-Toilet
Urinal • plumbing permit can be issued..
Other Fixtures:
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