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Permit CITY OF TIGARD PLUMBING PERMIT l:, COMMUNITY DEVELOPMENT Permit#: PLM2013-00386 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/29/2013 Parcel: 1 S135AB01002 Jurisdiction: Tigard Site address: 10220 SW GREENBURG RD 535 Project: Robert Half International Subdivision: METZGER,TOWN OF Lot: 9 Project Description: Relocate(1)sink,replace(1)sink and(1)water heater. No change in EDU's Contractor: MCKINSTRY COMPANY LLC Owner: LINCOLN CENTER LLC 16790 NE MASON ST., STE. 100 BY SHORENSTEIN PROPERTIES LLC PORTLAND,OR 97230 555 CALIFORNIA ST 49TH FL SAN FRANCISCO,CA 94104 PHONE: 503-331-0234 PHONE: FAX: 503-331-6907 FEES Quantity Description Date Amount 2 ea Sink 10/29/2013 $50.04 Specifics:, 1 ea Water Heater 10/29/2013 $37.52 1 12%State Surcharge- 10/29/2013 $10.51 Type of Use: COM Plumbing 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 N. a ion Ce - Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or di • t questions to OUNC b' -Ilia= • .232.1987 or 1.800.332.2344. Is-ued By: c 0// � / Permittee Signature: !/n4e44 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. Plumbing Permit Application Building Fixtures , : :° ,r a i FOR OFFICE USE ONLY Permit No.: ,C Ili .ii,,p/3 Dd• k, City of Tigard Received Datc/By: �� 94 / 3 ` �4J Qn 7 � v 13125 SW Hall Blvd.,Tigard,OR 974,2 . Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit No.:hit Pkgrtea TIGARD Inspection Line: 503.639.4175 t v, �r " .; Date Ready/By: Juris: El See Paget for Internet: www.tigard-or.gov - ,)'-; -.' Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑New construction For special information use checklist. ❑Demolition Description I Qty. I Ea. I Total ®Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 El I-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building ❑Multi-family Each additional bath/kitchen 25.02 ❑ Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 10220 SW Greenburg Road Catch basin or area drain 18.76 City/State/ZIP:Lake Oswego,Oregon 97204 Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.:535 Project name:Robert Half International Manufactured home utilities 50.03 _ ___ Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 'I Storm sewer(no.linear ft.:_) Page 2 MLI/t► fob 4# I-1203 Water service(no.linear ft.:_) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 3 I.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Relocate an existing sink to the revised Break Room location.Replace existing Dishwasher 25.02 sink,faucet and water heater Drinking fountain 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER ® TENANT Expansion tank 12.51 Name:Robert Half International Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) lee maker 12.51 ® APPLICANT ® CONTACT PERSON Interceptor/grease trap 25.02 Business name:McKinstry Co Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:Samantha Mack Roof drain(commercial) 12.51 Address: 16790 NE Mason Street Suite 100 Sink/basin/lavatory a 25.02 0-<</ City/State/ZIP:Portland,Oregon 97230 Solar units(potable water) 62.54 Phone:(503)331-0234 Fax::(503)331-6907 Tub/shower/shower pan 12.51 E-mail:samantham @mckinstry.com Urinal 25.02 CONTRACTOR Water closet 25.02 Water heater / 37.52 37,5a Business name:Same as above Water 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal D7.647 Phone:( ) Fax:( ) Minimum permit fee: $72.50 CCB Lic.: Plan review (25%of permit fee) X72$1 I Plumbing Lic.no.:37 -22PB State surcharge(12%of permit fee) //)• 5/ Authorized signature: O` a (y, y,/ TOTAL PERMIT FEE 9V,07 Print name:Samantha Mack Date:to/pi �� 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. 1:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee: Footing drain-151 100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer- 1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service- 1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Valuation: Permit Fee: Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50 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 Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to 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 charge-1/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to Reinspection 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 first$50,000.00 and$1.20 for (minimum charge- 1/2 hour) each additional$100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", Plan Review for Plumbing Installations 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. Quantity by(Fixture)Work Performed ❑ Any new commercial building with water service 2"and Fixture Type: Replace greater,except systems designed and stamped by licensed Previous Capped Added Existing engineer. Baptistry/Font -Tub/Shower ❑ New exterior plumbing site utilities for any complex structure Bath as defined in OAR918 780 0040. -Jacuzzi/Whirlpool Tub/S Car Wash Each Stall ❑ Medical gas and vacuum systems for health care facilities. Drive tall ❑ Any multipurpose fire sprinkler system. Cuspidor/Water Aspirator ❑ Any complex structure as defined in OAR918-780-0040. Dishwasher -Commercial Domestic Submit 2 sets of plans with any of the above. Drinking Fountain Eye Wash Isometric or Riser Diagram Floor Drain/sink -2" ❑ Isometric or riser diagram is required for new buildings that meet the qualifications above. Car Wash Drain Garbage -Domestic Disposal -Commercial Industrial Comments regarding fixture work: Ice Mach./Refrig.Drains Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower -Gang -Stall Sink -Bar/Lavatory a -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 Washer-Clothes Water Extractor fees assessed for the sewer increase must be paid before the plumbing p lumbin permit can be issued. Water Closet-Toilet Urinal Other Fixtures: \\mckinst ry\portland\Construction\Projects\705 OR SPG Hard Cards\20131171263 Robert Half Int\Pennits\71263-PLMB Permit Application.doc City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10220 SW GREENBURG RD 535, TIGARD, OR, 2013 -12 -03 00:00:00 97223 Record Type: Record ID: Commercial - Plumbing PLM2013 - 00386 Inspection Type: Result: 399 Plumbing final FAIL Comments: 1. Correction #1 inspection dated 11/4/13 not completed, recall inspection when completed. Also provide ladder Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 10220 SW GREENBURG RD 535, TIGARD, OR, 97223 Commercial - Plumbing 399 Plumbing final 2013-12-06 (null) PLM2013-00386 FAIL 1. Correct backpitched vent above sink. 905.1 Recall Violation Summary: Inspector Contractor