Permit i p CITY OF TIGARD PLUMBING PERMIT
"! COMMUNITY DEVELOPMENT Permit#: PLM2014-00036
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/06/2014
Parcel: 1 S135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 260
Project: Fleet Concepts Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Cap:(1)sink,(1)dishwasher&(1)garbage disposal. Relocate: (1)sink,(1)water heater. Add:(1)hub drain&(1)
primer.
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
3 ea Fixture/Sewer Cap 02/06/2014 $75.06
Specifics: 1 ea Floor Drain/Floor Sink/Hub 02/06/2014 $25.02
1 ea Primer 02/06/2014 $12.51
Type of Use: COM 1 ea Sink 02/06/2014 $25.02
Class of Work: ALT 1 ea Water Heater 02/06/2014 $37.52
Type of Const: 1 12%State Surcharge- 02/06/2014 $21.02
Occupancy Grp: Plumbing
Stories:
Total $196.15
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• -- -• to OUNC by calling 503.232.1987 or 1.800.332.2344.
1 =ued By: r 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.
Accumulative Sewer Tally
14- - u Tenant Name: Fleet Concepts `'' .•` •b+r,, SWR# N/A
Site Address: 10220 SW Greenburg Rd#260 'r.",;:''~. :^4 �; s PLM# 2014-00036
Parcel#: 1S 135AB01004
Fixture Value Previous Previous Credits Capped Fixture Fixture New New
# value count capped#s value count added# added value total#s total 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 1 2 0 -1 -2
Drinking Fountain 1 0 0 0 0 0
Eye Wash 1 0 0 0 0 0
Floor Drain/Sink: -2 inch 2 0 0 1 2 1 2
-3 inch 5 0 0 0 0 0
-4 inch 6 0 0 0 0 0
-Car Wash 6 0 0 0 0 0
Garbage Disposal:
-Domestic(to 3/4 HP) 16 0 0 0 0 0
-Commercial(to 5 HP) 32 0 0 0 0 (1
-Industrial(over 5 HP) 42 0 0 0 0 0
Ice Machine/Refrigerator Drain 1 0 0 0 0 0
Living Unit 16 0 0 0 0 (1
Oil Sep(Gas Station) 6 0 0 0 0 0
Rec.Vehicle Dump station 16 0 0 0 0 0
Shower. -Gang(per head) 1 0 0 0 0 0
-Stall 2 0 0 0 0 0
Sink:
-Lav/Bar-Non-Food Related 2 0 1 2 1 2 0 0
-Bradley 5 0 0 0 0 0
-Com/Sery/Util-Food Related 3 0 0 0 0 0
Swimming Pool Filter 1 0 0 0 0 0
Washer-Clothes 6 0 0 0 0 0
Water Extractor 6 0 0 0 0 0
Water Closet-Toilet 6 0 0 0 0 (1
Urinal 6 0 0 0 0 0
Previous EDU Count 0 O
Capped EDU Credit 0
TOTALS 0 0 2 4 2 4 0 0
Current Fixture Value 0 divided by 16= 0.000 Current EDU 1 EDU= $4,800.00
Previous Fixture Value 0 divided by 16= _ _ 0.000 Previous EDU
Change 0 divided by 16= 0.000 over (under) $ -
Enter EDU Change Here 0.000
Notes: No change in EDU's. Did not include garbage disposal as CWS does not charge for disposals in breakrooms.
Authorized Name/Signature: Debbie Adamski Date: 2/6/2014
Building Division
ote: The property owner shall retain the ORIGINAL sewer tally record. If credits exist,this document will serve as a voucher which must be
ubmitted to the City of Tigard Building Division to redeem credits towards future system development charges.
1:\Building\Sewer Tally\SewerTallySheet_4800._070113.xlsx
Plumbing Permit Application
Building Fixtures ECE1VED City
of Tigard �/"_ if y f Ti d g Date/By:Received (D /7 Petmit No.: 01e21./ ..tree 36,
11111 a 13125 SW Hall Blvd.,Tigard,OR 972 Plan Review
a Phone: 503.639.4171 Fax: 503.598 `t. -6 2014 Date/By: Other Permit No.:
Inspection Line: 503.639.4175 Date Read /B Suns: ® See Page 2 for
TIC;ARD Internet: www.tigard-or.gov ,' / • Ready/By: g
Notified/Method: r� Supplemental Information
❑New construction ❑Demolition For special information use checklist
Description I Qty. I Ea. I Total `t-,
®Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) k
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
437.78 "C th 2)bath 437.
❑ 1-and 2-family dwelling ®CommerciaVindustrial SFR( t
SFR(3)bath 500.32
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other
1 Fire sprinkler( sq.ft.) Paget J
£'' �Q$< LNF01 ,i1 0 A iON "' - �� .': Site utilities:
Job site address:10220 SW Greenburg Road Catch basin or area drain 18.76
City/State/ZIP:Tigard,Oregon 97223 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.:260 I Project name:Fleet Concepts Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: /5/:367)-6 O toe y Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Demo existing sink and water heater and relocate plumbing connections to the Dishwasher 25.02
new Break Room sink location.Includes new water heater,hub drain and trap Drinking fountain 25.02
primer Ejectors/sump 25.02
❑ PROPERTY OWNER I ® TENANT Expansion tank 12.51
Name:Fleet Concepts Fixture/sewer cap .3 25.02
Floor drain/floor sink/hub 1 25.02
Address: Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
® APPLICANT ® CONTACT PERSON Interceptor/grease trap 25.02
Business name:McKinstry Co Medical gas(value:$ ) Page 2
Primer ( 12.51
Contact name:Anotnija Krizanac
Roof drain(commercial) 12.51
Address:16790 NE Mason Street Suite 100 Sink/basin/lavatory 1 25.02
City/State/ZIP:Portland,Oregon 97230 Solar units(potable water) 62.54
Phone:(503)278-3971 Fax::(503)331-6907 Tub/shower/shower pan 12.51
E-mail:antonijak @mckinstry.com Urinal 25.02
Water closet 25.02
... „ . . CONTRACTOR >;,,, ,,
Water heater I 37.52
Business name:Same as above Water piping/DWV 56.29
■ Address: Other: 25.02
City/State/ZIP: Subtotal
Minimum permit fee: $72.50
Phone:( ) Fax:( ) _
M Plan review (25%of permit fee)
CCB Lic.:172811 ^' Plumbing Lic.no.:312,2„ f'� State surcharge(12%of permit fee)
Authorized signature: [�j� / TOTAL PERMIT FEE
Print name: ���JJJ ,v /)44 1 14 aa,Date: o 100/14/ 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.
$3
I:\Building\Permits\PLMU-PerwitApp.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-1"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
S1.00 to$5,000.00 Minimum fee S72.50
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
A :a 7 y )A.,,,AToiiikiki 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
Bath -Tub/Shower ❑ New exterior plumbing site utilities for any complex structure
as defined in OAR918-780-0040.
-Jacuzzi/Whirlpool
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 1 r Submit 2 sets of plans with any of the above.
Drinking Fountain
Eye Wash Isometric olr,Riser Diagram
Floor Drain sink 2" ❑ Isometric or riser diagram is required for new buildings
that meet the qualifications above.
-4"
Car Wash Drain
Garbage -Domestic I
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 f
-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 paid before the
Washer-Clothes
Water Extractor plumbing permit can be issued.
Water Closet-Toilet '
Urinal
Fixtures:
\\mckinstry\portland\Construction\Projects\705 OR SPG Hard Cards\2014211354-Fleet Concepts\Permmits\71354-PLMB Permit Application.doc
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 260, TIGARD, OR,
97223
Commercial - Plumbing
399 Plumbing final
2014-02-26 00:00:00
PLM2014-00036
PASS - No C of O
Violation Summary:
Inspector Contractor