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Permit • q CITY OF TIGARD �/ ' PLUMBING PERMIT 1111 • COMMUNITY DEVELOPMENT Permit#: PLM2014-00045 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/19/2014 Parcel: 1 S 135AB01004 Jurisdiction: Tigard Site address: 10220 SW GREENBURG RD Project: Lincoln Two-Classroom Subdivision: METZGER,TOWN OF Lot: 9 Project Description: Remove(1)sink in 2nd floor classroom. 2/24/14,reprinted to correct location of classroom to 2nd floor,not 1st 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 ea Sink 02/19/2014 $25.02 Specifics: 1 12%State Surcharge- 02/19/2014 $8.70 Plumbing Type of Use: COM 47 ea Minimum Fee Adjustment- 02/19/2014 $47.48 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. r Issued(.&_....) 12E„.04.....4.10, Permittee Signatur : 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 II COMMUNITY DEVELOPMENT Permit#: PLM2014-00045 T t G A R O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/19/2014 Parcel: 1 S135AB01004 Jurisdiction: Tigard Site address: 10220 SW GREENBURG RD Project: Lincoln Two-Classroom Subdivision: METZGER,TOWN OF Lot: 9 Project Description: Remove(1)sink in 1st floor classroom. 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 1 ea Sink 02/19/2014 $25.02 Specifics: 1 12%State Surcharge- 02/19/2014 $8.70 Plumbing 47 ea Minimum Fee Adjustment- 02/19/2014 $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 Notif •� n 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 direr uestions t OUNC by calling 503.232.1987 or 1.800.332.2344. lssu By: 6 Permittee Signature — re tLS—� 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 Applic lec '! Building Fixtures City of Tigard FEB 18 2t0 i4 Da;e/By: /r / Permit No.: aim rm[ 60e 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review 1 = Phone: 503.718.2439 Fax: 5 Inspection Line: 503.639.417 OrTIGARD Ready/By:Date/By: Other Permit No.:d 01 613 45 3O7 TIGARD www.tigard-or.gov Uo` r . om Date Notified Metho d: Juris: ® See Page 2 for Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑New construction ❑Demolition For special information use checklist. Description 1 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 1-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 El Accessory building El Multi-family Each additional bath/kitchen 25.02 El Master builder El Other: Fire sprinkler ... sq. Page 2-WA„ a f l • s x s Suilt :b t ,, ,E � ie ies Job site address: 10220 SW Greenburg Road Catch basin or area drain 18.76 City/State/ZIP:Tigard,OR 97223 Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name:2 Lincoln Classroom 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: Lot no.: Fixture or item: Tax map/parcel no.: /a/35 7)-6bl60 G� Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Removing one(1)sink Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER ❑ TENANT Expansion tank 12.51 Name:2 Linlcon 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:( ) 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:Antonija Krizanac Roof drain(commercial) 12.51 Address: 16790 NE Mason Street,Suite 100 Sink/basin/lavatory / 25.02 AS,09-- City/State/ZIP:Portland,OR 97230 Solar units(potable water) 62.54 Phone:(503)278-3971 Fax::(503)331-6906 Tub/shower/shower pan 12.51 E-mail:antonijak @mckinstry.com Urinal 25.02 Water closet 25.02 Water heater 37.52 Business name:McKinstry Co. Water piping/DWV 56.29 Address: 16790 NE Mason Street,Suite 100 Other. 25.02 City/State/ZIP:Portland,OR 97230 Subtotal Phone:(503)3310234 Fax:( ) Minimum permit fee: $72.50 7a.5 ) Plan review (25%of permit fee) •--- - CCB Lic.:172811 Plumbing Lic.no.: ,;7-.a.�.Pb State surcharge(12%of permit fee) g.70 Authorized signature: TOTAL PERMIT FEE g1.A0 Print name:Antonija Krizanac Date: 01..1(t.{I (l,r 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\PLMU-PermitApp.doc 10/01/09 440-4616T(I0/02/CAM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: _ Residential Fire Suppression Systems: Site Utilities Qty. [ Fee(ea) Total I 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 S5,000.00 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 each additional$100.00 or fraction thereof,to + S ate. a °}t a o 'h 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", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Quantity by Fixture Type Plan Review for Plumbing Installati Fixture Type for Replace/ Plan review is required for any of the following.Performed: Capped Added Relocate y ow g' Baptistry;Font Please check all that apply. Bath -Tub/Shower ❑ Any new commercial building with water service 2"and Jacuzzi/Whirlpool - greater,except systems designed and stamped by licensed Car Wash -Each Stall engineer. -Drive Thru ❑ New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918-780-0040. Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities. -Domestic ❑ Any multipurpose fire sprinkler system. Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040. Eye Wash Floor Drain/sink -2" Submit 2 sets of plans with any of the above. Isometric or Riser Diagram Car Wash Drain ❑ Isometric or riser diagram is required for new buildings-Domestic-non-food Disposal -Domestic-food related that meet the qualifications above. -Commercial-food related -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Comments regarding fixture work: Rec.Vehicle Dump Station Removing one(1)sink Shower -Gang -Stall Sink/Lav -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter Washer-Clothes *Note: If the fixture work under this permit results in an Water Extractor increase of sewer EDUs,a sewer permit will be issued and Water Closet-Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: W:\Construction\Projects\705 OR SPG Hard Cards\2014\71370 2 Lincolnjlassroom\Permits\Plumbing Permit App.doc Accumulative Sewer Tally 1111 'Tenant Name: Lincoln Iwo-1st Floor Classroom**'CRFI)l'1'S*** SWR# N/A I i,, ,i.n Site Address: 10220 SW Greenburg Rd PLM# 2014-00045 Parcel#: 1S135AB01004 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 0 0 0 0 Drinking Fountain 1 0 0 0 0 0 Eye Wash 1 0 0 0 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 6 0 0 0 0 0 Garbage Disposal: -Domestic(to 3/4 HP) 16 0 0 0 0 0 -Commercial(to 5 lIP) 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 Living Unit 16 0 0 0 0 0 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 0 -1 -2 -Bradley 5 0 0 0 0 0 -Com/Serv/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 0 Urinal 6 0 0 0 0 0 Previous EDU Count (1 0 Capped EDU Credit 0 TOTALS 0 0 1 2 0 0 -1 -2 Current Fixture Value -2 divided ln 16 = u l Current!MC 1 EDU = $4,800.00 Previous Fixture Value 0 divided by 16= 0.000 Previous EDU Change -2 divided by 16= -0.125 over (under) S (624.00) Enter EDU Change Here -0.130 Notes: 'CREDITS*** Authorized Name/Signature: Debbie \damski Date: 2/18/2014 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\Sewer TallyShcet_48(N)._(170113.xlsx 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, TIGARD, OR, 97223 Commercial - Plumbing 399 Plumbing ﬁnal 2014-03-25 00:00:00 PLM2014-00045 PASS - No C of O Violation Summary: Inspector Contractor