Permit 71 q CITY OF TIGARD PLUMBING PERMIT
, .
COMMUNITY DEVELOPMENT Permit PLM2014-00072
Date Issued: 03/17/2014
TI GA t ID 13125 SW Hall Blvd..Tigard OR 97223 503.718.2439 Parcel: 1 S135A603400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 190
Project: Conference Center Subdivision: METZGER, TOWN OF Lot: 9
Project Description: Interior plumbing Relocating(1)sink,and adding(1)2'floor drain.(1)primer,(1)sink, and(1)water heater.
Contractor: MCKINSTRY ELECTRICAL LLC Owner: LINCOLN CENTER LLC
16790 NE MASON STREET SUITE 100 BY SHORENSTEIN PROPERTIES LLC
PORTLAND. OR 97230 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO. CA 94104
P
PHONE: 503-412-4902
HONE: 503-278-3954
FAX: 503-331-6907
FEES
Quantity Description Date Amount
1 ea Floor Drain/Floor Sink/Hub 03/17/2014 $25 02
Specifics: 1 ea Primer 03/17/2014 $12.51
2 ea Sink 03/17/2014 $50.04
Type of Use: COM I ea Water Heater 03/17/2014 $37 52
Class of Work: ALT 1 12%State Surcharge- 03/17/2014 $15 01
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $140 10
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.
f �—
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Issued By: •--- / Permittee Signature: d 7 -iG
Call r 50 .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 SEWER CONNECTION PERMIT
111 . 4
COMMUNITY DEVELOPMENT Permit#: SWR2014-00021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/17/2014
Parcel: 1 S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 190
Project: Conference Center Subdivision: METZGER.TOWN OF Lot: 9
Project Description: 25 EDU increase.
Contractor: Owner: LINCOLN CENTER LLC
BY SHORENSTEIN PROPERTIES LLC
555 CALIFORNIA ST 49TH FL
SAN FRANCISCO. CA 94104
PHONE PHONE- 503-412-4902
FAX
FEES
Description Date Amount
Specifics: Sewer Connection Fee 03/1712014 $1.200.00
Type of Use: COM
Class of Work: ALT
Install Type: Building Sewer
Fixture Units:
Number of Dwelling Units: 25
Total $1 200 00
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: s
Call 503r.-636 741-7'51)y 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.
ill Accumulative Sewer Tally
s
Tenant Name: LINCOLN TOWER CONFERENCE CENTER SWR# SWR2014-00021
TIGARD
Site Address: 10260 SW GREENBURG RD P7.11 # PLM2014-00072
Parcel#: 1S1 35AI:303400
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 11 0 0 0
Car Wash: -Each Stall 6 0 11 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
I:ye Wash 1 0 U 0 0 0
Floor Drain/Sink: -2 inch 2 0 0 1 2 1 2
-3 inch 5 0 0 0 0 0
-4inch 6 0 0 _ 0 0 0
-Car Wash 6 0 0 0 0 U
Garbage Disposal:
-Domestic(to 3/4 IIP) 16 0 0 0 0 0
-Commercial(to 5 I IP) 32 0 0 0 0 0
- Industrial (over 5 I IP) 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 11
Rec.Vehicle Dump station 16 U 0 0 11 0
Shower: -Gang(per head) 1 0 0 0 0 0
-Stall 2 U U 0 0 0
Sink:
-lav/Bar-Non-Food Related 2 0 0 1 2 1 2
-Bradley 5 0 0 0 0 0
-Com/Sery/Util-Food Related 3 U 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 0 0
Capped EDU Credit 0
'1'OTAIS 0 0 0 0 2 4 2 _ 4
Current Fixture Value 4 divided by 16= 0.250 Current l'DU 1 EDU= $4,800.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change 4 divided by 16= 0.250 over (under) $ 1,200.00
Enter EDU Change Here 0.250
Notes:
Authorized Name/Signature: BRANDEN TAGGART X2449 Date: 3/17/2014
Building Division
Note: The property owner shall retain the ORIGINAL sewer tally record. I f 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\SewerTallyShe a t_4&10._070113.xls x
Plumbing Permit Application Sivktii i f i, It
. Building Fixtures �\ �-•1 FOR OFFICE USE ONLY
City of Tigard Received 7 �.
e 13125 SW Hall Blvd.,Tigard,OR 97223 11 Date By: 3/1 ]// •J ,� �i art�,�
Ill �Q Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 r r�( Date rt Other Permit No.: t4� )l�J- 1
TIGARD Inspection Line: 503,639.4175 ea. +`~ Date Ready By karts: 65 See Page 2 for -{�
Internet- www.tigard-or.gov G1�_ NotitiedMethod: 'r< Supplemental Information
TYPE OF WORK ` . FEE* SCHEDULE
❑New construction ❑ Demolition For special itrjormarion use checklist.
Description I Qty. I Ea. I Total
®Addition%alterati on/rep lacement ❑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: 10260 SW Greenburg Road Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,Oregon Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: 1" I Project name:Lincoln Tower Conference 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.: Backflow preventer 31,27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Reroute the drain for(I)existing sink and add(1)new break room sink with Dishwasher 25.02
water heater,hub drain and trap primer. Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER ❑ TE NANT Expansion tank 12.51
Name:Shorenstein Fixture/sewer cap 25.02
Floor drain::floor sinI hub 1 25.02 ,1.6-,4).,1-Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( i lcc maker 12.51
® APPLICANT CONTACT PERSON Interceptor/grease trap 25.02
Business name:McKinstry Co Medical gas(value:$ ) Page 2
Contact nameastau kple Pv�•rtOvt,'- K 2 "�^' Primer 1 12.51 1a _� 1
Roof drain(commercial) 12.51
Address: 16790 NE Mason Street Suite 100
Si nk/basin/lavatory a 25.02 50-041_
City/State/ZIP:Portland,Oregon 97230 Solar units(potable water) 62.54
Phone:(503)ty3Q511-•a1.6. flq I Fax::(503)331-6907 Tub/shower/shower pan 12.51
E-mail: t�✓'t bn J.:.1c.e trY-11. -S j•W/1' ' Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 1 37.52 S?. j
Business name:Same as above Water Pi tp in g/DWV 56.29
Address: Other: 25.02
City/State/ZIP: Subtotal /1,5'i n
Phone:( ) Fax:( )
Minimum permit fee. 572.50
Plan review (25%of permit fee)
CCB Lie.: ii..if Plumbing Lie.no.: State surcharge(12%of permit fee) /S 0/
Authorized signa • TOTAL PERMIT FEE .4,))w jt,3
Print name: (1l Date: ' 1
this permit application expires if a permit Is not obtained within 180 days
J.- L Vv--" after it has been accepted as complete.
'Fee methodology set by Tri-County Building Industry Service Board.
I:\Building`Perm its'PLMU-Pemi1App.doc 10'01'09 440-4616T(l0/02/COMLWEB)
Plumbing Permit Application - City of Tigard
. Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ca) 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 3,6(X) $169.69
3,601 to 7.200 $233.20
Sewer-1st 100' 62.54 7,201 and greater $32734
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.8z,Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 55,001.00 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 510,001.00 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 525,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$L45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 90.001r 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 Plan Review for Plumbing Installations
accurately report fixtures could result in increased sewer fees*. Plan review is required for any of the following.
Quantity by(Fixture)Work Performed Please check all that apply.
Fixture Type: Replace
Prcvioav Capped Added t 11%iing ❑ Any new commercial building with water service 2"and
Baptistry/Font _ greater,except systems designed and stamped by licensed
Bath -Tub/Shower engineer.
-Jacuzzi/Whirlpool ❑ New exterior plumbing site utilities for any complex structure
Car Wash -Each Stall as defined in OAR918-780-0040.
-Drive Thni ❑ Medical gas and vacuum systems for health care facilities.
Cuspidor/Water Aspirator ❑ Any multipurpose fire sprinkler system.
Dishwasher -Commercial ❑ Any complex structure as defined in OAR918-780-0040.
-Domestic
Drinking Fountain Submit 2 sets of plans with any of the above.
Eye Wash
Floor Drain/sink -2" Isometric or Riser Diagram
4•• ❑ Isometric or riser diagram is required for new buildings
Car Wash in that meet the qualifications above.
Garbage -Domestic
Disposal -Commercial
-Industrial
Ice MachJRefrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower -Gang
-
-Stall -
Sink -Bar/Lavatory ' I
-Bradley
-Commercial
-Service *Note: If the fixture work under this permit results in an
Swimming Pool Filter
washer-Clothes increase of sewer EDUs,a sewer permit will be issued and
_Water Extractor fees assessed for the sewer increase must be paid before the
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
\\mckinstry\portland\Construction\Projects\705 OR SPG Hard Cards\20I4471400 Lincoln Tower Conference Center\Permit\71400-PLMB Permit
Application.doc
Location:
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Inspector:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10260 SW GREENBURG RD 190, TIGARD, OR,
97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2014-00072
George Heimos
Violation Summary:
Inspector Contractor