Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2014-00273
T I GA RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/18/2014
Parcel: 1 S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 380
Project: Kforce Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Adding(1)new sink and(1)point of use water heater.
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 08/18/2014 $25.02
Specifics: 1 ea Water Heater 08/18/2014 $37.52
1 12%State Surcharge 08!1812014 $8.70
Type of Use: COM Plumbing
Class of Work: ALT 10 ea Minimum Fee Adjustment- 08/18/2014 $9.96
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: \ GC,* Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspectio te.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Applica („LiVti
Building Fixtures- FOR OFFICE LSE ONLY
City of Tigard AUG 18 2014 Received �y ` , Permit No.: Yu l , 0173
IIIII • 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: i '+��
_ Phone: 503.639.4171 Fax: '$?ItO T I V A � ) Plan Review
Date/By: Other Permit No.: 6(11:.1�2 -{ `
Inspection Line: 503.639.41U i rILDING DIVISION Date Ready/By:th tans H See Page 2 for
T I GA R D Internet: www.tigard-or.gov if U
0 8 Notified Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑New construction ❑Demolition For special information use checklist.
Description I Qty. I Ea. 1 Total
®Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) t�
CATEGORY OF CONS 1'RUCTION SFR(1)bath 312.70 itC.
❑ 1-and 2-family dwelling -I ®Commercial/industrial SFR(2)bath _ 437.78 'O
' SFR(3)bath 500.32
❑Accessory building ❑Multi-family
i Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler( sq.ft.) I Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 10260 SW Greenburg Road Catch basin or area drain 18.76
City/State/ZIP:Portland,OR Drywell,leach line,or trench drain 18.76 `C.
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.:380 Project name:Kforce 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 1
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: / �
'jI 3<Al 6 3 t/ O Backflow preventer I 31.27
DESCRIPTION OF WORK Backwater valve 12.51
t Clothes washer 25.02
install new sink and point of use water heater
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER ® TENANT Expansion tank 12.51
Name:Kforce Fixture/sewer cap I 25.02
Floor drain/floor sink/hub I 25.02
Address: Garbage disposal I 25.02
City/State/ZIP: Hose bib I 25.02 1
Phone:( ) Fax:( ) Ice maker 12.51
® APPLICANT El CONTACT PERSON Interceptor/grease trap I 25.02
Business name:McKinstry Co Medical gas(value:S ) Page 2
Primer 12.51
Contact name:Antonija Krizanac
Roof drain(commercial) I 12.51
Address: 16790 NE Mason Street Suite 100 Sink/basin/lavatory I 25.02 ,25,/,'>"
j
City/State/ZIP:Portland,Oregon 97230 Solar units(potable water) 62.54
Phone:(503)278-3971 I 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 1 37.52 37. 53-
Business name:Same as above Water piping/DWV 56.29+
Address: Other. 25.02
City/State/ZIP: Subtotal
Phone:( ) Fax:( ) Minimum permit fee: S72.50 7 2.
Plan review (25%of permit fee)
CCB Lie.: 172811 Plumbing Lic.no.: 31.- 21 g P
State surcharge(12%of permit fee) g 7e3,
Authorized signature: 1,4-- TOTAL PERMIT FEE /,ac
Print name:Antonija Kr' SC Date: 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 10/01/09 340-76161110:00.COM WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. 1 Fee(ea) Total Square Footage: _ Permit Fee:
Footing drain-I" 100' 50.03 0 to 2,000 __ S121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer-1st 100' j 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' 1 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 cha Qe-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 I ❑ New exterior plumbing site utilities for any complex structure
-Jacuzzi/Whirlpool 1 l _ as defined in OAR918-780-0040.
Car Wash -Each Stall 1 I ❑ Medical gas and vacuum systems for health care facilities.
-Drive Th ❑ Any multipurpose fire sprinkler system.
Cuspidor/Water Aspirator ❑ Any complex structure as defined in OAR918-780-0040.
Dishwasher -Commercial
_ -Domestic i Submit 2 sets of plans with any of the above.
Drinking Fountain I
Eye Wash 1 sometric 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 I Comments regarding fixture work:
Ice Mach./Refrig.Drains 1
Oil Separator(Gas Station)
Rec.Vehicle Dump Station _
Shower -Gang
-Stall
Sink -Bar/Lavatory I
-Bradley
-Commercial *Note: If the fixture work under this permit results in an
-Service I 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 lumbin�permit can be issued.
Water Extractor p b p
Water Closet-Toilet _
Urinal 1
Other Fixtures:
\\Mckinstry\portland\Construction\Projects\705 OR SPG Hard Cards\20I4471524 KForce\Permits\PLMF-PermitApp.doc
Location:
Record Type:
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Inspection Date:
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Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10260 SW GREENBURG RD 380, TIGARD, OR,
97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2014-00273
George Heimos
Violation Summary:
Inspector Contractor