Permit el CITY OF TIGARD PLUMBING PERMIT
:111111 = COMMUNITY DEVELOPMENT Permit#: PLM2014-00327
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/02/2014
Parcel: 1 S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 1170
Project: Ameriprise Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Install flood stop device on existing water heater and install new dishwasher.
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 Dishwasher 10/02/2014 $25.02
Specifics: 1 12%State Surcharge- 10/02/2014 $8.70
Plumbing
Type of Use COM 47 ea Minimum Fee Adjustment- 10/02/2014 $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 quest' UNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: (a-14.4` Permittee Signature:u_dt l
Call 503.639.4175 by 7:00 a.m.for the next available inspects 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 Applic
Building Fixtures CEI 1/ FOR OFFICE USE ONLY tri
City of Tigard Oki
Dare By �o ����/ Permit No.: /°�,/1/�pp 327
■ 13125 SW Hall Blvd.,Tigard,OR 2 2014 Plan Review
Phone: 503.639.4171 Fax: 591960 Date/By: Other Permit No.:.Q8j,S( IO 4O
TIGARD Inspection Line: 503.639.4175 ji y of.fiGApri Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov 3� + Notitied/Method: Supplemental Information
TYPE OF WORK 'l 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)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 Ns
El I-and 2-family dwelling ❑Commercial/industrial
SFR(2)bath 437.78
SFR(3)bath 500.32 'C
❑Accessory building ❑Multi-family K
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler(_sq.ft.) Page 2 O
_
JOB SITE INFORMATION AND LOCATION Site utilities: Ni
Job site address: 10260 SW Greenberg Road Catch basin or area drain 18.76 V\
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97233
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.:1170 I Project name:Ameriprise 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.: /3/ 3,;-,-)/',,, ,/ c Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
"" Clothes washer 25.02
Install flood stop device on existing hot water heater and new dishwasher Dishwasher 1 25.02 )co
Drinking fountain 25.02
McKinstry Job#71536 Ejectors/sump 25.02
❑ PROPERTY OWNER ® TENANT Expansion tank 12.51
Name:Ameriprise
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
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 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 7,...'---c
Phone:( ) Fax:( )
CCB Lic.: 172811 Plumbing Lic.no.: 3 - P Plan review (25%of permit fee)
gal
e1, � State surcharge(12%of permit fee) c O
Authorized signature 4 I TOTAL PERMIT FEE 'j.26.)
Print name:Antonija Krizanac Date: 1 o f I ) I 1.1.- 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\Pennits\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-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 $1.00 to$5,000.00 Minimum fee 572.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 S72.50 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
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 Thll ❑ 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
3 that meet the qualifications above.
-4"
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
-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
Other Fixtures:
\\Mckinstry\portland\Construction\Projects\705 OR SPG Hard Cards\2014271536 Ameriprise-Suite 1170\Permits\PLMF-PermitApp.doc
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Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10260 SW GREENBURG RD 1170, TIGARD, OR,
97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2014-00327
George Heimos
Violation Summary:
Inspector Contractor