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Permit CITY OF TIGARD PLUMBING PERMIT V ft " COMMUNITY DEVELOPMENT Permit#: PLM2015-00003 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/06/2015 Parcel: 1 S135AB00900 Jurisdiction: Tigard Site address: 10200 SW GREENBURG RD 740 Project: Pollmeier Subdivision: METZGER,TOWN OF Lot: 9 Project Description: Installation of(1)sink&(1)dishwasher. Fixtures relocated from suite 450. Credits from capped fixtures from PLM2015-00002 applied to this permit. 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 01/06/2015 $25.02 Specifics: 1 ea Sink 01/06/2015 $25.02 1 12%State Surcharge- 01/06/2015 $8.70 Type of Use: Plumbing Class of Work: 22 ea Minimum Fee Adjustment- 01/06/2015 $22.46 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 No on - . Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or dir- questions to OUNC b a ••• ;'3.232.1987 or 1.800.332.2344. I-sued By: / `// .11_■ r Perm ittee 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. Plumbing Permit Application CEIVE Building Fixtures 11'' um tm ici. I Si (1N.1 1 Received City of Tigard n�1 c C Date/By: / (o f, PermitNo.: ./.414,00,5---,04003 13125 SW Hall Blvd.,Tigard,OR 9� 6 201J Plan Review I Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.: Inspection Line: 503.639.4175 T I G A R D Date Ready/By: Juris. ® See Page 2 for Internet: www.ti ard-0r. ov ,1 Notified/Method:O� s IGA� Supplemental Information ormation „. 4 _ - 1 * k ❑New construction ❑Demolition For special information use checklist Description I Qty. I Ea. I Total ~ ®Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) 1 t t t e A a, e ,--, SFR(1)bath 312.70 % ❑ 1-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: 10200 SW Greenburg Road Catch basin or area drain 18.76 City/State/ZIP:Tigard,OR 97223 Drywell,leach line,or trench drain 18.76 /��IA /, Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.:740 I Project name: I/ 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.: Backflow preventer 31.27 Backwater valve 12.51 . . ., ) °• .1. ( ,AF WARD washer Clothes h 25.02 Eap-and-remeve 1 sink and 1 dishwasher install in suite 740 Dishwasher 1 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER 1 ❑ TENANT ; Expansion tank 12.51 Name:Shorenstein Properties LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:235 Montgomery Street,16th Floor Garbage disposal 25.02 City/State/ZIP:San Francisco,CA 94104 Hose bib 25.02 Phone:(415)772-7000 Fax:( ) Ice maker 12.51 9_ CM e', ® 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 1 25.02 City/State/ZIP:Portland,OR 97230 Solar units(potable water) 62.54 Phone:(503)331-0234 Fax::(503)331-6906 Tub/shower/shower pan 12.51 E-mail:antonijak @mckinstry.com Urinal 25.02 Water closet 25.02 tCONTRACTOR `4-44'', ' z , 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)331-0234 Fax:(503)331-6906 Minimum permit fee: $72.50 7,2 51) - CCB Lic.:172811 Plumbing Lic.no.:37-22PB Plan review (25%of permit fee) State surcharge(12%of permit fee) cc-VO Authorized signature: TOTAL PERMIT FEE g/. ) Print name:Antonija Krizanac Date: 1 1(0I (S 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.doe 10/01/09 440-4616T(IO/O2ICOM/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-I"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$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 Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to Other Inspections or Fees 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 Installations Fixture Type for Replace/ Plan review is any required for an of the following. Work Performed: Capped Added Relocate 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 1 ❑ 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. -3,' Isometric or Riser Diagram Car Wash Drain Garbage Domestic-non-food ❑ Isometric or riser diagram is required for new buildings 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 Shower -Gang -Stall Sink/Lav -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter *Note: If the fixture work under this permit results in an Washer-Clothes 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:\Projects\N-R\Russell Construction\100984 Pollmeier Ste 740 5 Linco12\001 Construction\Permits\PLMF-PermitApp.doc Accumulative Sewer Tally ;� Tenant Name: 1'. Ilmeier SWR# N/A Site Addres, I021)0 SW(ireenbur} Rd#740 PLM# 2015-00003 lit. \iiri Parcel #: 1S135AB00900 Fixture \slur Previous Previous Credits Capped Fixture Fixture \cw New # value count capped#s \aloe count added# added value hind #s 6 ital values Baptisery/1''ont 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 1 2 1 2 Drinking Fountain 1 0 0 0 0 II Eye Wash 1 0 0 0 0 0 Floor Drain/Sink: -2 inch 2 0 0 0 0 0 -3 inch 0 0 0 0 0 -4 inch 6 0 0 0 0 0 -Car Wash 6 0 I I 0 0 11 Garbage Disposal: -Domestic(to 3/4 111') 16 0 0 0 0 0 -Commercial(to 5 l IP) 32 0 0 0 0 0 -Industrial(over 5 I1P) 42 0 0 0 0 0 Ice Machine/Refrigerator Drain 1 0 0 0 0 0 Living Unit 16 I) 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 it 0 0 1 2 1 2 -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 0 Urinal 6 0 0 0 0 0 Previous EDU Count II 0 Capped EDU Credit 0.25 4 TOTALS 0 0 _ 0 0 2 _ 4 2 _ 0 Current Fixture Value 0 divided by 16= 0.000 Current EDU 1 EDU= $4,900.00 Previous Fixture Value 0 divided by 16= 0.000 Previous EDU Change 0 divided by 16= 0.000 over (under) S - Enter EDU Change Here 0.000 Notes: Credits from PLM2015-00002 applied to this permit. Authorized Name/Signature: Debbie Adamski Date: 1/6/2015 Building Division Note: The property owner shall retain the ORIGINAL sewer tally record. If credits exist,this document will serve as a voucher which nui:r lie submitted to the City of Tigard Building Division to redeem credits towards future system development charges. I:\Building\Sewer T ally\,SewerTal lySheet_490)L_070114.xlsx Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 10200 SW GREENBURG RD 740, TIGARD, OR, 97223 Commercial - Plumbing 399 Plumbing ﬁnal PASS - No C of O PLM2015-00003 George Heimos Violation Summary: Inspector Contractor