Permit q CITY OF TIGARD PLUMBING PERMIT
11111 111 . COMMUNITY DEVELOPMENT Permit#: PLM2015-00071
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/12/2015
Parcel: 1S135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 640
Project: Spec Space Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Cap(1)sink.
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 Fixture/Sewer Cap 03/12/2015 $25.02
Specifics: 1 12%State Surcharge- 03/12/2015 $8.70
Plumbing
Type of Use: COM 47 ea Minimum Fee Adjustment- 03/12/2015 $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 1.8
,ga......._.. c....._
Issued By: mittee Signature: AI
M
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.
FROM :MCKINSTRY FAX N0. :5033316906 Mar. 05 2015 02:27PM P8
Pk. mbin Permit A 0 licati j 1'�1 t t;lt ,>i 1 t< I , ,, i,11.,
Building Fixtures /g�i`D itacoived .g ' Permit Km: (..1l9a6. 7f
City of Tigarti mica
+t 13125 SW Hall Dlvd.,Tigard,OR 97 plan Review Other Permit No.;
lyatc/B OflI lift See Page 2 for
� phone' 503.718.2439 Pax: $03.598.1%U Y�
CITY OF I1(. Kl) �iueRen,yBY:
Inspection tine: 503.639.4175 Notifieeady/B d 5u',tetneatdInformation
r y,�r'.�r^
I i,'A1'.Ii Internet: www.tigard-or.gov • • a r D"!i ,,,,,!',il' '.,r j,, 1,r a{r,71 i+r3 tS yitr4 Ili iii iti1�;.,{{i>;1+ 1,�+'r1�..
,,.r.. y,ui .+�,n,,i;;"i� Y t A. ''3�, ,.'%''4i'f.'11 iir;' ,%!..1 tr('}�7rr4tr�ieoTi;A!1A eept,(!t:,+1�I{+Il l�l�p1N+Pri/y�tflt,'1: + ,:: ii�hi4;;7f Mflwl,r+4:•i)A4Wri;1i1;∎;;;7� 1.1frldArigIiiida,)ia'LWI
''':1-4';';',':::; r !! 1 r'!I r t+ 1 u 1 /,!"1 4 i' t r• I r r'a l v.,L 1{1,.i;',, ilr1L'7.,w;i0.,ivl,l r_Nr�1
+ ,d''6..r'1',..+,i�i` '', ,.1.��+rt■,A�!�r itl'„�a,��irlm,il+�.,�;l d,1 f�:,.v_nr l kll!'n.k�,r:,f n1e�N lulr,l1��.�r�rxrld+,6,.r F o e s p e c i e/( muatiPn use epee rli4t.
❑Demolition Ea. Total
Now construction Descri lion
❑
ix ❑ New 1 2-family dwellings(includes 100 ft.for each utility connection)
pddttton/ul[erahtm/replactrnont 312,70
f r 4 ), i,i) �d',.ir')1r�rl�0!%:r i{ }1;,. j v,,,,,,i,' •`. Q)bath
+,I;i6:f li+,a,i J .,„ /i f•1!i,}lli;l!i al'd II,GJ i:,,r 0 ,prr k,..L.∎rnei L�:ldl.iL Al!..e AO ri+.1d),'A l d4.d,.ilL IL) :i1i +,V, 437,78
tiPR(2)hath
❑ 1-and 2-family dwelling ®Cotnmerc't.�l/industrial - SFR(3)bath �� 500.32
Accessory building ❑Multi-family Each additional bath/kitchen 25.02
----
71 Muster builder ❑Other: Fire sprinkler( sq.ft.) Page 2
a i r�i A p�;,I Jw p r)+r ni e i f lYl+i{i;l } "i t ir4�i;;�t(r�4; r t Site utilities.
,! ;;;r. ,i: r Ski)) ) n 0,,,:i t,,I,,I rills rr! 1�l):,I�+!Pa l/n r:Noiwir)1A,11):i8I ls.)Ill, fl'4ill ,1 tANw)0,',
,.,�I�1 I�..,, ._.nr},r.,.,i.r:.R rui1�,.�.,A,,r Catch basin Or area dfAln 1 8.76
Job site address:10220 SW Greenhurg Road Drywcl1,leach line,or trench drain 18.76
City/State/ZIP;Tigard,OR 97223 - Footing drain(no.linear R:-�) Page 2
S 4e 50.03
Suite/bldg./opt.no.:7l�fe 'fu Project natuc:VSP Suite Manufactured home utilities
Cross a treet/directions to job site:
Manholes 18.76
- Rain drain connector -
Sanitary sewer(no.linear R.:J) Page 2
Stonn sewer(no.linear ft.__) Page 2 F
- Water service(no.linear It.; ) Page 2
Subdivision: Lotno.: Fixture or item:
-
'
Back flow prcve
nter 31.27
Tax map/parcel no.: /5./3 S; L* io
iI r 1 } l i r ;l ' r l v { r r 1N t�r r�,, 7 4,7 ;4m47,tir1 4 } 4ih1 4 Backwater valve 12.51
+;,,+ ,rI n i,/.1.1:1,Ui!LJ 1 r ,+,4.?M1 S.iy ir rr( 1 di4d_r t.it>.111i ,IIU rr`l iii� , 1!I 2ll 1'14� Clothes washer 25.02
Demo or
wink .. Dishwasher 25.02
Drinking fountain .. 25.02
- t-jectors/sump 25.02
l i:it ,l,,- {r ,l i 7,?. u, .iL S!I 11 rp r i ! + v°r( 1 r ?�{ q {1t Ex ansion tank
4t;ii �,
12.51
raa{ 4,,..,Yt 1!i G) , r i.4()e i uk u,«m))i: r.r]itir6iI .rllr 711j 11rI.ei Y7114vas 1f�!F 't+'jt E,filf • 5! .II Fixture/sewer cap / 25.02
d
Name:Shorenstein Properties Lis. Floor titian/floor sink/hub 25.02
Address:235 Montgomery Street,16'"Floor Garbage disposal 25.02 ...
City/State/7.,iP:San Francisco,CA 94104 Hose bib 25.02 -
Phone (415)772-7000 Fax ( ) Ice maker 12.51
I + ! I i I i .1 I i� 'f('' ',r, ,; i,I i irn ,' +1'�p1Po7.1} iIi;i okNA :} �,. Interceptor/grease trap 25.02
',5 ,r 1 f:,.n,�d,„"i.'i r. :Irii?i f.,.,t1, kr ;,;;uilAr,d 14/2/11 r.ist1 .iittm { d -
Medical gas(value;$ .) Page 2
Business name:Mel(Instry Co Primer 12.51
Contact name:Antonija Krizanae .. _ _ Roof drain(commercial) 12.51
Address:16790 NE Mason Street,Suite 100Smk/basin/lnvnbnyi T 25.02
City/Stato/ZIP:Portland,OR 97230 - Solar units(potable water) (+2.4
Fax::(503)331-6906 Tub/shower/shower pan 12.51 �
Phone:(503)331-0234 (
._ �. - Urinal 25 02
E-mail:a. nt o nUak @,.NJ:m ck i1 n s'try rem .`..
T•:,.!•;,:,,' , ; , r i : f +,i l . ,, ,l,V':d I I g,l i y,i i ri i 1tiM7041T1 IIr," �T1 + Water clot 25,02
i:,,., i..1. 1;.lr,l I 1 t ii,. i l: rll,ti[,I I4f.it J li 17( Vi!,te,..ta i.rn.N.:mi'Ve hli. ,VJr.� r�/d� .i1� _I; Water heater 37.52
._
Business name:McKlnstry Co. - Water pipitlg/DWV 56,29
Address:16790 NE Mason Street,Suite 100 Other; - 25.02
)
Subtotal
City/Statc/ZIP:Portland,OR 97230 -
Fax:(503)331-6906 Minimum permit foe: $72.50 7„ -
Phone:{5113)331-0234 Plan review (25%of permit fcc) -�
CCB Lic.:172811 Plumbing I,ic.no.:37-22PB
... State surcharge(12%of permit fcc) �1r57.7�G
Authorized signature: TOTAL PFRMIT FEE g(•oL
'fhia permit application expires if a permit b not obtained within Ian days
Print name Antonija ii se Date: I I S r/S after It has been accepted as complete.
! •1'6e mcthodoloay se by Tti-County Building Industry Service Board.
oeaildiesTereauuh.M11-rermitApP.dui 1e011n09 440.4616T(10/021cOM VED)
FROM :MCKINSTRY FAX NO. :5033316906 Mar. 05 2015 02:27PM P9
Plumbing Permit Application,- City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Su t •ression S stems:
,y^- hi "r', ,lrli'. r r tu,°s'r,r�'gyp, �•xti-f�. ) ^4 4.y'f t{T „{L Il,Ih'r,e--ll ,�.1 . Ei i(7h1�..�,' ,�1 N jil-'4f;�M,t �1' t S���'!
t,r,,, ,,, l ,,,iii u. q � 4 c 4 p ,{ 44 i pp•�1 r ,.1,,3, f .r ,d , P,; 2 11 , ,.,t.1
! Ii;, , ill tS rr, ';�til, r� ,+j , .11,k l x, :huiE .:.l �i I }t r ei.;.T:1-.I,;M�,71g-,,,•-1 nl'1;,∎.,n, 03,,J.aT�',. „1tM..ItI i,� q%.:"Z viii trA 71 7,.,....il ,
aa� M,,',1( .v1,r1,;r. ,tr„�,,r,;lwi,. „t�,,! tt 50.03 �� 0 to 2,000 $121.90
Footing drain-l°1 n0' 2 001 to 3,600 $169.69
Footing drain-each additional 100' 37.52 -601 to 7.200 $23320
Sewer-1st 100' t' 7,201 and greater $327.54 -
Sewer-each additional 100' ME 37.52
Water Service-1st 100' Medical Gas S stems:
Water Service-each additional l00' �� 1 11 7! ! .1 ;L r{µ t WI l.T ) y rrnrqi igp;,ik A y
" y
,� ,ji,la Ll,,it 'itiP!,;,4,d.Nlti,,i.>,,Ji„f.,6�w kr140u Pi1h l EL40
(7W,.0 1.'
Storm&Rain train-1st 100' NMI 62.54 $1.00 to$5,000.00 Minimum fee$72.50
Sturm&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
,N r ,:a p {SN
1' ,1 r)` 7 ;(R tir..r±. i Pw , r,+C O'PrPM�,ktP'•;i each additional$100.00 or fraction thereof,to
) ';, ; ',.I,.,,'s I,.,, t!, ,,1:f„d' r,,,,i a.i,dr t ,,,,:,t at,t,uhf i. T tV,,,.L 2 ;I{la
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$1.53 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
minimum char_ -1r2 hour and includin• $25000.00,
inspections outside of normal business II 90.00/hr 111 525,001.00 to$50,000.00 $379.50 for the first:$25,000.00 and$1.4S for
hours(minimum chime 2 hours each additional$100.00 or fraction thereof.to
Rcinspection 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
each additional$100,00 or fraction thereof.
minimum charge-1/2 hour) -
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurate) re sort fixtures could result in increased
„... ` sewer fees*.
s*.
fw 1 ,1 E Ij' E�'&t .. s a{ 7i. ` r:P,, ti u,"? r �arlzu^i
, ,,T e*Tsr , j 1y L j1l
wYfilspoTz���, �hj
;;,!,0li.�u.. >.~1 , ).01 l ii„l.1,,it a.ltis M 1_14, .,,1$ 4, %i , i
, . 1114m, ,I i fit -I� Nh"! h s)'� �A, lxi Plan review is required for any of the following-
Please check all that apply.
R tis. /font ❑ Any new commercial building with water service 2"and
Bath -Tub/Shower - greater,except systems designed and stamped by licensed
-lacuni/Whirlpool engineer.
Car Wash -Each Stall .. engineer.
New exterior plumbing site utilities for any complex structure
-Drive Thal as defined in OAR918-780-0040.
Cuspidor/Water shwher Asomme U Medical gas and vacuum systems for health care facilities.
Dishwasher -Commercial ❑ Any multipurpose fire sprinkler system.
-Domestic El M
Drinkin Nountaitl Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" - Submit 2 sets of plans with any of the*hove.y� rl �{y{
-3" .,Ny, Sr I ,7, itt r' 'A�r:,:r,�r�77 a pHr!y 4 y.{j!` p: x'411!13),, 1tal'{'ll�rrr,,,1�1s(', At'_ �¢
t i 1 , �1 .4r r 111 t i.
4., 'I ff +
Car Wash Drain '.ar�„�„ Ill..t a,t.J,,�I,A,4„t ,1 h,.! "� u:.,.,,,f,l.,. i m to>,,.i{ a.,viii.
•(;arhage -Domcstie-non-food ❑ Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
- Commercial-food related
-Industrial-tcxxt related
fee Mach./Rcfrig.Drains
Oil Separator(Chas Station) 1 Comments regarding fixture work:
Rcc.Vehicle Dump Station ,_ Demo one sink
Shower -Gang _
-Stall .
Sink/I.av -Non-food related
-Bradley
-Commercial-food related
-Service 1 '
Swimming Pool Filter *Note: Tf the fixture work under this permit results in an
Washer-Clothes increase of sewer ECUs,a sewer permit will be issued and
Water Closet _ _._
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 Cnnstruction1101731 VSI'Ste.604 2 Lineciln\t xl 2Constructiun\Pennits\1'LMF-PermitApp.doc
Accumulative Sewer Tally
cr Tenant Name: Spec Space '' (:RI?D1TS*** SWR# N/A
Site Address: 10220 SW(1recnburg Rd#640 PLM# 2015-00071
Parcel#: 1 S 135AB01004
Fixture \,ilu • Previous Previous Credits Capped Fixture Fixture New New
# value count capped#s value count added# added value total#s total values
Baptisery/ ■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 0 0 0
Drinking Fountain 1 0 0 0 0 0
Eye Wash 1 0 I) 0 0 0
Floor Drain/Sink: -2 inch 2 0 0 0 0 0
-3 inch 5 0 0 0 0 0
-4inch 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 HP) 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) I 0 0 0 0 0
-Stall 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 0 0
Capped EDU Credit 0
TOTALS 0 0 1 2 0 _ 0 _ -1 -2
Current Fixture Value -2 divided by 16= -0.123 Current EDU 1 EDU= $4,900.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change -2 divided by 16= -0.125 over (under) S (637.00)
Enter EDU Change Here -0.130
Notes: ***CREDITS*** rr
Authorized Name/Signs re: Qd2,,,k, Date: L/f4/'
Buil ing 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\Se verTallySheet_4900._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
10220 SW GREENBURG RD 640, TIGARD, OR,
97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2015-00071
George Heimos
2" capoff
Violation Summary:
Inspector Contractor