Permit q CITY OF TIGARD PLUMBING PERMIT
8 • COMMUNITY DEVELOPMENT Permit#: PLM2015-00185
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/09/2015
Parcel: 1S135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 305
Project: Matrix Absence Management Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Replace/relocate(1)2"floor drain,(1)sink,(1)primer and(1)water heater
Contractor: POWER PLUMBING CO Owner: LINCOLN CENTER LLC
PO BOX 19418 BY SHORENSTEIN PROPERTIES LLC
PORTLAND,OR 97280 235 MONTGOMERY ST, 16TH FLOOR
SAN FRANCISCO,CA 94104
PHONE: 503-244-1900 PHONE:
FAX: 503-244-8825
FEES
Quantity Description Date Amount
1 ea Floor Drain/Floor Sink/Hub 06/09/2015 $25.02
Specifics: 1 ea Primer 06/09/2015 $12.51
1 ea Sink 06/09/2015 $25.02
Type of Use: COM 1 ea Water Heater 06/09/2015 $37.52
Class of Work: ALT 1 12%State Surcharge- 06/09/2015 $12.01
Type of Const: Plumbing
Occupancy Grp:
Stories:
I Total $112.08
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: 7„.....„,- Perm Signature: n
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.
JUN-04-2015 15:24 From: To:5035981960 Pa9e:1'2
Plumbing Permit Application
Building Fixtures RECEIVED l 11R e), F7/ F- t Si. e1\l )
City of Tigard 4 2015 Dom' a" i°LMaO%��i�s'�
II''�^^II 4tirmit NO,:
13125 SW Hall Blvd..Tigard,OR 9Tb23`t Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit
Inspection Line: 503.639,4175 CI'(1( OF TIGARD DateReadyBy 4i turd: 0 SctPageArur
i I c A f:i? Internet: www.tigard or.gcry G
1 a. DIVISION Notified/Method: ? t• Supplemental inhumation Si.,
' t TYPE OF WO f ,4 •'SCHEDULE r i . . Q
J'o ,aJFh'E ��',
❑New construction 0 Demolition
' For special In/orrnalion use checklist.
Description 1 Qty. I Ea_ I Total 1
�Addrtion/alteration/replacement ❑Other: New 1.2-family dwellings(includes 100 ft.for each utility cormection)
'y_,as ,. .. , D j CATEGORY of;CONSTRUCTION.'. ',.1 t. ,. SFR(1)bath 312.70 w]
❑ 1-and 2-family dwelling ommcrcial/industrial SFR(2)bath 437.78 '!
Accessory building SFR(3)bath 500 72 \,
❑ ry g ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler sq.fl.) Page 2
i' ,'C °JOB ,; a. ItMATIOhI MID;LOGATI0' ... .
,:, Site utilitie:
-- cn m s.x-dram- ---- 18.76
Job site address: $d 2 20 .S W (7V-C cb fM.e 1 o 0 p-„
City/State/ZiP: ,p 9'7723 iUl" Drywell,leach line,or trench drain 18.76
�I dR I/ CI se_ Footing dram(no.linear ft.:_) Page 2
Suite/bldg./apt.no.:45 5. Project name:M gill`` A-b i-kt Li.-•. Manufactured home utilities 50.03
lu
Cross street/directions to job site: V M a y.44 tAti Manholes 18.76
Rain dram 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: 11.ot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer , 31.27
_,- v e, 8ackwattr valve 12,51•, .'i . , ;!DESCRIPTION`OF.,WORK ,,, ` ,1'., I �,, , , .
Clothes washer 25.02
E.ML __LA4 L_ Ma V4 p0 44,74- Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
c F^„ P❑-PRo OWNER r,:e , .-).1.'....'
>. , .... 0, 1A'1!iT-, '' ,' ,°, ,. Expansion tank 12.51
Fixture/sewer cap 25.02
Name:
Floor drain/floor sink/hub I 25.02 25.07--
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
•r W i••.i.•.JJ PI'ICANT r+,_:`I,' I•, E7,CONfACf 0IRSON Interceptor/geese trap 25.02
Business name: Pof� � j2/�rn/�� 6a Medical gas(value:S ) Page 2
� Primer I 12.51 )1.51
Contact name: 4JU h rL 6ii..64 Roof drain(commercial) 12.51
Address: PO DX _/94/ Sink/basin/lavatory - 11' 25.02 25.OZ
City/Slate/ZiP: --f q / O 97ek ) Solar units(potable water) 62.54
Phone:(9)3) i Oil-/900 Fax::(.03)a W- ig2S- Tub/shower/shower pan 12.51
' ACTOR Urinal 25.02
E-mall SQ(y► C.LCQ� L 1-.1yh1rnh- Kf ld l/' Water closet 25.02
Water heater ' 37.52 37.5 Z.
Business name: ?Om j4.4_, p/u b/ 6 . Water piping/DWV 56.29
Address: (p(p 1 i SW MUI17101 . d. 46_ 1/4 Other: 25.02
City/State/ZIP: �0%rll(.44, 0I2 7 2z3 Subtotal (00 1
Phone:(S3) ; q(.i-/q6o Fax:(spa) .21-114-88 Z�
minimum(25%permit fee: $7250
CCB Lie.: 513 7? Plumbing Lic.no.: 314-1�)P$, ��review rg (12%of permit fee)
State surcharge(12%of permit fee) . .-1...-
Authorized Authorized signature: et_ce a e - TOTAL PERMIT FEE S
Print name: ���"` I Date: I,, J This permit applictrpon expires if a permit it not abtabled Witt is ISO days
�a/� Q QQ 1 tX/�!/� after it Iota been aoerpted as Complete.
/
*Fee methodology set by Tri•County Building Induafry Service Board.
ha?•Or
1:1➢idldn Peroits\PL GI-PenuilAppAnc 10/01A)9 44e44fl174IM12K:OM/wt8)
JUN-04-2015 15:24 From: To:5035981960 Pa9e:2'2
Plumbing Permit Application - City of Tigard
Page 2-Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty F {ei0 oc111:°• ,S_,guak'e Footage: „Permit Fee: •
Footing drain-1"100" 50,03 0 to 2,000 $121.90
Footing drain-each additional 100' 3752 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
•Sewer-1st 100' 62.54 7,201 and heater 532754
Sewer-each additional 100' 3752
water Service-1st 100' 62.54 Medical Gas Systems:
Water Service-each additional l(Kt' 3752 0 Permit Fee ;
iituatltil..,
Storm&Rain Drain-1st 100' 62 $1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 3752 $5,001.00 to$10,000.00 $7250 for thc first$5,000.00 and$1.52 for
each additional$100.00 or fraction thereof,to
-Other.Inspecfinfii orFces---; 9b.'•- ,wee;{e��_. ou►1:,, F
•• _ and including$10,000.00.
inspection of existing plumbing ur for $10,001.00 to$25,000.00 $148.50 for thc tirst$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
----Eminimun-charge 1/2 hour) — - - 52'S�0099--..._ - -_ •
inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $37950 for the first$25,000.00 and$1.45 for
hours(minimum share-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
(minimum charge-112 hate) _ 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*.
Q by FSature Tie:' y, , plan,Review'for-Plumbing Installations,.. •
',littwe Type for Replace/` Plan review is required for any of the following.
•Work Performed: , .. Capped.1 'Added `• .'Relocate°
eapttsny/Fonc _ Please check all that apply.
Bath Tub/Shower ❑ Any new commercial building with water service 2"and
-lacuuzi/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 OAR91&780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic ❑ Any multipurpose Ore sprinkler system.
'Drinking Fountain ❑ Any complex structure as defined in OAR918-780.0040.
Eye Wash
Floor Drain/sink -2" 1 Submit 2 sets of plans with any of the above.
-3"
4" . _ Isometric or•..tiser 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
-hrdustrial-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
increase of sewer EDUs,a sewer permit will be issued and
Water Extractor
Water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal _ plumbing permit can be issued.
Other Fixtures: borate honk✓ I
http,l/w w w.tigard-o r.gov/document_center/Building/PLM'_Pcrmi(App.4
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 305, TIGARD, OR,
97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2015-00185
George Heimos
Violation Summary:
Inspector Contractor