Permit CITY OF TIGARD PLUMBING PERMIT
f ■ COMMUNITY DEVELOPMENT Permit#: PLM2015 00242
T[CARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/03/2015
Parcel: 1 S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 950
Project: Ameriprise Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Interior plumbing:Adding(2)2"hub drains and(1)sink;Installing(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 07/30/2015 $25.02
Specifics: 1 ea Sink 07/30/2015 $25.02
1 ea Water Heater 07/30/2015 $37.52
Type of Use: COM 1 12%State Surcharge- 07/30/2015 $10.51
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $98.07
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: Permittee 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.
JUL-27-2015 10:25 From: To:5035981960 Page:1/2
ctl Plumbing Permit ApplaftiC I VE D 1 1 ; t• AI*
tBuilding Fixtures JUL 2 7 2015 r(∎Fl i111( 1- I 'IF i)�l )
City of Tigard E' �,
• 13125 sw Han Blvd.,i ,6V TIOARD Flan Review NO,:
r Phase: 503.7182x39�I !VISION Dais/By: ,,. a `.._ /op.
\
inspection Line:
03.639 44175
T l A R D � Date Reattylliy. ., hair E • e 2
www ti 8and-or, v Notfed/Mehod: �. SupplemenLol Information
:. c . TYPE;OF WORK r•f ;' ;. '. ' s iTE $CDUIE r '1 • 4
.For special v{fu
❑New construction ❑Demolition nwatiun use checklist.
Description T Qty. I Ea. I Total
J gAddition/alteration/replacement ❑Other: New 1-2-family dwelling%(include%100 ft.for each utility connection)
CATIiGORY•'di'CONSTRUCr * SFR(1)bath 312.70
A,❑ 1-and 2-family dwelling
CammerciaU SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ❑Multi-family
Each additional batt/kitchen 25.02
❑Harter builder ❑Other: Fire sprinkler(_sq.R) Page 2
S .., ` JOB,SITE•.INFORMATIOIV!.AND LOCATION .,' • Site utilities:
Ql Job site address: I 04,6 sup Catch basin or arta drain 18.76
J 17rywell,leach line,or trench drain 18.76
4 City/StatcfZ1P: j{ '�,-]� -
��-�'ti.v1 � �� Footing drain(no,linear ft,: ) Page 2
Suit ldgiapt.no. 50 Project name: Manufactured home utilities 50.03
. Cross strcct/directions to job site: Manholes 18.76
Rain drain connector 18.76
til Sanitary sewer(no.linear ft.:-) Page 2
Storm sewer(no.linear ft:_) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Ba:kflow preventer 3127
7DESCRLPIION:OF,WORN' ' Backwater valve 12.51
Clothes washer 25.02
_ .1 �,u -1./1.1 i r Dishwasher
25.02
Drinking fountain 25.02
Ejectors/sump 25.02
t( i .'," 0 PROPERTY OWNER , :1 ,1a;1'ENAN�.1' 'e. ' ,, Expansim tank 12.51
Name: Fixturelsewer cap 25.02
Flux drain/floor si Amt,-- iff7��.+>• -- ria 5.c)
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib
lee pc
l��f 2$.112
Phone:( ) Fax ( ) e maktr 1/Hi 1231
, 1 .d APPLICANT , .D oNTACI''PERSOIT, , , to ptor/grease trap fJ�p7', 25.02
Business name: fp pi/ bj' Medical gas(value:$ ) Page 2
T J Primer 12.51
Contact name: h f O��)
OR drain(commercial) 12.51
Address: !8�_ �H/ s in/lavatory f 25.02 2ya2-
City/SlaIeIZIP: elf- L q 74-8-b u units(potable water) 62.54
Phone:( ) - /9 V() Fax::( ) ). _�i. .5 Tub/shower/shower pan 12.51
E-mail: 10144 Urinal 25.02
6z
. Water closet 25.02
• , .. CONTRACrORi•'..r ,1. �'. L
Water healer 37.52
Business name: �.(� ,�/ Watapiping/DWV 56.29
Address: i )00 /0 4/ 6 Other: 25.02
City/State/ZIP: pm-- 4-7 -.1r6 Subtotal.. E 375i,
Phone:( ) cp_C J4..- )C 01) Fax:( ) L.k..--ii'i,45 Minimum permit fee: $7230
Plan review (25%of Permit fee)
CCB Lie.: k Plumbing Lic_nu-: Slate stnrbarge(12%of permit fee)
Authorized signature: TOTAL.PERMIT �I
This permit apptinlloa expires if a permit la not obtained within l !,
Print name: S -// �.J Date: after it has been accepted as complete. YU,
*Fee methodology set by Tri-Cotmty Building Industry Service d.
L\ButItik'PermitstPttdU-PemitAppdia 1010Lti9 4404616T(10i02/COM/WED)
,,,/
JUL-27-2015 10:25 From: To:5035981960 Paue:2'2
•
Plumbing Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site'Utilities may l?M fm> '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' 3752 _ Va#uatlon:. pl'>t•mlt 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 55,001.00 to$10,000.00 $72.50 for the first$5,000-0)and$1.52 for
�tlleC TI1S ectious OI e�ee8 °?, T? each additional 5100.00 or fraction thereof.to
p and including$10,000.00.
Inspection of existing plumbing or for $10.001.00 to$25,000.00 $14830 for the first$10,00(1.(0 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 $37930 for the first$25,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Rcinspcction Fecs 90.00/hr and including$50,000.00.
Additicmal plan review for revisions 90.00/hr $50,001.00 and up $742.(x)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'(.
Quantp by Fixture Type . Plan.Review Installations
Fixture Type for . Replaed' Plan review is required for any of the following,t.
Wort Performed:. ' '! Capped ,Added , Relocate
Baprie /Font Please check all that apply.
Bath Tit/Shower El 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 1'hru ❑ New exterior plumbing sitc 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 ❑ Any multipurpose fire sprinkler system.
nrinlcing Fountain ,/e3� ❑ Any complex structure as defined in OAR918-780-0040.
Eye Wash Gam'
Floor Drain/sink •2" klub I 1161;ileijic submit 2 sets of plans with any of the above.
- , . . Isometric,or Itis'er Diagram
car ar Wash Drain ❑ Isometric or riser diagram is required for new buildings
Garbage •Domestic-non-food
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/Lay -Non-food related 1
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter
W ashcr-Cloth *Note: If the fixture work under this permit results in an
es
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:
http://www.tigard-or.gov/document_ccntcrBuilding/PLMF_PermitApp.dtg
Accumulative Sewer Tally
X
Tenant Name: AMERIPRISE SWR# SWR2015-00094
Site Address: 10260 SW GREENBURG RD PLM# PLM2015-00242
I i c n r,» Parcel#: 15135AB03400
Fixture Value Previous Previous Credits Capped Fixture Fixture New New
# value count capped#s value count added# added value total#s total values
Baptisery/Font 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 0 0 0 0
Floor Drain/Sink: -2 inch 2 0 0 1 2 1 2
-3 inch 5 0 0 0 0 0
-4 inch 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) 1 0 0 0 0 0
-Stall 2 0 0 0 0 0
Sink:
-Lav/Bar-Non-Food Related 2 0 0 1 2 1 2
-Bradley 5 0 0 0 0 0
-Com/Serv/Util-Food Related 3 0 0 0 0 0
Swimming Pool Filter I 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 _ 0 _ 0 2 4 __ 2 4
Current Fixture Value 4 divided by 16= 0.250 Current EDU 1 EDU= $5,100.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change 4 divided by 16= 0.250 over (under) $ 1,275.00
Enter EDU Change Here 0.250 *
*Round EDUs to the nearest 1/100th: a count ending in.005 shall be rounded up to.01,and a count ending in.014 or less shall be rounded down to.01.
Notes:
Authorized Name/Signature: BRANDEN TAGGART X2449 Date: 7/29/2015
Building Division
rote: The property owner shall retain the ORIGINAL sewer tally record. If credits exist,this document will serve as a voucher which must be
ubmitted to the City of Tigard Building Division to redeem credits towards future system development charges.
1:\Building\Sewer Tally\Sewer 1'allySheet_5100_070115.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
10260 SW GREENBURG RD 950, TIGARD, OR,
97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2015-00242
George Heimos
Violation Summary:
Inspector Contractor
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
10260 SW GREENBURG RD 950, TIGARD, OR,
97223
Commercial - Plumbing
399 Plumbing final
FAIL
PLM2015-00242
George Heimos
1- provide air gap for water heater pressure relief tube at hub drain. 608.5
2. Provide hot/cold water for inspection. 415.0
3. Support dishwasher hose to underside of cabinet counter. 807.4
4. Recall inspection when corrections have been completed. Re-inspection required.
103.5.6.1
Violation Summary:
Inspector Contractor