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Specifications CITY OF TIGARD PLUMBING PERMIT `7 2 -- COMMUNITY DEVELOPMENT Permit#: PLM2015 00346 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/13/2015 Parcel: 1S 135AB00900 Jurisdiction: Tigard Site address: 10200 SW GREENBURG RD 700 Project: Somerset Investment Subdivision: METZGER,TOWN OF Lot: 9 Project Description: Interior plumbing:Replacing(1)sink and(1)dishwasher;Capping(1)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 10/13/2015 $25.02 Specifics: 1 ea Fixture/Sewer Cap 10/13/2015 $25.02 1 ea Sink 10/13/2015 $25.02 Type of Use: COM 1 12%State Surcharge- 10/13/2015 $9.01 Class of Work: ALT Plumbing Type of Const: Occupancy Grp: Stories: Total $84.07 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: 4 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. Plumbing Permit Application 135'-jar -"Building Fixtures Foli OFFICE USE ONLY Received City of Tigard id / 3 / - Permit No.: ``i IS_ y� IN it, DateBy: �Q 7"}- r}�w 13125 SW Hall Blvd.,Tigard,OR Plan Review __VV'' �i lt+�+s Phone: 503.718.2439 Fax: 503. 960 4`°�� Date/By: Other Permit No.:ftii3O/5--_/..02.sz Inspection Line: 503.639.4175 q >T I G n R D S§;\ D.to ReadyBy: lulls: ® See ge 2 for Internet: www.tigard-or.gov \d ,`.�� c,, 'fied/Method: p- Supplemental Information ❑New construction ❑Demo jt�h��, ' For special information use checklist U♦V Description I Qty. I Ea. I Total ®Addition/alteration/replacement ❑Oth' New 1-2-family dwellings(includes 100 ft.for each utility connection) . t .g � � SFR(1)bath 312.70 f ® ❑ 1-and 2-family dwelling ® m Comercial/industrial SFR(2)bath 437.78 ❑Accessory building ❑Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 ❑Master builder ❑Other Fire sprinkler( sq.ft.) Page 2 ''':V. .;..,,. t OB , W k /at d;"". iOC4j1 600 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 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.:700 I Project name:Somerset Investments 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 A ' DESCRII I OF FfR t Backwater valve 12.51 . ,$ .,.,,. . ,mot„ ... ,. - ©N , TOK timi Clothes washer 25.02 Pull and replace sink and faucet,removing(1)and replacing(1)dishwasher Dishwasher ! 25.02 a,5 0)- Drinking fountain 25.02 Ejectors/sump 25.02 .] PROPERTY OWNER, `®<TENAINIT -'"ni 1 Expansion tank 12.51 Fixture/sewer cap j 25.02 Name:Somerset I � ---- 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 0 M GAkT, l CONTACT PERSON , Interceptor/grease trap 25.02 Business name:McKinstry Co Medical gas(value:5 ) Page 2 Primer . Contact name:Tria Day Roof drain(commercial) 12.51 Address:16790 NE Mason Street,Suite 100 Sink/basin/lavatory _I. 25.02 015 01 City/State/ZIP:Portland,OR 97230 Solar units(potable water) i 62.54 Phone:(503)278.3917 Fax::( ) Tub/shower/shower pan 12.51 E-mail:triad @mckinstry.com Urinal 25.02 Ad&, ( tp h Water closet 25.02 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 -75;00 Phone:(503)278.3917 Fax:( ) Minimum permit fee: $72.50 CCB Lic.:172811 Plumbing Lic.no.:37-22PB Plan review (25%of permit fee) State surcharge(12%of permit fee) 0+ Authorized signature: TOTAL PERMIT FE • CO Print name: Date: This permit application expires if a permit is not obtained with' 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. i\Building\Permits\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 Su s s ression S stems: tFC4`; a} iT,-° 1 3 " t ��YW 4�QQ r 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 r 4411:4 n.• .Permit Storm&Rain Dram 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 each additional$100.00 or fraction thereof,to �eC(ea "#'O�iltl� 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: I Other Fixtures: 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 Fixture Type for Replace/ Plan'Review for Plumbing Installations Work Performed: Capped Added Relocate Baptistry/Font Plan review is required for any of the following. Bath -Tub/Shower Please check all that apply. -Jacuzzi/Whirlpool El Any new commercial building with water service 2"and Car Wash -Each Stall greater,except systems designed and stamped by licensed -Drive Thru engineer. Cuspidor/Water Aspirator ❑ New exterior plumbing site utilities for any complex structure Dishwasher -Commercial as defined in OAR918-780-0040. -Domestic ❑ Medical gas and vacuum systems for health care facilities. Drinking Fountain ❑ Any multipurpose fire sprinkler system. Eye Wash ❑ Any complex structure as defined in OAR918-780-0040. Floor Drain/sink -2" 3„ Submit 2 sets of plans with any of the above. -4" Car Wash Drain Isometric or Riser Diagram .. _ Garbage -Domestic-non-food iser Dia g Disposal -Domestic-food related ❑ Isometric or riser diagram is required for new buildings -Commercial-food related that meet the qualifications above. -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Rec.Vehicle Dump Station Comments regarding fixture work: Shower -Gang -Stall Sink/Lav -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter Washer-Clothes Water Extractor *Note: If the fixture work under this permit results in an Water Closet-Toilet increase of sewer EDUs,a sewer permit will be issued and Urinal fees assessed for the sewer increase must be paid before the W:\Projects\N-R\Russell Construction\104227 Somerset Investments Suit2700,5 Lincoln\001 Mechanical Construction\Permits\PLMF- PermitApp.doc Accumulative Sewer Tally Er 'Tenant Name: SOMERSET INVESI'MliN1'S SWR# N/A Site:Address: 10200 SW GRI I NBURG RD SUITE 700 PLM# 2015-00346 I 43 Parcel#: 1S135AB00900 Fixture Value Previous Previous Credits Capped Fixture Fixture New New # value count capped#5 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: -1?ach 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 1 2 0 -1 -2 Drinking Fountain 1 0 0 0 0 0 l?vc Wash 1 0 0 0 0 0 Floor Drain/Sink: -2 inch 2 0 0 0 0 0 -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 I IP) 16 0 0 0 0 0 -Commercial (to 5 I IP) 32 0 0 0 0 0 - Industrial (over 5 I IP) 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: - I.av/Bar-Non-Food Related 2 0 0 0 0 0 - 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 IIxtractor 6 0 0 0 0 0 Water Closet-Toilet 6 0 0 0 0 0 Urinal 6 0 0 0 0 0 Previous I:DU Count 0 0 Capped 1?DU Credit 0 T(/.1..A I.S _ 0 0 1 _ 2 0 0 -1 -2 Current Fixture Value -2 divided by 16= -0.123 Current I?DU 1 EDU= $5,100.00 Previous Fixture Value 0 divided by 16 = 0.000 Previous I?DU Change -2 divided by 16= -0.125 over (under) S (663.00) Enter EDU Change Here -0.130 * *Round I.DUs 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: ***C RIIDIl'**' Authorized Name/Signature: BRANDEN TAGGART X2449 Date: 10/13/2015 Building Division Note: The property owner shall retain the ORIGINAL sewer tally record. If credits exist,this document will serve as a voucher which must be submitted to the City of Tigard Building Division to redeem credits towards future system development charges. I:A Building\Sewer Tally A Sewer1'allyShcet_5I011_07(1115.xlsx