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Permit (41) CITY OF TIGARD PLUMBING PERMIT t 14 g.' COMMUNITY DEVELOPMENT Permit#: PLM2016-00217 T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/21/2016 Parcel: 1S135AB01004 Jurisdiction: Tigard Site address: 10220 SW GREENBURG RD 640 Project: Old Republic Subdivision: METZGER,TOWN OF Lot: 9 Project Description: Install(1)new break room sink and(1)water heater with drip pan&flood stop. Contractor: MCKINSTRY COMPANY LLC Owner: LINCOLN CENTER LLC 16790 NE MASON ST., STE. 100 BY SHORENSTEIN PROPERTIES LLC PORTLAND, OR 97230 235 MONTGOMERY ST, 16TH FLOOR SAN FRANCISCO, CA 94104 PHONE: 503-331-0234 PHONE: FAX: 503-331-6907 FEES Quantity Description Date Amount 1 ea Sink 04/21/2016 $25.02 Specifics: 1 ea Water Heater 04/21/2016 $37.52 1 12%State Surcharge- 04/21/2016 $8.70 Type of Use: COM Plumbing Class of Work: ALT 10 ea Minimum Fee Adjustment- 04/21/2016 $9.96 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 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 B( , Permittee Signature: • e."1-Y- 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 Building Fixtures City of Tigard RECEIVED Received p �� /y, Permit Date/By. O`/ t ■ 13125 SW Hall Blvd.,Tigard,OR 97223 tJ'J LI C o�I�OJ��7 a Phone: 503.718.2439 Fax: 503.598.190P R 2 1 Plan Review Other Permit No. e�� 2 Q,6 Date/By: &A) 2OM it q TIG,K p Inspection Line: 503.639.4175 Date ReadyBy: Auris: is See Page 2 for Internet: www.tigard-or.gov CIT • A Notified/Method: Supplemental Information ✓' �.s � � t LS to k � sam A itp ''� ❑New construction ❑Demolition For special information use checklist ; Description Qty. I Ea. I Total _ ®Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) a t €: > SFR(1)bath 312.70 a El1-and 2-family dwelling ®CommerciaUindustrial SFR(2)bath 437.78 SFR(3)bath 500.32 �1 0 Accessory building 0 Multi-family Each additional bath/kitchen 25.02 0 Master builder ID Other Fire sprinkler( sq.ft.) Page 2 -- .� "?'. \� ® �,--II sm..x�-'n. a.` +�o €i'i , . r. °ey ' , .l ',„, I,. s�.„ li,. M� f �< ' '' '' Site utilities: Job site address:10220 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.:640 I Project name:Old Republic 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.: / rj- / 3 ej A 6o Backflow preventer 31.27 . 12.51 > , , I ih , VBackwatervalve# #_,-,„:- L __ ry Clothes washer 25.02 Install new sink,2.5 gallon water heater,drip pan and flood stop Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 am ' . 9Expansion tank 12.51� 'a � A . . Fixture/sewer cap 25.02 Name:Old Republic 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 2® >r s ` Interceptor/grease trap 25.02 Medical gas(value:$ ) Page 2 Business name:McKinstry Co Contact name:Tria day Primer 12.51 Roof drain(commercial) 12.51 Address:16790 NE Mason Street,Suite 100 Sink/basin/lavatory I 25.02 City/State/ZIP:Portland,OR 97230 Solar units(potable water) 62.54 Phone:(503)331-0234 Fax::( ) Tub/shower/shower pan 12.51 E-mail:triad@mckinstry.com Urinal 25.02 25.02 closet) . a+a.,. 1.,,,:1,:4:7:114,\,',„: ' Water heater I 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:( ) Minimum permit fee: $72.50 TX 50 Plan review (25%of permit fee) CCB Lic.:172811 Plumbing Lic.no.:37-22PB State surcharge(12%of permit fee) g76 Authorized signature: ,( zo -D O------ TOTAL PERMIT FEE Print name:Tria Day Date:4/15/16 This permit application eapires if a permit is not obtained within 80 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 440-4616T(10/02/COM/WEB) l: uilding\Permits\PLMU-PermitApp.doc 10/01/09 B Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Su s s ression S stems: 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 S stems: Water Service-each additional 100' 37.52 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 t. . Leapareach additional$100.00 or fraction thereof,to s r 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 char:e-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 char:e-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 char_e-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*. Quand by Fixture Typea a� twat ftp ,,,. , Fi4u re type I`u' 3 ; ' P a dk Plan review is required for any of the following. WoiFF'erfotne :�„ �K__ ktx d _ Please check all that apply. Baptistry/Font Bath -Tub/Shower 0 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 0 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 ❑ 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. emeorshiserunagra Car Wash Drain 0 Isometricriserdiagramisrequired for new buildings Garbage -Domestic-non-food or g 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\107106 Old Repblic Ste 640,2-Lnjti\001 Mech Const\Permits\Plumb\PLMF-PermitApp.doc 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 PLM2016-00217 Don Sylvester 1. Plumbing ﬁnal approved, note: tie in ok. Violation Summary: Inspector Contractor