Permit CITY OF TIGARD PLUMBING PERMIT
S . COMMUNITY DEVELOPMENT Permit#: PLM2016-00082
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/26/2016
Parcel: 1 S135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD
Project: Lincoln Center Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Water main replacement(1121'),(2)backflow preventers&(1)fire hydrant.
Contractor: TITAN UTILITIES LLC Owner: LINCOLN CENTER LLC
11562 SW 175TH AVE BY SHORENSTEIN PROPERTIES LLC
BEAVERTON, OR 97007 235 MONTGOMERY ST, 16TH FLOOR
SAN FRANCISCO, CA 94104
PHONE: 503-706-8288 PHONE:
FAX:
FEES
Quantity Description Date Amount
1121 If Water Service 07/21/2016 $475.26
Specifics: 2 ea Backflow Preventer 07/21/2016 $62.54
25 Misc Other Fee 07/21/2016 $25.02
Type of Use: COM 1 12%State Surcharge- 07/21/2016 $67.54
Class of Work: ALT Plumbing
Type of Const: 1 Plan Review 07/21/2016 $140.71
Occupancy Grp:
Stories:
Total $771.07
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 . ay obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
r
Issued By:Ai.i....„6......_ I
C disi Permittee Signature:
, ill
Call 503.639.4175 by 7:00 a.m.for the next available inspe;tion d.
This permit card shall be kept in a conspicuous place on the job site until ..mple i.i
the pr.ject.
Approved plans are required on the job site at the time of each r p-ction.
Plumbing Permit Applic *C. ` -
Site Utilities I O R 01 1 k 1 t ',t 'O M '
3
7 Received
CityofTigard - ?016 q i Pe, PermitNo� fA d&-- a-
Date/By: /� � �� /tA
r 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revie LL r
I Phone: 503.718.2439 Fax: 5934184' �y / r J � 62� ,✓ /� /�// •
�y Date/By: � �//��/�j""�fJ
Inspection Line: 503.639.4175` ,1 ' I a l'UikS" M See Page 2 for 'I
I I C i A R I) n Date Ready/By: 1mis: g >..
Internet: www.tigard-or.gov' 1,1ILI)IN(v E)1 ISI1 Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
El New construction 0 Demolition For special information use checklist.
Description I Qty, I Ea. I Total
®Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION . ' •.. SFR(1)bath 312.70
❑ 1-and 2-family dwelling i Commercial/industrial SFR(2)bath 437.78
buildingSFR(3)bath 500.32
0 Accessory ❑Multi-family
Each additional bath/kitchen 25.02
0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:10220 SW Greenburg Road Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97223 Dtywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name:Lincoln Center Water Main .
Manufactured home utilities 50.03
Cross street/directions to job sic:SW Greenburg Rd/SW Washington Square Rd Manholes 18.76
Rain drain connector 18,76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.:_) Page 2 4 7 rr,210
Water service(no.linear ft.;1.19O 12.. Page 2 4"
Subdivision: I Lot no.: Fixture or item: 4121
Tax map/parcel no.: Backflow preventer 2 31.27 62.54
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Replacement of water main,reconnection of services and fire suppression systems Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
181 PROPERTY OWNER I 0 TENANT Expansion tank 12.51
I Name:Shorenstein Properties,LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:10220 SW Creenburg Road
Garbage disposal 25.02
City/State/ZIP:Tigard,OR 97223 Hose bib 25.02
Phone:(503)619-3100 Fax:( ) Ice maker 12.51
® APPLICANT ® CONTACT PERSON Interceptor/grease trap 25.02
Business name:Tualatin Valley Water District Medical gas(value:$ ) Page 2
;j �3������q�
Contact name:Peter Boone oofd 12.51
t S
Roof drain(commercial) 12.51
Address:1850 SW 170th Ave. Sink/basin/lavatory 25.02
ACity/State/ZIP:Beaverton,OR 97003 Solar units(potable water) 62.54
Phone:(503)848-.30561 Fax::( ) Tub/shower/shower pan 12.51
E-mail:peter.boone@tvwd.org Urinal 25.02
CONTRACTOR Water closet 25,02
Water heater 37.52
Business name: -,11)77-4.N.,) LtTT LI-fig eo LLC Water piping/DWV 56.29
Address: l l5(e) I..o 1-7 St-- to 0 r tiOther Pt u,�.. 14 y ctko.t,,,-}k j 25,02 ,25.02-
P
City/State/ZIP: - .Jt„LT bk c,R__ `Z-700-7 Subtotal .589:25
I Phone:(5:53) 7014,-. gad g ( ) .j ..,--
Minimum permit fee: $72.50 ! tv,
Fax: � � L �nw
CCB Lic.: 1 s$/S7/00,, qp// Plumbing " � � Plan review (25%of permit fee) �!
/�! 7 � , State surcharge(12%of permit fee) .683'
Authorized signature: 6k.....4..1
e l r•�
///��� 000��� TOTAL PERMIT FEE
Print name:Peter Boone Date:1 7/2016 This permit application expires if a permit is not obtained wit • days
after it has been accepted as complete. /7nn r'
*Fee methodology set by Tri-County Building Industry Servi Booar'
is Buildingd'eunits\PLMU-PermitApp.doe 10'01109 440-4616T(I 0/02,COM/WEB)
Plnmbine Permit Application - City of Tigard
Page 2- Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Q4'• Fee(ea) Total Square Footage: Permit Fee:
Footing drain-1l 100' 50.03 0 to 2,000 $121.90
2,001 to 3,600 $169.69
Footing drain-each additional 100' 37.52 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' 1 62.54 62.54 Medical Gas Systems:
Water Service-each additional 100' 1 37.52 373 2rf 412/1 Valuation: Permit 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 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Fee(u) Total each additional$100.00 or fraction thereof,to
Other Inspections or Fees ' 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 90.00/1v $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. _
Additionallan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
p each additional$100.00 or fraction thereof.
(minimum charge-1/2 hour)
Subtotal: 1).„ r4
•
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 Tyle Plan Review for Plumbing Installations
Fixture Type for RePlaCapped Added ei Plan review is required for any of the following.
Wprk Performed: Please check all that apply.
Baptistry/Font 0 Any new commercial building with water service 2"and
Bath -Tub/Shower greater,except systems designed and stamped by licensed
-Jacuzzi/Whirlpool
Car Wash -Each Stall engineer.
-Drive Thru ® New exterior plumbing site utilities for any complex structure
Cuspidor/WaterAspirator
as defined in OAR918-780-0040.
Dishwasher -Commercial
❑ Medical gas and vacuum systems for health care facilities.
-Domestic 0 Any multipurpose fire sprinkler system.
Drinking Fountain 0 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.
a" Isometric or Riser Diagram
Car Wash Drain 0 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/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
Closet Clooseet-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
N:\ACTIVE PROJECTS\Lincoln Center Main Reitlacement_C12429 E76}46\Design\90 percent plans\PLMU-PermitApp.docx
ivaIbs
RECEIVED
engineering APR 7 2018
CITY OF TIGARD
BUILDING DIVISION
TRANSMITTAL
DATE: April 6, 2016
TO: City of T. rd
Per enter
FROM: Nathan Abercrombie
Wallis Engineering
RE: Lincoln Center
Job No. 1365A
COPIES DESCRIPTION
2 90%project drawings
COMMENTS
If you have any questions,please call 360-695-7041 or email
nathan.abercrombiewalliseng.net
Thank you.
215W 4th Street, Suite 200 Vancouver,WA 98660 Office t360) 695-7041 Fax (360)694-1043 www.wafliseng.net