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Permit (62) CITY OF TIGARD PLUMBING PERMIT t> COMMUNITY DEVELOPMENT Permit#: PLM2016-00441 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/16/2016 Parcel: 1 S 135AB01004 Jurisdiction: Tigard Site address: 10220 SW GREENBURG RD 530 Project: AG Spanos Corp Subdivision: METZGER,TOWN OF Lot: 9 Project Description: Install(1)break room sink,(1)domestic dishwasher,(1)water heater and(1)hub drain. Contractor: RAYBORN'S PLUMBING INC Owner: LINCOLN CENTER LLC PO BOX 69 BY SHORENSTEIN PROPERTIES LLC 19990 SW CIPOLE RD 235 MONTGOMERY ST, 16TH FLOOR TUALATIN, OR 97062 SAN FRANCISCO, CA 94104 PHONE: 503-692-4139 PHONE: FAX: 503-691-2328 FEES Quantity Description Date Amount 1 ea Dishwasher 08/16/2016 $25.02 Specifics: 1 ea Floor Drain/Floor Sink/Hub 08/16/2016 $25.02 1 ea Sink 08/16/2016 $25.02 Type of Use: COM 1 ea Water Heater 08/16/2016 $37.52 Class of Work: ALT 1 12%State Surcharge- 08/16/2016 $13.51 Type of Const: Plumbing Occupancy Grp: Stories: Total $126.09 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 direc -.-stions to •. C by calling 503.232.1987 or 1.800.332.2344. Iss ed By: `AILAA_Alf_,U 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. Prom:Rayborns Plumming INC 503..-697+2328 08/10/2016 13:33 #401 P.001/002 Plumbin. Permit A I •`I IT i ' Building Fixtures FOR OFFICE USE ONLY Received �/ Cak ! Permit No.: 4111/14,400 �4/ City of Tigard LIG_�4 ?nib Date.'By. d /(/(p �. �'`�� 1 q 13125 SW Hall Blvd.,Tigard, K' 2�3 Plan Review 1 Other Permit No.:�� ;�a Phone: 503.639 4171 Fax 503.,59 46 6+ Dare:By: o.. s A'� Juris: 0 See Page 2 for .9-- Inspection Line: 503 634�1� � ';, e j Date Ready/By: � Supplemental Information TIGARD Internet: w'ww.t7gatd-or. ox ��t 0 Notified/Method: 1 Tyft, .! RK 3 + {�2 FEE* SCHEDULE For special information use checklist ❑New construction ❑Demolition j Description 1 Q . I Ea. 1 Total I Other: New I-2-family dwellings(includes 100 ft.for each utility connection) I �dditionlatteratiot�`replacement l- } SFR(l)bath 312.70 437.78 CATEGORY OF CONSTRUCTION L -b I SFR(2)bath � I 1-and 2-family dwelling j .2'C ommereieindustrial o I 11:11 SFR(3)bath i 500.3_ Accessory building ❑ Multi-family j j Each additional bath/kitchen 2002 I ❑Master builder Other: Fire sprinkler❑ I rinkler( sq.ft.) I Page 2 j f� ` 1I Site utilities: 1 JOB SITE INFORMATION AND LOCATION 18.76 Q r,,, p j� ,,( Catch basin or area drain Job site address: /© .2 W (-^s s�e,i.rdp l)Y'Cr� [�"` Drywell,leach line,or trench drain 18.76 ! Q �J / Footing drain na.linear tt..^.) Page 2 City/State/ZIP: Q� �l��-3 j � � 1 � � 1 50.03 1 Project name: tt,,p� Nd5 aa_e home utilities � Suite/bldg./apt.apt.no.: S 3p J l'FI !, C Cross street/directions to job site: Manholes 18 76 18.76 Rain drain connector � Sanitary sewer(no.linear ft.',) � f Page 2 -I Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft: ._) Page 2 1 Lot no.; Fixture or item: Subdivision: 1 � 31.27 V I Backflow preventer Tax maprparcet no.: /25/�''jQ/Q0I 12.51 I � Backwater valve I i DESCRIPTION OF WORK a.0_ 1 I ,- � I i i ff ` Clothes washer Itis f 1/• 1 f( SIA caSkve✓ J t-4U' Dishwasher I 25.02 c� 4 St.,.�1f r i e�Jex: „ I 25.02 e�.lr, ,X' Drinking fountain i U.la�etr Ejectors/sump j 25.02 jI j 0 PROPERTY OWNER j ❑ TENANT Expansion tank 12.51 25.02 Fixturelsewer cap Name: ; j Floor drain'iloorsinkhub I / j 25.02 Address: Garbage disposal j 25.02 City.'State%ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 Interceptor'pease imp I 2 0'02 jPPLICANT I 0 CONTACT PERSON hMedical gas(value:S ) Page 2 t Business name: _ /S A i-u Nit�a tA- Primer 12.51 . /v Contact name: / j Roof drain(commercial) ; 12.51 I Address; i ctctct 0 Sv( C.t?O kP Sink'basin'lavatory / I 25.02 /2 0 C.Z j Solar units(potable water) j 62.54 I City:'StateiZlP �s�ldt�/� _ ®2 �l 12.51 P/ Tub/shower/shower1 j y 01) 6 L(( ., a' i I pan Phone:( U3) u�CC� Ck 13 Fax::( Urinal j 25.02 E-mail: /(, � I11p,v�/1jOtd't2 S_ ..o•i----' Water closet 25.02 / CC1 sTR ACTOR I Water heater ) 37.52 Business name: 1111° L4,1b Water piping!DWV 56.29 � � 1 -� S .0.ddress: Q,q,� � 1 i r 01 . � Other: 25.02 Subtotal ��oF�'_. ,• City/State/ZIP. ��6' j I A Minimum permit fee: 872.50 Phone:(yo3 ) 6 -I{13�( Fax:( '3) 640/ '� iv -^ Plan review (25%of permit fee) CCB Lic.: . 7 85� 1.....P1 r.bitg ); 3 M} State surcharge(12%of permit fee) , �" 0 �� TOTAL PERMIT FEE Authorized signature: / �� , �/�'�/ This permit application expires if a permit is not obtained within 180 days -% • a- - ^ Q-- 6 after it has been accepted as complete. /J �'� *Fee methodology set by Tri-County Building Industry Service Board. a_- :nrn+n1 d40-+6t6T( 0.,0=!COSt'w'EB) From:Rayborns Plumming INC 503+691+2328 08/11/2016 10:02 #402 P.002/003 Plumbing Permit Application - City of Tigard Page 2-Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities QO: e ( ) Total Square Footage• Permit Fee: Footing drain-1"100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,OOi to 3,600 $]69.69 f Sewer-1st 100' 3,601 to 7,200 $233.20 6`54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 -` Water Service-I st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Storm Rain Drain-1st 100' Valuation: Permit Fee: 62.54 51.00 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$5,000.00 and$1.52 for other InSpQetiOIES,Or Fe(eSn' Fee��) Total = each additional$100.00 or fraction thereof,to and including$10,000,00. Inspection of existing plumbing or for _S10,001.00 to 525,000.00' Sl48.50 for the first$10,000,00 and$1.54 for which no fee is specifically indicated 90.00/ttr 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,(101.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional S100.00 or fraction thereof,to Reinspection Fees 90.00/hr and including$50,000.00. Additional plan review for revisions 90.001n $50,001.0(1 and up $742.00 for the first$50,000,00 and$1.20 for (minimum charge-I/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*. Plan Review for Plumbing Installations Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replace/ Please check all that apply. Work Performed: Capped Added Relocate Baptistry/Font ❑ Any new commercial building with water service 2•'and Bath: Tub/Shower greater,except systems designed and stamped by licensed -Jacuzzi/Whirlpool engineer. EICar Wash: -Each Stall New exteriorplumbing site utilities for any complex structure Drive ThtL as defined in OAR918-780-0040. Cuspidor/Water Aspirator CI Medical gas and vacuum systems for health care facilities, Dishwasher: -Commercialirator ❑ Any multipurpose fire sprinkler system. -Domestic ,' ❑ Any complex structure as defined in OAR918-780-0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: -2" 3., Isometric or Riser Diagram ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain b 9 Garbage -Domestic,ton-hood that meet the qualifications above. Disposal: -Domestic food related -Commercial food related -Industrial food related lee Maclt.'Refrig.Drains Commen s regprding fixtur work: Oil Separator(Gas Station) {/J "e- 1.- ,Q�ytL42 Sho.vehicle Dump Station �� /J Shower: -Gang 1KI ��- • -Stall Sink: -Las Bar non-food related -Bradley -ComSery/Util food related -Service *Note: If the fixture work under this permit results in an Swimming Pool Filter Washer-Clothes increase of sewer EDUs,a sewer permit will be issued and Water Extractor fees assessed for the sewer increase must be paid before the Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: C:\Users\Nate.RPI\AppData\Local\ 4icrosoft\Windows\Temporary lntcrng Files''_Content.Outlook\SS8K153H\PLMF_PennitApp.doc 08/04/201 I 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 530, TIGARD, OR, 97223 Commercial - Plumbing 399 Plumbing ﬁnal PASS - No C of O PLM2016-00441 Chip Barnett Violation Summary: Inspector Contractor