Permit (68) CITY OF TIGARD PLUMBING PERMIT
.11111
COMMUNITY DEVELOPMENT
Permit#: PLM2017 00274
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/13/2017
T f Com°�` �? Parcel: 1 S 135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 450
Project: Apex Systems Subdivision: METZGER,TOWN OF Lot: 9
Project Description: TI-Adding(1)2"floor drain,(1)primer&(1)water heater. Replacing(1)dishwasher&(1)sink.
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 Dishwasher 07/13/2017 $25.02
Specifics: 1 ea Floor Drain/Floor Sink/Hub 07/13/2017 $25.02
1 ea Primer 07/13/2017 $12.51
Type of Use: COM 1 ea Sink 07/13/2017 $25.02
Class of Work: ALT 1 ea Water Heater 07/13/2017 $37.52
Type of Const: 1 12%State Surcharge- 07/13/2017 $15.01
Occupancy Grp: Plumbing
Stories:
Total $140.10
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: 1C.// I Permittee Signatu
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-06-2017 10:02 From: To:5035981960 Pace:1'2
Plumbing Permit Applica CEIV
EP
Building Fixtures
Folz i)rrlc=l_ 1;sr_ ()Nl_\
City of Tigard nauisY 7 /,� /1 'Ti Permit 13125 SW Hall Blvd_,Tigard,OR 974131L 6 2017 1,44a4n7-,:::4.t79.
PlaPhone: 503.718.2439 Fax: 503.598.1960 Dae Review ��,, �3�
CM
Date/By: 011ier Pamir No.. nVJt'�
Inspection Line: 503.639.4175 ��` ('�c y ` RD y'
'116 n R l L l V P' �t�� lU► Dace Ready/ey; Jure: ®See Pate 2 f
Internet: www.tigard-or.gov w
t�•S 7P _ e. NohfiedJAieuuod: Supplemental Informatifalon
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- H a'- r.•.....,.a:�.�'..�al:.i..k��_"..�.x .•.� N7.!Mil ��> �ia',Frdi./t �°•• ;17.a:..�..n. »-�.J'T:� i!".Y"• 'Y T..'.
0 New construction ❑Demolition Fors e o maLion use checklist.
Addition/alteration/replacement ❑Other: Du5criptton I Qty. I Ea, T Total '�
i5 y ., ''dit on te i-� eme nt ^r� ,y New 1-2-family dwellings(includes 100 ft.for each utility connection)
- a,.�sra. ;tib �"'�k.e xdG..tiki b ...,,:.':.,_.:u.r.? * SFR(1)� 312,70 f
r]1-and 2-family dwelling Commercial/indusirial SFR(2)bath 437.78 Q
❑Accessory building 0 Multi-family SFR(3)bath 500.32 Q
El Master builderEach additional balh/lcitcht s 25.02 6�
G :`tom 's z t* F w 0Other: Fire sprinkler( sq,ft.) Page 2
;,w .;r,21:1TE VON i" ,'' , r..�•�Q' i fir+: ;"y''yf E> Site u _
.., ....G,r..s...:"a n•'"`vk'7,�c•..5:#+2,1iJi .ir�i "blies:
Job site address: 1 02 2,49 51,t) i^,yefr. el i uyl&e/1 Z Catch basin or areadrain 18.76
Atywell.leach line,or trench drain 18.76
City/State/ZIP: .did C3P...- 9 122-3
Footing drain(no,linear ft,: ) Page 2
Suite/bldg./apt.no.: i-fo Project name: 1 /
4/(54erit �7 33 Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
4 Sanitary sewer(no.linear IL: ) Page 2
•- Storm sewer(no.linear ft.:_J Page 2
Water service(no.linear fL: ) Page 2
Subdivision: I Lot no.: Fixture or items -
Tax map/parcel no.: 15 135A6 D loo a Backflow pnwe Iter 3127
wt airepF �" .�..( ip' 9:14. V' ira !ry'r.�•art Backwater valve 124
17,../...4,4C1.14.---P- !li. fieri/G9'11e.n " Cloches washer 15,02
T Dishwasher ) 25.02 2'j.(Y2-
Drinking fountain 25.02
Ejectors/sump 25.02
fes" ROPR Q .Eglai', 471 "w= , 20� Epansot tank 1251
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub25,02 4�rx d7
Address: -
City/State/ZIP: Garbage disposal 25.02
Bose bib 25.02
Phone:( ) Fax:( )
Ice maker 12.51
:t",, k ,EXC.A..ftir r E,' 0 �� 0 '. '.,gy,• Interceptor/grease nap _ 25'.02
Business name: / pl(,(ryh,bjm, Medical gas(value:$_) Page 2
Contact name: 7 y I f �,�,frd,f ry f
Primer 1 12.51 I
p Roof drain(commercial) 1251
Address: f ` O, x ! 41 g'
Sink/basin/lavatory t
City/State/ZIP:
a��ft av, 5 9-77-.V7
11 z' soh,units(potable water) 2 �
Phone:(' ) -21,1(1-- /5, I Fax::( i3) acifif-T(-25 Tub/showcr/shower pan I2.51
E-mail: (5 ( J4 �+ 1171 Lo�-�>i fes„ �8✓Yj Urinal 25.02
;rst•f` t-,i' '' rf ..: ` ' i;?"��' p•, s ;�w^t�v �. rt*ye � EAtr mow✓ atctckiset 25.02
:ctQA a.b w!�{„D17! ,d �' �wtlai !�Lr
,.w li +� r G1 1 ilk '• Water heater 37 SZ
Business name: 1QI/ Pial _., ) 37,52
Water piping/DWV 56.29
Address: (au 5(„) awl gY1 iw- MVI Other_
City/State/ZIP: f•� . . 97 2Z 3 25,02
(aux,
Subtotal
Phone:(6)3) 4'q. (/00 Fax:CVO)2 -a8-2.< Minimum permit fee: $7230 12`1.09
CCB Lie.: 4j�-�-T Plumbing Lie,no.: , .-1 sive/3Plan review (25%of permit fee) _
State surcharge(12%of permit fee) 15. A
Authorized signature: 0h„7aad TOTAL PERMITa
IPrint came: /� 1 Kola r7
Art 5/-7 r? vrci of if Date: 7.u-i T p application expires If a permit is not obtained within Ito days
after it baa been accepted err complete,
*Fe methodology set by Tri-County Building Industry Service Board.
t:teuildiegTermixttn,#tu.P mitApp.doc iOdo]A19 440-4616T(10/02/OWN/M1)
JUL-06-2017 10:02 From: To:5035981960 Paoe:2'2
Plum ne Per-mit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Su u mressioa.Systems:
f4.77,-f...---y:::,l 2 47•�".,:„•yz.,_d 74- 4
,.Apbn.u:,„r,+iaulmr.-e alI " r „ 1v -,15,4 r a ut. W-r Gr 5 tP ^a. 7s,,cif
lA A.A y w . L^ tm.: ta �'•+ vPu d3 Uaw'v4, , .!.g2 . bT.4.: r.:i, w±i. 4,I,u .t4S.: aW'�.i .lFooting drain-tp
100' 50.03 0 to 2,000 5121.90
Footing drain-each additional 100' 1111111111E1112,001 to 3,600 5169.69
IL
5ewar-1st 100' 62.54 3,601 to 7,2011 5233.20
I- 7.201 and rester
Water Service-istWO' 11111111111101111111111 Medical Gas Systems:
Water Service-each additional 100' =' -i m.>�.. N., erca"t tt:.'r., I„ , ” r"5."°y;' w �
� ,:
,y g »f, !. msa , 4 )Storm&Rein Drain-1st 100' 62.54
$1.00 to$5,000,00 Minimum fee$72.50
Storm&Rain Drain each additional 100' IMIIMEMIE $5,001.00 to$10,000.00 572.50 for the first 55,000.00 and$1.52 for
z f „ 1x,17- 7 t `b,y la each additional$100.00 or fraction thereof,to
Y,;w k-.--. Lf1W and including 510.000.00.
• Inspection of existing plumbing nr for $10,001.00 to$25,000.00 $148.50 fur the first S10,000.00 and$1.54 for
winch no ice is specifically indicated 90.00/hr ■ each additional$100,00 or fraction thereof,to
(minimum oh• -1/2 hour) and including 525.000.00.
Inspections outside of normal business 90.00/h $25,001.00 to$50,000.00 5379.50 for the fust 525,0(10,00 and 51.45 for
incurs minimum e-2 hours) each additional 5100.00 or fraction thereof,to
Reinspection Fees _ 90,00/hr and including$50.000-00.
Additional plan review for revisions 90,00/hr - 550,001.00 fmd up 5742.00 for the first$50,000.00 and 51.20 for
minimum- ; e-112 hour) each additional 5100.00 or fraction thereof. ,
Subtotal; _M_
S. ..
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*.
`-, x ' T i' a',' .:,-!t'--* ;. 0 , 3 iviiircT, ,;w t,' t"' k F I r4' .� p y,,�c
....y -,:::,;4--....174. ,mow d. ..•.,—,_,_. ,r i'.Yw•.:'' ., r tlttiril iso r' i,,L h G+77�` 2 ya
; ' .. f r� + K'+,h-m+za e-:
_limplavd r, LT^'
• ,,,ri+•-Zµ ..f 7 p ,� -Adva, -:•wnc ,e Plan review is required for any of the following,
Baptistrv/Font Please check all that apply,
Bath Tub/Shnwer
D Any new commercial building with water service 2"and
-Jaeutti/Whirinool greater,except systems designed and stamped by Iicensed
Car Wash -Each Stall
engineer.
-Drive Vim I 0 New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator ` as defined inOA1t 11 -780-0040.
Dishwasher -Commercial 0 Medical gas and vacuum systems for health care facilities.
-Domestic •f. I ❑ Any multipurpose fire sprinkler system.
Drinking Fountain 0 Ally complex structure as defined in OAR91S-7$0-0040,
Eye Wash
Floor Drain/sink -2" _, X I Submit 2 sets of plans with any of the above.
-3"
,,erns' I"
Car Wash Drain ` 4 � � M" 1,,+7.!1 fl � 'c .'cam' f -. -- F F- ii .Garbage -Domestic-non-food ❑ Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related I that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice MaehJRefrig.Drains
'Oil Separator(Gas Station) I _ -, Comments regarding fixture work:
Rec.Vehicle Dump Station •
Shower -Gang
-Steil - -
SinlR.av -Non-food related X I
-Bradley
-Commercial-food related
-Service -
swimming Pool Filter *Note: If the fixture work under this
Washer•clothes I permit results in an
Wats Extractor l increase of sewer,EDUs,a sewer permit will be issued and
WaterCloset-Toilet i . fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures; I
httpJ/www.tigar i-or_gov/city_hall/departments/cd/docsrPLMF-PcrmitApl�doc
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10220 SW GREENBURG RD 450, TIGARD, OR,
97223
Record Type: Record ID:
Commercial - Plumbing PLM2017-00274
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor