Permit CITY OF TIGARD PLUMBING PERMIT
'. COMMUNITY DEVELOPMENT Permit#: PLM2020-00052
T I tJ AR 013125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/30/2020
Parcel: 1 S 135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 630
Project: Prodapt Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Replacing(1)dishwasher,(1)hub drain,(1)primer,(1)sink,and(1)water heater for TI.
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: 503-413-4844
FAX: 503-244-8825
FEES
Quantity Description Date Amount
1 ea Dishwasher 01/30/2020 $25.02
Specifics: 1 ea Floor Drain/Floor Sink/Hub 01/30/2020 $25.02
1 ea Primer 01/30/2020 $12.51
Type of Use: COM 1 ea Sink 01/30/2020 $25.02
Class of Work: ALT 1 ea Water Heater 01/30/2020 $37.52
Type of Const: 1 12%State Surcharge- 01/30/2020 $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. .1987 or 1.800.332.2344.
Issued By: refMlttee Signature: cc-
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 C(``
Building Fixtures RECEIVE FOR C)Ph'I('E USE ON1.
City of Tigard JqN 2 7 2020 Received / 30 /OPP 7. • _ ✓(I
04 III
13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: ` t L
_ - Phone: 503.718.2439 Fax: 503.598.1960^ TIGARD Plan Review Y
Inspection Line: 503.639.4175 ITY OF Date/By: JJ r -z7. ib
TIGARD DNISIL'' y y: FA See Internet: www.tigard-or.gov BUILDING Not fedd/M Ready/By:
loos. SSupplemental information
TYPE OF WORK n';I`4�i' '''` FEE*'SCHEDULE
e
0 New construction 0 Demolition For special information use checklist.
Description FV1F 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
0 1-and 2-family dwelling ►2 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 10260 SW GREENBURG RD Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:TIGARD,OR 97223
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.:, 25' Project name:20-16Pe
�301 IrOdap 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
DESCRIPTION OF WORK Backwater valve 12.51
• Clothes washer 25.02
I'RODAPT TENANT IMPROVEMENT Dishwasher I 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER .I 0 TENANT Expansion tank 12.51
Name: Fixture/sewg � 25.02
Floor dram/floor sink/hub 1 25.02
Address: �----
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:POWER PLUMBING CO Medical gas(value:$ ) Page 2
Primer 1 12.51
Contact name:MIKE WARREN
Roof drain(commercial) 12.51
Address:P.O.BOX 19418 &n asin/lavatory 1 25.02
City/State/ZIP:PORTLAND,OR 97280 Solar units(potable water) 62.54
Phone:(503)244-1900 Fax::(503)244-8825 Tub/shower/shower pan 12.51
E-mail:SERVICE@POWERPLUMBINGCO.COM Urinal 25.02
Water closet 25.02
CONTRACTOR
' Water heater 1 37.52
Business name:POWER PLUMBING CO Water piping/DWV 56.29
Address:6611 SW MULTNOMAH BLVD. Other: 25.02
City/State/ZIP:PORTLAND,OR 97223 Subtotal
Phone:(503)244-1900 Fax:(503)244-8825 Minimum permit fee: S72.50
Plan review (25%of permit fee)
CCB Lic.:52378 Plumbing Lie.no.:34-150PB
Authorized signature: '-
/ State surcharge(12%of permit fee)
TOTAL PERMIT FEE
Print name:KRISTIE BRAMWELI, Date:2-27-2020 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I.\Building\Penn its\PLMU-PernritApp.doc I0/01dm9 440-4616T(to/02/COM1/WES)
Plumbing Permit Application - City of Tigard '
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee:
Footing drain- l"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
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
Other Inspections or Fees Qty. Fee(ea) T� 1 each additional$100.00 or fraction thereof,to
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:
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 Plan Review for Plumbing Installations
Fixture Type for Replace/ Plan review isrequired for anyof the following.
Work Performed: Capped Added Relocate
Baptistry/Font Please check all that apply.
BathTub/Shower El 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 ❑ 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 1 ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" 1 Submit 2 sets of plans with any of the above.
-3"
Isometric or Riser Diagram
Car Wash Drain
Garbage Domestic-non-food El Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice MachiRefrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang ALL FIXTURES REMOVE/REPLACE
-Stall Sink/Lav -Non-food related 1 PLEASE CALL MIKE WARREN WITH QUESTIONS
-Bradley 503-936-5929 THANK YOU
-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:
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