Permit INCITY OF TIGARD PLUMBING PERMIT
R: COMMUNITY DEVELOPMENT Permit#: PLM2020-00083
T f G AR O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/26/2020
Parcel: 1S135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD
Project: Lincoln Center Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Interior plumbing for 2nd floor restrooms:Capping(1)drinking fountain,(1)3"floor drain, (2)sinks, and(1)water
closet; Replacing(4)sinks, (6)water closets,and(2)urinals.
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: 503-224-9560
FAX: 503-244-8825
FEES
Quantity Description Date Amount
5 ea Fixture/Sewer Cap 02/26/2020 $125.10
Specifics: 4 ea Sink 02/26/2020 $100.08
2 ea Urinal 02/26/2020 $50.04
Type of Use: COM 6 ea Water Closet 02/26/2020 $150.12
Class of Work: ALT 1 12%State Surcharge- 02/26/2020 $51.04
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $476.38
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: Permittee Signature: 4 —
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 i-tP7"1.,J 1,VE ) I OR in It l: t sl, tONLI
City of Tigard Received / M t_gDate/By: /jjJ"�lhj permit No.: itt "IOV677.9_ 1)S.■ 13125 SW Hall Blvd.,Tigard,OR 97223 ? 1 9 202.7) I
Plan Review
t IllPhone: 503.718.2439 Fax: 503,598.1960 A Other Permit No.:
/j6e 2 for (xx1�r
TiG AItD Inspection Line: 503.639.4175 . - DatDateReadyBy - bins- ® See Page 2 for
Intcmet: w'\rw.heard-Ur-gov Notified/Method: r ""- (., Supplemental Information
TYPE OF WORK FEEa SCHEDULE
❑New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. ( Total
®Addition/alteration/replacement ❑Other: New I-2-family dwellings(includes 100 ft,for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
❑ 1-and 2-family dwelling ElCommercial/industrial SFR(2)bath 437.78
❑Accessory building El Multi-familySFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 10300 SW GREENRURG RD 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/bidg./apt.no.:2N°F I Project name:20-166 iv-c C!!/V CP/oFz-/- 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: ISM 3J r4]c .g 0/ � 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 LINCOLN 2N°FLOOR RESTROOM FIXTURE UPDATE Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER 0 TENANT Expansion tank 12.51
Name: _. Fixture/sewer cap / 5 25.02 (.S-. to
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
❑,APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name:POWER PLUMBING CO - Medical gas(value:$_) Page 2
Primer 12.51
Contact name:MIKE WARREN
Roof drain(commercial) 12.51
Address:P.O.BOX 19418 Sink/basin/lavatory ! 4 25.02 lLri) .LI
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 2 25.02 5-0 (i4
Water closet ✓ 6 25.02
R< t t1» s "" r OR lS�.
Water heater 37.52
Business name:POWER PLUMBING CO Water p'p' g/I m DWV 56.29
Address:6611 SW MULTNOMAH BLVD. Other: 25.02
City/State/ZIP:PORTLAND,OR 97223 Subtotal 1(7-5-�" i.r
Phone:(503)244-1900 Fax:(503)244-8825 Minimum permit fee: $72.50
CCB Lic.:52378 Plumbing Lic.no.:34-150PB Plan review (25%of permit fee)
t State surcharge(12%of permit fee) Ste .,J t�
Authorized signature: ri )A TOTAL PERMIT FE
Print name:KRISTIE RAMWELL Date:2-19-2020 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 BsildinaMermits'.PLMU-PermiIApp.doe 10/01/09 440-4616T(I0/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Qty. Fee(ea) Total 'Square Footage: Permit Fee:
Site Utilities q g '
Footing drain-1s'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'
Stonn&Rain Drain-1st 100' 62.54 S I.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 3752 S5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
Other Inspections or Fees and including$10,000.00.
Inspection of existing plumbing or fur $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
each additional$100.00 or fraction thereof.
(minimum charge-1/2 hour)
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 is required for any of the following.
Work Performed: Capped Added .. Relocate
Please check all that apply.
Baptistry/Font ❑ 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 0 New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial 0 Medical gas and vacuum systems for health care facilities.
-Domestic 0 Any multipurpose fire sprinkler system.
Drinking Fountain 1 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.
3" 1
a' Isometric or Riser Diagram
Car Wash Drain ❑ 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 PLEASE CALL MIKE WARREN WITH QUESTIONS
Shower -Gang 503-936-5929 THANK YOU
-Stall
Sink/Lay -Non-food related 2 4
-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 Clooset-Toilet I 6 fees assessed for the sewer increase must be paid before the
Urinal 2 plumbing permit can be issued.
Other Fixtures:
C:\Users\Laura\Desktop\Permit Applications\TIGARD PERMIT APP.doc2
Accumulative Sewer Tally
■
Tenant Name: LINCOLN CENTER SWR# N/A
Site Address: 10300 SW GREFNBURG RD PLM# 2020-00083
Parcel#: 1 S 135AB01003
Fixture Value Previous Previous Credits Capped Fixture Fixture New New
# value count capped#s value count added# added value total#s total values
Baptisery/Font 4 0 0 0 0 0
Bath: -Tub/Shower 4 0 0 0 0 0
-Jacuzzi/Whirlpool 4 0 0 0 0 0
Car Wash: -Each Stall 6 0 0 0 0 0
-Drive through 16 0 0 0 0 0
Cuspidor/Water Aspirator 1 0 0 0 0 0
Dishwasher: -Commercial 4 0 0 0 0 0
-Domestic 2 0 0 0 0 0
Drinking Fountain 1 0 1 1 0 -1 -1
Eye Wash 1 0 0 0 0 0
Floor Drain/Sink: -2 inch 2 0 0 0 0 0
-3 inch 5 0 1 5 0 -1 -5
-4 inch 6 0 0 0 0 0
-Car Wash 6 0 0 0 0 0
Garbage Disposal:
-Domestic(to 3/4 HP) 16 0 0 0 0 0
-Commercial(to 5 HP) 32 0 0 0 0 0
-Industrial(over 5 HP) 42 0 0 0 0 0
Ice Machine/Refrigerator Drain 1 0 0 0 0 0
Living Unit 16 0 0 0 0 0
Oil Sep(Gas Station) 6 0 0 0 0 0
Rec.Vehicle Dump station 16 0 0 0 0 0
Shower: -Gang(per head) 1 0 0 0 0 0
-Stall 2 0 0 0 0 0
Sink:
-Lav/Bar-Non-Food Related 2 0 2 4 0 -2 -4
-Bradley 5 0 0 0 0 0
-Com/Serv/Util-Food Related 3 0 0 0 0 0
Swimming Pool Filter 1 0 0 0 0 0
Washer-Clothes 6 0 0 0 0 0
Water Extractor 6 0 0 0 0 0
Water Closet-Toilet 6 0 1 6 0 -1 -6
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
'TOTALS 0 0 5 16 0 0 -5 -16
Current Fixture Value -16 divided by 16= -1.000 Current EDU I EDU= $5,800.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change -16 divided by 16= -1.000 over (under) $ (5,800.00)
Enter EDU Change Here -1.000 *
*Round EDUs to the nearest 1/100th: a count ending in.005 shall be rounded up to.01,and a count ending in.014 or less shall be rounded down to.01.
Notes: '**CREDIT***
Authorized Name/Signature: BRANDEN TAGGART X2449 Date: 2/25/2020
Building Division
Note: The property owner shall retain the ORIGINAL sewer tally record. If credits exist,this document will serve as a voucher which must be
submitted to the City of Tigard Building Division to redeem credits towards future system development charges.
I:\Building\Sewer Tally\SewerTallySheet_5800_070119.xlsx