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Permit CITY OF TIGARD PLUMBING PERMIT 1111 COMMUNITY DEVELOPMENT Permit #: PLM2011 -00046 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/11/2011 Parcel: 1 S135AB00900 Jurisdiction: Tigard Site address: 10200 SW GREENBURG RD 400 Project: Bridgewell Resources Subdivision: LINCOLN CENTER /FIVE LINCOLN Lot: 0 Project Description: Interior plumbing: Replacing (2) sinks in break room. Contractor: MCKINSTRY COMPANY LLC Owner: LINCOLN CENTER LLC 16790 NE MASON ST., STE. 100 BY SHORENSTEIN PROPERTIES LLC PORTLAND, OR 97230 555 CALIFORNIA ST 49TH FL SAN FRANCISCO, CA 94104 PHONE: 503 - 331 -0234 PHONE: FAX: 503 - 331 -6907 FEES Quantity Description .Date Amount 2 ea Sink 02/11/2011 $50.04 Specifics: 1 12% State Surcharge - 02/11/2011 $8.70 Plumbing Type of Use: COM 22 ea Minimum Fee Adjustment - 02/11/2011 $22.46 Class of Work: ALT Plumbing Type of Const: Occupancy Grp: Stories: Total $81.20 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 ad•• -• by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952- !.1 -0.e0. You m- obta spy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800 Issued By: Permittee Signature: / ( /// [.' Call . 4tio■ 175 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 p � A NV� - `r ..FOR OFFIC .USE,ONLY Received /jp�- p ermit No.: J ^" / � C1 of Tigard ', 'q 13 1 2 5 SW Hall Blvd., Tigard, OR 972 �5 Date/By: : p? �/ �U // Pt -/'►�p449.,, f I �(,1'IUZJ�/ s � � Plan Review • Pho ne: 503.639.4171 Fax: 503.598.1960 n �o Other Permit No: � p i / IA GV Date/By: f // .T,IGARD Inspection Line: 503 639 4175 'Pate Read /By Jun B See Page 2 for • 1 Internet: www.tigard or.goV otified /Method: Supplemental Information � `� Sl ..... .,. �.-- R,�'t.�� 't� 9.- ,: .. t;. ., . � :3,`i 1•r. ..�N.t. ' ,:,;� ,. ,., . , �. `• , ...::. ".. .�TI'P,.E OF =HWORI+.� - ° �'i. SGHE , .� , a; ,, �s��� .., •.., , �,. 'F E- ❑ New construction ❑ Detl• .n For special information use checklist Description Qty. Ea. Total ® Addition /alteration /replacement ❑ Other: New 1- 2 - family dwellings (includes 100 ft. for each utility connection) '„ >:. i: , ,- 1 • :- SFR 1 z ,: ` C DOFF CONS7R iIGT1 ©N ( ) bath 312.70 -.,...,- nth > ',�' � ���,. � ,.,,, .._,..._ ___ _ ..,,.u,� --_. ;- __- _ -. -_.. � ,,. ❑ 1- and 2- family dwelling ® 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.) Pa 2 �t''i ;jtA•, " Site utilities: :�°_ : JtB°. tSI= TES ;INF, „ORIVI F ':; 3 =a � ° ' , ;.: � m , a f , 3, . t iR1 ��i kV... .. th to Catch basin or area drain 18.76 Job site address: U1�3U SW Greenburg Road - 4 & 5 Floors Drywell, leach line, or trench drain 18.76 City /State /ZIP: Portland, OR 97223 Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: Project name: Bridgewell s�>s 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 McKinstry Job #9427 Water service (no. linear ft.: _ ) Page 2 Subdivision: Lot no.: 04600 Fixture or item: Tax map /parcel no.: 1S135AB Backflow preventer 31.27 ,�^ :_, t,,,.,• ; �,. .. -- .;.. ';DES RIPTIO OF :WORK ': -. >- ..,.<;::��:•ttt a, <_ -:... . �,� ... ��.,_ .. ,.? »fit ,,, > Backwater valve _. N �- „�.,- '' -:N' .. -.. �.- - �'_- Clothes washer 25.02 5 Floor: Install (2) new break room sinks. Dishwasher 25.02 Drinking fountain 25.02 Ejectors /sump 25.02 a;E`u � ;;v,' ',' - , El t fi� .' ;,`¢- ' crx-s, =• ," m PRpPER;fY OWNER< ; �,;s i 4 . : '0�:: l ', e: ; : 4 T - Expansion tank 12.51 a•w, .�' lawn` %,,4.,i .t... , ?: , ,-,64.-,,,--„.. ..- . ,. T , ` A �.. t•:.t v.� „ ^�s � �.. t . ._..r....nv- ...: .,�_ _ _ Name: Bridgewell T.1. Fixture /sewer cap 25.02 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 . � " ;,'�3;' ...;F,. .c"i,, ,i ? "�E ." c3i• '',:�mI3•..t a:�,'--y .5 �-�,',r,,. ,;, , ; ® - ; ;€ 1::: :=�= ®tCOI\TACT ; PERSON - Interceptor /grease trap 25.02 x :,' tq� Business name: McKinstry Company, LLC Medical as (value: $ ) Page 2 Primer 12.51 Contact name: Diane Parke, Project Coordinator Roof drain (commercial) 12.51 Address: 16790 N.E. Mason Street, Suite 100 Sink/basin/lavatory 2 25.02 City /State /ZIP: Portland, OR 97230 Solar units (potable water) 62.54 • Phone: (503) 331.2465 Fax: : (503) 331.6907 Tub /shower /shower pan 12.51 E -mail: dianep @mckinstry.com Urinal 25.02 < z ,., ,,, .. ",,.t ,,; . Water closet 25.02 i'�. CCSIVTRACTOR° = .� �,: . _ - _ , „, <���._. <� �, -. �... _ _._. Water heater 37.52 Business name: McKinstry Company, LLC Water piping/DWV 56.29 Address: Other: 25.02 City /State /ZIP: • Subtotal To 0. Phone: ( ) Fax: ( ) Minimum permit fee: $72.50 7) i CCB Lie.: 172811 Ai ii a, (_ umbinq Lic. no.: 37 - 22PB Plan review (25% of permit fee) State surcharge (12% of permit fee) 6„ 70 Authorized signature 91FA M A /111L / TOTAL PERMIT FEE ( s Print name: Diane Par • e Date: �1 [ `/ This permit application expires if a permit is not obtained within 811 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. h\ Building \Permits \PLMU- Perm¢App.doc 10/01/09 440- 4616T(10/02/COM /WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: F ee ea otal ><te �Vtilit�es:.:•.... _ :,, 3 , �Y . , Qty�� �,t ) : ware: F oota , a :; =�;y ;: Perm Fe'e:: ,, S ro r °; Q, Footing drain - 1 100' 50.03 0 to 2,000 $121.90 Footing drain - each additional 100' 37.52 2,001 to 3,600 $169.69 Sewer - 1st 100' 62.54 3,601 to 7,200 $233.20 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 � valuatioMn° - PerniltFee: Storm & Rain Drain - 1st 100' 6254 $1.00 to $5,000.00 Minimum fee $7250 " " %. 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 °,, ;"• ";y;;;3 3;::; < =r, °-QtY �� Fee R each additional $100.00 or fraction thereof, to Ot�l "er4nspeCttons or r CS. y a ;:.,Tots •�� - ( e-� a 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 ", p-1 n- Reviewjior Pl h. bi h` llati "..' please indicate work performed by fixture. Failure to Plan review is required for any of the following. accurately report fixtures could result in increased sewer fees Please check all that apply. ❑ Any new commercial building with water service 2" and Fixture T =` 'ii"c�il'1;; =�' `a'' =':'Art "" :Replace eater, except systems designed and stamped b YP v= r`:.� l, 1;� 3,,,,, 3 �' P Y g P Y licensed W ,� P.revinus 1 i'Capped . 9 :Added= = ,Ezistiu� engineer. - - Baptistry/Font Bath - Tub /Shower ❑ New exterior plumbing site utilities for any complex structure as defined in OAR918- 780 -0040. - Jacuzzi/Whirlpool Car Wash -Each Stall ❑ Medical gas and vacuum systems for health care facilities. Drive Thru ❑ Any multipurpose fire sprinkler system. Cuspidor /Water Aspirator ❑ Any complex structure as defined in OAR918- 780 -0040. Dishwasher - Commercial Domestic Submit.2 sets of plans with any of the above. Drinking Fountain Eve Wash a ` 4fi J somet)ric 1 ,P A ' iser I ><a Floor Drain /sink - 2" ❑ Isometric or riser diagram is required for new buildings that meet the qualifications above. Car Wash Drain Garbage - Domestic Disposal - Commercial Industrial Comments regardin fixture work: (� I • , Ice Mach. /Refrig. Drains 1(I .4t Cq Oil Separator (Gas Station) l� J Rec. Vehicle Dump Station Shower -Gana -Stall Sink - Bar/Lav on,' A -Bradley" - Commercial *Note: If the fixture work under this permit results in an - Service increase of sewer EDUs, a sewer permit will be issued and Swimming Pool Filter fees assessed for the sewer increase must be paid before the Washer - Clothes Water Extractor plumbing permit can be issued. Water Closet - Toilet Urinal Other Fixtures: W:\PDX - Special Projects Group\Projects \2011 - PROJECTS \9427 Bridggwell TI \Permits \PLMF - PermitApp.doc