Permit w
CITY TIGARD PLUMBING PERMIT
I'� DEVELOPMENT SERVICES PERMIT #: PLM2006 -00024
; �'� II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 1/17/2006
PARCEL: 1 S 135AB -00900
SITE ADDRESS: 10200 SW GREENBURG RD 150 ZONING: C -P
SUBDIVISION: LINCOLN CENTER /FIVE LINCOLN LOT: JURISDICTION: TIC
Project Description: Relocating existing fixtures and cap dishwasher. Other fix. hot water dispenser.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: 0 OTHER FIXTURES: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: 1 RAIN DRAIN: ft
Owner: FEES
EQUITY OFFICE PROPERTIES TRUST Description Date Amount
ONE SW COLUMBIA ST #300
PORTLAND, OR 97258 [PLUMB] Permit Fee 1/12/2006 $72.50
[TAX] 8% State Surcharp 1/12/2006 $5.80
Phone : Total $78.30
Contractor:
MCKINSTRY CO
5400 NE COLUMBIA BLVD REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97218
Contact # : PRI 331 - 0234
FAX 503- 331 -6906
Reg #: LIC 40981
PLM 37 -22PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of these rules or direct questioon OUNC by
calling 503 -246 -6 9 or 1- 800 - 332 -2344. ' �
Issued By: Permittee Signature: i
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that bus -ss day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
1. ECEIV ED
Plumbing Permit A plicati FOR OFFICE USE ONLY -
. 1 . 1 006
City of Tigard Received / - / ,, _ D �p J s Z Permit No.: . 44 i Db � Q o a�l
13125 SW Hall Blvd., Tigard, OR 97223 Date /By: / j�i Ir
Phone: 503.639.4171 Fax: 503.59 71 (IF T�GARD R eview ,S'ON � o � I Date /B y Other Permit No.:
24- Hour Inspection Line: 503.639. DING DIN A Date Ready /By: Ju Ei See Page 2 for
Internet: www.ci.tigard.or.us Notified /Method: Supplemental Information
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❑ New construction 0 Demolition
For special information use checklist.
Description Qty. Ea. Total
® Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
X3:1 '= �.�;e: ,• ::c.$n,., -5 ;; :�::�r�'t�± =:yea
;:�xmr _ -� : CAT E GORY OF•GON RLIC�T10N,.�,�,,, ,•,�.•,��::.� •- SFR (1) bath 24920
❑ 1- and 2- family dwelling ® Commercial /industrial SFR (2) bath 350.00
ID Accessory building ❑ Multi- family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder 0 Other: Ire n e
s < <, < °;s,3 :." :.. _;;..:,: � ;, i ;: ., :F ,,,; _ ; x , -{ spri r( sq. ft.) Page 2
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,1 J OB SITE; INEORMAT AND I T ION '
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Job site address: 102%SW Creenburg Rd. - Lincoln 3 Catch basin or area drain 16.60
City/State /ZIP: Portland, Oregon Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: 150 I Project name: Fieldstone Mortgage Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.: Absorption valve 16.60
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, .. . ... Backflow preventer Page 2
Relocate existing undercounter water heater, sink, faucet and Backwater valve 16.60
hot water dispenser Clothes washer 16.60
Dishwasher a 16.60
a, .<.; . , ,..... <, » Y Drinking fountain `/ 16.60
'i' ER x , ` TENANT
®P.ROEERTX', . i ® .
<��a;_a,3€ :t�,.�,..,, .,.... < , :.r;�� »,�;� " ;�� � ��r.�n,��� ° " ., . � � _.. _ _ - Ejectors /sump 16.60
Name: Fieldstone Mortgage Expansion tank 16.60
Address: 102200 SW Creenburg Rd. Fixture /sewer cap 16.60
City/State /ZIP: Portland, Oregon Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
,,, = ::: >: t; i o , Hose bib 16.60
1-; :.J; ;' f > ,' i; x i ® >: APP. LICANTu . , CONTACT, :EER - - s ^x
__ _ �, _ _ _ :,_ Ice maker 16.60
Business name: McKinstry Co.
Interceptor /grease trap 16.60
Contact name: Earl Salsbury Medical gas (value: $ ) Page 2
Address: 12012 NE Airport Way Primer 16.60
City/State /ZIP: Portland, Oregon 97220 Roof drain (commercial) 16.60
Phone: (503) 331 - 0234 I Fax: : (503) 331 - 6906 Sink/basin/lavatory i 16.60
Tub /shower /shower pan 16.60
E - mail: earls @mckinstry.com Urinal 16.60
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-` "" � 16.60
Business name: McKinstry Co. Water heater , 16.60
Address: 12012 NE Airport Way Other: L /4 .U/ DDS 1'
City/State /ZIP: Portland, Oregon 97220 11 Subtotal
Minimum permit fee: $72.50
Phone: (503) 331 -0234 Fax: (503) 331 -6906 Residential backflow minimum permit fee: $36.25 12v
CCB Lie.: 40981 Plumbing Lic. no.: 37 -22PB Plan review (25% of permit fee)
State surcharge (8% of permit fee) rj ^ 2P
Authorized signature: ' lI/ 0� __ ` I_ TOTAL PERMIT FEE - g •
Print name: Earl Salsbury '- Date: 01/16/06 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 \Permits \PLM- PermitApp.doc 06/05 440- 4616T(I0 /02 /COM /WEB)
Accumulative Sewer Tally Parcel # 1S135AB -00900
Tenant Name: Fieldstone mortgagae This SWR# NA
Site Address: 10200 SW Greenburg #150 This PLM# 2006 -00024 CREDIT DUE
Fixture Value Previous Previous Credits Capped Fixture Fixture New New
# value capped off value added added total total
count off #s count # value #s values
Baptisery/Font 4 0 0 0 0 0
Bath - Tub /Shower 4 -f ,r 0 ,4 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 A: o 0 1 2 0 -1 -2
Drinking Fountain 1 *. 0 0 0 0 0
Eye Wash 1 4' 0 0 0 0 0
Floor Drain /Sink - 2 inch 2 0 0 0 0 0
- 3 inch 5 0 0 0 0 0
- 4 inch 6 0 0 0 0 0
- Car Wash Drn 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
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 - Bar /Lavatory 2 0 0 0 0 0
- Bradley 5 0 0 0 0 0
- Commercial 3 0 0 0 0 0
- Service 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 0 0 0 0
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 1 2 0 0 - -2
Current Fixture Value -2 divided by 16 = -0.1 Current EDU 1 EDU = $ 2,600
Previous Fixture Value 0 divided by 16 = 0.0 Previous EDU
Change - divided by 16 = -0.1 over (under) $ (260.00)
Enter EDU Change Here -0.
Notes:
Authorized Name /Signature: Barbara Butler Date: 1/17/2006
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.xls 7/1/05
'
CITY OF TIGARD , . • ,
BUILDING DIVISION
A" PERMIT #: am2006.0024
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/17/2006
Phone: (503) 639-4171 Jai ifil'
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 717/2006 TIME: 7:02AM PAGE: 16
SITE ADDRESS: 10700 SW GREENOURG RD 150 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/FIVE LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: FIELDSTONE MORTGAGE
DESCRIPTION: Relocating existing fixtures and cap dishwasher. Other fix. hot water dispenser.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: WICKINSTRY CO PHONE #: 331-0234
•
Inspection Request Scheduled For: Date: 217/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 026415-01 360-907342 N
Corrections/Comments/Instructions:
I
r
.
...--------
/
lig -SS 0 PARTIAL APPROVAL El CANCEL 1 NO ACCESS
I FAIL Ill CALL FOR INSPECTION H ADDITIONAL FEES ASSESSED
Inspector:
) 7 1 /1 Date: _p_i Phone #: (503) 718-
CITY OF TIGARD r. .
BUILDING DIVISION
PERMIT #: PU1,1200,5-00014
D ATE
13125 SW Hall Blvd., Tigard, OR 97223 E ISSUED: 1/17,2006
Phone: (503) 639-4171 I i .
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 1/25/2006 TIME: 7:03AM PAGE: 66
SITE ADDRESS: 10200 SW GREENBURG RD 150 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/FIVE LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: FIELDSTONE MORTGAGE
DESCRIPTION: Relocating existing fixtures and cap dishwasher. Other fix. hot water dispenser.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: MCKINSTRY CO PHONE #: 331-0234
Inspection Request Scheduled For: Date: 1/25/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough-in 026693-01 360-907-3425 N
Corrections/Comments/Instructions:
,e-
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i IlL ...../__ , ' 0.1111PAILINallIL
- A /
/ 7-e"--
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— --
PASS fl PARTIAL APPROVAL 0 CANCEL Li NO ACCESS
fl FAIL I I CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED
Inspector: i' ( V (.. Date: /1)C5/6 ‘ Phone #: (503) 718-34:4_