Permit f I
C ITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2006 -00375
DATE ISSUED: 8/18/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1 S 135AB -01003
SITE ADDRESS: 10300 SW GREENBURG RD 470 ZONING: C - P
SUBDIVISION: LINCOLN CENTER /ONE LINCOLN LOT: JURISDICTION: TIG
Project Description: Install (1) new sink, supply lines to refer & coffee maker.
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: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
EQUITY OFFICE PROPERTIES TRUST
ONE SW COLUMBIA ST #300 Description Date Amount
PORTLAND, OR 97258 [PLUMB] Permit Fee 8/9/2006 $72.50
[TAX] 8% State Surcha 8/9/2006 $5.80
Phone : Total $78.30
Contractor:
MCKINSTRY CO
5400 NE COLUMBIA BLVD
PORTLAND, OR 97218 REQUIRED ITEMS AND REPORTS
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 questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: Permittee Signature: G;c
y ����� 6677//6e 1 44244 C
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business 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.
•
Plumbing Permit Application, . FOR OFFICE USE ONLY
City of Tigard '° ` _ Permit No.: `.
u ` l" Rece -� $ j
13125 SW Hall Blvd., Tigard, OR 97223 - Date /By: . � r �Q �J
Phone: 503.639.4171 Fax: 503.598.1960 " 'N "I lo 1111 Plan Date /B iew Other Permit No.: \n
, /�rir7 }W W �s
AUG 24- Hour Inspection Line: 503.639.4175 A J,� I
W
Internet: www.ci.tigard.or.us v 0 V 9 9 L 1�• Notified/Method: Supplemental Information
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❑ New construction 01LJJ TON ealg For special information use checklist.
'
mohtt Desc Qty. Ea. Total
® Addition/alteration/replacement ❑ Other: New 1- 2 - family dwellings (includes 100 ft. for each utility connection)
;`m,Fi:?i, a1 -; CATEGORY .OF%CONSTRUCTION s'- SFR 1) bath 24920
❑ 1- and 2- family dwelling ® Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
:,),
f ; JOB= SITE "INFORMATION 4A 'LO ; . ,,. , , ;
. -, ,,,z„ ,.. �a,n •: -T „�� :, .. .. ,v 1a3333,IH13.Y�c. - - ., - _ «.,,, «.,... , .,. vJ Site n t te$
Job site address: 10300 SE Greenburg Road C/ /7 0 Catch basin or area drain 16.60
City/State /ZIP: Tigard, OR 97223 Drywell, leach line, or trench drain 16.60
Suite /bldg. /apt. no.: l Lincoln Project name: Nationwide 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 I Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
s .
:0 . s;;; .- . `DESCRIPT
'TON.„ , WORK Y,';3
'�' -� : , « . ;z ,: ti . "x : . _ ,.;�; « , - _ . � za,��a�;� ``' i�;� , . - .__ Backflow preventer Page 2
INSTALL /VEV) PAM AND FA t/CFT. 2N5m1,1 NEW i.✓A1T/t Backwater valve 16.60
I-I E,4r( yN CIA LL CUPPl. LINES '>y REFE2 ,4,v0 CorPTE. Clothes washer 16.60
RU' Nil„ W,4S7e, (r 6>L r / wA Tr R y J r Dishwasher 16.60
»., ,, ; ;, r gli�'> Drinking fountain 16.60
_ :PROPERTY_,OW == ;; �' ° T ®;TE �,:., , �,,, >!!3
=`;k: ;.. «�31 _ . .� .::.:... . ... .__._.. « ... .. - .. :;�, 3 s 4�` .;_ . ,.� 31,Ia3ri11 ..l„
° °�� ° ° - °�� - � E ject ors /sump 16.60
Name: Nationwide Expansion tank 16.60
Address: 10300 SE Greenburg Road Fixture/sewer cap 16.60
City /State /ZIP: Tigard, OR 97223 Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
„, „K „ P,P!1:IG ON T�r1C T, ' , , PERS O N� �: `�;
_ « = Ice maker 16.60
Business name: Mckinstry Co.
Interceptor /grease trap 16.60
Contact name: Jason Carver Medical gas (value: $ ) Page 2
Address: 12021 NE Airport Way, Suite G Primer 16.60
City/State /ZIP: Portland, OR 97220 Roof drain (commercial) 16.60
Phone: (503) 331 - 0234 Fax: : (503) 331 -6906 Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E - mail: jasoc @mckinstry.com
Urinal 16.60
' CONfi CTOR'v : "N `;
"l: =? -” ��.'i " =' � �'� Water closet 16.60
...333: ..�'1�' '•�:'�= ;�. , ,.,. .......... �»� ° � .._�- .�? "<:.'
' �,,
Business name: Mckinstry Co. Water heater , 16 -60
Address: 12021 NE Airport Way, Suite G Other:
City/State /ZIP: Portland, OR 97220 Subtotal
Minimum permit fee: $72.50
Phone: (503) 331 - 0234 Fax: (503) 331 -6906 Residential backflow minimum permit fee: $36.25 .
CCB Lic.: 40981 Plumbing Lic. no.: 22PB Plan review (25% of permit fee)
State surcharge (8% of permit fee)
Authorized signature: TOTAL PERMIT FEE -7 y , 3o
Print name: Jason rver Date: 8/7/06 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.
is \ Building \ Permits \PLM- PermitApp.doc 06/05 440 -4616T( l0 /02 /COM/WEB)
PliTinbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
C 3 3 3 F (�
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_ �S uare�Foofa' e. ...Permit "Fee::
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Footing drain - 1S 100' 55.00 0 to 2,000 $115.00
Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00
3,601 to 7,200 $220.00
Sewer - 1st 100' 55.00 7,201 and greater $309.00
Sewer - each additional 100' 46.40
Water Service - 1st 100' 55.00 Medical Gas Systems:
___.
Water Service - each additional 100' R > .:= .::: ,�, '•r °
r Valuation: F ;Permit F e e ' : ; ?''
Storm & Rain Drain - 1st 100' 55.00
$1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each
-- "• t" . ;sF,ee: ea Total additional $100.00 or fraction thereof, to and
i tur A.Or, Stem - Y r' " t. ' :Q Y• ( );
including $1000000 .
Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to
(minimum permit fee $36.25) 27.55 and including $25,000.00.
Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
each additional $100.00 or fraction thereof, to
Inspection of existing plumbing or and including $50,000.00.
specially requested inspections - per hour 72.50 $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
Subtotal: each additional $100.00 or fraction thereof.
Fixture Work: Pl an -Rev ew f or Co plez Str ct ures ; -T
Are you capping, adding or replacing fixtures? If "yes ", A "complex structure" is defined as an installation of a plumbing
please indicate work performed by fixture. Failure to system that meets any of the following criteria.
accurately report fixtures could result in increased sewer fees*. Please check all that apply.
1 `' Quanti ti' " "` txfii'`re Work Per "formed;;; ❑ Any new commercial building.
y .�
❑ Any new exterior plumbing site utilities.
'�'izture T e.�? �;;:: "• °: ;. Y P
. .R•::; �:. revrous PP dt . dde i'3'E
❑ A commercial building with installation, alteration or add ition
Baptistry/Font of nine (9) or more new or relocated plumbing fixtures.
Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities
- Jacuzzi /Whirlpool providing services to human beings.
Car Wash -Each Stall ❑ Plumbing installations, alterations or additions to food service
-Drive Thru facilities where new plumbing fixtures, including interceptors,
Cuspidor /Water Aspirator are being installed for the food service area.
Dishwasher - Commercial ❑ Any new residential building containing three (3) or more
- Domestic dwelling units.
Drinking Fountain ❑ Any NFPA 13 - multipurpose fire sprinkler system.
Eye Wash
Floor Drain/sink - 2" Submit 2 sets of plans with any of the above.
-3"
4 "
a ram
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Car Wash Drain .y.,a ��,. � ... '�, m; � � „�
Garbage - Domestic ❑ Isometric or riser diagram is required for new buildings
Disposal - Commercial three (3) or more stories in height.
- Industrial
Ice Mach. /Refrig. Drains
Oil Separator (Gas Station) Comments regarding fixture work:
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar /Lavatory
- Bradley /
- Commercial
- Service
Swimming Pool Filter
Washer - Clothes *Note: If the fixture work under this permit results in an
Water Extractor
Water Closet - Toilet increase of sewer EDUs, a sewer permit will be issued and
Urinal fees assessed for the sewer increase must be paid before the
Other Fixtures: plumbing permit can be issued.
c \Build \Permits \PLM- PermitApp.doc 07/06/05
. . '
• CITY OF TIGARD ...
• BUILDING DIVISION
PERMIT #: PL.M2006-00375
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/18/2006
Phone: (503) 639-4171 Ago/NoMi Inspection Requests Requests (24 Hrs.): (503) 639-4175 A41 11.
1
INSPECTION WORKSHEET FOR DATE: 9/1/2006 TIME: 7:01AM PAGE: 33
SITE ADDRESS: 10300 SW GREENBURG RD 470 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/ONE LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: NATIONWIDE
DESCRIPTION: Install (1) new sink, supply lines to refer & coffee maker.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: MCKINSTRY CO PHONE #: 331-0234
• Inspection Request Scheduled For: Date: 9/1/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 035948-01 206-255-3693 N
Corrections/Comments/Instructions:
cei, e1 ,,, - -11 ' P 1/')
IX PASS • PARTIAL APPROVAL n CANCEL El NO ACCESS
—
I FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector': ribA ,.A1.-;% \ \ ■ irt.d.-2.— Date: 0 \ \ \ \ 0\, Phone #: (503) 718-
,, . . ... . . .
CITY ���������������
��o m n ��m n n����nu�� 'p
BUILDING DIVISION PERMIT #: PLK82006'00375
13125 SW Hall Blvd., Tigar . OR 97223 DATE ISSUED: 8118/2O05
Phone: (503) 639-4171
Inspection Roque�s(24Hra.):(5O3)G3Q-417S ~��� ^��
INSPECTION WORKSHEET FOR DATE: 8121/2006 TIME: 6:68AM PAGE: �U
SITE ADDRESS: 10300 SVV0REENBUR@R0 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/ONE LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: N/Al0NVN0E
DESCRIPTION: Install (1) new sink, supply lines to refer & coffee maker.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: K8CK|NGTRY CO PHONE #: 331'0234
Inspection Request Scheduled For: Date: 8/21/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 P|umbingrough'in 035298-01 206'266'3683 N
Corrections/Comments/Instructions:
PASS I I �� �ANCEL �� NO ACCESS
. / PARTIAL / / ��
FAIL U CALL FOR INSPECTION ri ADDITIONAL FEES ASSESSED
Inspector: Date: 7 \?\[. Phone #: (603) 718-
.
.