Permit -- CITY OF TIGARD PLUMBING PERMIT
111 -- COMMUNITY DEVELOPMENT Permit #: PLM2013 -00147
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/16/2013
T t c: n>� n Parcel: 1 S 135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 570
Project: Wave Connex Subdivision: METZGER, TOWN OF Lot: 9
Project Description: ADD (1) sink, (2) 2" hub drains and REPLACE (1) sink and (1) dishwasher for TI
Contractor: POWER PLUMBING CO Owner: LINCOLN CENTER LLC
PO BOX 19418 BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97280 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503 - 244 -1900 PHONE:
FAX: 503 - 244 -8825
FEES
- Quantity Description Date Amount
•
1 ea Dishwasher 05/16/2013 $25.02
Specifics: 2 ea Floor Drain /Floor Sink/Hub 05/16/2013 $50.04
1 ea Primer 05/16/2013 $12.51
Type of Use: COM 2 ea Sink 05/16/2013 $50.04
Class of Work: ALT 1 ea Water Heater 05/16/2013 $37.52
Type of Const: 1 12% State Surcharge - 05/16/2013 $21.02
Occupancy Grp: Plumbing
Stories:
Total $196.15
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.
Jk af - Issued By: Permittee Signature: ,4 ip 1 kRok
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.
MAY /13/2013/MON 02:27 PM POWER PLUMBING FAX No. 503 244 8825 P. 001
Plumbing Permit Application RECEIVED
Building Fixtures MAY 13 2013 FOR Ul'E1C :1; USE ONLY
City of TlgaPd �-1 Received 1 S'� Pe No,: pal4V1
q 13125 SW Bap Blvd., Ti gard, OR 9722CITY OF TIGARD Plaer 3 / obi 4
I 11 ( Phone; 503.718.2439 Fax: 5OS9 BP.DING DIVISIO I beny: Renew s i h 3 u Other Permit No:`J 1 dJ9-,- 013• - csOl0(0
Inspection Line: 503.639.4175 '
T I Ci n K 1 Internet www_ti d -0r. ov Date Ready/ r I , / 3 �/ '' 5d for
g _ a a i Notified/Metho J ( 'n Su Sce lemental Page 2 Inianonatioa
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❑ New construction ❑ Demolition For special Information use checklist
Descri.tion • • Ea. Total
L % • r dition/alteration/replacement p El Other: New I- 2-family dwellings (includes 100 ft. for each utility connection)
1 . , --e, 1 "� D1 /fill.V?.47 g,4A'b x1C 1 •It{ ` I g7,W E , SFR l bath
II , O 312.70
12 1- and 2-family dwelling 1 ommercialfindustrial SFR (2) bath 437.78
SFR (3) bath 500.32
Q Accessory building rl Multi- family
Each additional bath/kitchen - 25 -02
Q Master builder I] Other: Fire sprinkler (r_ sq. ft_)
`•" � ��, `'�� - «�F.ym j- '��.:• x,r� ,r «r'•�ifi.Y�� � {a Pagez
.: r 17 .77,,,. i a1.0)) � ^li. i 1[_h@trili.1 l'13 *� a�i�Mra i. UY(' b il �.c it � L« = site utilities:
r • • • / - � Catch basi or area drain 18.76
• V J Drywell, leach line, or trench drain 18.76 MI
City/State/ZIP: / f 1� (51/ G7) �] ).
Footing drain (no. linear R,; ___) Page 2
6 ui. •ldg. /apt no.: S Project name: , r + .. A j 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 f.: -J Page 2
Subdivision: Lot no.: Fixture or Item:
Tax map /parcel no.: /5 ( E 3 "4'5 Q I/ A Backflow preventer _Mil
i ,: ' :2 r iT f .� Ir 'a �, -- 1 ,y ") : af7 f I Backwater valve 12.51 ' -
'i. f r ;4 ,"- I6, .7 !1 ] , U - 2 ,_, �. L i'iY� LwSL ;1A'i .0 :.-.,1
r t1 � "~. �.:�� , Clothes washer 25,02. ,-
., u[ 4 ' . $A i lb .! i•_/-.._.... Dishwasher 111 25.02
Drinking fountain . 25.02 1.1
Ejectors/sump 11111111 25.02 I
a .r_i l i )liYp �7`'! 1 7 0� i� 1 -f ��'y* "c`t ' 5:1 y,,,5 Expansion tank IBM111111111111111
Fixturelsewer cap 25.02
Name: ..„A .) '. . A A. 44 / . Floor drain/floor st ub __ 25.02 0 b
Address: Garbage disposal 25.02
City /State/ZIP: Hose bib ■ 25.02
Phone: ( ) Irt Ice maker M 12.51
L` 1 ;;) 1C' C� � W_F r q , 7 ^ -- it?i i ,., + r r , : a ria ° „� a t . Interceptor /grease trap 25.02
Business name: - y ' p bra' L✓ i� / _.L� Medical gas (value: $ ) IZIEI
Primer 111.11 IIMII
Contact name:
F .. . . . ........ ............. .. Rogj~d rain ,(commercial).............. _
Address: I • t t I Sin • 1-in/lavatory 25.02 0
.. - City /State/2W :.. _ ._ - Y. ...
Phone: ( ) 41111 Pax: : ( ) gS Tub /shower /shower pen 12.51
Email Urinal 25.02
s ° •�' 4 " " c'. ;717,• > "�7 1 1'.. ` i d r,•r, 4lr i l, 'ti WEi1e closet ' 25.02
I�i1�. ,, S S , K 4 y . ( (lO l;1� { • p � '.jt *. - , 4
A" -44 r ,,ry 1 R J
f ,.�; „�_' •- -• - - -- ..._. a +b •,'t.._ i W a ter heater U. 37 MIMI
Business name: 1 / M Water piping/DWV 11111 56.29 IIII
Address: P b ' ) q (4/ 8" Other: . . 25.02
City /State/ZIP: , 0N/ / 1, Q . Subtotal 15C) I i
pp O Minimum permit fee: 572.50
Phone:( ) - � -- G 1_ • r Plan review (25% of permit fee)
Plumbing Lic. no.: l7, State surcharge (12% of permit fee)
Authorized signature:
is not obtained within ISO days /1. : TOTAL PERMIT FEE r�
-
Fiat /lr S Date: ./13/13 This permit application expires If a permit
name: �') atter it has been accepted as complete.
`Fee methodology set by Tn - County Building Industry Service Board.
t :1Buildinglre mitAPr.MU- ParmltA.yy.4°c 10/01/09 440.4616T(t0/O2/COM/1NEBl 1 _ G2
MAY /13/2013/MON 02:28 PM POWER PLUMBING FAX No, 503 244 8825 P. 002
Plumbin Permit Application - City. of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Su s 1, ression stems:
<,.. �r P, f =:,'- f,�.// e,,• :x,7-:97.7--:-..%: ny, ? ^° SC:�� v . q _ [ J. } •_ t • rr -.-t
� ' %F r:1V �,r� r� / ` 1_ X11. O� ,,,,,,� SG�F E 17 - 1 " �5h t l _ " ' 4 Vx i i ,-
4l..:: >...u._ +..E . � vr � {�» r sxsdl ~= , ?, . =1 o Ve �. -- .1_ cl a� ),u �1 r. , 1 :5 - - �' I `1 l' - L. k t! �.r~ :.. h; ', 4
Footing Footing draiin - each additional 100' • 37.52
2,001 to 3,600 $169.69
2,601 to 7,200 $233.20
Sewer - 1st 100' IIMI 62 7,201 and greater $3274
Sewer - each additional 100' 3752
Water Service -1st 100' MIMI 62.54 Medical Gas stems:
Water Service- each additional 100' 111= 37.52 �r e -. rte . . o m c ?r -a s+ r
' " U , o,lkilti, 1 0j -{i �' k .+ , ) J .t .1'11 ,11 3: N.w ,..:(A ,,, ,e..' ,∎ r � . . t
Storm & Rain brain -1st 100' 62.54 $1 - 00 to $5,000.00 Minimum fee $72,50 ,�.
Storm &Rain Drain Dra each additional 100' 37.52 y $5,001.00 to $ I0,000.00 $52.50 for the first $5,000.00 and $132 for _
1' v i_ , I �-Lx r � - 1.7 a i '1' .*- • �' . g) r a r G: - 1,E _ each additional $100.00 or fraction thereof to
, il- r • . • 1 1jy P ai ,,Itrel,Y1c.,1 :1f.• 1 91' r .s l'
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 III 90.00/hr ■
(minimum ch,r: - 1/2hour each additional $100.00 fractionthereof;to
and d inncluuding ng $255,0000.00, 0.
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
hors minimum char • e - 2 hours each additional $100.00 or fraction thereof to
Reinspection Fees ME 90.00/hr NMI 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 $120 for
. minimum char -1/2 hour each additional $100.00 or fraction thereof.
Subtotal.' _1111111_
•
Commercial Fixture Work:
Are you capping, adding or replacing fixtures? If "yes ", ,
please indicate work performed by fixture. Failure to
accurately report fixtures could result to rr increased a sewer fees'.
I
F uu {Ti1f P;' 9. , 'IN p' "" ' `C"I.' ^' n,i, 11,gC{�. ':� Ne? \'., - x r - t fie a c 1 ! u , '; ;$." - -v i �,.� 1- �" 3- r�+5r." 1T
'r , �. k k1 „,!1 ta.t. F {I , L.[ i s 1r 1. !7 C i z '9., I � ILI(t) t . .3,g
� 1p 1,71&. -ki;S t y y %' -'1, ES'Ar3 f 1. 4 � 1P '. x_,. ....i..
r \.`P1 a f� „4 K a r _ i� �' Plan review is required for any of the following.
Baptistry/Font Please check all that apply.
Bath Tub /Shower In 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 OAR915- 780 -0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic i ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918 780 - 0040.
Eye Wash
FloorDrain/sink - 2" - a Submit 2 sets of plans with any of the above. •
- 4" . • P- 1 ✓ ;1 7.7, u • . a,7 2"
lam`{ � .r .� 3 T t� .., - ",U1,!,,.-.,A)/ c? l {:f ti, 12 t : l :.. J �
-. . ,.. -Car-Was ... - -- �- _ -
Garbage - Domestic - non - food ❑ Isometric or riser diagram is required for new buildings
Disposal ,.__Domestio-food related - _ , .. . that meet the . alifications above. .
Commercial -food related _
- Industrial -food related ,
Ice MachfRefrig, Drains
Oil Separator (Gas Station) Comments regarding fixture work:
Rec. Vehicle Dump Station •
Shower -Clang ,
-St •
Sink/Lav - Non -food related I - , I '
- Bradley -
•Commercial4bod'related
- Service . -
Swimming Pool filter *Note: If the fixture work under this ermit results in an
Washer - clothes increase of sewer EDUs, a sewer permit will be issued and
Water Extractor r P
WaterCloset - Toilet - -- fees assessed for the sewer increase must be paid before the
• • Urinal . . plumbing permit can be issued.
Other Fixtures: •
-
http: / /www.tigard- or.gov/ city_ halt / departments /cd /docs/PLMF- PcrmitApp2doc -
3
Accumulative Sewer Tally
I III C Tenant Name: \C'ave Convex SWR # 2013 -00106
TIGARD Site .Address: 10220 SW Grcenbuig Rd., Ste. 570 'Tigard, OR 97223 PL \l # 2013 - 00147
Parcel #: 1 S135AB01004
Fixture Value Previous Previous Credits Capped Fixture Fixture New New
# value count capped #s value count added # added value total #s total values
Baptistry /Font 4 0 0 0 0 0
Bath: -'l'ub /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 0 0 0 0
Eye Wash 1 0 0 0 0 0
Floor Drain /Sink: - 2 inch 2 0 0 2 4 2 4
- 3 inch 5 0 0 0 0 0
- 4 inch 6 0 0 0 0 0
- Car Wash 6 0 0 0 0 0
Garbage Disposal:
- Domestic (to 3/4 I IP) 16 0 0 0 0 0
- Commercial (to 5 I IP) 32 0 0 0 0 0
- Industrial (over 5 I IP) 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:
- l.av /Bar - Non -Food Related 2 0 0 1 2 1 2
- 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 0 0 0 0
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
'I'O'1':11_.S 0 0 0 0 3 6 3 6
Current Fixture Value 6 divided by 16 = 0.375 Current I :DU 1 EDU = $4,665.00
Previous Fixture Value 0 divided by 16 = 0.000 Previous EDU
Change 6 divided by 16 = 0.375 over (under) S 1,772.70
Enter EDU Change Here 0.380
Notes:
Authorized Name /Signature: Shirley Treat Date: 05/13/2013
Building Division
Note: The property owner shall retain the ORIGINAL sewer tally record. I f 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.
l:\ Building \ Sewer "rally \Scwcr'1'allyShcct- 4665.xls 07/01/12
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10220 SW GREENBURG RD 570, TIGARD, OR,
97223
Commercial - Plumbing
320 Plumbing rough-in
05/28/2013 00:00
PLM2013-00147
PART
1. Correct Existing sink drainage in break room, at floor has serious back graded drain
and complete installation
NOTE added sink in lab room, rough/test with air pass.
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10220 SW GREENBURG RD 570, TIGARD, OR,
97223
Commercial - Plumbing
320 Plumbing rough-in
06/03/2013 00:00
PLM2013-00147
PASS
Running test provided
Violation Summary:
Inspector Contractor