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Permit CITY OF TIGARD EVISED PLUMBING PERMIT 'r1 . COMMUNITY DEVELOPMENT `U/0 //3 I Permit#: PLM2013-00327 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/30/2013 Parcel: 1 S 135AB04500 Jurisdiction: Tigard Site address: 10250 SW GREENBURG RD 110 Project: Family Health Subdivision: 1991-055 PARTITION PLAT Lot: 1 Project Description: Cap(1)lay,add(1)lay&(1)water closet.10/28/13,adding a relocated sink,no change in EDU's Contractor: WEST COAST CENTRAL PLUMBING LLC Owner: LINCOLN CENTER LLC 12714 SE MAJESTIC LN BY SHORENSTEIN PROPERTIES LLC HAPPY VALLEY,OR 97086 555 CALIFORNIA ST 49TH FL SAN FRANCISCO, CA 94104 PHONE: 503-298-0435 PHONE: FAX: 503-855-3264 FEES Quantity Description Date Amount 1 ea Fixture/Sewer Cap 09/30/2013 $25.02 Specifics: 1 ea Sink 10/28/2013 $25.02 1 ea Lavatories 09/30/2013 $25.02 Type of Use: COM 1 ea Water Closet 09/30/2013 $25.02 Class of Work: ALT 1 12%State Surcharge- 10/28/2013 $12.01 Type of Const: Plumbing Occupancy Grp: Stories: Total $112.09 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: I Permittee Signature: C'� � �/� Call 503.•39.4175 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. CITY OF TIGARD PLUMBING PERMIT `' ..: _ COMMUNITY DEVELOPMENT Permit#: PLM2013-00327 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/30/2013 Parcel: 1S135AB04500 Jurisdiction: Tigard Site address: 10250 SW GREENBURG RD 110 Project: Family Health Subdivision: 1991-055 PARTITION PLAT Lot: 1 Project Description: Cap(1)lay,add(1)lay&(1)water closet. Contractor: WEST COAST CENTRAL PLUMBING LLC Owner: LINCOLN CENTER LLC 12714 SE MAJESTIC LN BY SHORENSTEIN PROPERTIES LLC HAPPY VALLEY, OR 97086 555 CALIFORNIA ST 49TH FL SAN FRANCISCO, CA 94104 PHONE: 503-298-0435 PHONE: FAX: 503-855-3264 FEES Quantity Description Date Amount 1 ea Fixture/Sewer Cap 09/30/2013 $25.02 Specifics: 1 ea Lavatories 09/30/2013 $25.02 1 ea Water Closet 09/30/2013 $25.02 Type of Use: COM 1 12%State Surcharge- 09/30/2013 $9.01 Class of Work: ALT Plumbing Type of Const: Occupancy Grp: Stories: Total $84.07 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 ification -:.ter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or ect questions to O • .Ili • 503.232.1987 or 1.800.332.2344. Is ued By: �I , Permittee Signature: 1 ��'' -- 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. Plumbin. Permit A t I lie. ',Lo!_t.fi El V Building Fixtures SEP 12 2013 i OII, (.Brit is i",l.: rp'i.\ City of Tigard RDeseccrl, 940Z 0 pnmitNo.- ' /3_00302- 13125 SW Hall Blvd.,Tigard,OI %OF TIGA�+RD Ilan Review Other:� Ai • Phone: 503.718.2439 Fax: fit. DIVISION Y' too ��^mil -r I c:.A R n inspection Line: 503.639.4179-'�+' Date /g ; GA/3 iuth: la Sae Pan for Internet: www.tignrd-or.gov et :r Sappt<menmi Iarormadon WOE OF'WOR1( 4,1 a /cf2 4 :• ,•'.'FtE�:S.tTFDULE';...:.,- r',. ❑New construction ❑Demolition For special lnfbrnmlton use checklist. Descton 1 Qty. 1 Ea. ( Total Addition/alteration/rcpiaccment ❑Other: New 1-2-family dwellings(includes 100 if.for each utility conncctionL r` CATEGORY.OF;CONSTRUCTION • SFR(I)bath 312,70 ❑1-and 2-family dwelling Commercial/industrial SFR.(2)bath 437.78 - ' ❑Accessory building SFR(3)bath 500.32 0 66 �- Each additional bath/kitchen 25.02 ❑Master builder Mc9-50 ❑Other: Fire sprinkler( sq.ft.) Page 2 •JOB:SiT1E.iNFORMATION AND LOCATION Site utilities: `CX Job site address: `� Catch basin or area drain 18.76 �' � Drywell,leach lint,or trench drain 18,76 City/State/Zu A 4 ei i _ Footing drain(no.linear R: ) Page 2 Q •1dg./apt,no.: ��ln Project name: �i � Manufactured home utilities 50.03 Cross strect/dircctions to job site: l Manholes 18,76 Rain drain connector 18.76 Sanitary sewer(no.linear R.: ) Page 2 - Storm sewer(no.linear R: ) Page 2 Water service(no.linear it.: ) Page 2 Subdivision: Lot no.: Fixture or item: Tax map/parcel no.: /.3/ 35H'/IJD11SG2� Backfowprcvenrcr 31.27 (, Backwater valve 12.51 D SCRiP7 ION'OF WtORK. e 1 � Clethos washer 25.02 14 p Vi t. t- 'Dr -+ Dishwasher 25.02 - c Drinking fbuntain 25.02 Ejectors/sump _ 25.02 0 PROPERTr OWNER 0 TENANT. . • . Expansion tank 12.51 Fixture/sewer cap 25.02 r .t1 • Name: Floor drain/floor sink/huh 25.02 Address: _ -Garbage disposal 25.02 i City/State/ZTP: _ Hose bib 25.02 Phone:( ) Fax:( ) ice maker 12.51 . a APPLICANT . . CONTACT.PERSON Interceptor/grease trap 25.02 Z. Business name: • Medical gas(value:$�,_-) Page 2 . i ni ti N ., + Primer 12.51 Contact name: T �, . ' Roof drain(commercial) 12.51 Address: is.�r _ • Sink/basinllavatnry � 25.02 b 11)t. Solar units(potable water) 62,54 Phone ( 1 ) 'f.. ly sct' I )'' e' Tub/shower/shower pan 12.51 L� _Urinal 25.02 t F..-mail:.! . ors ► • - _' 1i ! 1 1 %! i�- Water closet � 25.02 ,Q CONTRACTOIF Water heater 37.52 Business name: �Q1� n p- a ,_t .__ ill ., 4 Water pipingJDWV 56.29 .-- 1.) Address: 1 • ' rt • .. Other, 25_m2 ��■ Subtotal r. ,I�, .r 111E: 1 • n• A AM. Fax: , 1 4 " " 'M41- Minimum permit fee: $72.50 i i s Q Plumbing Lie.no.: 2i ► Plan review (25%ofpermit feel State surcharge(12%of permit fee) 61.Q - Authorized signature: tio. I ' TOTAL PERMIT FEE (411,01 Thin Kroft t nppliottion empires if n permit Ls not obtained within Ra days " , �. ,M t '. Tote: /� i after it lam been accepted as complete. "Fla mcthodobpy set by Tri-Conaty Building Industry Service Board,Dili Plulnnbin _PerTnjt cation - City of Tigard Page 2-Supplemental Information Residential Fire Su 1 .ression S stems: Fee Schedule: Total. care Foota;.ii-::::,..; Perdtit'F :' : . .,; ' $121.90 50.03 0 to 2.000 $121.99 3 601 to 7 10 Footing drain-1"100' 2 001 to 3600 $233.20 Sewing drain-each additional 100' �� 7 01 and greater $327.54 Sewer-eat 100' �� Water-each additional 0 100' 62.54 Water service-I at 100' Medical Gas S stems: Valuation::f::: ". .:::::P.erniit Fee:: ' . Water& -each 1st additional 0' l00' �� si.00 to$5 000.00 Minimum fee$72.50 Storm&Rain Drain•each 100' �� $5,001.00 to$10,000.00 $n.50 for the first$5,000.00 and$1.52 ibr Storm&Rain Drain-each additional 100' each additional$100.00 or fraction thcreot to Total' and includin• $10 000.00. Ater In:e i ling pl plumbing ng Fees $145.50 for the first$10.100.00 and$1.54 for $10,001.00 to$ZS.xw.00 $ whichno c is existing plumbing or for 90.00/hr each additional$100.00 or fraction thereof,to which no fee is specifically ho indicated and includm_$25 000.00. minimum co, ce of o m - 90.00/hr x,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours thin outside of normal business each additional$100.0 or fraction thereof.to NIBhours minimum a :e-2 hours 90.00/hr and includin;$50 000.00. Additional plan review for revisions first 90.00/br $50,001.00 and up each addiooe l$0 0 r$50,000.00 and thereof.for minimum ch, _ -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 re v ort fixtures could result in increased sewer fees*. _ . ouan , .Extort Type Phan ReVieW for'•Plumbing.Iinstallationi. .:.' Mann Replace/ Wo tlt P review is requited for any of the following. k Performed:Type for ermcd: .. Cap Added Relocate Please check all that apply. 13aptistrY/Fom ❑ Any new commercial building with water service 2"and Rath -Tub/Shower d licensed greater.except systems designed and stamped by Jac h Stall �,•1 engineer. Car Wash -Each Srnll ❑ New exterior plumbing site utilities for any complex structure -Drive Thou �- as defined in OAR918-780.0040. C i Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities. Dishwasher -Dommercial ❑ Any multipurpose fire sprinkler system. -Domestic 0 Any complex structure as defined in OAR918-780-0040. Drinki Fountain E e Wash Submit 2 Acts of plans with any of the above. Floor Drain/sink -2" •4" •Isomet�ric:or.• erias? m Car Wash Drain Tsomettic or riser diagram is required for new buildings Garbage -Domestic-non-food that meet the calif cations above. Disposal -Domestic-fond related -Commercial-food related -Industrial-food related related Ice M :mtorfnG. Stab fir- Comments regarding fixture work: Oil rotor Dos Station Rec.Vehicle Dump Station Shower al -Stall — —' Stall l MUM Sink/Lav Non-Non related -Bradley -commercial-food related -Service Swimming Pool Filter *Note: If the fixture work under this permit results in an Waalrer-Clothes _ IIII� increase of sewer EDUs,a sewer permit will be issued and Water Extractor fees assessed for the sewer increase must be paid before the Uri aClosct- 1'oilct plumbing permit can be issued. Urinal Other Fixtures: 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 10250 SW GREENBURG RD 110, TIGARD, OR, 97223 Commercial - Plumbing 399 Plumbing ﬁnal 2013-10-28 13:49:00 PLM2013-00327 PASS - No C of O Permit for additional sink provided by contractor. 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 10250 SW GREENBURG RD 110, TIGARD, OR, 97223 Commercial - Plumbing 399 Plumbing ﬁnal 2013-10-28 00:00:00 PLM2013-00327 FAIL 1. Add one sink to existing permit. 103.4.: Violation Summary: Inspector Contractor