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Permit
� q CITY OF TIGARD PLUMBING PERMIT z COMMUNITY DEVELOPMENT Permit#: PLM2014-00344 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/16/2014 Parcel: 1 S135AB01004 Jurisdiction: Tigard Site address: 10220 SW GREENBURG RD 250 Project: Sodexo Subdivision: METZGER,TOWN OF Lot: 9 Project Description: Interior plumbing: Adding(1)breakroom sink,and installing(1)water heater. 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 1 ea Sink 10/16/2014 $25.02 Specifics: 1 ea Water Heater 10/16/2014 $37.52 1 12%State Surcharge- 10/16/2014 $8.70 Type of Use: COM Plumbing Class of Work: ALT 10 ea Minimum Fee Adjustment- 10/16/2014 $9.96 Type of Const: Plumbing 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 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. 4 Issued By: Permittee Signature: 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. Plumbing Permit Application 15 i 3.-5- ` & 1oc 1 Z, /q- Building Fixtures FUR (III ( F l SF, ONI,Ci of Ti and ROCC1 P rmit N g ' cr,\Ic.'..S.0 DateB : e o . to a i• 13125 SW Hall Blvd.,Tigard,• I• ^ �Q :� ■ Phone: 503.718.2439 Fax: 50 • . • 1 16 L� Plan Review Other Permit No.: 7,,,o ist--Gdo f Date/By: 4 Inspection Line: 503.639.4175 �,� �Qo Date Ready/By: June: See age 2 for T I G A R D Internet: www.ti ard or. ov Q r i�r°° g g �X� Notified/Method: I Supplemental Information TYPE OF WORD 1r . FEE* SCHEDULE ❑New construction ❑ on For s ecial information use checklist Description Qty. Ea. Total ©Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ❑ 1-and 2-family dwelling (a Commercialfmdustrial 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.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: fO�V E(� Catch basin or area drain 1 8.76 City/State/ZIP: .�J� �'� Drywell,leach line,or trench drain 18.76 v Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.:/74-0 I Project name: c20/12j (9 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 ft.: ) Page 2 Subdivision: l Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 i it S U ,"I,v /v,1l_. 1,cg1, e Y Dishwasher 25.02 C rO Jam.. 3.1,-../L3 Drinking fountain 25.02 Ejectors/sump 25.02 PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: !,�O Fixture/sewer cap 25.02 UU IC l e vl Floor drain/floor silk/hub 25.02 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 QKAPPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name: MC��to� Medical gas(value:$ ) Page 2 Contact name: �,,`_- Primer 12.51 l`e/y", R- ' - 1 144 C5 Roof drain(commercial) 12.51 Address: /6 7c10 iu _ //{„yam - Sink/basin/lavatory / 25.02 (j T a- City/State/ZIP: Gv4i/A, 0 V___ 617 Z 3 0 Solar units(potable water) 62.54 Phone:6c3 ) 331 .0 .3'-( Fax::( ) Tub/shower/shower pan 12.51 E-mail: ,�2(1�ta-,P Pclemsi-et . { CL'^'L Urinal 25.02 CONTRACTOR Water closet 25.02 Water heater / 37.52 3 7.s--). Business name: /(4.. 1,Imo_ IT Water piping/DWV 56.29 Address: f(2'710 AC 5 c..i Other: 25.02 City/State/ZIP: ` e r lcutzA 0lz- 41 o2 () Subtotal (, A.Sal Phone:(5? ) ?31_6 2„,-3 U/ Fax:( ) Minimum permit fee: $72.50 �? CCB Lic.: 1 1 yg i I Plumbing Lic.no.:37- 2�i3 Plan review (25%of permit fee) 1 State surcharge(12%of permit fee) Y. U Authorized signature: .011111 - TOTAL PERMIT FEE 8 Print name: f__-;_k- to yy� Date:`O// This permit application expires if a permit is not obtained within 1 0 days �. f f Z�I t.� ( (a/ i after it has been accepted as complete. "Fee methodology set by Tri-County Building Industry Service Board. aA 14,1 I:\Building Wermita\PLMU-PenaitApp.doc 10/01/09 440-46I6T(10/02/COM/WEB) 3-7.a 71 r. D Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee: 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 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 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 Valuation: Permit Fee: Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50 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 dditional Other Inspections or Fees Qty. Fee(ea) Total and inc including$10,00 fraction thereof,to 0.00. 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", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Plan Review for Plumbing Installations Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replace/ Please check all that apply. Work Performed: Capped Added Relocate Baptistry/Font ❑ Any new commercial building with water service 2"and greater,except systems designed and stamped by licensed Bath: -Tub/Shower -Jacuzzi/Whirlpool engineer. Car Wash: -Each Stall ❑ New exterior plumbing site utilities for any complex structure -Drive Thru as defined in OAR918-780-0040. Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities. Dishwasher. -Commercial CI Any multipurpose fire sprinkler system. Domestic 11:1 Any complex structure as defined in OAR918-780-0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: -2" 3" Isometric or Riser Diagram ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain Garbage Domestic non-food that meet the qualifications above. Disposal: -Domestic food related -Commercial food related -Industrial food related Ice Mach./Refrig.Drains Comments regarding fixture work: Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -Lav/Bar non-food related 1 -Bradley -Com/Serv/Util food related -Service *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and Washer-Clothes fees assessed for the sewer increase must be paid before the Water Extractor p Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: I:1 Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 iiiAccumulative Sewer Tally 4:ia Tenant Name: SODEXO SWR# 2014-00111 Site Address: 10220 SW GREENBURG RD SUITE 250 PLM# 2014-00344 TI(“kit ) Parcel#: 1S135AB01004 Fixture Value Previous Previous Credits Capped Fixture Fixture New New # value count capped#s value count added# added value total#s total values Baptisery/Font 4 0 0 0 0 0 Bath: -Tub/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 I 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 0 0 0 -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 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 I 0 0 0 0 0 Living Unit 16 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: -Lav/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 TOTALS 0 0 0 0 1 2 1 _ 2 Current Fixture Value 2 divided by 16= 0.125 Current EDU 1 EDU= $4,900.00 Previous Fixture Value 0 divided by 16= 0.000 Previous EDU Change 2 divided by 16= 0.125 over (under) $ 637.00 Enter EDU Change Here 0.130 Notes: Authorized Name/Signature: BRANDEN TAGGART X2449 Date: 10/16/2014 Building Division ote: 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_4900._070114.xlsx Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 10220 SW GREENBURG RD 250, TIGARD, OR, 97223 Commercial - Plumbing 399 Plumbing final PASS - No C of O PLM2014-00344 George Heimos Violation Summary: Inspector Contractor