Permit CITY OF TIGARD PLUMBING PERMIT
111111 S COMMUNITY DEVELOPMENT Permit#: PLM2015-00038
T[CARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/09/2015
Parcel: 1 S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 830
Project: Mortgage Express Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Demo(2)sinks.
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
2 ea Fixture/Sewer Cap 02/09/2015 $50.04
Specifics:, 1 12%State Surcharge- 02/09/2015 $8.70
Plumbing
Type of Use: COM 22 ea Minimum Fee Adjustment- 02/09/2015 $22.46
Plumbing
Class of Work: ALT
Type of Const:
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 OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspectio a
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
Building Fixtures
City of Tigard Received Date/By: 9 „'S-- j Permit No.: hy3C js-coo 36
311 us 13125 SW Hall Blvd.,Tigard,OR 972230 EIVED Plan Review
Date/By: ( /5 ±
= Phone: 503.718.2439 Fax: 5 f Other Permit No.: .7v �}
Inspection Line: 503.639.4175 Date Read B Juris ® See Page 2 for
TIGARD Ready/By. g
Internet: www.tigard-or.gov 9 2415 Notified.Method Supplemental Information
TYPE OF WO FEE* SCHEDULE
❑New construction f I •,el ltigi<GAAD For s•ecia!in ormation use checklist
D�V�°1Ql�N Descri•tion MINI Ea. Total
v
®Addition/alteration/replacement B New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION ,, SFR(1)bath 312.70
SFR(2)bath 437.78
❑ 1-and 2-family dwelling ®Commercial/industrial -- - _
SFR(3)bath 500.32
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
El Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
,.04.0V" 1 ORMATION AND LOCATION Site utilities:
Job site address: 10260 SW Greenburg Road Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97223 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.:8 flr I Project name:Mortgage Express 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: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
� w Clothes washer 25.02
Demo 2 sinks
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER ® TENANT Expansion tank 12.51
Name:Shorenstein Realty Services L.P. Fixture/sewer cap 25.02 �J, pt�
Floor drain/floor sink/hub 25.02 //
Address: 10220 SW Greenburg Road,Suite 310
Garbage disposal 25.02
City/State/ZIP:Portland,OR 97223 Hose bib 25.02
Phone:(503)619-3100 Fax:(503)619-3110 Ice maker 12.51
® APPLICANT ® CONTACT PERSON Interceptor/grease trap 25.02
Business name:McKinstry Co Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Antonija Krizanac
Roof drain(commercial) 12.51
Address: 16790 NE Mason Street,Suite 100 Sink/basin/lavatory �2- 25.02
City/State/ZIP:Portland,OR 97230 Solar units(potable water) 62.54
Phone:(503)331-0234 Fax::(503)331-6906 Tub/shower/shower pan 12.51
E-mail:antonijak @mckinstry.com Urinal 25.02
-(,,w6,,,,,,
k f ? OT kf v x° , a Water closet 25.02
° a0 CNRACTOR ,\ ,
Water heater 37.52
Business name:McKinstry Co. Water piping/DWV 56.29
Address: 16790 NE Mason Street,Suite 100 Other: 25.02
City/State/ZIP:Portland,OR 97230 Subtotal 5d. t.141
Phone:(503)331-0234 Fax:(503)331-6906 Minimum permit fee: $72.50 "31
Plan review (25%of permit fee)
CCB Lic.: 172811 Plumbing Lie.no.:37-22PB
State surcharge(12%of permit fee) 8- Zj
Authorized signature: TOTAL PERMIT FEE Sl ,dz
Print name: ltil'i �� Gv-.aL Date: �,I 41 IS This permit application expires if a permit is not obtained within 180 days
1 7 after it has been accepted as complete.
iFee methodology set by Tri-County Building Industry Service Board.
I\Building\Permits\PLMU-PermitApp.doe 10/01/09 440-4616T(10/02/COM/WEB)
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
Storm&Rain Drain-1st 100' 62.54 Valuation: Permit Fee:
$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
each additional$100.00 or fraction thereof,to
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 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*.
Quantity by Fixture Type Plan Review for Plumbing Installations
Fixture Type for Replace/ 1
re
Plan re∎iex\ i;required for an of the follov,ing.
Work Performed: Capped Added Relocate
Baptism/Font Please check all that apply.
Bath -Tub/Shower ❑ 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 OAR918-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040.
Eye Wash _
Floor Drain/sink -2" 2 Submit 2 sets of plans with any of the above.
Isometric or Riser Diagram
Car Wash Drain ❑ Isometric or riser diagram is required for new buildings-Domestic-non-food
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related _ -
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station Demo 2 existing sinks.
Shower -Gang
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *
Washer-Clothes Note: If the fixture work under this permit results in an
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
W:\Projects\N-R\Russell Construction\101238 Mortgage Express\001 Lin2bln Tower 8th Floor\Permits\PLMF-PermitApp.doc
Sli Accumulative Sewer Tally
Tenant Name: Mortgage IixpresCRliDI'1'S*** SWR# N/.\
Site Address: 10260 SW Grcenburg Rd#830 PLM# 2015-00038
Parcel#: 1S135AB03400
Fixture \ ,ilu, Previous Previous Credits Gapped Fixture' Fixture New New
# value count capped#s v.due count added# added value total#s total values
Baptisery/Font 4 0 0 0 I) 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 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 0 0 0
-3inch 3 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) I 0 0 0 0 0
-Stall 2 0 0 0 0 0
Sink:
Lav/Bar-Non-Food Kelatc l 2 0 2 4 0 -2 -4
-Bradley 5 0 II 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 2 _ 4 0 0 _ -2 -4
Current Fixture Value -4 divided by 16= -0.250 Current EDU 1 EDU= 54,900.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change -4 divided by 16= -0.250 over (under) S (1 225.00)
Enter EDU Change Here -0.250
NotesiMINIMIll
Authorized Name/Signature: Debbie Adamski Date: 2/9/2015
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
'ubmitted to the City of Tigard Building Division to redeem credits towards future system development charges.
r
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
10260 SW GREENBURG RD 830, TIGARD, OR,
97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2015-00038
George Heimos
Violation Summary:
Inspector Contractor