Permit CITY OF TIGARD PLUMBING PERMIT
' COMMUNITY DEVELOPMENT Permit#: PLM2015-00267
T1GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/12/2015
Parcel: 1 S135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 370
Project: Epic Land Solutions Subdivision: METZGER,TOWN OF Lot: 9
Project Description: TI-Cap(1)existing sink,add(1)sink,(1)dishwasher&(1)water heater.
Contractor: MCKINSTRY COMPANY LLC Owner: LINCOLN CENTER LLC
16790 NE MASON ST., STE. 100 BY SHORENSTEIN PROPERTIES LLC
PORTLAND,OR 97230 235 MONTGOMERY ST, 16TH FLOOR
SAN FRANCISCO, CA 94104
PHONE: 503-331-0234
PHONE:
FAX: 503-331-6907
FEES
Quantity Description Date Amount
1 ea Dishwasher 08/12/2015 $25.02
Specifics: 1 ea Fixture/Sewer Cap 08/12/2015 $25.02
1 ea Sink 08/12/2015 $25.02
Type of Use: COM 1 ea Water Heater 08/12/2015 $37.52
Class of Work: ALT 1 12%State Surcharge- 08/12/2015 $13.51
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $126.09
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 ques•••. • NC by calling 503.232.1987 or 1.800.332.2344.
Issued =y: ` , t 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 Applic*4 CEI IVEJ)
Building Fixtures FOR OFFICE USE ONLI
City of Tigard AUG 12 2015 Date/By: 0 /4(/, `` fi') Permit No.: 4Lli�/5 4 J � 7
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review /
MI
Phone: 503.718.2439 Fax: °If Date/By: Other Permit No. / �[-..6/ley
Inspection Line: 503.639.4 "' ti J
T 1 GARD Date ReadyBy. runs ® See Page 2 for
Internet wNNNN tigard-or go ILDIN J Notified Method. Supplemental Information
TYPE OFFWORK- -FEE* SCHEDULE Ii
❑New construction ❑Demolition For special information use checklist
Description I Qty. I Ea. I 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 ®Commercial/industrial SFR(2)bath 437. Ti
1
❑Accessory building CI Multi-family SFR(3)bath 500.32 8
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities: 1
Job site address:1 Lincoln,10300 SW Greenburg Rd. 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.:370 I Project name:Epic Land Solutions 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: / /t 3 sf11od I Lot no.: Fixture or item:
Tax map/parcel no Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Demo of existing sink,install of new sink,dishwasher and water heater Dishwasher 1 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER ❑ TENANT Expansion tank 12.51
Name:Shorenstein Fixture/sewer cap / 25.02
Floor drain/floor sink/hub 25.02
Address: Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
® APPLICANT ® CONTACT PERSON 7 Interceptor/grease trap 25.02
Business name:McKinstry Co Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Tria Day
Roof drain(commercial) 12.51
Address: 16790 NE Mason Street,Suite 100 Sink/basin/lavatory I 25.02
City/State/ZIP:Portland,OR 97230 Solar units(potable water) 62.54
Phone:(503)331-0234 Fax: :( ) Tub/shower/shower pan 12.51
E-mail:triad @mckinstry.com Urinal 25.02
Water closet I 25.02
�t .T �,..., � '�` ._`s , 4 .. ..,," Water heater 1 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
Phone:(503)331-0234 Fax:( ) Minimum permit fee: $72.50
CCB Lie.: 172811 Plumbing Lic.no.:37-22PB Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: �� TOTAL PERMIT FEE ,
This permit application aspires if a permit is not obtained within 180 days
Print name: 'r s �+ Date: �/I O/IS- after it has been accepted as complete.
i *Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PennitApp.doc 10/01109 440-4616T(10/01ICOM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
.; Fee(ea) Total Square-Foot e Ternut
Footing drain- 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 S stems:
Water Service-each additional 100' 37.52 ; � �� . MEAN
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
tlfal each additional$100.00 or fraction thereof,to
er Pec > ix,Fe eti ... :.- 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:
Other Fixtures:
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
Fixture The for. Replace' Plan Review for tibll7t>lull t l bons
Work Performed: Capped Added Relocate
Baptistry/Font Plan review is required for any of the following.
Bath Tub/Shower Please check all that apply.
-Jacuzzi/Whirlpool ❑ Any new commercial building with water service 2"and
Car Wash Each Stall greater,except systems designed and stamped by licensed
-Drive Thru engineer.
Cuspidor/Water Aspirator ❑ New exterior plumbing site utilities for any complex structure
Dishwasher -Commercial as defined in OAR918-780-0040.
-Domestic 1 ❑ Medical gas and vacuum systems for health care facilities.
Drinking Fountain ❑ Any multipurpose fire sprinkler system.
Eye Wash ❑ Any complex structure as defined in OAR918-780-0040.
Floor Drain/sink -2"
-3" Submit 2 sets of plans with any of the above.
-4„
Car Wash Drain IA'I'o Sometiic or Riser Diagra 1
Garbage -Domestic-non-food ""`
Disposal -Domestic-food related ❑ Isometric or riser diagram is required for new buildings
-Commercial-food related that meet the qualifications above.
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station)
Rec.Vehicle Dump Station Comments regarding fixture work:
Shower -Gang
-Stall
Sink/Lay -Non-food related 1 r '�►
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter
Washer-Clothes *Note: If the fixture work under this ermit results in an
Water Extractor p
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
W:\Projects\N-R\Russell Construction\103740 Epic Land Solutions,Suite270 1 Lincoln\001 Mechanical Construction\Permits\PLMF-
PermitApp.doc
Location:
Record Type:
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Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10300 SW GREENBURG RD 370, TIGARD, OR,
97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2015-00267
George Heimos
Violation Summary:
Inspector Contractor