Permit CITY OF TIGARD PLUMBING PERMIT
17 COMMUNITY DEVELOPMENT Permit#: PLM2015-00318
T WARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/22/2015
Parcel: 1 S135AB01003
Jurisdiction: TIGARD
Site address: 10300 SW GREENBURG RD 380
Project: MasterCare Solutions Subdivision: METZGER,TOWN OF Lot: 9
Project Description: TI for existing tenant moving to this new location. Work includes demolition and wall construction.
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 09/22/2015 $25.02
Specifics: 1 12%State Surcharge- 09/22/2015 $8.70
Plumbing
Type of Use: COM 47 ea Minimum Fee Adjustment- 09/22/2015 $47.48
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 by calling 503.232.1987 0 .-... ._ 44.
Issued By: - • ignature: (›/CD
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.
f taR
Plumbing Permit Application I ij-,, (4 OP „ LT-- `
Building Fixtures FOR OFFICE USE ONLY
City of Tigard I V E��'eceived Permit No.: i,
■ 13125 SW Hall Blvd.,Tigard,OR 97223RECE aateBy: �//5 -- `! I -Glitjid�
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 DateBy: Other Permit No.: gai S
Inspection Line: 503.639.4175 SEP 2 2 2015
T I G A R D f Date Ready/By: kris' ® See Page 2 for
Internet: www.tigard-or.gov Votified/Method: Supplemental Information
TYPE OF WORK CITY 01"'1'IGA ,;. FEE* SCHEDULE
❑New construction ❑ De I�tidrfiNG D`V` %ON 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
❑ I-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
Accessory building SFR(3)bath 500.32
ID ry g ❑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 addrece•1�•o NW 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.:380 I Project name:Mastercare TI 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
LL�I- _ tJ1tis
_ Storm sewer(no.linear ft.: ) Page 2
P-cit s,-,;-fr-- 37s
Water service(no.linear ft.: ) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
a a ; i f icem A > k,,,4 ,a s , - Backwater valve 12.51
t _ w.A, a z _ 4:
Clothes washer 25.02
Relocate dishwasher from Lincoln Tower,Suite 375 to 1 Lincoln Suite 380 Dishwasher i 25.02
1),„5 cam.
Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Name:Mastercare Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 10260 SW Greenburg Rd Garbage disposal 25.02
City/State/ZIP:Tigard,OR 97223 Hose bib 25.02
Phone:( ) Fax:( ) 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:Tria Day
Roof drain(commercial) 12.51
Address: 16790 NE Mason Street,Suite 100 Sink/basin/lavatory 25.02
t City/State/ZIP:Portland,OR 97230 Solar units(potable water) 62.54
Phone:(503)278-3917 Fax::( ) Tub/shower/shower pan 12.51
is E-mail:triad @mckinstry.com Urinal 25.02
x �j II, 1 5 , Water closet 25.02
Water heater 37.52
i� 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 o_5TO2-,
Phone:(503)278.3917 Fax:( )
Minimum permit fee: $72.50 72 Sp
-
CCB Lie.:172811 Plumbing Lic.no.:37-22PB Plan review (25%of permit fee)
State surcharge(12%of permit fee) e.,
Authorized signature: 5 Cj - TOTAL PERMIT FEE a0
Z Z
Print name:Tria Day Date: q/ S This permit application expires if a permit is not obtained within ftl0 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
4
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-1s`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: :� ' it
$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 Replacc/- Plan review is required for an of the followin
Work Performed: Capped Added tlz_ate Please check all that apply. y g
Baptistry/Font
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" Submit 2 sets of plans with any of the above.
-3"
4" Isometric or Riser Diagram
Car Wash Drain
Garbage Domestic-non-food ❑ Isometric or riser diagram is required for new buildings
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
Shower -Gang
-Stall
Sink/Lay -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes
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\104269 Mastercare Suite 380, 1 Litioln TI\001 Mechanical Construction\Permits\Plumb App.doc
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Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10300 SW GREENBURG RD 380, TIGARD, OR,
97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2015-00318
Chip Barnett
Violation Summary:
Inspector Contractor