Permit CITY OF TIGARD PLUMBING PERMIT
`'! ' COMMUNITY DEVELOPMENT Permit#: PLM2016-00100
T 1GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/01/2016
Parcel: 1 S135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 200
Project: Rian Group Subdivision: METZGER,TOWN OF Lot: 9
Project Description: TI-Replace/relocate(1)2"floor drain,(1)primer,(1)lay and(1)water heater.
Contractor: POWER PLUMBING CO Owner: LINCOLN CENTER LLC
PO BOX 19418 BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97280 235 MONTGOMERY ST, 16TH FLOOR
SAN FRANCISCO, CA 94104
PHONE: 503-244-1900 PHONE:
FAX: 503-244-8825
FEES
Quantity Description Date Amount
1 ea Floor Drain/Floor Sink/Hub 03/01/2016 $25.02
Specifics: 1 ea Primer 03/01/2016 $12.51
1 ea Lavatories 03/01/2016 $25.02
Type of Use: COM 1 ea Water Heater 03/01/2016 $37.52
Class of Work: ALT 1 12%State Surcharge- 03/01/2016 $12.01
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $112.08
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct• -stions to O''C • ailing 503.232.1987 or 1.800.332.2344.
Iss'ed By: /10i 4 Permittee Signal re:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
MAR-01-2016 01:22 From: To:5035981960 Paee:1/2
Plumbing Permit Ap licat'
t IVSD
Building Fixtures
City of Tigard2 6 Dacey 0 / f(y Permit No,: alo i 4r-06�0
13125 SW Hall Blvd..Tigard, 223 1
Plan Review
0 Phone: 503.7111.2439 F x_ 3.5 k Date/By: Other Permit No.: ,
Inspection Line: 503.639 Y U1" 1(L1AnL/ r �O,p
TIG,\R.D P� Date Ready/By: rte: el See Page 2 for
Internet: www.tigard•Ly. ,, .C ISIS N Notifed/Methoch Supplemental Information
x' , Tifil;';O?WORx,:, I ?EE SCHEDULE ..
❑Ncw construction 0 Demolition For special Wensurtion rue checklist.
Description 1 Qty_ T Ea. I Total
04ddition/altcration/replaucment 0 Other: New 1-2-family dwellings(includes 100 R.for each utility connection)
1 1 ',' S' CATEGORY OF (ON$TROC77.ON ' 1. SFR(1)bath 312.70
ElI-and 2-family dwelling *LCommercial/industrial SPR(2)bath 437-78
❑Accessory building 0 Multi-family SFR(3)bath 50032
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler(,_sq.ft.) Page 2
r' 1 l', JOB SLTE FOR4ArIONA+4ND°L'OCAT0N, . -;s. " Site utilities:
Job site address: O2,0 6 31/03 biowt_b ed Catch basin or area drain 11.76
y- iiDrywcll,leach line,re trench drain 18.76
-
City/State/ZIP: I It G\0-4.0(, 0 97 .3 Footing drain(no.linear ft.:_) Page 2
Suitc/bldg./apL no c10 p`) Project name: (l`1,.14 17YRLt . Manufactured home utilities 50.03
Cross street/directions to.job site: Manholes 11.76
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: [Lot no.: Fixture nr item:
Tax map/parcel no.: Backflow preveater 3L27
;'..,s; a,,:' Si f.''' �., ,y�DSC
ERII'.11oN'Ole'*,,O,tri� E. :as',i' rE',4 R,': a, atvalve
Backw er 12 5I
Clothes washer 25,02
T�..vl a.f.4 71 1 1#.401f-,!� -f Dishwasher 25.02 ,
Drinking fountain 25.02
Ejectors/sump 25.02
'''.1:•'''.,,,.7f fl sEROI7 iYt OV,.,tWR s if, ` {.' O TENATOr' �5:6 '`', ,' Expanaitxc tank 12.51
Name: Fixture/sewer cap 25.02
floor drain/floor sink/hub 1 25.02 ,25,OZ
Address:
Garbage disposal 25.02
City/Statc/Z1P: Hose bib _ _ 25.02
Phone:( ) Fax:( ) Ice maker 1251
,,< ,..i iiO„.APti LICALVge;1.,‘,,!‘:.;;;),,,:,:::41,1 ,:t, :'.....1.171.;',0K4.:.44#$0.1-'T4` Interceptor/grcaac trap 25.02
Business name: Vo i..e r T I u yyt.b i n to Medical gas(value:$ ) Pagc 2
t_,l Primer ' 1251 li,5 I
Contact name: CA4 ax� 1 I.a./I
/ Roof drain(commercial) _ 12.51
Address: Lo Le () SvJ 11/44.14I I r[ 0✓4.a.A-- CS(VU(. Sink/basin/lavatory I 25.02 25,01.
City/State/L1P: PP4r' 4. 0 9-1Zz3 Solar unites(potable water) 62.54
Phone:(5D ) t Lr L(- I.:706 I Fax::(spy a Ni-e g Tub/shower/shower pan 12.51
E.mau 542 r V II
[.Q�^C 1 d J ,_ co ,6 Urinal 25.02
>+ CO `CTOZt Y�[.�L fG� ,
Wa ter close
l 25-(y2
/ ` Water heater ' 3752 37.52-
Business name: POLJQ , PI u ill 10111 Li) - Water i in WV 56.29
J PP F�
Address: Pc, >()X lc/Li/g Other: 25.02
City/State/Z1P: 190 0--I� 61 Oe. 9.-1.)-8-1) Subtotal !DO,eft
Phone:(503) otiq.19'06 Fax:($DJ ayL/_g gMinimum permit fee: $72.50
CCB Lie.: 5 Z 378 Plumbing Lic.no.:3(4_/54 pe Plan review (25%of permit fee) -----
CCB surcharge(12%of permit fee) i'2._(5(0
Authorized signature: Vc` .03
TOTAL PERMIT FEE !12.O cb
Print name: Date:3////(0, This permit application expires if a 'u not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by'l n.County Building tudusuy Service Board,
I;iRw dinglrtmitxl'I_M11-PetmitApp.doc 10/01/09 440.41t6T(lO,O2COM/WP11)
MAR-01-2016 01:22 From: To:5035981960 Page:2/2
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Sjstems:
Site Utilities. ' 'Qty. .Fee(ea) •rot5l oo g - F ' '
, , . SquatceF" �ta e� Pert»t �ee.:
Footing drain-1"100' 50.03 0 to 2,000 W$121.90
Footing drain-each additional 100' 37.52 r 2,001 to 3600 $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-lit 100' 62.54 Medical Gas Systems:
Water Service cath additional 100' 37.52 Yi hu'atibd:. . 'Per i nit Fee: 'i l
Sturm&Rain Drain•1st 100' 62.54 $1.00 to$5,000.00 Minimum fcc$72.50
Storm&Rain Drain-each additional 100' 3732 $5,001.00 to$10,000.00 $7250 for the first$5,000.00 and$1.52 for
r
Other Irispeetio iis::or.Fees;.' , ,QI.Y•;" :Fee;(ea), Iotaf and
additional$100000000 or fraction thereof,to
including inspection of existing plumbing or for $10,001.00 to$25,000.00 $14850 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 90.00/1u $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
Rcinspcction Fees 90.00/hr and including$50,000.00.
Additicmal plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
(tnittitutuu 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 Plane'Resiew�for'.Plumbing Installations
Fixture>ape for: Afp / Plan review is required for any of the following.
Work Performed : , , .,.. ', . Capped ' ' Added' "Rdawte',
13aptistry/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'II= 0 New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspiratoras defined in OAR918-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic 0 Any multipurpose fire sprinkler system.
Drinking Fountain 0 Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink 2" 1 Submit 2 sets of plans with any of the above.
' ' Isometric Or RiserDiagrani
_ Car Wash Drain . - 0 Isometric or riser diagram is required for new buildings
-Garbage -Domestic-non-food
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-industrial-food related
Ice MachfRefrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall _
Sink/I av -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Fitter
Washer-Clothes *Note: if the fixture work under this permit results in an
Wain,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 p
lumbi permit can be issued.
—
_Other Fixtures:4)0..1e...1'h_ kse _ 1
http://www.tigard-or.gov/documcnt_cenler/Building/PLMF PennitApp.dRC
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
10300 SW GREENBURG RD 200, TIGARD, OR,
97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2016-00100
Chip Barnett
Violation Summary:
Inspector Contractor