Permit CITY OF TIGARD PLUMBING PERMIT
it' COMMUNITY DEVELOPMENT Permit#: PLM2016-00105
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/02/2016
Parcel: 1S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 500
Project: Experis Subdivision: METZGER,TOWN OF Lot: 9
Project Description: TI-Replace(1)sink
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 Sink 03/02/2016 $25.02
Specifics: 1 12%State Surcharge- 03/02/2016 $8.70
Plumbing
Type of Use: COM 47 ea Minimum Fee Adjustment- 03/02/2016 $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 qu-. •OUNC by calling 503.232.1987 or 1.800.332.2344.
Issue. By: 4/ // / Permittee Signat.11111
•,
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 02:37 From: To:5035981960 Page:1/2
Plumbing Permit ApplicaittCEIVED
Building Fixtures
City of Tigard M AR 1 2016 ;.t"ro /4, () o Permit No.: L��/4_.&,ids-
41 13125 SW Hail Blvd.,Tigard,OR 97223NI I \�`�,
Phone: 503.718.2439 Fax: 5onnyeeF TIGARD D Plan paa,/By Kw Ohm Permit No.:kuP�eid,-1060rp.2,
Inspection Line: 503.639.417 ! i� #\ S r two Date Ready/By:/B Jurls: ®See
1 "\t 1 i Internet: www.ti and err. nv �".1ILD'! o. S1ON y o Penlsl i t
8 S Notified/Method: Supplemental Information
, :. .. . . . TYPE O1, ,WORK I. ,,r .. i r,,, „ .' t{ t :1I3E•„Se PU* , t
❑Ncw construction 0 Demolition For special information use checklist.
Description I Qty. I En. I Total
Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
,.'CATEGORY,OF'CONSTRUCTION,. e', ' SFR(1)bath 312.70
❑1-and 2-family dwelling I Commercial/industrial SFR(2)bath 437 78
SFR(3)bath 500.32
❑Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler sq.ft.) Page 2
I. .` ; , JOB FmITE,,,INFORMATION ANYD4 LOCATION'' . 's c. . 'She utilities:
Job site address: l OZ Loa Svc �l 4U7 x& Q Catch basin or arca drain 18.76
City/State/ZIP: I �d 7t2-3"'""✓I Dryweu.,each ride.or trench drain 18.76
p , O e Footing drain(no.linear ft.: ) Page 2
Suite/bldg,./apt-no.:O5 '7) Project name: l;X nRe r-i S Manufactured home utilities 50.03
Cross street/directions to job site: , Manholes 18.76
Ram drain corrector 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
'„;;: -, 1. . , i:.' :I..,i V'DE$CR1P710N OF K,RIc :' ") 1 :;+;,
eaekwater valve 12.51
Clothes washer 25.02
eA4 ILAJ 1 Vll ftOV �. TDishwasher 25.02
lard ftej S1 ti 11
Drinking fountain 25.02
l J / Ejectors/sump 25.02
. i Cl PROYIsRIY;OW.I!I , r 11. , ,❑ E?,r4,4 T": }l,'+...,:: Expansion tank 1251
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: Crtrbagc disposal 25.02
City/Statc/ZdP: Hone bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
r tar
.'..!!x` a� alR.�e )<CA'N7'. ,, � ��COI,VTAC.'T PERSON �'. In t:eptor/grease trap 25,02
Business name: pn( As Pi u_.04_ (0 Medical gas(value:$_) Primer12ge
.2
Contact name; (Vi-Ot�lip H.all o 12.5
R1
Roof drain(commercial) 12,51
Address: U tk 0 5vr,} (u ►
l l '0 04&..k g l v,c;(._ Sink/basin/lavatory 1 25.02 25:p2,
City/Statc/ZIP: Qe 'i.a-.1.1,E )le., 8722 3 Solar units(potable water) 62.54
Phone:(Sp3)2 it t l-'goo Fax::L:(9 '2tel Li q_O g Tub/showcr/shower pan 1251
E-mail: Se r Y l t pow J 1..L,,,1'L'LL.;.i co.l d, Urinal _ 25.02
CO CTOR `
Water closet 25.02
Water heater 37.52
Bu inesb name: 0L.11-2.L /2h4,07,1 b..e...t. y €9 • Water piping/DWV 56.29
Address: P Ox ig,we• l Other: 25.02
-
City/Statc/ZIP: }//iii..ypi AO< 47--22?-6 _ Subtotal 2...oz '
Phone:(5a3) 0/1-/v-/90 0
Fax:(S)3),,21,,(1/.-g'g s- Minimum permit fcc: $72.50 -72.. .)
CCB Lic.:5-� 7 g Plumbing Lic.no.:3 N...1 s--11 Pg Plan review(25%of permit fee) -
i
j , State surcharge(12%of permit fee) 15,70
Authorised signature: Gam' C.�f' TOTAL PERMIT FEE g 0 , /
Print name: Date Thin permit utmr anion eepirex if a permit is not obtained within 180 days ,�/
LA-1--t-.11-A-- ,�e05 _ -.3/i/�40 r it been accepted as co mpkte. t
*Fee methodology set by Tri-County Building Industry Service Board.
I:\allllaingWermits't.ML1-PennitApp.doc i0/71A19 44O-4616T(1(UU2 OM/WEB)
MAR-01-2016 02:37 From: To:5035981960 Pane:2'2
Plumbing Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
. iii � .Fee(e ),•� Tial
'�Slte,'�til><hes� • , - ;� a '
Square Footage: Permit'F ee:', ,
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' 6254
Medical Gas Systems: 1
Water Service-each additional 100' 37.52r;
.Valuation:. LPermit fee: 1..,
Storm&Rain Drain-1st 100' 62.54 $1.00 to$5.000.00 Minimum foe$7250
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
Other.Inspections;Or Fees „ 'OtY Fee(ea): Total each additional .l or fraction.
en(he reof,to
atu
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-1t2 hour) and including$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $37950 for the first$25,000.00 and$1.45 for
hours(minimum charge-2 hours)._ each additional$100-00 or fraction thereof.to
Reinspcction Fccs 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) tach 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 byFixturc Type.'. n'wPlan Review for Plumbing1nsta titins: '
S'Itctute' ypc for ' Capped
a tMdtd' .-tarn.+ Plan review is required for any of the following.
"Worlurerformedr r
Please check all that apply.
apt's°y/F°nt 1:1Any new commercial building with watcr service 2"and
Bath -nib/Shower
lac uzalvVhirlpoul - greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru 0 New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial 0 Medical gas and vacuum systems for health care facilities.
-Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain 0 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.
Car Wash Drain '' somet.ric':or Riser'Diagra19ta`;
Garbage Domestic-non-food tl Lsometrie or riser diagram is required for new buildings
Disposal -Domestic-food related - that meet the qualifications above.
-Commercial-food related
-budusttial-food related
-
Ice Mach/Rettig.Drains
Oil Separator(Clan Station) Comments regarding fixture work:
Rex.Vehicle Dump Station
Shower -Gang
-Stall
_Sinit/Lav -Non-food related I
-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:
http//www.tigard-ar.gov/document_ccntcrBuilding/PLMF3ermitApp.dCE
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 500, TIGARD, OR,
97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2016-00105
Chip Barnett
Violation Summary:
Inspector Contractor