Permit (55) CITY OF TIGARD PLUMBING PERMIT
,11111
COMMUNITY DEVELOPMENT
Permit*: PLM2017-00329
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/15/2017
Parcel: 1 S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 1200
Project: Reinisch Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Cap(1)break room 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 Fixture/Sewer Cap 08/15/2017 $25.02
Specifics:, 1 12%State Surcharge- 08/15/2017 $8.70
Plumbing
Type of Use: COM 47 ea Minimum Fee Adjustment- 08/15/2017 $47.48
Class of Work: ALT Plumbing
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 or 1.800.332.2344.
Issued By: T' Permittee Signature:
cif/ i" /CT/C1
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.
UPIAccumulative Sewer Tally
C Tenant Name: Reinisch SWR# N/A
TI G A R D Site Address: 10260 SW Greenburg Rd.,Ste 1200 PLM# PLM2017-00329
Parcel#: 1S 135AB03400
Fixture Value Previous Previous Credits Capped Fixture Fixture New New
# value count capped#s value count added# added value total#s total values
Baptisery/Font 4 0 0 0 0 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
-3 inch 5 0 0 0 0 0
-4inch 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 1 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) 1 0 0 0 0 0
-Stall 2 0 0 0 0 0
Sink:
-Lay/Bar-Non-Food Related 2 0 1 2 0 -1 -2
-Bradley 5 0 0 0 0 0
-Com/Sery/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 1 2 0 0 -1 -2
Current Fixture Value -2 divided by 16= -0.125 Current EDU 1 EDU= $5,500.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change -2 divided by 16= -0.125 over (under) $ (715.00)
Enter EDU Change Here -0.130 *
*Round EDUs to the nearest 1/100th: a count ending in.005 shall be rounded up to.01,and a count ending in.014 or less shall be rounded down to.01.
Notes: .13 EDU CREDIT.
Authorized Name/Signature: Dianna Howse Date: 8/15/2017
Building Division
'Note: The property owner shall retain the ORIGINAL sewer tally record. If credits exist,this document will serve as a voucher which must be
submitted to the City of Tigard Building Division to redeem credits towards future system development charges.
I:\Building\Sewer Tally\SewerTallySheet_5500_070117.xlsx
Plumbing Permit Applientb ( II)
VE
nE _A .,
Building Fixtures FOR OFFICE USE ONLY
City of ard Received .,..- ,
,I,Ilh .4 13125 SW Hall Tige Blvd,.Tigard,OR uTMG 1 4 2017 patany, .• /...> /7 ,e1)#---- Pelmit Ni40417,2/9/7,--4/03. 9
Plan ReVieW
1 3, Phone: 503.718.2439 Fax: 503.59/,3ll.I 960 Dat
Cake!Permit No.:
TIGARD Inspection Fine: 503.639.4175 C I IOF TIGARD e/By:
Date Ready/By: 31111, RI See Page 26w
Internet: www.tigard-or.gov
Notified/Sicthod: Supplemental Information
TYPE 0 liljALIIING DIVISION
' FEE* SCHEDULE
0 New construction 0 Demolition For special information use checklist,
Descri don Qt:. Ea. Total
1,... Add it ion/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft,for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath31230
_
T
0 I-and 2-family dwelling r Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
0 Accessory building 0 Multi-family
Each additional bath/kitchen
0 Master builder 0 Other:
Fire sprinkler( sq.ft.) I Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:10260 SW GREENBURG RI) Catch basin or area drain i 18.76
Drywelk leach line,or trench chain i 18.76
City/Stale/ZIP:TIGARD,OR 97223
-
Footing drain(no.linear ft.: ) l'aig2
Suitelbldg./apt.no.:1200 Project name:17-749 RE-/Ai/SC/4/ Manufactured home utilities 50.03
Cross street/directions to job site:
Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) i Page 2
Storm sewer(no.linear ft.: 1 Page 2
Water service(no,linear ft.: I
_ Page 2
Subdivision: Lot no.: Fixture or item: -
Tax map/parcel no.: Backtlow preventer 31.27
DESCRIPTION OF WORK Backwater valve 121.1111111111111111111111111111.11111
Clothes wisher
TENANT IMPROVEMENT cep ,6/2.,---pie_ /200,1 _s-,, I b ' 25.02
/,5-u---: Dishwasher 25.02
Drinking fountain 25.02
,._
Ej ectoi sisun ip 25.02 I
0PROPERTY OWNER 0 TENANT Expansion tank 12.51
-
Name: Fixture/sewer cap 1 25.02 25.0/
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
0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap /5,02
_
Business name:POWER PLUMBING CO Medical gas(value:S ) Page 2
....___
Primer 1151
Contact name:MIKE WARREN
Roof drain(commercial) 12.51
Address:P.O.BOX 19418
Sink/basin/lavatory 25.02
_
City/State/ZIP:PORTLAND,OR 97280-9418 Solar units(potable water) 62.54
Phone:(503)244-1900 Fax::(503)244-8825 Tub/shower/shower pan 12.51
_______
E-mail:SERVICE@POWEIIPLUMBINGCO.COM tirinal 25.02
25.02
CONTRACTOR -_-_ \‘NN;:iltteeir.cheaterls'l
37.52
Business name:POWER PLUMBING CO,
Water piping/DWV 56.29
Address:6611 SW IMULTNOMAII BLVD
Other: 25.02
City/State/ZIP:PORTLAND,OR 97223
Subtotal 25.02
Phone:(503)244-1900 Fax:(503)244-8825 Minimum permit fee: 572.50 72.50
Plan reviess: (250 of permit fee)
CCB Lw.:52378 Plumbing Lie.no.:34-15OPB -------
„, ., i t State surcharge(12%of permit fee) 8.70
Authorized signature: . (L:" 2 t*---z-i,.-(--*-• - -/ iPEtRohMh1;11.:cFd,,i
EE81.20
I Print name:KRISTIE DRAM WELL ! Date:8- -17 ----- This permit aO
pplication expires ifs l'ircrnTackiLs not
thin ISO days
_ • _ after it has been accepted as complete.
l'ilee nieihndology,:et by Tri-county Building tadustry Sc-t:\ice Board.
MO mid telOPermit..1.11.7\11'PO Mit ArT.,1,% 1 0/01AP 4411,.0 i On 10/02/CONVW.L.131
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qly. Fee(ea) Total Square Footage: Permit Fee:
Footing drain-l'100' 56,03 0 to 2,000 S121.90 _
Footingdrain-each additional 100' - 37.52 2.001 to 3.600 5169.69
3,601 to 7,200 5233.20
Sewer- 1st 100' 62.54
7,201 and greater 5327.54
Sewer-each additional 100' 37.52
Water Service- 1st 100' 62.54
Medical Gas Systems:
. _
Water Service-each additional 100'
37.52 Valuation: Permit Fee:
Storm&Rain Drain- 1st 100' 62.54
51.00 to$5,000.00 Minimum fee 572.50
„ .
Storm&Rain Drain-each additional 100' 37.52 55.001.00 to S10.000.00 I 572.50 for the first$5,000.00 and SI.52 for
I each additional S100.00 or fraction thereof,to
Other Inspections or Fees Qty. Le(ea) Total
and including$10,000.00.
Inspection of existing plumbing or for
510.001.1)0 to S25.000.00 $148.50 for the first 510,000.00 and 51.54 for
which no fee is specifically indicated 90.00/hr
each additional 5100.00 or fraction thereof,to
(minimum charge, 1/2 hour)
and including$25,000.00.
Inspections outside of normal business O0,00/hr 515,001.00 to$50,000.00 5379_50 for the first$25,000.00 and 51.45 for
hours(minimum charge-2 hours) each additional$I 00.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including 550,000.00.
. „
Additional plan review for revisions 90.00/hr S50,001.00 and up 5742.00 for the first$50,000.00 and$1.20 for
(minimum charge 1/2 hour) II
each additional S100.00 or fraction thereof.
-
Subtotal:
. .
Commercial Fixture Work:
Ave 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/ „„..... ..
Plan review is required for any of the following.
Work Performed: Capped Added Relocate
Please check all that apply.
Raptistry/Font
Bath -Tub/Shower Any new commercial building with water service 2"and
Jaeuz/f/Vs'hirlpool greater.except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-I)rive.'Dim 0 New exterior plumbing site utilities for any complex structure
Cuspidor/\Vater Aspirator as defined in OAR918-78(1-0040.
Dishwasher -Commercial 0 Medical gas and vacuum systems for health care facilities.
Domestic 0 Any multipurpose fire sprinkler system.
Drinkin2.Fountain 0 Any complex structure as defined in OA R9 I 8-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
-3"
-4"
Car Wash Drain I Isometric or Riser Diagram
0 Isometric or riser diagram is required for new buildings
Garbage -Doinestic-non-lOod
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
rial- related
-I
Ice Mach,/Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Las -Non-food related 1 , g. .'' r..... co ill 5o// '. _
-Bradley
-Commercial-food related
-Se.rvice
Swimming Pool Filter
*Note: If the fixture work under this permit results in an
washer-Clothes
Water Extractor increase of sewer EI)Us,a sewer permit will be issued and
Water Closet-Toilet tees assessed for the sewer increase must be paid before the
Urinal plumbing permit can he issued.
Other Fixtures:
. . „
C:\Users1Laura\DownloadskPLMF_PermitApp(I),doc 7
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City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10260 SW GREENBURG RD 1200, TIGARD, OR, August 17, 2017 at 8:49:09
97223 AM
Record Type: Record ID:
Commercial - Plumbing PLM2017-00329
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor