Permit (31) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2017-00422
T1GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/13/2017
Parcel: 1 S 135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 375
Project: Spec Space Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Replace existing plumbing fixtures for TI: (1)dishwasher,(1)2"floor drain,(1)non-food related sink,(1)primer,
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 Dishwasher 10/13/2017 $25.02
Specifics: 1 ea Floor Drain/Floor Sink/Hub 10/13/2017 $25.02
1 ea Primer 10/13/2017 $12.51
Type of Use: COM 1 ea Sink 10/13/2017 $25.02
Class of Work: ALT 1 ea Water Heater 10/13/2017 $37.52
Type of Const: 1 12%State Surcharge- 10/13/2017 $15.01
Occupancy Grp: Plumbing
Stories:
Total $140.10
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.
:Ti/2/1
Issued By: 'fi , 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.
1
Plumbing Permit ApplicationR � I,�
Building Fixtures `
City of Tigard OCT 12 2017 Received
III 13125 SW Hall Blvd.,Tigard,OR 9722 Date/By: /e/4,7//7 p iiia,NoPz -/7 22ij,'�
Phone: 503.718.2439 Fax: 503.598.[��' ( Plan Review
l 5`�"z(/
L M:01 i Oh I itjAifiD Date/By: Other Permit N v, //7-412?
TIGARD Inspection Line: 503.639.4175 BUILDING DIVISION)
SS 1\/�[+��A i ate Ready/By: A.,j / Jun 63 See Page 2 for
Internet: www.tigard-or.gov Lll1! +7 I`CNotified/Method:L`if /7 Supplemental Information
TYPE OF WORK49,(.7.,9//,_ /s7 1'EE* SCHEDULE
For special information use checklist.
0 New construction ❑Demolition
Description I Qty. ] Ea. I Total
®Addition/alteration/replacement 0 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 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:10260 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.:375 I Project name: 17-782,VSP 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: 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
Dishwasher I 25.02 25.02
TENANT IMPROVEMENT Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Address: Floor drain/floor sink/hub I 25.02 25.02
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 25.02
Business name:POWER PLUMBING CO. Medical gas(value:$ ) Page 2
Contact name:MIKE WARREN Primer 1 12.51 12.51
Roof drain(commercial) 12.51
Address:P.O.BOX 19418
Sink/basin/lavatory 1 25.02 25.02
City/State/ZIP:PORTLAND,OR 97280 Solar units(potable water) 62.54
Phone:(503)244-1900 Fax::(503)244-8825 Tub/shower/shower pan 12.51
E-mail:SERVICE@POWERPLUMBINGCO.COM Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 1 37.52 37.52
Business name:POWER PLUMBING CO.
Water piping/DWV 56.29
Address:6611 SW MULTNOMAH BLVD Other: 25.02
City/State/ZIP:PORTLAND,OR 97223 Subtotal 125.09
Phone:(503)244.1900 I Fax:(503)244-8825 Minimum permit fee: $72.50
CCB Lie.:52378 Plumbing�, LLicc..nno /o�:34-150PB Plan review (25%of permit fee)
State surcharge(12%of permit fee) 15.01 ,
Authorized signature: J �r a " TOTAL PERMIT FEE 140.10 1/
Print name:KRISTIE SRAMWELL Date:10-12-17 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:lliuitding\PermitslPLMU-PerrnitApp.doc 10/01/09 4404616T(10/02/COMVWEB)
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-I"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
Valuation: Permit Fee:
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
Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
p 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 Replace/
Work Performed: Capped Added Relocate Plan review is required for any of the following.
Baptistry/Font Please check all that apply.
Bath -Tub/Shower 0 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 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 1 0 Any multipurpose fire sprinkler system.
Drinking Fountain 0 Any complex structure as defined in OAR9 I 8-780-0040.
Eye Wash
Floor Drain/sink -2" I Submit 2 sets of plans with any of the above.
-3"
4" Isometric or Riser Diagram
Car Wash Drain
Garbage Domestic-non-food
0 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 MachfRefrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related 1
-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:
C:\Users\Laura\Downloads\PLMF_PermitApp(5).doc 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10260 SW GREENBURG RD 375, TIGARD, December 8, 2017 at
OR, 97223 9:04:34 AM
Record Type: Record ID:
Commercial - Plumbing PLM2017-00422
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor