Permit (42) CITY OF TIGARD PLUMBING PERMIT
: .: COMMUNITY DEVELOPMENT , Permit ft: PLM2018-00274
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 or // Date Issued: 06/08/2018
I f ''I`I g irogI i`I� Parcel: 1 S135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD
Project: 5 Lincoln Center Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Restroom remodel, 1st floor. CAP(1)urinal,RELOCATE(4)lays,(5)water closets and(1)urinal. 8/19/18:
REPRINT to add(1)sump pump for elevator shaft.
Contractor: POWER PLUMBING CO Owner: LINCOLN CENTER LLC
PO BOX 19418 BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97280 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503-244-1900 PHONE:
FAX: 503-244-8825
FEES
Quantity Description Date Amount
1 ea Fixture/Sewer Cap 06/08/2018 $25.02
Specifics: 4 ea Lavatories 06/08/2018 $100.08
1 ea Urinal 06/08/2018 $25.02
Type of Use: COM 5 ea Water Closet 06/08/2018 $125.10
Class of Work: ALT 1 12%State Surcharge- 06/08/2018 $33.03
Type of Const: Plumbing
Occupancy Grp: 1 ea Ejectors/Sump 07/19/2018 $25.02
Stories: 0 12%State Surcharge- 07/19/2018 $3.00
Plumbing
Total $336.27
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: i/ . Permittee Signature:IF 'V/7.
/ I A
/4‘,• ,
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 ApplicOirer,i,
„E
Building Fixtures 11%.1.14V., -Lir D FOR OFFICE. , .
IOR OFFICE LSE ONLY
City of Tigard Received
RI 13125 SW Hall Blvd.,Tigard,OR-4i,1 8 7018 1.23 ''')
114 pp:tee/D/B:.
- Plan Review 7 ( /*/-1.5-,M-Perinit No.fia/(Aoir-ood 2Y
• 2 Phone: 503.718.2439 Fax: 503.598.1960 Other Permit No.:
Inspection Line: 503.639A17C i Ty OF TIGARD
TIGARD Date Ready/By: Sunk: 0 See Page 2 for
Internet: www.tigard-or.gov
Notified/Method: Sup'temental Information
1"
0 New construction 0 Demolition For special information use checklist.
Description I Qty. I Ea. I Total
4 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY Or'coNsritucitrioisr ,,,,,.;-' -,,,,7 ., ,,,q, SFR(1)bath 312.70
El 1-and 2-family dwelling i Cii Commercial/industrial _SFR(2)bath
437,78 ,.
-- - SFR(3)bath 500.32
0 Accessory building 0 Multi-family - . _
- Each additional bath/kitchen 25.02
0 Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
OB *TE trOiAmAtiort AND LOCATION- '''",;4,.:,,- -- -'-';:, Site utilities:
Job site address:10200 SW GREENBURG RD Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:TIGARD,OR 97223
_....... Footing drain(no.linear ft.: ) ,. Page 2
Suite/bldg./apt.no.: Project name: 50.03
Manufactured home utilities
_......
Cross street/directions to job site: Manholes 18.76
FIRST FLOOR,5 LINCOLN 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 or item:
...........
Tax map/parcel no.: Backflow preventer 31.27
12.51
DE$eicaproN OF.WORK
Backwater
Clothes washer 25.02
ADD TO EXISTING PERMIT PLM2018-00274
Dishwasher 25.02
56(ptt10 pieketp C11,1' ',//e-..-ve-flo,r-- ,Sk&•(Pt _Drinking fountain 25.02
Ejectors/sump I 25.02
0,PROPERTY OWNER;:;--,!',.-.,' ,,, . .. ,' , ru,,„TFNAtier,, -,„q Expansion tank 12.51
,44 4 - -"-- '- -- -74'47, 'c
Fixture/sewer cap 25.02
Name:
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
01 APPLIG. ` ,'''''"h0 GOi'titACtIP*11S01210'-'i- Interceptor/grease trap 25.02
Business name:POWER PLUMBING CO Medical gas(value:S ) Page 2
--- Primer 12.51
Contact name:
-- - Roof drain(commercial) 12.51
Address:P.O.BOX 19418 ......
Sink/basin/lavatory 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@POWERPLUNIBINGCO.COM Urinal 25.02
25.02
e6-14"1',140011',,,,1:',,,_-,-''3'- ,.,";:-"IP ''"''',.:',. '-,1„, Water closet
Water heater 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
Phone:(503)244-1900 Fax:(503)244-8825 Minimum permit fee: $72.50
CCB Lie.:52378 Plumbing Lic.no.:34-150PB _.... Plan review (25%of permit fee)
-
- State surcharge(12%of permit fee)
Authorized signature: lat,44..-e TOTAL PERMIT FEE
mix. Aar
. .
Print name: KRISTIE BRAMWELL Date:7-17-18 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 Budding Industry Service Board.
1:1BuilclingTermits\PLNIU-PermitApp.doc 111/01t04 440-46161(10/02/(OMPATE)
Plumbing Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
"Site eiltioiV:- .. --,014-,A,. -01, Fee,* To41,4': 84Oare:FOotagei , N„ „i -a Fee',f,,o'''
Footing drain-I"100' 5003 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 ViiiiiiitIon:::tiV Kirinit Fee:i4,-.---
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
66i Ingiieetinanr Fees ' Qty,:- ' Fee(41",' Total, ''' 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 $141.50 for the first$10,0067150 anTii1:54for
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
each additional$100.00 or fraction thereof.
(minimum charge-1/2 hour)
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*.
Quantly by Fixture Type :: Phut Review for Plumbing Iristaliations
Fixture Type for Replace/
Plan review is required for any of the following.
Work performed. Capped Added Relocate
. Please check all that apply.
Baptistry/Font
0 Any new commercial building with water service 2"and
-Jacuzzi/Whirlpool
Bath -Tub/Shouter , greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thm0 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 0 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.
- ' ' Riseitragrain '
rothetc C o
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 Mach/Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station ADDING SUMP PUMP TO ELEVATOR SHAFT.
Shower -Gang , PLEASE CALL MIKE WARREN WITH QUESTIONS
-Stall
Sink/Lay -Non-food related ,.. . 503-936-5929
-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-Toiletfees assessed for the sewer increase must be paid before the
.. ...
Urinal plumbing permit can be issued.
....
Other Fixtures: . .''' '--
C:\Users\Laura\Desktop\Permit Applications\TIGARD PERMIT APP.doc2
ilig , CITY OF TIGARDPLUMBING PERMIT
COMMUNITY DEVELOPMENT Pe
rmit#: PLM2018-00274
T r G, R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/08/2018
Parcel: 1 S 135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD
Project: 5 Lincoln Center Subdivision: METZGER,TOWN OF
Project Description: Restroom remodel, 1st floor. CAP(1)urinal,RELOCATE(4)lays,(5)water closets and(1)urinal. Lot: 9
Contractor: POWER PLUMBING CO Owner:
PO BOX LINCOLN CENTER LLC
PORTLAND,19418 97280 BY SHORENSTEIN PROPERTIES LLC
555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503-244-1900 PHONE:
FAX: 503-244-8825
FEES
Quantity Description Date Amount
1 ea Fixture/Sewer Cap 06/08/2018 $25.02
Specifics: 4 ea Lavatories 06/08/2018
$100.08
Type of Use: COM 1 ea Urinal 06/08/2018 $25.02
Class of Work: ALT 5 ea Water Closet 06/08/2018 $125.10
Type of Const: 1 12%State Surcharge- 06/08/2018 $33.03
Plumbing
Occupancy Grp:
Stories:
Total $308.25
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 ttoo�OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: �/
�j
--1. ____ 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.
Plumbing Permit ApplicaticfnIECEIVED
BuildingFixtures
JUN 0 4 2018
FOR OFFICE1 SE ONLY
City of TigardCITY OF T ' RD Received .- ?".. ...-1
iGA . Plan/BReview.iew 0. -- 4,,,- Permit
, Ili 13125 SW Hall Blvd.,Tigard,OR;en
? 4
allig
e
: I Phone: 503.718.2439 Fax: 503.V.9 . IING DIVISION!'.1
Other Permit No.:
Date/By:
Inspection Line: 503.639.4175
T I G A R D
Date Ready/13y: ././..;//„t... ,....,6104,,„e" luris: fa see page 2 for
Internet: www.tigard-or.gov Notifted/MethodP -, irr "e7y Supplemental Information
-. 4 . 7,, 4:,,,.....,, PEE' getikritiii
TYPg OF WORK -,,,, ' '- ',, ' ' IS ' , ' ,
0 New construction 0 Demolition For special information use checklist.
Description I Qty. I Ea. J Total
14 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY oil ei:',NfiitibTiof4 :,•'•i:: ',, t` y, --', '-,:;,,„ "',„`"" SFR(1)bath 312.70
0 1-and 2-family dwelling ri Conimercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
0 Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
0 Master builder D Other:
Fire sprinkler( sq.ft.) Page 2
3011 SITE INFOR1VIATIO1.(-Afsto LoCATIQN1 q., lr t :v - - Site utilities:
-
Catch basin or area drain 18.76
Job site address:10200 SW GREENBURG RD
Drywell,leach line,or trench drain 18.76
City/State/ZIP:TIGARD,OR 97223
J
......, /
Suite/bldg./apt.no.:18T F I Project name: 18-899 Footing drain(no.linear ft.: ) Page 2 5 ii,veek,„,
Manufactured home utilities 50.03
Cross street/directions to job site: CCA./1 E.;,,,/2.-. 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 3127
...„.,0...,',,. „.,,,,,o ,....„ ‘„,.. „,,e,.. 4 44 ,Il., 34 V` ,Tl. 4,- ,''' Backwater valve 12.51
..-,E.- ,-...r...40 "--,,vywn....1, -v r, 1-
' Clothes washer 25.02
TENANT IMPROVEMENT,FIRST FLOOR TOILET ROOM
Dishwasher 25.02
5 LI Ft eel 14 Drinking fountain 25.02
Ejectors/surnp 25.02
i - 0,,TENANT t - • - Expansion tank12.51
'••. . 0•PROPERTV4 OWNER . , „ ' 4 , , , ,
Name:
Fixture/sewer cap 1 25.02
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,CONTACT p•ERs iv,, 9
25.02
,40,1AppyadANT "-4, , 4 4 :. - 9 .,, , Interceptor/grease trap
Business name:POWER PLUMBING CO Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:MIKE WARREN
Roof drain(commercial) 12.51
Address:P.O.BOX 19418
Sink/basin/lavatory 4 25.02
City/State/ZIP:PORTLAND,OR 97280 Solar units(potable water) 62.54
Phone:(503)244-1900 I Fax::(503)244-8825 Tub/shower/shower pan 12.51
Urinal 1 25.02
E-mail:SERVICE@POWERPLUMBINGCO.COM
Water closet 5 25.02
' •k- ,^ It' -,,', -4 t•- -t, 4,- y v .," ......... . .,,,.....-,,... 0 T.:- - •• -., y, .4 4, , fl 44
" -4, .4 „4. -•'-', „4. '.4. -"' '4' 4,4, -,,c Curl'RA‘,..,,,w8
-, --,,,, . ''', ,,,, ,- 4." -4.: - 4, ,- ,, -- • '•---" - ',-''4-''• --"" ' " ' '' Water heater 37.52
Business name:POWER PLUMBING CO
Water piping/DWV 56.29
Address:6611 SW MULTNOMAII BLVD. Other: 25.02
City/State/ZIP:PORTLAND,OR 97223
Subtotal 1 75
Phone:(503)244-1900 Fax:(503)244-8825 Minimum permit fee: $72 50
CCB Lie.:52378 Plumbing Lie.no.:34-150P8
Plan review (25%of permit fee)
/ State surcharge(12%of permit fee) _53
Authorized sig,nature: ateit, /
TOTAL PERMIT Fa 0e; als"
.,
I Print name:KRISTIE B AMWELL Dat-.6-4-18
] This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete. 4*--
*Fee methodology set by Tri-County Buildiug industry Service Board.
1:kBuildingTermitsIPLNIU-PermitApp.tioc IWO IAN 440-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Sup i ression Systems:
Site 11 ttIeS 7i. y.', Cady �Ttital 7 Quar nota e: 7 Permit,Fee: <.,t t-_
Footing drain-1"100' 50.03 Oto 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 ,q .=-r. ,, 4 `
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
D- nig i r Qty; Feel ) each additional$100.00 or fraction thereof,to
(�tlel`� S�eCt10nS Or Fees ',,,y. ,r _ 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
each additional$100.00 or fraction thereof.
(minimum charge-1/2 hour)
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 ;� A Elan Review for Plumbing Installations
Fixture TypeReplace/
forPlan review is required for any of the following.
Work Performed: CappedAdded ed Relocate
Please check all that apply.
Baptistry/Font
Bath Ttib/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/Vs'ater Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial 0 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" Submit 2 sets of plans with any of the above.
3'
IS, ni,Pt110.9r4, e : ,aagra �, _ Vis. ,''r
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 Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station Er7d�f/ ,' Pe/740i-74.. //..-/16--
Shower -Gang /41//4--E- 1.tJ z n-71J (;)
-Stall
4 CC�/kJ't'-/4/"1 1� -///C 7-zI/ C /
Sink/Lav -Non-food related.
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes increase of sewer EDUs,a sewer permit will be issued and
Water Extractor
Water Closet-Toilet 5 fees assessed for the sewer increase must be paid before the
Urinal (Citt9I I plumbing permit can be issued.
Other Fixtures:
C:\llsers\Laura\Desktap\Permit Applications\TIGARD PERMIT APP.doc2 •
Accumulative Sewer Tally
1111 S Tenant Name: 5 Lincoln Center SWR# N/A
T 1 G n R D Site Address: 10200 SW Greenburg Rd PLM# 2018-00274
Parcel#: 1S 135AB00900
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
-Stall 2 0 0
0 0 0 0
Sink:
-Lay/Bar-Non-Food Related 2 0 0 0 0
0
-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
Urinal 6 0
0 1 6 0 -1 -6
Previous EDU Count 0
0
Capped EDU Credit
0
TOTALS 0 0 1 6 0 0 -1
-6
Current Fixture Value -6 divided by 16= -0.375 Current EDU 1 EDU=
$5,500.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change -6 divided by 16= -0.375 over (under) $ (2,090.00)
Enter EDU Change Here -0.380 *
*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: ***EDU CREDITS***
Authorized Name/Signature: Dianna Howse Date: 6/8/2018
Building Division
rote: 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
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10200 SW GREENBURG RD, TIGARD,
OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2018-00274
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor