Permit (49) CITY OF TIGARD MECHANICAL PERMIT
'e ! 2.' COMMUNITY DEVELOPMENT Permit#: PLM2018 00268
T f GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/11/2018
Parcel: 1S135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 301
Project: Sterling Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Interior Plumbing:Adding(1)sink and installing(1)primer,(1)water heater,and(1)hub drain.
Contractor: RAYBORN'S PLUMBING INC Owner: LINCOLN CENTER LLC
PO BOX 69 BY SHORENSTEIN PROPERTIES LLC
19990 SW CIPOLE RD 235 MONTGOMERY ST, 16TH FLOOR
TUALATIN, OR 97062 SAN FRANCISCO, CA 94104
PHONE: 503-692-4139 PHONE:
FAX: 503-691-2328
FEES
Specifics: Description Date Amount
Floor Drain/Floor Sink/Hub 06/11/2018 $25.02
Type of Use: COM Primer 06/11/2018 $12.51
Class of Work: ALT Type of Const: Sink 06/11/2018 $25.02
Occupancy Grp: Water Heater 06/11/2018 $37.52
Stories: 12%State Surcharge-Plumbing 06/11/2018 $12.01
Fuel
Fuel Types:
Gas Pressure:
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 .1:y of the rules
or direct questions to OUNC by callin• 503.232.1987 or 1.:.1. . ' ..,
Issued By: t. , Permittee ignature:
...411111#
Call 503.639.4175 by 7:00 a.m.for the next available inspec;fd• •.
This permit card shall be kept in a conspicuous place on the job site unti om de ion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application I. / L i A _ ,0,`,
Building Fixturesi-IEGEIVE FOR OFFICE LSE ONE
City of Tigard Received V J Permit No.: L) {/
14 IN Date/By: tJ �� i f ��� �� �Y 1/"Q
13125 SW Hall Blvd.,Tigard,OR 97223 J U N 6 2 0 1 8 Plan Review KW
Phone: 503.718.2439 Fax: 503.598.1960 �"� Other Permit No.:�`//��11'-t..�} 15:1,A.)15."0
_ Date/By: /'�1�1T.�W�U"[,k)1S�
.. No.:
p
T Ic ARD Inspection Line: 503.639.4175 elYI� OF rr gga" Rf
tl t c s 3,,,__ate Ready/By: , / Juris: ® See age 2 for
Internet: www.tigard-or.gov 31 III
f�q Nyy! D V•SpQ1 ttfied/Method:(P/L JL(/ Supplemental Information
�- i!IiV I,J�V��81�4�!
TYPE OF WORK FEE*..SCHEDULE
❑New construction 0 Demolition For special information use checklist.
Description Qty. Ea. Total
W/l(ddition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSIRU N SFR(1)bath 312.70
❑ 1-and 2-family dwelling 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 0 Other: Fire sprinkler( sq.ft.) Page 2
,. JQB,$hTE INFORMATION ANI) LOCATION, le Site utilities:
Job site address: (0 t2.p S w (rte-e..44 Catch basin or area drain 18.76
Q n Drywell,leach line,or trench drain 18.76
City/State/ZIP:
T�1(r.b..a, ' Oa q'4-2 i 3 Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: ✓" i I Project name: 5-ft.r IN.., Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
3 L," e o lit sV 1 3o I 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
Backwater valve 12.51
DESCRIPTION OF WORK �
�..° . ' Clothes washer 25.02
A Ott t 5", .k Dishwasher 25.02
(1) /424,17 c/a!IW "ky kiti*e-Atallzr Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER ( 0 TENANT 'i4„`5-r Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor s' lib of l v- r 25.02 257,()).
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
4 APPLICI$T 'tr "t 0 CONTACT PERSON I Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name: kvt,.f34 RNf Ri umauJ 6
Primer 1 12.51 i.4,5'1
Contact name: ..1-1A.At S ' At Ltp (.LJ ofi Roof drain(commercial) 12.51
Address: (1 cop std C ieb i e
Sink/basin/lavatory 1 25.02 4,j:Dy,_
City/State/ZIP: et,.(44.0\_. a 2 el'7 op L. Solar units(potable water) 62.54
Phone:(sii 3 ) 8q 1 - 313 b Fax::( ) Tub/shower/shower pan 12.51
E-mail: ,fk.�s ,i .� �d5, Cav✓'1 Urinal 25.02
Water closet 25.02
CONTRACTOR",
'. . Water heater I 37.52 3102
Business name: cp, 80(44'6 9 ) 131nl1. Water piping/DWV 56.29
Address: LCk44o 3-,4 6,596(e, old Other: 25.02
City/State/ZIP: ..rv,,,(G,h^ 6g ' -�(o Z Subtotal ilk),n.7
Phone:(S-0 3) (Kat .. J 2,36, Fax:(563) coR ( - Z 3 Z Minimum permit fee: $72.50
CCB Lic.: PlumbingLic.no.: Plan review (25%of permit fee)
78 s Z 3y- /b6 P3 State surcharge(12%of permit fee)
Authorized signature: eV., TOTAL PERMIT FEE ii),.)1'
Print name: Date: This permit application expires if a permit is not obtained within 180 days
%.,) ti�J ✓ .JII/✓L ZO 1 Pi after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
#bite Untie . w,. Qty. Fee(ea) Total ,Square Footage: Per
Footing drain-1 s`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
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 Plan fiPlumbing Installations..
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate
Baptistry/Font
0 Any new commercial building with water service 2"and
greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
-Jacuzzi/Whirlpool engineer.
Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure
Drive as defined in OAR918-780-0040.
Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system.
-Domestic ❑ Any complex structure as defined in OAR918-780-0040.
Drinking Fountain
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink: -2"
Ac or Riser Diagram
0 Isometric or riser diagram is required for new buildings
-Car Wash Drain
Garbage Domestic non-food that meet the qualifications above.
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
Ice Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -Lav/Bar non-food related
-Bradley
-Com/Serv/Util food related
-Service *Note: If the fixture work under this permit results in an
Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and
Washer-Clothes fees assessed for the sewer increase must beaid before the
Water Extractor p
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10220 SW GREENBURG RD 301 , TIGARD,
OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2018-00268
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor