Permit (116) CITY OF TIGARD PLUM
I. COMMUNITY DEVELOPMENT Permit#: PLM2018-00514BINGPERMIT
11111
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/13/2018
T ELL"' g Parcel: 1 S 135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 125
Project: Spec Space Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Interior plumbing:Capping(1)2"floor drain and(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
IFEES
Quantity Description Date Amount
1 ea Floor Drain/Floor Sink/Hub 11/13/2018 $25.02
Specifics: 1 ea Sink 11/13/2018 $25.02
1 12%State Surcharge- 11/13/2018 $8.70
Type of Use: COM Plumbing
Class of Work: ALT 22 ea Minimum Fee Adjustment- 11/13/2018 $22.46
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: "111119 ' /; f 7-.7t-e---,
_ � Permittee Signature: eA7 e �/'�6/ c,9-7717"/
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 Applicat`
Building Fixtures lOR OFFICE 1 SE ONL1
City of Tigard O C IT 2 9 2018 Received
Date/B I i Permit No.: n/�„261 _(ie C,
1;113125 SW Hall Blvd.,Tigard,OR 7223 /044,1026143.,
_�;Lrd J
_ g �� Plan Review
Phone: 503.718.2439 Fax: 503 RD
Other Permit No.:
8� ':/ Date/By: c?l.4.-,6?)G8j- &7l y
Inspection Line: 503.639A175B tjiLniyN r l t h,, Date Ready/By: ^l�oris-:� ®See Page 2 for
Internet: www.tigard-or.gov Notified/Method: ""'� Supplemental Information
TYPE OF WORK 4
❑New construction 0 Demolition For special information use checklist. ,
Description I Qty. I Ea. I Total
®Addition/alteration/replacement 0 Other. New 1.2-family dwellings(includes 100 ft.for each utility connection)
(CATEGORY iF'CO °:VT1O y
SFR(1)bath 312.70.
❑ 1-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
0 Accessory buildingSFR(3)bath 50032
0 Multi-family
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:10220 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.:125 l Project name:18-966 S' ` 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: Lot no.: Fixture or item:
Tax map/parcel no.: /5 f 3,3 o i�,� Backflow preventer 31.27
A , ��'� u Backwater valve 12.51
*,► SGPTI(TN OE 14r0
Clothes washer 25.02
TENANT IMPROVEMENT SUITE 125,3 LINCOLN Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
LI PROPERTY OWNER 0 TENAP T,Q1,, Expansion tank 12.51
Name: Fixture/sewer cap 2 25.02C/ ,1
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
- k ;lp ' ,, , 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:POWER PLUMBING CO Medical gas(value:$ ) 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@POWERPLUMBINGCO..COM Urinal 25.02
-, O eWater Closet 25.02
;l,=14 tiN I) AIPOpiHw11 9. �£ --awi :, 4 ,yi '� oflii lrRipIiiu "a
Water heater 37.52
Business name:POWER PLUMBING CO Water piping/DWV 56.29
Address:6611 SW MULLTNOMAH BLVD. Other: 25.02
City/State/ZIP:PORTLAND,OR 97223 Subtotal 5 c--0-1
Phone:(503)244-1900 Fax:(503)244-8825 Minimum permit fee: $72.50 7)_�--L
CCB Lic.:52378 Plumbing Lic.no.:34-150PB Plan review (25%of permit fee)
State surcharge(12%of permit fee) r, 7i;
Authorized signature: i, .� rte TOTAL PERMIT FEE
Print name:KRISTIE BRANIWELL Date:10-29-18 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 Building Industry Service Board.
I:\6uitding\Permts\PLMU•PennitApp.doc 10/01/09 440.4616T(10102/COMIWEB)
Plumbing Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site gt i✓i ''w ,,,- Q )i`_ Fee(ea) ',Total ,Permit
�t. .= ��. qu�►re�'ga#agt*. '��,,
dee: , r
Footing drain-1"100' 50.03 0 to 2,000 S121.90
Footing dram-each additional 100' 37.52 2,001 to 3,600 $169;69
3,601 to 7,200 $233.20
Sewer-1st 100' 6254 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
Valitif nl: ' :Permit.Fee: r..
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 $7230 for the first$5,000.00 and$1.52 for
Other Inspection*Or,Pees Qt t Fee(ea) To ,w 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
(minimum charge-1/2 hour) each additional$100.00 or fraction thereof,to
and including$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the fust$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*.
()unruly by Fixture Plan Revii a,for Plumliuig Installations
Fixture Type for Replace/
Work Performed: Gapped Added Relocate Plan review is required for any of the following.
Baptistry/FontPlease check all that apply.
Bath -Tub/Shower ❑ 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 ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspiratoras defined in OAR918-780-0040.
Dishwasher -Commercial ❑ 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" 1 Submit 2 sets of plans with any of the above.
3"
4„
"011ie nn or Rtser l)ia '
Car Wash DrainJ��M. gi�anl ��
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 Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related L
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter
Washer-Clothes *Note: If the fixture work under this permit results in an
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\Desktop\Permit Applications\TIGARD PERMIT APP.doc2
Accumulative Sewer Tally
Iffi _ Tenant Name: SPEC SPACE
SWR# N/A
Site Address: 10220 SW GREENBURG RD SUITE 125 PLM# 2018-00514
TIGARD
Parcel#: 1 S 135AB01002
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 1 2 0 -1 -2
-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:
-Lav/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 2 4 0 0 -2 -4
Current Fixture Value -4 divided by 16= -0.250 Current EDU 1 EDU= $5,650.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change -4 divided by 16= -0.250 over (under) $ (1,412.50)
Enter EDU Change Here -0.250 *
*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: ***CREDIT***
Authorized Name/Signature: BRANDEN TAGGART X2449 Date: 11/5/2018
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
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10220 SW GREENBURG RD 125, TIGARD,
OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2018-00514
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
1 . Cap off fixtures- approved
Violation Summary:
Inspector Contractor