Permit CITY OF TIGARD PLUMBING PERMIT
III II COMMUNITY DEVELOPMENT Permit#: PLM2020-00448
Date Issued: 12/15/2020
T-1+:7 rtRO 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S135CA00902
Jurisdiction: Tigard
Site address: 11349 SW GREENBURG RD
Project: Quail Court Apartments Subdivision: None Lot: None
Project Description: Interior plumbing for office bathroom:(1)lavatory sink replacing(1)utility sink in same location and (1)water closet
replacing(1)clothes washer in same location.
Contractor: APOLLO DRAIN& ROOTER SERVICE Owner: QUAIL COURT APARTMENTS LLC
853 NE HARLOW RD 3570 SW RIVER PKWY#2307
TROUTDALE, OR 97060 PORTLAND, OR 97239
PHONE:
PHONE: 503-239-8801
FAX: 503-669-9568
FEES
Quantity Description Date Amount
1 ea Lavatories 12/11/2020 $25.02
Specifics: 1 ea Water Closet 12/11/2020 $25.02
1 12%State Surcharge- 12/11/2020 $8.70
Type of Use: COM Plumbing
Class of Work: ALT 22 ea Minimum Fee Adjustment- 12/11/2020 $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: - Permittee Signature: y.
'lam, C .K-./X�—i_
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 Application
Building Fixtures 1.1tCEIV . , (ilt (1111( 1. 1 Sl (lyl ,
City of Tigard and `1'�'-1V 0 5 2020 Received
`.] Date/By: `If ci71) AGO () PentitNo.PL,1 ZC '-06 Ji
n 13125 SW Hall Blvd.,Tigard,OR 97223
I Phone: 503.718.2439 Fax: 503.598.19601y OF TIGARD Plan Review Other Permit Nw asiza ..Ii
1'I ,A R U Inspecti°°Litre: 503.639.4175 V,_; LD I N G DIVISION!
Date neady/By: / Am
El see Pee 2 for 1,�j7t IJ.2)(u�✓
Internet: www.tigard-or.gov Notified/Method: ///�'1 ' �/G' Suppkmentai 1Mormation S(g 1 -
t, t
TYPE OF wtaRlr. .; �4L-
r 79441,4/r E' SCHEDULE
❑New construction ❑Demolition For special inforraalion use checklist
Description ( Qty. I Ea. ( Total
Addition/alteratiott/replacement ❑Other. New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF'CONSTRUCTION SFR(1)bath 312.70
CI I-and 2-family dwelling geommercial/industrial SFR(2)bath 437.78
IDAccessory building )4Mu1ti-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder ❑Other Fire sprinkler( sq.ft.) Page 2
JOH SITE INFORMATION AND LOCATION Site utilities:
Catch basin or area drain 18.76
Job site address: L-1 CI S t{�1 krA r Dryweit,leach line,or trench drain 18.76
�,
City/State/ZIP: i j j r1' � Jr�'tyrFooting drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: 1,J TProject name: Cil„1,9 i L. C(,Jj,(.i,L-r Manufactured home utilities 50.03
Cross street/directions to job site: .416 i-}E=-i e04 e1//13 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.: Backllow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
_ 1 Di I'Q+- q .^ sf C `_` Clothesishw hewarher 25.02
� and
L -� Dishwasher 25.02
a C C.? 1x'-+broorn . 0 Ck ^(l to ` Drinking fountain 25.02
rail 1 i Cl 7 ni 1`.Q+-� Vi i ik ^ a'i I� 4 .- l/�.n fie be< Ejeetors/sump 25.02
PROPERTY OWNER If 0 TENANT ran 41brn Expansion tank 12.51
Name:(j. ' ( 6ti wi ,I.F. ?
S -o )/, ru Fixre/sewer cap 25.02
tVV� Y Floor drain/floor sinks/hub 25.02
Address: •1, orpj.t{� �� Garbage disposal 25.02
City/State/ZIP:: f Ou V O 1 v~+CI 2.. Hose bib 25.02
Phone:( ) U, ll Fax:( ) Ice maker 12.51
.....` APPLICANT ONTACT PERSON Interceptor/grease trap 25.02
Business na p .}�r-�L �/ oc ,` '--9 C Medical gas(value:$_) Page 2
Contact namni ' A�� ` `k {jr• A i'� ... 1l ' Primer 12.51
�me- Roof drain(commercial) 12.51
Address:eea �E ,Ck\I Sink/basin/lavatory I 25.02 ,cy
City/State/ZIP:/Zt� \-i c ) t.£1 O C fl (p Solar units(potable water) 62.54
r ITub/shower/shower an 12.51
Phone:{ '� C� Fax: :( ) P
E-mail' V a Y\A I i c4 I - is n e C[[, Urinal 25.02
v L[) OR Water closet i 25.02 ��
Water beater 37.52
Business rtatne: i,b iJ ti r� n c _n s Water t m W V 56.29
11 � 1 q'') �Q PP B�
Address: 85 k --} (c Y�v\ Other: 25.02
City/State/ZIP:"` t✓`4-e\0..e_, 1 C cl.-1 c )C Subtotal
Phone:(fit:1 -2..,?-"Ci 923C-1, Fax:( ) Minimum permit fee: $72.50 -72, S ci
CCB Lie.: t qzl i _Plumbing Lie.no.:'��j- Plan review (25%of permit fee)
State surcharge(12%of permit fee) �, 7 6
Authorized signature: 05
r TOTAL PERMIT FEE If/, 1
Print name: (t ] t^U - ,9 ) /Y c.� Date: k -i I! This permit appliatiou expires If a permit ie sot obtained within 180 days
4'✓\t�,�t"'11l/� itie S,� \ y �� after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
L1BuiidineYermite\PLMU-PerraitApp.doc 10/01/09 440-0616r(10/01JCOM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qh', Fee(ea) Total Square Footage; Permit Fee:
Footing drain 1"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:
Stone&Rain Drain-1st 100' 62.54 $1 00 to S5 000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 S5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Qty Fee(�) Total each additional S100.00 or fraction thereof to
Other Inspections or Fees 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 fast$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 Review for Plumbing Installations
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Repba! Please check all that apply.
Work Performed: Capped Added Relocate
0 Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower engineer.
-Jacuzzi/Whiilpoo}
Car Wash: -Each Stall 0 New exterior plumbing site utilities for any complex structure
as defined in OAR918-780-0040.
-Drive Thru
Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities.
0 Any multipurpose fire sprinkler system.
Dishwasher: -Commercial
Domestic 0 Any complex structure as defined in OAR918-780-0040.
Drinking Fountain
Eye Wash Submit a,sets of plans with any of the above.
Floor Drain/sink: -2"
Isometric or Riser Diagram
0 Isometric or riser diagram is required for new buildings
-Car Wash Drain
that meet the qualifications above.
Garbage -Domestic non-food
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
Ice MachiRefrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station) ;}ft_ 7'(•"t." ( ' c-n. -}i,?' S.jl,tw "-L
Rae.Vehicle Dump Station 64.72.r,r j ; 1:. i L.,..r c;r,- 9€,.wr .a41-e'
Shower: -St
Gan {Gang
y' p i f tt. �,/ �'u .r c G,ice
Sink: -IaV/Bar non-food rel r .'"i '?•'1 . L(-,-.. Il i
-Bradley
-Com/Serv/Util food related i
-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 be paid before the
Water Extractor
Water Closet-Toilet t plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
Accumulative Sewer Tally
7111 I Tenant Name: Quail Court Apartments SW12 If N/A
-I-l u Site Address: 11349 SW Greenburg Rd PLM t 2020-00448
Parcel#: 1 S 135CA00902
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 (1 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 0 1 2 1 2
-Bradley 5 0 0 0 0 0
-Com/Serv/Util-Food Related 3 0 1 3 0 -1 -3
Swimming Pool Filter 1 0 0 0 0 0
Washer-Clothes 6 0 1 6 0 -1 -6
Water Extractor 6 0 0 0 0 0
Water Closet-Toilet 6 0 0 1 6 1 6
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 2 9 2 8 0 -1
Current Fixture Value -1 divided by 16= -0.063 Current EDU 1 EDU= $5,800.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change -1 divided by 16= -0.063 over (under) S (348.00)
Enter EDU Change Here -0.060 *
*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*** (1)CLOTHES WASIIER IS BEING REPLACED BY(1)WATER CLOSET IN SAME LOCATION AND(1) U'I'ILITY
SINK IS BEING REPLACED BY(1)LAVATORY SINK TS SAME LOCATION.
Authorized Name/Signature: BRANDEN TAGGART X2449 Date: 12/15/2020
Building Division
ote: 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\SewerTa0yShcct_5800_070119.xlsx