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IICITY OF TIGARD PLUMBING PERMIT
'` COMMUNITY DEVELOPMENT Permit#: PLM2021-00502
Date Issued: 4/20/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S135BC01100
Jurisdiction: Tigard
Site address: 11117 SW GREENBURG RD
Project: Greenburg Space Center Subdivision: None Lot: None
Project Description: Site utilities: (1)new catch basin.
Contractor: ROBINSON CONSTRUCTION CO Owner: GREENBURG SPACE CENTER LLC
8060 NE WALKER RD 4804 NW BETHANY BLVD STE 1-2#243
HILLSBORO, OR 97124-9321 PORTLAND, OR 97229
1
PHONE: 503-226-1285 PHONE:
FAX: 503-645-5397
FEES
Quantity Description Date Amount
1 ea Catch Basin or Area Drain 12/09/2021 S18 76
Specifics: 1 12%State Surcharge- 12/09/2021 $8.70
Plumbing
Type of Use: COM 54 ea Minimum Fee Adjustment- 12/09/2021 $53.74
Class of Work: ALT 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 f rth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
Issued By: Permittee Signature: e//ct��L
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 // /J 1 4
. 5;tc, (Al-,Ilfik-- .
City of Tigard C; Received �
Date/By: ;Pi '/ Permit No.: a
�I ; /
13125 SW Hall Bivd.,Tigard,OR 97223 Plan Review G/M�4 "v �
Phone: 503.718.2439 Fax: 503.598.1960 iei;'i.i ) r Other Permit No.:
Inspection Line: 503.639A175 "+ NilDate/By: /t/
T I G A R I) Date Ready/By: / orris: See Page 2 for
Internet: www.tigard-or.gov Notified Method f�,�/��i Supplemental Information
ci pi,TYPE OF WORK 1 1 1 it ,� FEE* SCHEDULE
is tilt ,_', r` t
❑New construction ❑Demolition or special information use checklist.
Description Qty. I Ea. Total
Q 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 ®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
JOB SITE INFORMATION AND LOCATION Site utilities:
Catch basin or area drain 1 18.76 eg. 7Job site address: 11117 SW Greenburg RD
c,
Drywell,leach line,or trench drain 18.76
City/State/ZIP:
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name: l- 'ti'S‘,^, ��r-, (a,.
iy-e. Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
iSanitary 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
New catch basin
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Fixture/sewer cap 25.02
Name: Greenburg Space Center LLC
Floor drain/floor sink/hub 25.02
Address: 4804 NW Bethany Blvd Suite 1-2#23 Garbage disposal 25.02
City/State/ZIP: Portland, OR 97229 Hose bib 25.02
Phone:(503 )757-9011 Fax:( ) Ice maker 12.51
® APPLICANT ® CONTACT PERSON Interceptor/grease trap 25.02
Medical gas(value:S ) Page 2
Business name: VLMK Engineering + Design
Primer 12.51
Contact name: Amy Tallent Roof drain(commercial) 12.51
Address: 3933 S Kelly Ave Sink/basin/lavatory 25.02
City/State/ZIP: Portland, OR 97239 Solar units(potable water) 62.54
Phone:(503 )222-4453 Fax: :( ) Tub/shower/shower pan 12.51
Urinal 25.02
E-mail: amyt@vlmk.com
Water closet 25.02
CONTRACTOR Water heater 37.52
Business name: Robinson Construction Water pipingiDWV 56.29
Address: 8060 NE Walker Rd Other: 25.02
City/State/ZIP: Hillsboro, OR 97124 Subtotal Jr'7
Phone:( 503)645-8531 Fax:( ) Minimum permit fee: S72.50 71,5-0
Plan review (25%of permit fee)
CCB Lie.: 63147 Plumbing Lie.no.: 34-460BP State surcharge(12"/u of permit fee)
-7t.
Authorized signature: j;lie...ri- TOTAL PERMIT FEE it%J •,p
Print name: Amy Tallent Date: 11/30/21 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.
1:\Building\Permits\PLMU-PermitApp.doc 10,01,09 440-4616T(10/02/COM/WEB)