Permit (6) CITY OF TIGARD PLUMBING PERMIT
■ COMMUNITY DEVELOPMENT Permit#: PLM2022-00329
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 8/26/2022
Parcel: 1 S126DC00902
Jurisdiction: Tigard
Site address: 9500 SW GREENBURG RD
Project: Crown Oaks Apartments Subdivision: LEHMANN ACRE TRACT Lot: 5
Project Description: Building 2.Replacing fixtures and re-piping water and waste lines.
Contractor: MODERN PLUMBING Owner: OREGON SUNSHINE LLC
11120 SW INDUSTRIAL WAY BY CARPENTER, HARRIET
TUALATIN,OR 97062 15435 SW WOODWIND CT
BEAVERTON,OR 97007
PHONE: 503-691-6166 PHONE:
FAX: 503-691-6771
FEES
Quantity Description Date Amount
8 ea Expansion Tank 08/26/2022 $100.08
Specifics: 8 ea Garbage Disposal 08/26/2022 $200.16
16 ea Sink 08/26/2022 $400.32
Type of Use: COM 8 ea Tub/Shower/Shower Pan 08/26/2022 $100.08
Class of Work: ALT 8 ea Water Closet 08/26/2022 $200.16
Type of Const: 8 ea Water Heater 08/26/2022 $300.16
Occupancy Grp: 1 12%State Surcharge- 08/26/2022 $156.12
Stories: Plumbing
Total $1,457.08
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 copy of the rules
Issued By: Permittee Signature:
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 pzx- "��eL)
Building Fixtures 111111111101
City of Tigard Revers Permit No
• 13125 SW Hall Blvd.,Tigard,OR 97223
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 DaieM Ocher Permit No.:
Inspection Line: 503.639.4175 Date Ready/By:: reds: H See Page 2 for
fntemet: www.tigard-or.gov Notificd/Method: S Itu"talInformation
TYPE OF WORK FEE* SCDTH E 'S`
❑New construction ❑Demolition Fora cia!information use checklist
Description Ea. Total
Addition/alteration/replacement Cl Other: New 1-2-family dwtWo s(includes 100 ft.for each utility connection)
- �
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
❑
SFR(2)bath 437.78
1-and 2-family dwelling E]Commercial/industrial
SFR(3)bath 500.32
❑Accessory building Multi-family 25.02
Each additional bath kitchen
❑Master builder ❑Other: Fire sprinkler(__sq.ft.) Page 2
doB&rE"M",Ax'IOtt[„ L"OCkfYUP1 Site ntilitiea:
�� C Catch basin or area drain 18.76
Job site address: e�
Drywcll,leach line,or trench drain 18.76
City/State/ZIP: 'ri [] b9_ 9'- Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: ;- Project name:CrbLzrN 5 Manufactured home utilities 5003
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 R:�) Page 2
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: I s'j ;Z � C)Z Backflow valve ter 31.27
Backwater valve 12.51
DESCRIMON of WORK 25.02
Clothes washer
Dishwasher 25.02
�' Drinking fountain 25.02
;7f r .-I} �4a Ejectorslstunp 25.02
3�+�L C.IJI�� PROPERTY'OWNER [ITENANT Expansion tank 12.51
-- - --- Fixture/sewer cap 25.02
Name: 25.02
Floor drain floor sink/hub
Address: 1 S Garbage disposal 25.02 Qfl,
City/State/ZIP: d Hose bib 25.02
Phone:( ) Fax:( )
fce maker 12.51
❑ APPLICANT 48 CONTACT PERSON Interceptor/grease trap 25.02
Medical gas(value:S�) Page 2
Business name: 12 51
Primer
Contact name: 12 Roof drain(commercial) 12.51
Address: n}jj L - Sink/basin/lavatory 25.02
Citylstate/ZiP. Solar units(potable water) 62.54
Tub/shower/shower pan 12.51 of 04.0
Phone:( ) [_ ( Fax: ( tt- 1 25.02
Urinal
)rmaiL �
ri iY1ar�C1"�t�t LtM�7tnL+ 25.02
Water closet
CO -I T611 � Water heater 37.52 3O 6.[
Business name:M0 Water piping/DWV 56.29
Address: f/JOU ST91AL Other: 25.02
Subtotal
City/State/ZIP:--FL �� ��
) Fax (Sb?) ' ` Minimum permit fee: 572.50
(�
Phone: 3 10q j-G
Plan review (25%of pemtit fee)
CCB Lic: $ Plumbing Lic.no State surcharge(12%of permit fee)
Authorized signature: �s TOTAL PERMIT FEE `
This permapp 'F
L N /^! it application expires if a permit is not obtained within 180 days
Print name: Date:8 fter it has been accepted as complete.
*Fee methodoloagy set by Tri-County Building Industry Service Board.
I:%BuitdingnPmmnsIPLMU-PermitAppdoc 10/01/09 440-4616T(IQWLVM/WE8)
Plumbing Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Suppression S sterns:
-7j5Site Utilitiesry 1Fce t��, T� S itare Fiesta' . `. ` .Perrmt Fee:
50.03 0 to 2,000 $121.90
Footing drain-11,100, 2,001 to 3,600 5169.69
Footing drain-each additional 100' 3752 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 Sstemps:
Water Service-each additional 100' 37.52 Vidna4diisa-'` - I runt Yee .J'
62
Stone&Rain Drain-l st 100' .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 55,000.00 and$1.52 for
triy. Nee(ea) , Total each additional$100.00 or fraction thereof,to
otherW etio is or and including,$Lo.o00.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $14850 for the first 510,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
minimum char e-1/2 hour) and includin 525,000.00•
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first 525,000.00 and$1.45 for
each additional$100.00 or fraction thereof,to
hours(minimum char or 2 hours _
Reinspection Fees 90.00/hr and incl udue 550,000.00.
$50,001.00 and up $742.00 for the first 550,000.00 and$1.20 for
90.00/hr
Additional plan review for revisions each additional$100.00 or fraction thereof.
minimum chng-1/2 hour
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurate( report fixtures could result in increased sewer fees*. plan Review for Plumbin Installations
uantity by Fixture T e Plan review is required for any of the following.
Fixture`Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate ❑ Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: Tub/Shower engineer.
-Jacuzzi/Whirlpool ❑ New exterior plumbing site utilities for any complex structure
Car Wash: -Each Stall as defined in OAR918-780-0040.
-Drive Thru ❑ Medical gas and vacuum systems for health care facilities.
Cus idodwater Aspirator ❑ Any multipurpose fire sprinkler system.
Dishwasher: -Commercial ❑ Any complex structure as defined in OAR918-780-0040.
-Domestic
Drinking Fountain Submit 2 sets of plans with any of the above.
Eye Wash
Floor Drain/sink: 2"
3„ Isometric or Riser Diu ram
4" El 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 Comments regarding fixture work:
Ice Mach./Refri .Drains
Oil Separator Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -IavBar 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 be paid before the
water Extractor plumbing permit can be issued.
Water Closet-Toilet
Urinal
Other Fixtures:
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