Permit (9) CITY OF TIGARD PLUMBING PERMIT
ie COMMUNITY DEVELOPMENT Permit#: PLM2022-00333
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 8/26/2022Parcel: 1S126DC00902
Jurisdiction: Tigard
Site address: 9500 SW GREENBURG RD
Project: Crown Oaks Apartments Subdivision: LEHMANN ACRE TRACT Lot: 5
Project Description: Building 4.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: MF 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:
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
UL' � -,Y.A-
Building Fixtures
City of Tigard D Permit No L ! 3
13125 SW Hall Blvd.,Tigard,OR 97223 pian Reviewa Phone: 503.718.2439 Fax: 503,598.1960 Otho Permit No
Inspection Line: 503.639.4175 Date Ready/By: Juris: 0 See Page 2 for
Internet: www.tigard-or.gov Noti6ed/Method: Supplicasental Information
r�
TYPE OF WORK , FXE* SCEMDULF
❑
Fors New construction Demolition clot in orntation use ckeckUA
Dcseri tion Ea. Total
Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utile connection)
CATEGORY OF CONSTRUCTION i SFR(1)bath 312.70
SFR(2)bath 437.78
❑ I-and 2-family dwelling ❑Commercial/industrial SFR(3)bath 50032
❑Accessory building Multi-family Each additional batb/kitchen 25.02
❑Master builder ❑Other. Fire sprinkler(__sq.ft.) Page 2
jOg g) : p()l pN.AND]LOCATION Site utilities:
Catch basin or area drain 1876
Job site address:
/h 19-1
Drywell,leach tine,or trench drain 18.76
City/State/ZIP: 'F1b V� �I`1 Footing drain(no,linear ft:_) Page 2
Suite(bldg./apt.no.: y Project name: 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:
Backflow preventer 31.27
Tax map/parcel no.: 1 s'j a 1ox3 ___._
Backwater valve 12.51
pF$CRIPITON OF WORK Clothes washer 25.02
PIPF Dishwasher 25.02
N ,�" Y71,1Drinking fountain 25.02
}}�" Ejectors/sump 25.02
Z( L.+� 12.51 )00.08
PROPERTY OWNER ❑ TENANT Expansion tank
Fixturelsewer cap 25.02
Name: Floor drain/floor sink/hub 25.02
Address: S Garbage disposal 25.02 (�+
City/State/ZIP: AVAVIZ 9-7,bn Hose bib 25.02
Phone:( } Fax:( ) Ice maker 12.51
. ___ _. . 25.02
❑ APPLICANT_ * CONTACT PERSON Interceptor/grease trap
Medical gas(value:S ) Page 2
Business name: 12.51
Primer
Contact name: Q Roof drain(commercial) 12.51
Address: I j 1 NbS]' L - Sink/basinAavatory 25.02 '(00,
City/Stafe/ZlCA Solar units(potable water) 62.54
;( Tub/shower/shower pan 12.51
Fax:
Phone:( /_ ( Sa 1- r 25.02
Urinal
E-trail: 1 25.02 �.t Water closet
_ C'CUR Water heater 37.52 30 0.
Business name: MO Waterpiping/DWV 56.29
Address: I l i z. 5 1/00U SZP4 AL LAA4
Other: 25.02
City/State/ZIP:'T" .f (Aj �� Subtotal
(� ) Fax:�3)lq l `4o� Minimum permit fee: $72 50
Phone: 3 (�(-G 1 Plan review (25%of permit fee)
CCB Lic_:
Plumbing Lic.no.: State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
1r � � Date: 2 This permit application expires if a permit is not obtained within 180 days
Print name: after it has been accepted as complete.
'Fee methodology set by Tri-County Building Industry Service Board.
I:tBuiAittg?ctmts\PLMU-PermitAppdoc 10/01109 4104616T(10IO2/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Suppcession Systems:
Site Utilities ' Qty. Fee(ea) Tota' S'ware"Foote e. Pernut
Footing drain-1"100' 50.03 0 to 2,000 $1200
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-I st 100' 62.54 Medical Gas S stems:
Water Service-each additional 100' 37.52
Vaivat><ad: '1rmit;Fees.
Storm&Rain Drain-1 st 100' 62.54 51.00 to$5,000.00 Minimum fee$73.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000,00 $72.50 for the first$5,000.00 and 5 1.5 2 for
Qty Fee(ea) " `Total each additional$100.00 or fraction thereof,to
bther:Ins actions or la'ees . 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 51.54 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 51.45 for
hours minimum charge-2 hours each additional 5100.00 or faction thereof,to
Reinspection Fees 90.00/hr and including 550,000.00.
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
each additional$100.00 or fraction thereof.
(minimum charge-1/2 hour)
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
uantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Relocate Relocate Please check all that apply.
Work Performed: Capped Added
place/ ❑ Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower engineer,
-Jacuzzi/Wbirlpool ❑ New exterior plumbing site utilities for any complex structure
Car Wash: -Each Stall as defined in OAR918-780-0040.
-Drive Thur
❑ Medical gas and vacuum systems for health care facilities.
Cuspidor/Water Aspirator
Dishwasher: -Commercial ❑ Any multipurpose fire Sprinkler system.
El 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 1.11 m
4" ❑ 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 MachJRefri .Drains
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 be paid before the
Water Extractor
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
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