Permit (2) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2022-00335
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 6.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
12 ea Expansion Tank 08/26/2022 $150.12
Specifics: 12 ea Garbage Disposal 08/26/2022 $300.24
32 ea Sink 08/26/2022 $800.64
Type of Use: MF 12 ea Tub/Shower/Shower Pan 08/26/2022 $150.12
Class of Work: ALT 12 ea Water Closet 08/26/2022 $300.24
Type of Const: 12 ea Water Heater 08/26/2022 $450.24
Occupancy Grp: 1 12%State Surcharge- 08/26/2022 $258.19
Stories: Plumbing
Total $2,409.79
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. l`/
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"va, Pexm L{- BU W I j
Building Fixtures
City of Tigard 7Date/By:
Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223
■ Phone: 503.718.2439 Fax: 503.598.1960 Other Permit No.:
Inspection Line: 503.639.4175 runs: id See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
1"M`bF WOW,
Fffi"' SCE�LIIE
❑New construction [:1 Demolition Fors afaf In ormation use ckecktes[
Description I Qty. I Ea. Total
Addition/alteration/replacement ❑Other: New i-2-family dwe lia s(includes 100 ft.for each utili connection)
CATSGORY��CrON�f3CtiON, SFR(1)bath 312.70
1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building '�Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler(_sq.ft.) Page 2
JOg y )� iNi7lf)A1�fi1b LaGATII?p Site utilities:
Job site address: oo Q Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
city/State/ZIp: 'r jj b� �
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: 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.:r) Page 2
Water service(no.linear ft.: Page 2
Subdivision: N Lot no.: Fixture or hero:
Tax map/parcel no.: f �j'f (p Backflow preventer 31.27
� � WOR1K Backwater valve 12.51
Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Z1 LA+ Ejectors/sump 25.02
•v��
j D Ow l ®,lNiNr Expansion tank f a 12.51
Name: Fixture/sewcr cap 25.02
Floor drain/floor sink/hub 25.02
Address: Garbage disposal f 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
'b�PUCANT p Interceptor/grease trap 25.02
Business name: Medical gas(value:S_) Page 2
Primer 12.51
Contact name: BEWAJDA RARAMR-E
Roof drain(commercial) 12.51
Address: t 1 N - Sink/basin/lavatory 25.02
City/St8toJZ1 - Solar units(potable water) 62.54
Phone:(534.1,11-(.164sFax::( f- ( Tub/shower/shower pan f 12.51
Email: ` Urinal 25.02
Rag I Man Water closet f 25.02 3D
Water heater / 37.52 ,Z
Business name: Water piping/DW V 56.29
Address: M1 fl)()U ST A Other: 25.02
City/State/ZIP: Subtotal
Phone:(% )fq Fax:(S53)(A f.C Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lic,: $ Plumbing Lic.no.: °
State surcharge(12/°ofpermit fee)
Authorized signature: TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180 days
Print name: t,.) Date: S 2 after it has been accepted as complete.
'"Fee methodology set by Tri-County Building Industry Service Board.
I:lauildingAPamiu\PLMU-PermiVW,doc 10101M 404616T(10(02/C0MfwEB)
Plumbine Permit Application - City of Tigard
Page 2-Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site utilities F te<i road S uare Foot e: Permit Fee:
Footing drain-V 100' 50.03 0 to 2,000 $121.90
Footing drain-each additional l00' 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-1 st 100' 62.54 Medical Gas Sys ms:
Water Service-each additional 100' 37.52 Valuation: Permit l+ew '
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 $72.50 for the first$5,000.00 and$1.52 for
Other Ins Ons'Or Fees �- Fee Imo) T�1
each additional$100.00 or taction 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 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$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 Plumbin Installations
uanfiby FRUhtwu 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
Car Wash: -Each Stall C3 New exterior plumbing site utilities for any complex structure
as defined in OAR918-780-0040.
-Drive Tluu
Cuspidor/Water idor/Water As irator El Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system.
Domestic ❑ Any complex structure as defined in OAR918-780-0040.
Drinking Fountain
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink: 2"
3' -°° Isometric or Riser Dia' am
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
Ice Mach./Refri .Drains Comments regarding fixture work:
Oil Separator Gas Station
Rec,Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -LavlBar 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
Water Extractor fees assessed for the sewer increase must be paid before the
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
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