Permit CITY OF TIGARD PLUMBING PERMIT
IIIs ' COMMUNITY DEVELOPMENT Permit#: PLM2022-00466
Date Issued: 11/17/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S126DC00902
Jurisdiction: Tigard
Site address: 9500 SW GREENBURG RD
Project: Crown Oaks Apartments Subdivision: LEHMANN ACRE TRACT Lot: 5
Project Description: Installing new rain drain lines.
Contractor: JKR CONSTRUCTION Owner: OREGON SUNSHINE LLC
PO BOX 2263 BY CARPENTER, HARRIET
GRESHAM, OR 97030 15435 SW WOODWIND CT
BEAVERTON, OR 97007
PHONE:
PHONE: 503-201-2062
FAX:
FEES
Quantity Description Date Amount
940 If Storm Sewer 11/17/2022 $400.22
Specifics: 1 12%State Surcharge- 11/17/2022 $48.03
Plumbing
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $448.25
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: G Permittee Signature: •'C- / r'3 /CGE'Cl/
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
Site Utilities r _a FOR OFFICE USE ONLY
i City of Tigard ' Received
/ / / / �,{,,�•J
• 13125 SW Hall Blvd.,Tigard,OR 97223 y,e` / 2 /// P j
,i B ry Plop Rev.
! I phone: 503.718.2439 Fax: 503.598.t96tl/a Z02 Date/By: Other Pem»tNa.:
r l C A R o Inspection Line: 503,639.4175 • pate Ready/By: ' Ea Page 2 for
Internet: www.tigard-or.gov er �'f - Notified/Method: Supplemental Information
TYPE OF:WORIO C iyi' i` FEE* SCft1i:DULE
❑New construction 0 Demolition For special tuforninrton use checklist
Description I Qty. I Ea. I Total
Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 10011.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
❑ I-and 2-family dwelling ❑CotnmerciaU SFR(2)bath 437.78
hidustrlal SFR(2)bath 500.32
❑Accessory building Multi-family Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler(_sq.IL) Page 2
JOB SITE INFORMATION AND LOCATION. She utilities:
Job site address: +e,a S IA) 4iciototl j'j,u r H � 6 Catch basin or area drain 18.76
J Drywall,leach line,or trench drain 18.76
City/State/ZIP: y» tir fl,t. '3 it Z,j Footing drain(no.linear ft.: 1 Page 2
Suite/bldg./apt.no.: �,f 1 Project name: 19 g)Q �lt, y /1 Manufactured home utilities 50.03
Cross street/directions to job site: [� St.) ffifiV►�u f q `_ _l eft, Manholes 18.76
b , -'„ i �1� _„_J C-.1 i4 tt 8.1tj . J •,` Rain drain connector 18.76
1�VWOVVIn (J� c�rV 1�1 l Sanitary sewer(no.linear ft.: 1 Page 2
Storm sewer(no.linear ft.:,^) (iv Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: 1 S lab DC 4OQ 2 1. I Lot no.: Fixture or item:
Tax map/parcel no.: p2"?j Baekflow preventer 31.27
Backwater valve 12.51
AESCIIIPAfOIJ:OF�'ORIC 25.02
S Clothes washer
WeAw kin cloth tlirgS Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
': PROPERTY OWNER 1 Q TENANT Expansion tank 12.51
-....1`p Fixlure/sower cap 25.02
Floor drain/flelsewe sirdcArub 25.02
Address; if si/p 7 /I/I,tJ /ail A a r 5. 4.4. _.- Garbage disposal 25.02
City/State/ZIP: ( O,'f-1,0„ jA, Oft- 47 -77 1 Hose bib 25.02
Phone:( 0 Z 'D I Fax:(5D 3) &Sa '02`JJ/ tee maker 12.51
KAPPIdCANT:' CI CONTACT PERSON
Interceptor/grease trap 25.02
Medical gas(value:$_) Page 2
Q
Business name: t,D 00 171, 12,51
J Primer
Contact name: .e.„;;; RSc( ttOrt. Roof drain(commercial) 12.51
Address: 1417 iJ W Cf.. Cj'a ICI f_ d%Ari♦^ S-r Sink/basin/lavatory 25.02
City/State/ZIP: �l(.�ryg/y1 "O' Solar units(potable water) 62.54
Phone: ) 10' rW('j:51g Fax::(�)LKO 03.41 Tub/shower/shower pan 12.51
(� Urinal 25.02
Email J{� pati� one i .cow% water closet 25.02
CC COiV[AACIOR Water heater 37,52
Business name: � 1�
J�t\. "'ll S1�`v��l�n Water piping/DWV 56.29
Address: tDd 00 `211o3 L, Other: 25.02
City/State/ZIP: rk. 1 .09., ' 7O3G' Subtotal
'3`. Minintunt(permit fee: $72.50
Phone jl (0 2 Fax 1 •f 2✓.1_/Ly/( P1an review 23%of await fee)
CCB Lie,: _ 14 4 Plumbing Lin tlo.: 6,3 4�1 State surcharge(12%of permit fee)
Authorized signature: I TOTAL PERMIT FEE
This permit npndonexpires if a permit is not obtained within ISO days
Print name: P/}r�f BRA Date: lIl/7 fLZ plkafter it has been accepted as tamplete.
"Pee methodology set by Tri-County Building Industry Service Board.
I:Usuild6an'ermnatPLatU'PermiIAfp,doe 10l01109 410.1616T(10/02/COMAVED)
Plumbing Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Su r t ression Systems:
bra
Footing drain-1"100' 50.03 0 to 2,000 $121.90
2,001 to 3,600 $169.69
Footing drain-each additional 100' 37.52 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 S stems:
Water Service-each additional 100' '
37.52 111..Pittri- 1 s 9 Jil <s L3
Storm&Rain Drain-1st 100' qu, 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
,,i ;- "- - �7,t�t. [ i9 fC3e7' wt' *'. each additional$100.00 or fraction thereof,to
r,�e i j7 t i J.Z,j,r ','�3-- } t r 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
each additional$100.00 or fraction thereof.
(minimum charge-1/2 hour)
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to �_ yy_ ���.x
S'i. �' #A i• . 1.1 4 J'r''. � ,fp,;°{.t�,�, y _'
accurately report fixtures could result in increased sewer fees`. � rs. � , ¢xjuj' tom"
Qdaritity b yF37tt�itg r3�ypex�'. Plan review is required for any of the following.
Fi><lure'ty�e�'or' *r` Yr ge. kepliti"/ Please check all that apply.
worst Performed. Capped}± A .+ etocare!; Cl Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower engineer.
-Jacuzzi/Whirlpool Cl New exterior plumbing site utilities for any complex structure
Car Wash -Each Stall as defined in OAR918-780-0040.
-Drive Thru 0 Medical gas and vacuum systems for health care facilities.
Cuspidor/Water Aspirator ❑ Any multipurpose fire sprinkler system.
Dishwasher: -Commercial 0 Any complex structure as defined in OAR918-780-0040.
-Domestic
Drinking Fountain Submit 2 sets of plans with any of the above.
Eye Wash
Floor Drain/sink. -2"
Fit:
%C r S- yy l•
_,tpdi�Y 6�vy3�y',ak Y°3.S.LL`t�,,.1'.�rl..�'.�r. ?�� �.::��� •,�,.,. � &=`$+�.<..
a" ■ 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./Refrig.Drains
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink. -LavBar non-food related
-Bradley
-Com/Serv/Util food related
-Service *Note: lithe 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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