Permit CITY OF TIGARD PLUMBING PERMIT
III _ Permit#: PLM2022-00393
COMMUNITY DEVELOPMENT
TIGARD A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/27l2022
f
Parcel: 2S110DB01500
Jurisdiction: Tigard
Site address: 11375 SW NAEVE ST
Project: Pacific Ridge Apartments Subdivision: PACIFIC RIDGE APARTMENTS Lot: 2
Project Description: Interior plumbing for a new 36-unit apartment building:Building 1.
Contractor: WOLCOTT PLUMBING Owner: PACIFIC RIDGE APARTMENTS LLC
1075 W HISTORIC COLUMBIA RIVER HWY 5285 MEADOWS RD STE 171
TROUTDALE, OR 97060 LAKE OSWEGO, OR 97035
PHONE: 503-667-1781 PHONE:
FAX: 503-667-9891
FEES
Quantity Description Date Amount
36 ea Clothes Washer 10/27/2022 $900.72
Specifics: 36 ea Dishwasher 10/27/2022 $900.72
36 ea Expansion Tank 10/27/2022 $450.36
Type of Use: COM 4 ea Floor Drain/Floor Sink/Hub 10/27/2022 $100.08
Class of Work: ALT 36 ea Garbage Disposal 10/27/2022 $900.72
Type of Conet: 1 ea Hose Bib 10/27/2022 $25.02
Occupancy Grp: 4 ea Primer 10/27/2022 $50.04
Stories: 36 ea Sink 10/27/2022 $900.72
60 ea Lavatories 10/27/2022 $1,501.20
60 ea Tub/Shower/Shower Pan 10/27/2022 $750.60
60 ea Water Closet 10/27/2022 $1,501.20
36 ea Water Heater 10/27/2022 $1,350.72
1 Plan Review 10/27/2022 $2,333.03
1 12%State Surcharge- 10/27/2022 $1,119.85
Plumbing
Total $12.784.98
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 folio e ule aopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may o in a p f rules
Issued By: /42 041 / 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 completio the project.
Approved plans are required on the job site at the time of each inspec n.
Plumbing Permit Application
Building Fixtures FOR OFFICE USE ONLY
City of Tigard Received
Date/By: Permit No.: '�LM +t�r1�f _n/v�]p•7
ilill • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review 1 ` R Lh IJI J J 1 7
= Phone: 503.718.2439 Fax: 503.598.1960 Date/By: /O-/ /-2ci2� O� Other Permit No.:
T I G A 11Il Inspection Line: 503.639.4175 Date Ready/By: Ruts: ® See Page 2 for
Internet: www,tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
New construction ❑ Demolition For special information use checklist.
Description Qty. Ea. I Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
ID1-and 2-family dwelling x Commercial/industrial SFR(2)bath 437.78
El Accessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder ❑Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: (I yi 5 5.w, R0.eU e St.
Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: -re 6_4. Oft. t 1223
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name: sisc. 7 c`01:4 R4... �1^j', Manufactured home utilities 50.03
Cross street/directions to job site: p Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) .1".' Page 2 t
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
{( 6 31� 1 Clothes washer 36 25.02 qa1,72
���e*.r:isr \t4N� i nS . u Y S. Dishwasher 3 / 25.02 e�BV.r�2
J Drinking fountain t� 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER ❑ TENANT Expansion tank 16 12.51 Z/5[1 3b
Name: Fixture/sewer cap 25.02
Address:
Floor drain/floor sink/hub 2/ 25.02 JaO,OR
Garbage disposal 3 i, 25.02 goo,.72
City/State/ZIP: Hose bib ( 25.02 a 5p2_
Phone:( ) Fax:( ) Ice maker 12.51
0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name: Medical gas(value:$_) Page 2
Contact name: Primer 4/ 12.51 50,o q
Roof drain(commercial) 12.51
Address:
ielp Sink/basin/lavatory 46 25.02 9.4,11,12
City/State/ZIP: i
Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan tp 12.51 950, 46
E-mail: Urinal 25.02
CONTRACTOR Water closet CO 25.02 )S A/ 20
Water heater
Business name: �(' 37.52 )3S0,7a
Water piping/DWV 56.29
Address: Other: 25.02
City/State/ZIP: Subtotal 9332,10
Phone:( ) Fax:( ) Minimum permit fee: $72.50
Plan review (25%of it fee) • 3 ,02
CCB Lie.: Plumbing Lic.no.: perm t
State surcharge(12%of pennit fee) I//cr,fis
Authorized signature: TOTAL PERMIT FEE /2t9 qg
Print name: Date: 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-PermiIApp.doe 10/01/09 440-4616T(10/02/COM/WEB) 'aV L ba
gtnW=36
Plumbing Permit Application - City of Tigard ' , A
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee:
Footing drain-1"100' 50.03 0 to 2,000 $121.90
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-1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52 Valuation: Permit Fee:
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 S5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
Other Inspections or Fees 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:
. .Ali
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
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate
El Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower 60 engineer.
-Jacuzzi/Whirlpool ❑ New exterior plumbing site utilities for any complex structure
Car Wash: -Each Stall as defined in OAR918-780-0040.
-Drive Tlim
0 Medical gas and vacuum systems for health care facilities.
Cuspidor/Water Aspirator
-Commercial ❑ Any multipurpose fire sprinkler system.
Dishwasher: - omme ommeic '�6 ❑ Any complex structure as defined in OAR918-780-0040.
-D
Drinking Fountain Submit 2 sets of plans with any of the above.
Eye Wash
Floor Drain/sink: -2" Y
3 Isometric or Riser Diagram
❑ 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 .36
-Commercial food related
-Industrial food related
Ice Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station) Woi-es 1 oaf's Ftooi- clr:,�i..5 6.v2 .frv.v 4-L-1-
Rec.Vehicle Dump Station t..i iq+-av 14.p _4/ -rd.P N2 l le i- ua iwi
Shower: -Gang
-Stall
Sink: -LavBar non-food related
-Bradley
-Com/Serv/Util food related 31:-
-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 3` fees assessed for the sewer increase must be paid before the
Water Extractor plumbing permit can be issued.
Water Closet-Toilet Le
Urinal
Other Fixtures:
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
CITY OF TIGARD FEE AND PAYMENT HISTORY
i 2 13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
TIGARD
PLM2022-00393 - 11375 SW NAEVE ST, TIGARD, OR 97224
Pacific Ridge Apartments
Fee Description Revenue Fee Amount Invoiced Paid Date Paid Payment Receipt# Due
Account Number Method
12%State Surcharge-Plumbing 100-0000-24001 $1,119.85 $1,119.85 $0.00 $1,119.85
Clothes Washer 230-0000-43101 $900.72 $900.72 $0.00 $900.72
Dishwasher 230-0000-43101 $900.72 $900.72 $0.00 $900.72
Expansion Tank 230-0000-43101 $450.36 $450.36 $0.00 $450.36
Floor Drain/Floor Sink/Hub 230-0000-43101 $100.08 $100.08 $0.00 $100.08
Garbage Disposal 230-0000-43101 $900.72 $900.72 $0.00 $900.72
Hose Bib 230-0000-43101 $25.02 $25.02 $0.00 $25.02
Lavatories 230-0000-43101 $1,501.20 $1,501.20 $0.00 $1,501.20
Plan Review 230-0000-43109 $2,333.03 $2,333.03 $0.00 $2,333.03
Primer 230-0000-43101 $50.04 $50.04 $0.00 $50.04
Sink 230-0000-43101 $900.72 $900.72 $0.00 $900.72
Tub/Shower/Shower Pan 2 30-000 0-43 1 01 $750.60 $750.60 $0.00 $750.60
Water Closet 230-0000-43101 $1,501.20 $1,501.20 $0.00 $1,501.20
Water Heater 230-0000-43101 $1,350.72 $1,350.72 $0.00 $1,350.72
Totals for Fees $12,784.98 $12,784.98 $0.00 $12,784.98
Receipt# Payment Method Check# Payor: Receipt Date Receipt Amount
Total Payments:
Balance Due: $12,784.98
CITY OF TIGARD FEE AND PAYMENT HISTORY
q
13125 SW Hall Blvd„Tigard OR 97223
503.639.4171
TIGARD
SWR2022-00185 - 11375 SW NAEVE ST, TIGARD, OR 97224
Pacific Ridge Apartments
Fee Description Revenue Fee Amount Invoiced Paid Date Paid Payment Receipt# Due
Account Number Method
Sewer Connection Fee 500-0000-25500 $238,500.00 $238,500.00 $0.00 $238,500.00
Sewer Inspection -Commercial 230-0000-43118 $45.00 $45.00 $0.00 $45.00
Totals for Fees $238,545.00 $238,545.00 $0.00 $238,545.00
Receipt# Payment Method Check# Payor: Receipt Date Receipt Amount
Total Payments:
Balance Due: $238,545.00
Accumulative Sewer Tally
Tenant Name: PACIFIC RIDGE APARTMENTS SWR# 2022-00185
r i c A t� Site Address: 11375 SW NAEVE ST PEA/# 2022-00393
Parcel#: 2S110DB01500
Fixture Previous Previous Credits Capped Fixture Fixture New New
# value count capped#s value count added# added value total#s total values
Baptisery/Font 4 0 0 0 0 0
Bath: -Tub/Shower 4 0 0 0 0 0
-Jacuzzi/Whirlpool 4 0 0 0 0 0
Car Wash: -Each Stall 6 0 0 0 0 0
-Drive through 16 0 0 0 0 0
Cuspidor/Water Aspirator 1 0 0 0 0 0
Dishwasher: -Commercial 4 0 0 0 0 0
-Domestic 2 0 0 0 0 0
Drinking Fountain 1 0 0 0 0 0
Eye Wash 1 0 0 0 0 0
Floor Drain/Sink: -2 inch 2 0 0 0 0 0
-3 inch 5 0 0 0 0 0
-4 itch 6 0 0 0 0 0
-Car Wash 6 0 0 0 0 0
Garbage Disposal:
-Domestic(to 3/41-IP; 16 0 0 0 0 0
-Commercial(to 5 HP) 32 0 0 0 0 0
-Industrial(over 5 HP) 42 0 0 0 0 0
Ice Machine/Refrigerator Drain 1 0 0 0 0 0
Living Unit 16 0 0 36 576 36 576
Oil Sep(Gas Station) 6 0 0 0 0 0
Rec.Vehicle Dump station 16 0 0 0 0 0
Shower: -Gang(per head) 1 0 0 0 0 0
-Stall 2 0 0 0 0 0
Sink:
-Lav/Bar-Non-Food Related 2 0 0 0 0 0
-Bradley 5 0 0 0 0 0
-Com/Serv/Util-Food Related 3 0 0 0 0 0
Swimming Pool Filter 1 0 0 0 0 0
Washer-Clothes 6 0 0 0 0 0
Water Extractor 6 0 0 0 0 0
Water Closet-Toilet 6 0 0 0 0 0
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 0 0 36 576 36 576
Current Fixture Value 576 divided by 16= 36.000 Current EDU 1 EDU= $6,625.00
Previous Fixture Value 0 divided by 16 = 0.000 Previous EDU
Change 576 divided by 16= 36.000 over (under) $ 238,500.00
Enter EDU Change Here 36.000 *
*Round EDUs to the nearest 1/100th: a count ending in.005 shall be rounded up to.01,and a count ending in.014 or less shall be rounded down to.01.
Notes:
Authorized Name/Signature: BRANDEN TAGGART X2449 Date: 10/26/2022
Building Division
Note: The property owner shall retain the ORIGINAL sewer tally record. If credits exist,this document will serve as a voucher which must be
submitted to the City of Tigard Building Division to redeem credits towards future system development charges.
I:\Building\Sewer Tally\SewerTallySheet_6625_070122.xlsx
Accumulative Sewer Tally
IIII Tenant Name: PACIFIC RIDGE APARTMENTS SWR# 2022-00185
TIGARD Site Address: 11375 SW NAEVE ST PLM# 2022-00393
Parcel#: 2S110DB01500
Fixture Previous Previous Credits Capped Fixture Fixture New New
# value count capped#s 'alue count added# added value total#s total values
Baptiserv/Font 4 0 0 0 0 0
Bath: -Tub/Shower 4 0 0 0 0 0
-Jacuzzi/Whirlpool 4 0 0 0 0 0
Car Wash: -Each Stall 6 0 0 0 0 0
-Drive through 16 0 0 0 0 0
Cuspidor/Water Aspirator 1 0 0 0 0 0
Dishwasher: -Commercial 4 0 0 0 0 0
-Domestic 2 0 0 0 0 0
Drinking Fountain 1 0 0 0 0 0
Eye Wash 1 0 0 0 0 0
Floor Drain/Sink: -2 inch 2 0 0 0 0 0
-3 inch 5 0 0 0 0 0
-4inch 6 0 0 0 0 0
-Car Wash 6 0 0 0 0 0
Garbage Disposal:
-Domestic(to 3/4 HP) 16 0 0 0 0 0
-Commercial(to 5 HP) 32 0 0 0 0 0
-Industrial(over 5 HP) 42 0 0 0 0 0
Ice Machine/Refrigerator Drain 1 0 0 0 0 0
Living Unit 16 0 0 36 576 36 576
Oil Sep(Gas Station) 6 0 0 0 0 0
Rec.Vehicle Dump station 16 0 0 0 0 0
Shower: -Gang(per head) 1 0 0 0 0 0
-Stall 2 0 0 0 0 0
Sink:
-Lav/Bar-Non-Food Related 2 0 0 0 0 0
-Bradley 5 0 0 0 0 0
-Com/Serv/Util-Food Related 3 0 0 0 0 0
Swimming Pool Filter 1 0 0 0 0 0
Washer-Clothes 6 0 0 0 0 0
Water Extractor 6 0 0 0 0 0
Water Closet-Toilet 6 0 0 0 0 0
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 0 0 36 576 36 576
Current Fixture Value 576 divided by 16= 36.000 Current EDU 1 EDU= $6,625.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change 576 divided by 16= 36.000 over (under) $ 238,500.00
Enter EDU Change Here 36.000 *
*Round EDUs to the nearest 1/100th: a count ending in.005 shall be rounded up to.01,and a count ending in.014 or less shall be rounded down to.01.
Notes:
Authorized Name/Signature: BRANDEN TAGGART X2449 Date: 10/26/2022
Building Division
Note: The property owner shall retain the ORIGINAL sewer tally record. If credits exist,this document will serve as a voucher which must be
submitted to the City of Tigard Building Division to redeem credits towards future system development charges.
I:\Building\Sewer Tally\SewerTally Shee t_6625_070122.xls x