Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2022-00128
Date Issued: 7/7/2022
T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S110DB01400
Jurisdiction: Tigard
Site address: 11375 SW NAEVE ST
Project: Pacific Ridge Apartments Subdivision: 2008-057 PARTITION PLAT Lot: 1
Project Description: Site utilities for(2)new apartment buildings.
Contractor: JTSC LLC Owner: TIGARD COVENANT CHURCH INC
5285 MEADOWS RD, SUITE 171 11321 SW NAEVE ST
LAKE OSWEGO, OR 97035 TIGARD, OR 97224
PHONE: 503-308-7324 PHONE:
FAX: 503-684-0102
FEES
Quantity Description Date Amount
10 ea Catch Basin or Area Drain 06/06/2022 $187.60
Specifics: 5 ea Drywell,Leach Line or Trench 06/06/2022 $93.80
Drain
Type of Use: MF 1168 If Footing Drain 06/06/2022 $462.75
Class of Work: ALT 6 ea Manholes 06/06/2022 $112.56
Type of Const: 8 ea Rain Drain Connector 06/06/2022 $150.08
Occupancy Grp: 578 If Sanitary Sewer 06/06/2022 $250.14
Stories: 1905 If Storm Sewer 06/06/2022 $775.42
362 If Water Service 06/06/2022 $175.10
2 ea Backflow Preventer 06/06/2022 $62.54
17 ea Backwater Valve 06/06/2022 $212.67
50 Misc Other Fee 06/06/2022 $50.04
1 Plan Review 06/06/2022 $633.18
1 12%State Surcharge- 06/06/2022 $303.92
Plumbing
Total $3,469.80
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 • •low the rules adopted by the Oregon
Utility Notification Center. Those rules are set A forth in OAR 952-001-0010 through OAR 952-00 :r90. You may o• ain a copy of the rules
/ 11 Aly/ f/i p)
Issued By: / /e Permittee Signatu -•
Call 503.639.4175 by 7:00 a.m.for the next available" (Pection date.
This permit card shall be kept in a conspicuous place on the jobs. until completion of the project.
Approved plans are required on the job site at the time of each inspection.
,
Plumbing Permit Application S3" Z 221 2.-
Site Utilities RECEIVE 1 FOR OFFICE USE ONLY
City of Tigard Received
03f3/ ZU1.e.. Permtxn.: ��(XJ��B
IN ■ 13125 SW'Hall Blvd.,Tigard,OR 97223 FEB 2 2 2022 Plan Review
■ Phone: 503.718.2439 Fax: 503.598.1960 J ^y / OtherPermitNo.:
Date/By: S_
Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: Gj'r ® See Page 2for
"'" g g BUILDING DIVISIO�roti5ed/Method: `j . /t) Supplemental
Internet: www ti ardor. ov rE S lemental Information
TYPE OF WORK , ,,4-,( Jed it._ FEE* SCHEDULE
®New construction ❑Demolition For special information use checklist
Description I Qty. I 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
El1-and 2-family dwelling ElCommercial/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
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:ll Naeve St. Catch basin or area drain 10 18.76 187.60
'sw /! 3 5-r //,3 1c /tau-vr S
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,Oregon 97224
Footing drain(no.linear ft.: ) 1168 Page 2 650.35
Suite/bldg./apt.no.: I Project name: Pacific Ridge Apartments Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 7 18.76 131.32
Lots directly behind Tigard Covenant Church on corner of 99W&SW Naeve Street. Rain drain connector 8 18.76 150.08
Sanitary sewer(no.linear ft.: ) 838 Page 2 362.70
Storm sewer(no.linear ft.: ) 1331 Page 2 550.30
Water service(no.linear ft.:_) 1132 Page 2 475.26
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: 2S110DB1500,2S110DB1400 Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Two multi-family buildings with parking lot.
Dishwasher 25.02
'/..,. Drinking fountain 25.02
Ejectors/sump 25.02
in PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name:Tigard Covenant Church Fixture/sewer cap 25.02
41
Floor drain/floor sink/hub 25.02
Address:11321 SW Naeve Street
Garbage disposal 25.02
City/State/ZIP:Tigard,OR 97224 Hose bib 25.02
Phone:( 503 )639-3084 Fax:( ) Ice maker 12.51
iiii ID APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name:JTSC,LLC Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Jesse Nemec Roof drain(commercial) 12.51
Address:5285 Meadows Road,Suite 171 Sink/basin/lavatory 25.02
City/State/ZIP:Lake Oswego,Oregon 97035 Solar units(potable water) 62.54
Phone:( 503 )730-8620 Fax::( ) Tub/shower/shower pan 12.51
E-mail:jnemec@jtsmithco.com Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: JTSC ,LLC. Water piping/DWV 56.29
Address: Other: 25.02
City/State/ZIP: Subtotal 256i=:6'T`-
Phone:( ) Fax:( ) Minimum permit fee: $72.50
Plan review (25%of permit fee) .b25:g0
CCH Lie.: 200237 Plumbing Lic.no.:
State surcharge(12%of permit fee) .91
Authorized signs . zs" �' .. TOTAL PERMIT FEE -.243s'42
Print name: Jesse Nemec Date: 2/16/2022 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 Boa rd.�_
I:\Buildmg\Pemas\PLMU-PemdtApp.doc 10/01/09 440-4616T(10/02/COM/WEB) 4 , i
•
Plumbing Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee:
Footing drain-1"100' 1 50.03 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 16 37.52 3,601 to 7,200 $169.69
60D.32 3,601 to 7,200 $233.20
Sewer-1st 100' 1 62.54 62.54 7,201 and greater $327.54
Sewer-each additional100' 8 37.52 300.16
Water Service-1st 100' 1 62.54 62.54 Medical Gas Systems:
Water Service-each additional 100' 11 37.52 412.72 Valuation: Permit Fee:
Storm&Rain Drain-1st 100' 1 62.54 62.54 $1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 13 37.52 487.76 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
pand 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*.
Quantity by Fixture Type Plan Review for Plumbing Installations
Fixture Type for Bep18Ce/ Plan review is required for any of the following.
Work Performed: Capped Added Relocate
Baptistry/Font Please check all that apply.
Bath Tub/Shower El Any new commercial building with water service 2"and
Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OARS 18-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic El Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
-3"
Isometric or Riser Diagram
Car Wash Drain
Garbage -Domestic-non-food ❑ Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice MachJRefrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
L:\Building\Permits\PLMU_PermitApp.doc 2
Ill
Site Utilities — Plumbing Permit Application
I ill
Plan Submittal Requirements
TIGARD
A plumbing permit for site utility plumbing work is required for sanitary sewer, storm sewer
and potable water systems on private property.
1. SITE PLAN and vicinity map showing the geographic location (fully dimensional, drawn
to scale) labeled with:
A. El map& tax lot# ❑ project name ❑ site address ❑ suite number
El zoning ❑ applicant name ❑ phone number
B. North arrow.
C. Scale (architectural or engineering only).
�D. Street names.
E. Building pads with project location.
2. PLUMBING PLANS-Two (2) complete sets, civil only.
All details listed below shall be incorporated into the plumbing plans:
A. Storm drainage plan showing:
1) Finish elevations throughout the developed site.
2) Grade breaks determining area serving each catch basin.
3) Location of catch basins.
4) Pipe size.
5) Type of material.
6) Slope of piping.
7) Manholes and field drains.
8) Cleanouts provided for each 100 feet or fraction thereof.
9) Roof drain laterals specifying cleanouts at each upper terminal.
10) Location of existing or proposed connection to a public sewer line.
B. Utilities plan showing:
1) Sanitary sewer line location,pipe size, type of material, slope of piping,manholes
and cleanouts provided as required for storm.
2) Size and location of domestic water piping and drainage.
3) Proposed location of connection to a public water or sanitary sewer line.
I:\Building\Permits\PLMF-PennitApp.doc 12/30/05