Permit (90) CITY OF TIGARD PLUMBING PERMIT
' . COMMUNITY DEVELOPMENTIN
Permit#: PLM2015-00378
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/23/2016
Parcel: 1 S 126DC00900
Jurisdiction: TIGARD
Site address: 9510 SW GREENBURG RD
Project: Greenburg Apartments Subdivision: LEHMANN ACRE TRACT Lot: 5
Project Description: Plumbing site utilities for 6 new apartment buildings.Scope of work to include:(6)catch basins/area drains,(4)
manholes,(6)rain drain connectors,800'of sanitary sewer,2700'of storm sewer&600'of water service.
Contractor: DUKE CONSTRUCTION&EXCAVATION LLC Owner: GREENBURG RD APARTMENTS LLC
17860 SE FOSTER RD 7420 SW HUNZIKER RD, STE A
DAMASCUS, OR 97089 TIGARD, OR 97223
PHONE: 503-492-0530 PHONE:
FAX: 503-492-0760
FEES
Quantity Description Date Amount
6 ea Catch Basin or Area Drain 06/23/2016 $112.56
Specifics: 4 ea Manholes 06/23/2016 $75.04
6 ea Rain Drain Connector 06/23/2016 $112.56
Type of Use: MF 800 If Sanitary Sewer 06/23/2016 $325.18
Class of Work: NEW 2700 If Storm Sewer 06/23/2016 $1,038.06
Type of Const: 600 If Water Service 06/23/2016 $250.14
Occupancy Grp: 1 Plan Review 06/23/2016 $478.39
Stories: 1 12%State Surcharge- 06/23/2016 $229.62
Plumbing
17 ea Info Process/Archiving-Lg 06/23/2016 $34.00
$2.00(over 11x17)
Total $2,655.55
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
or dire estions to NC by calling 503.232.1987 or 1.800.332.2344.
Issued By: 0 /0 , / Permittee Signature:
I
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.
Pl4mbin2 Permit Application '
Site Utilities FOR OFFICE: l SF ONLY N2n15 „
N CIV 1 2.
City of Tigard Received
, Dpaattee:y:.400 6...- -06;;;V Permit NV:24"40/.5" ..eAt.,,,,3,zi?
il 13125 SW Hall Blvd.,Tigard,OR 97213,1 I .''s ut. i i(vAtiti
' ill Phone: 503.718.2439 Fax: 503.598.1560
III Plan Revieb402
/04//,s'-- Other Permit No.:374;2ei:c.ete 4g
Inspection Line: 503.639.4175 3731,1)ING n :`1. Date RYendy/By: 4 izz___DA
TIGARD .5„.... Juris• tpSpeleemPaegneta2i Informationfor
Internet: www.tigard-or.gov Notified/Method:Ar..•-/1.-Tr••••-/
..,
TYPE OF NVOIM /4/445" Th -d4 FEE* scHEDEILE
/
For special information use checklist
11( New construction 0 Demolition
Description Qty. I Ea. Total
0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
. ‘. .
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
SFR(2)bath 437.78
El 1-and 2-family dwelling CI Commercial/industrial
SFR(3)bath 500.32
0 Accessory building kMulti-family
Each additional bath/kitchen 25.02
0 Master builder tr,......,,, Other: Fire sprinkler( sq.ft.) Page 2
tth -XI, 7-.) /0_,
95/e), 496.-A B Sffir INFORMA7MN ILOCATION Site utilities:
f Catch basin or area drain
(4) 18.76 Ageoe
Job site address: .r....Ser-' 5 L ) .?E.E 13-Lkoar u .--- ri" . -
Drywell,leach line,or trench drain - 18.76
City/State/ZIPh71(.,A 0_1p 0 a_. 9 -7 2_2-3
Footing drain(no.linear ft.:___.) Page 2 '
Suite/bldg./apt.no.. I Project name: &s2..Et„.3-,,L30_6 Ai,-„, Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 1 18.76 k'
Rain drain connector
(P 18.76
C:--YF p I-PFL)elk- B 00 r 5 0 F •i-L5 LA-
Sanitary sewer(no.linear ft.:t'W) Page 2 32.c,1/3
Storm sewer(no.linear ft.:7:740 Page 2 /0
Water service(no.linear tt.:(9,C0) Page 2 zcc ,)
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.:
Backflow preventer 31.27
Z
Backwater valve 12.51
DESCRIPTION OF WORK
Clothes washer 25.02
A-41/-f 0 i A/C-• --5 175-1477"77 -3- /C-CV1--- Go Alez' Dishwasher 25.02
r9-/-1/9A-7-741 1/7-,g- C1/i.-i6/A/ -62--5 964(74- Drinking fountain 25.02
Ejectors/sump 25.02
tlit
PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Fixture/sewer cap 25.02
Name: C')R,EE A-N. )1.Q.(.) .--?C> • FA`PAI larrii%e...tOrS Li-C•-• ____.
Floor drain/floor sink/hub 25.02
Address: -7 Lf22 SUL) IAL)kr%_‘ ...i.R----- -l-). ••.)t-r*_ 'N Garbage disposal 25.02
City/State/ZIP: -7-k u A 2_0 0 12__ ei 7Z.2-3 Hose bib 25.02
Phone:(5•o ) (0 7.,,c . 9).3 Fax:(51)3) le 2S • 9510 Ice maker 12.51
521 AprucANT C:1 CONTACT PERSON Interceptor/grease trap 25.02
Medical gas(value:$___) Page 2
Business name: E\I•E,(-L 02_E E,0 i5L)tt_t>E,(2 5
Primer 12.51
Contact name: T2)A ._,...e,__. ----R .-1-z-t_APf Roof drain(commercial) 12.51
Address: 1,17_0 , ,.,0 ., Rc•• . -5%..)t-r-c_ 1 Sink/basin/lavatory 25.02
City/State/ZIP: "7-i( A e_6 o(2_ ci 1"z-z- Solar units(potable water) 62.54
Phone:(co. 6 oP b . Do L.t s Fax::(5,9I) (p-z s. '7c3z, Tub/shower/shower pan 12.51
_
Urinal 25.02
E-mail: ---D A.sz.,,,,,L....c.-_, 3 fv\v3,-A,--R9 p EitsTIE s. c
- '''''' Water closet 25.02
CONTRACTOR 1.- 1 ": Water heater 37.52
Business name: --re,14,4._ a.,..,'irk u-E.,1-io 0 .v.-- E)(ad&ne,n.) 1-4-e- Water piping/DWV 56.29
Address: ' /-7 Q6,6 CarCe.- 647 r,..e-- kt) Other: 25.02
City/State/ZIP:T pt 5e_t,__ 6 e_ 570c/9' Subtotal
Phone:(56.3 ) Fax:( _ 4/l, 91 5.5 Minimum permit fee: $72.50
y 92,-. 0 53a ) ‘
• ti-1 Cs.3? Plan review (25%of permit fee) 54,6-72•-"*.- -
CCB Lic.: f -.."7 513 .//2-tiet Plumbing Lic.no.: 5- 5-go P6 . „3,1,9,9,49-State surcharge(12%of permit fee) 2,.....+175)-1"
.---- _ 1/1117
Authorized signature: __...-sz.,._74sktr,t , t-)2.1 tog 1,66- TOTAL PERMIT FEE Ma-774
Date: i I /S This permit application expires if a permit is not obtained within 180 days
Print name: . p,R,,i' , ....1-..z_L...4 fvfafter it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
Aetif Fft. $3/.00
IABuilding\PermitskPLMU-PermitAppxloo 10/01/09 440-4616T(10/02/C0
--7;f7mAvr"4-1-'7=3"'
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-151100' / 50.03 50,03 0 to 2,000 $121.90
Footing drain-each additional 100' 3 37.52 1�Z 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer-1st 100'. / 62.54 �r c 7•9/ 7,201 and greater $327.54
Sewer-each additional 100' 7 37.52 2(,2 6)(
Water Service-1st 100' 62.54 G 51
Medical Gas Systems:
Water Service-each additional 100' c' 37.52 /67 eo
Storm&Rain Drain-1st 100'
/ 62.54 iv z Valuation: Permit Fee:
S $1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 2fv 37.52 97s,6'1.- $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
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*.
Quantity by Fixture Type Plan Review for Plumbing Installations
Fixture Type for Replace/
Work Performed: Capped Added Relocate Plan review is required for any of the following.
Baptistry/Font Please check all that apply.
Bath Tub/Shower ❑ 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 0 New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial 0 Medical gas and vacuum systems for health care facilities.
-Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain 0 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"
,
Car Wash Drain
Isometric or Riser Diagram
Garbage Domestic-non-food
0 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 Mach./Refrig.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
Washer-Clothes *Note: If the fixture work under this permit results in an
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:
I:\Building\Permits\PLMU PermitApp.doc 2
I
•
Site Utilities — Plumbing Permit Application
•
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. ❑ map&tax lot# ❑ project name ❑ site address ❑ suite number
❑ zoning LI applicant name 0 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-PermitApp.doc 12/30/05
EVERGREEN BUILDERS LLC
Date: 11/3/15
To:City of Tigard
From: Evergreen Builders
Re:Greenburg Road Apartments SDR2014-00002
Attached please see the application for the site utilities permit including 2 full sets of civil plans
Thank you,
Daryl Retzlaff
Evergreen Builders
503.680.0045
daryl@jmwproperties.com
7420 SW Hunziker Rd., Suite D • Tigard, OR 97223 • Office: (503) 625-1183
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9510 SW GREENBURG RD, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2015-00378
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
1 . Plumbing final for site utilities, to include test results for back flow devices- approved
Violation Summary:
Inspector Contractor