Permit (12) CITY OF TIGARD PLUMBING PERMIT
,11111
COMMUNITY DEVELOPMENT Permit#: PLM2016-00336
13125 SW Hall Blvd.,Ti Date Issued: 10/06/2016
T[Ca. ta. and OR 97223 503.718.2439 9
Parcel: 1 S 126DC00900
Jurisdiction: Tigard
Site address: 9510 SW GREENBURG RD
Project: Greenburg Apartments Subdivision: LEHMANN ACRE TRACT Lot: 5
Project Description: Building 1 -Interior plumbing for new 6 unit apartment building
Contractor: WOLCOTT PLUMBING Owner: GREENBURG ROAD APARTMENTS LLC
1075 W HISTORIC COLUMBIA RIVER HWY 7420 SW HUNZIKER RD SUITE A
TROUTDALE, OR 97060 TIGARD, OR 97223
PHONE: 503-667-1781 PHONE:
FAX: 503-667-9891
FEES
Quantity Description Date Amount
4 ea Rain Drain Connector 10/06/2016 $75.04
Specifics: 6 ea Clothes Washer 10/06/2016 $150.12
6 ea Dishwasher 10/06/2016 $150.12
Type of Use: MF 1 ea Expansion Tank 10/06/2016 $12.51
Class of Work: NEW 6 ea Garbage Disposal 10/06/2016 $150.12
Type of Const: 2 ea Hose Bib
10/06/2016 $50.04
Occupancy Grp: 6 ea Sink 10/06/2016 $150.12
Stories: 6 ea Lavatories 10/06/2016 $150.12
6 ea Tub/Shower/Shower Pan 10/06/2016 $75.06
6 ea Water Closet 10/06/2016 $150.12
6 ea Water Heater 10/06/2016 $225.12
1 Plan Review 10/06/2016 $334.62
11 ea Info Process/Archiving-Lg 10/06/2016 $22.00
$2.00(over 11x17)
1 12%State Surcharge- 10/06/2016 $160.62
Plumbing
Total $1,855.73
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: 52P 1mittee Signature: �' t►
it F«t_
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Applica ' } - , c e 0>�
BuildingFixtures 'F ° �'
MR 01 JR I• I`SI 0\1 1
City of Tigard ,; , Received
114
13125 SW Hall Blvd.,Tigard,OR 97223''1
Date/By: �j -a�f � Permit No.: ,/�,.84 /„
s Phone: 503.718.2439 Fax 503.59$.1960 Plan Review .tJs��
Inspection Line: 503.639.4175 ? .T Date/By Q-�q.,t6 10,1 Other Permit No ,JQ,�j/6wa"23
1 1 . A k I) p Date Read/B
Internet: www.tigard-or.gov •_ Jury I ® See Page 2 for
a ) P Notified/Method ( 1
�"P�-��#�, �'a eSuppiementallnformahon
TYPE`OF ,iii, .,!,; I 1 �- .. .
New construction � o ��* ��
❑Demolition For special information use checklist.
Description
❑Addition/alteration/replacement 0 Other. Qty. Ea. Total
New 1-2-family dwellings(includes 100 ft.for each utility connection)
cA►TEGq y,oF Ct)NN:;!RUCTIt3N SFR(1)bath -"t..>
312.70
❑ 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
❑Accessory building ig Multi-family SFR(3)bath 500.32 rr,
❑Master builder ❑Other:
Each additional bath/kitchen 25.02 11
Fire sprinkler( sq.ft.) Page 2
TE
JOB SIINFORI AT1OT. AND fLOC TION
Site utilities:
Job site address: Gi Sci) , -5Utz%9, A_,9_,(..-3}2..(., .- --0Catch basin or area drain 18.76 r�N
City/State/ZIP:�� I Drywell,leach line,or trench drain 18.76
4 0 O G1?z 2-3
Footing drain(no.linear ft.:
Suite/bldg./apt.no.: / Project name: A -__) Page 2 l�
( e � 2a � p 1S Manufactured home utilities 50.03
Cross street/directions to job site: Manholes
18.76
��ri k)51x2_�.: f k.A:.-t- Rain drain connector y 18.76 -Ty, pj
Sanitary sewer(no.linear ft.: ) Page 2
Stonn sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.:.._) Page 2
Subdivision:
1
Lot no.: Fixture or Item:
Tax map/parcel no.: /S / a(p"Ds-(1 Q o lit Backflow preventer 31.27
23ESqu,IP'T1oN,OR WORK Backwater valve 12.51
Clothes washer
Ne„A.) CO.1/4..)`N -fr uc I1o/3 ,/NA 25.02 LSO 11-
' Y x ��t �''� Dishwasher
��� (.v 25.02 10.0--
Drinking fountain 25.02
6' li ro LT-ED Ejectors/sump 25.02
PROPLRT+ TEN Expansion tank
�. '. '� , YET ' � Pa J 12.51 l 2 ,
Name: _ wit" cai r, koeu,ohtit• &A Fixture/sewer cap- 25.02
Address: -142_0 SLA3 t 1\^\ti A.).- ..� J. It
Floor drain/floor sink/hub 25.02
1 `�� Garbage disposal 25.02 %' ,128
City/State/ZIP: -1l 6 4,2. ( (37-z.-z-"-,
Hose bib
) � Z 25.02 SD.�'f
Phone:(
3 C27 ., k k 521 Fax:( ) Ice maker 12.51
0,APPLICANT " CONTACT PERSON interceptor/grease trap 25.02
Business name: �e_6e Medical gas(value:$ ) Page 2
Contact name:'-"/:: ),A. ,�,2--.. ZL a Primer 12.51
Address: �� 1 Roof drain(commercial) 12.51
AuIV" +c�.e. U 5,„%_ Sink/basin/lavato
_City/State/ZIP:`�kutle ( 17i 25.02 7,ap.L�
Z Z Solar units(potable water) 62.54
Phone:(`5)--)t�(L,, �.,,. 5 Fax::( ) Tub/shower/shower pan G 12.51 -7'"06
Ematt:�t-r` `L `-- 3Ct.j:YlZeS' ���lts �c��� Urinal
1 25.02
CO>+i IRAQ O1 Fater closet (P 25.02 / D,I
Business name: Water heater ( 37.52 ZZS.1.Z.
t7Lc,�' t.J.rii !L'
(wi Waterpiping/DWV o
Address: 05 t 1..0 � ( 56.29
a. _ i V ' t Other: 25.02
City/State/ZIP:-'r?C 'DA L c. oL c/-706o c7
Subtotal 13 38.yci
)
��j `� ' Fax:( ) Minimum permit fee: $72.50
Phone:(
CCB Lic.: Plan review (25%
22"Z(� Plumbing Lic.no.�R _ of permit fee) 3 3 c/t 6 a
Authorized signature: State surcharge(12%of permit fee) /60.6/
`J
TOTAL PERMIT FEE 1833, 7a
Print name:-TeC � � Date: a _ 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.
I:'Buildige‘Permits\PLMU-PennitApp.doc 10,01,09
440-4616T(10,02 COM-WEB)
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 PLM2016-00336
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
1 . Interior plumbing final for bldg. #1 - approved
Violation Summary:
Inspector Contractor