New 1- 2-family dwellings
(includes 100 ft. for each utilit
y
connection)
SFR(1)bath
SFR(2)bath
SFR(3)bath
Each add. bath/kitchen
sq. ft.)
*Up to 100 Feet
Fire sprinkler (
Site Utilities
Catch basin/area drain
Sanitary sewer (no. linear ft.: )*
Storm sewer (no. linear ft.: )*
Water service (no. linear ft.: )*
Fixture or item
Absorption valve
TYPE OF WORK
Demolition
Other:
CATEGORY OF CONSTRUCTION
Project name:
DESCRIPTION OF WORK
PROPERTY OWNER
Name:
Address:
Email:
CONTACT PERSON
Email:
CONTRACTOR
City/State/ZIP:
Phone:
APPLICANT
Email:
This permit is issued under OAR
918 -780-0060.
Permits are i ssued only to the p erson or contractor doing
the work. This permit application expires if a permit is not obtained within
180
d ays after it has been accepted
a s complete.
Plumbing Permit Application
Permit No.:
New construction
Addition/alteration/replacement
1- and 2-family dwelling
Accessory building
Master builder
Job site address:
City/State/ZIP:
Suite/bldg./apt. No.:
Cross street/directions to job site:
Subdivision:
Tax map/parcel no.:
FEE SCHEDULE
For special information use checklist.
Description
Total
Backwater valve
Clothes washer
Dishwasher
Drinking fountain
Ejectors/sump
Expansion tank
Fixture/sewer cap
Floor drain/floor sink/hub
Garbage disposal
Hose bib
Ice maker
Interceptor/grease trap
Medical Gas (value$ )
Primer
Roof drain ( commercial)
Sink/basin/lavatory
Tub/shower/shower pan
Urinal
Water closet
Water heater
Other:
Other:
$2 7.30
Subtotal
Minimum Permit
Plan Review ( % of permit fee)
State Surcharge ( 12% of permit fee)
TOT AL PERMIT FEE
Backflow preventer
Permits expire if work is not started within
181
days of issuance or if work is
suspended for
180
days.
Phone 503-992-3229
Fax: 503-992-3202
IVR Inspection Request Line 1-888-299-2821
1924 Council Street/P.O. Box 326 Forest Grove, OR 97116
239.50
316.75
386.25
41.72
13.90
13.90
46.35
13.90
13.90
46.35
46.35
46.35
13.90
13.90
13.90
13.90
13.90
13.90
13.90
13.90
13.90
13.
90
13.90
13
.90
13.90
13.90
13.90
13.90
13.90
13.90
13.90
13.90
13.90
13.90
13.90
Qty.
Ea.
Business name:
Contact name:
Address:
City/State/ZIP:
Phone:
Business name:
Address:
City/State/ZIP:
Phone:
CCB Lic No.:
Authorized Signature:
Print name:
Commercial/industrial
Multi- family
JOB SITE INFORMATION AND LOCATION
Other:
City of Cornelius
By City of Forest Grove
Lot no.:
City/Metro Bus Lic. No.:
PB Lic No.
Date:
Dry well, leach line or trench drain
Footing Drain (no. linear ft )*
Manu. Dwelling/Prefab Utilities
Manholes
Rain drain connector
click to sign
signature
click to edit
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