TYPE OF WORK
New construction Demolition
Addition/alteration/replacement Other:
CATEGORY OF CONSTRUCTION
1- and 2-family dwelling Commercial/industrial
Accessory building Multi-family
Master builder Other:
JOB SITE INFORMATION AND LOCATION
Job site address:
City/State/ZIP:
Suite/bldg./apt. no.: Project name:
Cross street/directions to job site:
Subdivision:
Lot no.:
Tax map/parcel no.:
DESCRIPTION OF WORK
PROPERTY OWNER TENANT
Name:
Ad
dress:
City/State/ZIP:
Phone: (
)
Email:
APPLICANT CONTACT PERSON
Business name:
C
o
ntact name:
Address:
City/State/ZIP:
Phone: (
) Email:
CONTRACTOR
Business name:
Address:
City/State/ZIP:
Phone: (
)
CCB lic.:
PB Lic. no.:
Authorized signature:
Print name:
Date:
FEE* SCHEDULE
For special information use checklist.
Description Qty. Ea. Total
New 1- 2-family dwellings (includes 100 ft. for each utility connection)
SFR (1) bath 239.50
SFR (2) bath 316.75
SFR (3) bath 386.25
Each additional bath/kitchen 41.72
Fire sprinkler ( sq. ft.)
By sq ft
Site utilities
Catch basin or area drain 13.90
Drywell, leach line, or trench drain 13.90
Footing drain (each 100 ft.: ) 46.35
Manufactured home utilities
Manholes 13.90
Rain drain connector 13.90
Sanitary sewer (each 100 ft.: ) 46.35
Storm sewer (each 100 ft.: ) 46.35
Water service (each 100 ft.: ) 46.35
Fixture or item
Absorption valve 13.90
Backflow preventer 13.90
Backwater valve 13.90
Clothes washer 13.90
Dishwasher 13.90
Drinking fountain 13.90
Ejectors/sump 13.90
Expansion tank 13.90
Fixture/sewer cap 13.90
Floor drain/floor sink/hub 13.90
Garbage disposal 13.90
Hose bib 13.90
Ice maker 13.90
Interceptor/grease trap 13.90
Medical gas (value: $ )
By value
Primer 13.90
Roof drain (commercial) 13.90
Sink/basin/lavatory 13.90
Tub/shower/shower pan 13.90
Urinal 13.90
Water closet 13.90
Water heater 13.90
Other: 13.90
Other:
Subtotal
Minimum permit fee $ 27.30
Plan review ( ___% of permit fee)
State surcharge (12% of permit fee)
TOTAL PERMIT FEE
P
lumbing Permit Application
City of Forest Grove
This permit application expires if a permit i s not obtained within 180 days after it has been
accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board
Phone: 503-992-3229 Fax: 503-992-3202
1924 Council Street/P.O. Box 326, Forest Grove OR 97116
IVR Inspection Request Line: 888-299-2821
Email:
Permit Number:
City/Metro Bus Lic:
click to sign
signature
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