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Permit
CITY OF TIGARD PLUMBING PERMIT 114 ' COMMUNITY DEVELOPMENT Permit#: PLM2021-00089 and OR 97223 503.718.2439 13125 SW Hall Blvd.,Ti Date Issued: 3/4/2021 Tft;AliT7 9 Parcel: 2S112BD00100 Jurisdiction: Tigard Site address: 14620 SW 76TH AVE Project: Bonita Villa Apartments Subdivision: DURHAM ACRES Lot: 65 Project Description: repairing 400 ft of storm drain within center of property Contractor: CLOG BUSTERS LLC Owner: HOUSING AUTHORITY OF WASHINGTON COUN 2900 SE CORNELIUS PASS RD, STE 549 111 NE LINCOLN ST #200-L HILLSBORO, OR 97123 HILLSBORO, OR 97124 PHONE: 503-680-8947 PHONE: FAX: FEES Quantity Description Date Amount 400 If Storm Sewer 03/04/2021 $175.10 Specifics: 1 12%State Surcharge- 03/04/2021 $21.01 Plumbing Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $196.11 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: \ ` ,„{n t O Permittee Signature: ��H�� \Vl`r-� �-�jl...� � �� 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 ApplicatiJEC t\ED Site Utilities MAR 0 3 2021 City of Tigard CITY OF TIGAHv Received D3-o 20 Permit No.:" Lvu^ c9' 13125 SW Hall Blvd.,Tigard,OR '�j''i [DING DIVISION Date/By: Plan Review Phone: 503.718.2439 Fax: 503.5':. Date/By: Other Permit No.: T'I G 'It I:) Inspection Line: 503.639.4175 Date Ready/By: orris: BI See Page 2 for Internet: www.tigard-or.gov Notified/Method:K T/'� �/���►� Supplemental Information i it 1�*��F1 r�; 'x `�(t4�1"� �-: ' ' ��17 Ni �a� ,�` ri � d p far x�" a .;;;i1 �� :141 'TYPE OF , r i°; t ' - i'� °.� ,tl�/ FEE* SCHED � 5� a ❑New construction ❑Demolition For special information use checklist. Description j Qty. I Ea. I Total N Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) : dz fli 1 ° TEGORYO CC ��rON w4",' SFR(I)bath 312.70 ID1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building M Multi-family - Each additional bath/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 a; x a JO SiTE 1NFOR141 �t , ;P �L©CATIO ,.s,i 4 o 'c �"�?; Site utilities: I� Y P.k.,� c w �7 7PNd�tlNl� 94 Job site address: 14650 SW 76th Ave Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: Portland OR 97224 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: 1 Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 LOCATED ON THE EAST SIDE OF SW 76TH AVE APPROXIMATELY Rain drain connector 18.76 170 FEET SOUTH OF SW BONITA RD Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.40Q 1 Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 v s)i + ii iAta,ia i r Backwater valve 12.51 Clothes washer 25.02 Rain drain repair of two buildings within center of property and tie into Dishwasher 25.02 Storm Drinking fountain 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER 0 TENANT Expansion tank 12.51 Name: Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 �` ,1" kiii) �A ,,. Interceptor/grease trap 25.02 Medical gas(value:$ ) Page 2 Business name: Clog Busters LLC Contact name: Primer 12.51 Tricia Wolfe Roof drain(commercial) 12.51 Address: 2900 SE Cornelius Pass Rd #549 Sink/basin/lavatory 25.02 City/State/ZIP: Hillsboro, OR 97123 Solar units(potable water) 62.54 Phone:(503)680-8947 Fax::( ) Tub/shower/shower pan 12.51 E-mail: Tricia@clogbustersllc.com Urinal 25.02 ;, i i ,al`� t h;, hq C� iii �) P Water closet 25.02 , ��� r ,'CONTRACTOR ,. ,,,No°i�`ion,li rt,,,: Water heater 37.52 Business name: Clog Busters LLC Water piping/DWV 56.29 Address: 2900 SE Cornelius Pass Rd #549 Other: 25.02 City/State/ZIP: Hillsboro, OR 97123 Subtotal Phone:(503)680-8947 Fax:( ) Minimum permit fee: $72.50 CCB Lie.: 200212 Plumbing Lie.no.:PB1383 Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: `--_ TOTAL PERMIT FEE Print name: Tricia Wolfe Date:03/03/21 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. 1:\Building\Permits\PLMU•PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)