Permit irpqCITY OF TIGARD PLUMBING PERMIT
. COMMUNITY DEVELOPMENT Permit#: PLM2021-00081
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 3/1/2021
Parcel: 1 S135DA04600
Jurisdiction: Tigard
Site address: 11161 SW HALL BLVD
Project: Village at Washington Square-Building C Subdivision: 1998-038 PARTITION PLAT Lot: 1-2
Project Description: Units 17-19: replace(3)water heaters and(2)hose bibs.
Contractor: CALIBER PLUMBING& MECHANICAL INC Owner: VILLAGE AT WASHINGTON SQUARE
2615 NW ST HELENS RD LIMITED PARTNERSHIP
PORTLAND, OR 97210 BY CPAH
PO BOX 23206
TIGARD, OR 97281
PHONE: 971-563-1672 PHONE:
FAX:
FEES
Quantity Description Date Amount
2 ea Hose Bib 03/01/2021 $50.04
Specifics: 3 ea Water Heater 03/01/2021 $112.56
1 12%State Surcharge- 03/01/2021 $19.51
Type of Use: MF Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $182.11
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: 1 Permittee Signature:
1 '' �►-� �a� e4-- lee J
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.
m
Plumbing Permit Application RECEIVE
/L z. 2U r
Building Fixtures
Cityof Tigard DEC 2 2 2021 Received ELM i-00027
g Date/By:
2'Z4/Z/ 4 e PennitNo
u 13125 SW Hall Blvd.,Tigard,OR 97223
ITY OFTIGARD Plan Review
111A1I Phone: 503.718.2439 Fax: 503.598.19b(a Other Permit No.:
Date/By:
Inspection Line: 503.639.4175 : J I LD I N G DIVISION Date Read /B lads: la See Page 2 for
T'TCiA1t1J Y Y , E
Internet: www tigard-or.gov Notified/Method: Z' /2/ 4 0Supplemental Information
TYPE OF WORN `' FEE*:SCHEDULE
❑New construction 0 Demolition For special information use checklist.
Description I Qty. I Ea, I Total
%Addition/alteration/replacement 0 Other: New I-2-family dwellings(includes 100 ft.for each utility connection)
~ CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
ElAccessory building Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.IL) Page 2
4.OB;:SITE IN11ORMA'tION:AND LOCATION.;. Site utilities:
Job site address: S�!✓ Hca i a LVD T Catch basin or area drain 18.76
"` ql Drywell,leach line,or trench drain 18.76
City/State/ZIP:
t i'e r el U R f 7D3 Footing drain(no.linear ft.: ) Page 2
+�Suite/bldg./apt.no.: ,./� Project name: + g
W4;5>�f��...r�, Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: Lot no.: Fixture or Item:
Tax map/parcel no.: Backflow preventer 31.27
- + Backwater valve 12.51
DECRIPr ON Pin`9.*:
Clothes washer 25.02
'!1 S II GTc+S ..IT r h tt Dishwasher 25.02
Gt/`// /,7',/ei Drinking fountain 25.02
' Ejectors/sump 25.02
.
PROPERTY OWNER O TENA)4T Expansion lank 12.51
Name: mmitgil p .1Y_C-,f A. A1Z b� i f�fps�0 Fixture/sewer cap 25.02
"� /"1 .J Floor drain/floor sink/hub 25.02
Address: cuv, SW aprflO! h SLitt" Garbage disposal _/ 25.02
City/State/ZIP: ?or+lova r op, q 7 a 9 Hose bib .� ///"""G( 25.02
Phone:(5°03 ) 2 3, . gtov Fax:( ) Ice maker 12.51
0 A1PLICANT :.: {3 CONTACT PERSON Interceptor/grease trap 25.02
,
Medical gas(value:$ ) Page 2
Business name: CCI I it t Pl)umhrIr14 ) Mfthan 1 i TY C p 1 1C.
Contact name: �j' �J Primer 12.51
c i G IM Ghypu O J Roof drain(commercial) 12.51
Address: a 61 s N1&) S...rnf i-'C kris Rd Sink/basin/lavatory 25.02
City/State/ZIP; Por'11 Gn d s C.)R of 1) 40 Solar units(potable water) 62.54
Phone:(503 ) 20 6 751 i Fax::( ) Tub/shower/shower pan 12.51
`_ ft� Urinal 25.02
E-mail: J t1 S i?1 ( j I�(/MIP on icy,js C ter) y
`: Water closet 25.02
C ./iii'RAI. ; Water heater ill 37.52 !r"t 0 l
Business name: C(At loer Pi4mI , i !Y ec.bkiq go,I Tilt. - - Water piping/DWV 56.29
S f
Address: ` 6 1 AAi s,,e1+ fit'�ns r J Other: 25,02 /jf, -(,„C
City/State/ZIP: Po r"}Iar1t! , U R ot'.... It. Subtotal J/«
1 Min
imum permit fee: $72.50
Phone:(1303 ) a>6• �S /v Fax:( ) .
I� Plan review (25%of permit fee) p,, 5/
CCB Lie.: 4)o8+ LiS Plumbing Lic.no.:le/65&..-o �� �
State surcharge(12%of permit fee) / A a i
Authorized signature: TOTAL PERMIT FEE
tf This permit application expires if a permit is not obtained withi 1 0 days
Print name: Isi►urk GA '0 Date;/ja/ J o after it has been accepted as complete, �f 07,</
*Fee methodology set by Tri-County Building bndusuy Service 5i ttir.�ra.
I:tBuilding\pe,nMs\PLMU-PcrmilApp.doc 10/01109 440.4616T(I0/02/COMAVEB) o""""