Permit f
CITY OF TIGARD PLUMBING PERMIT
" 111 'IN COMMUNITY DEVELOPMENT Permit#: PLM2021 00080
Date Issued: 2/26/2021
T i G„ RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S135DA04600
Jurisdiction: Tigard
Site address: 11159 SW HALL BLVD
Project: Village at Washington Square-Building B Subdivision: 1998-038 PARTITION PLAT Lot: 1-2
Project Description: Units 20-26: replace(7)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 02/26/2021 $50.04
Specifics: 7 ea Water Heater 02/26/2021 $262.64
1 12%State Surcharge- 02/26/2021 $37.52
Type of Use: MF Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $350.20
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/ke1- �. ,, Permittee Signature: ,7,,,17 /L,s�4/ 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.
Plumbing Permit Application /i 2z to t "
Building Fixtures RECEIVED
City of Tigard Received / / Permit No
a 13125 SW Hall Blvd.,Tigard,OR 97223 `'C 2 2 2021Pl
III Date/By: �Z / I � ire 2�LI'IX�O�t�
t{ Phone: 503.718.2439 Fax: 503.598.1T7�-Y OF TIGARD Date/By:an Review Other Permit No.:
YJ
Inspection Litre: 503.639A 175 Date Read /e furls: ® See Page T1c,P,1t1) BUILDING DIVISION Y o yli a 2Inf
Internet: wwtv.tigard-or.gov Notified/Method: �ZI �� Supplemental Information
TYPE OF VyORIC •FEE* SCHF..DULE
❑New construction ❑Demolition For special information use checklist.
Description l Qty. I Ea, I Total
Addtttou/alteta lion/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
i TEOORY O1''CONSTRUCTION SFR(1)bath 312.70
❑ 1-and 2-family dwelling CICommercial/industrial SFR(2)bath 437.78
❑Accessory building Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
JOB ,bui,E,I140.(. MATION-AND 1,.00ATION Site utilities:
LV Catch basin or area drain 18.76
Job site address:
SL1/ ;'1k++1 j fl Drywell,leach line,or trench drain 18.76
City/State/ZIP:
P ew elr OR f DD3 Footing drain(no.linear'ft.: ) Page 2
Suite/bldg./apt.no.: Project name:+,,, f�Qo Manufactured home utilities 50.03
Cross street/directions to job site: W Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: 1 Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.:,,_) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
12.51
DESCI(;.L PTION OF't?1tORK Backwater valve -
-�^ ii �+_ }} Clothes washer 25.02
-f-r) 1i G-c L A' r heoders - Dishwasher 25.02
GAL A/% at 'va-. Drinking fountain 25.02
• Ejectors/swap 25.02
: tank
J'ROPERT�' OVyrJtvIt ;❑`�'EI�ANT Expauston 12.51
" Fixture/sewer cap 25.02
Name: P `_n'r- ArActcle'Ibtx cSj
Floor drain/floor sink/hub 25.02
Address: g 3 SW Caps f! /I 1Yfw4Jy Garbage disposal 25.02
City/State/ZIP: po.+1,4d r oil of7 3 9 Hose bib -- 25.02 f S'r2 ,yg"
Phone:(503 ) 3 39 y0 Fax:( ) Ice maker _. 12.51 -
. ❑ APii.i4„AI�T . ', { it n'ter PERSON hiterceptor/grease trap 25,02
Medical gas(value:$ ) Page 2
Business name: COL I iber P kim LAG i Met bon t
Contact name: J Primer 12.51
TUS t4CA GirearptAS D Roof drain(commercial) 12.51
Address: t 6 j g- rvw S.,►h t Of lens Rd Sink/basin/lavatory 25.02
City/State/ZIP: por 1I 4ri d , v R oat) io Solar units(potable water) 62.54
Phone:(503 ) 206 751 t Fax::( ) Tub/shower/shower pan 12.51
E-mail: "' f !! Urinal 25.02
. to c ti� Cad t lrer Ale(bon/CA_is C eer -
CON G01 Water closet 25.02
} Water heater 37.52 ���
Business name. i iper P tm6� 1 l/ .ehe at. I plc, Water piping/DWV 56,29
Address: `Q g is- AAA) s vq} tie tens Re) Otter: 25,02 310,t.,..,p'
City/State/Z1P: poril,i4d , oR tt' .. J0, Subtotal 14 -36
Minimum permit fee: $72.50
Phone:(-O3 ) a06. �Srt 1 Fax:( )
CCB Lie.: ad®5 Q y, - Plumbing Lic.no.:/'/6SF Plan review (25%of permit fee) ;7, �,.�-
State surcharge(12%of permit fee)
Authorized signature: `-eirc"2='. TOTAL PERMIT FEE j3, 1
Is 'This permit application expires if a permit is not obtained within Mt days
Print name: tNSI Gnt 1t�10 Date;/a/aa/aoafter it has been accepted as complete, 5OQc 2,0
*Fee methodology set by Tri-County Building Industry Service oard:0
1:1Buiidiug\Perrniis1PLMU-PcrmitApp.doc 10/01/09 440.4616T(10/02/COM/WEB)