Permit CITY OF TIGARD PLUMBING PERMIT
11 COMMUNITY DEVELOPMENT Permit#: PLM2021-00271
Date Issued: 7/6/2021
T t-G AR.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S110DA10400
Jurisdiction: Tigard
Site address: 10771 SW LADY MARION DR
Project: Trillium Hill Sales Trailer Subdivision: TRILLIUM HILL Lot: 4
Project Description: Water service to temporary sales trailer.
Contractor: MALMEDAL ENTERPRISES INC Owner: WEEKLEY HOMES LLC
PO BOX 207 1111 N POST OAK RD
BANKS, OR 97106 HOUSTON,TX 77055
PHONE: 503-324-0759 PHONE:
FAX: 503-324-0580
FEES
Quantity Description Date Amount
230 If Water Service 06/28/2021 $137.58
Specifics: 1 12%State Surcharge- 06/28/2021 $16.51
Plumbing
Type of Use: COM 90 Investigation Fee 06/28/2021 $90.00
Class of Work: OTR 11 Investigation Plumbing 12% 06/28/2021 $10.80
Type of Const: State Surcharge
Occupancy Grp:
Stories:
Total $254.89
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: ./, • Permittee Signature:
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.
Plumbine Permit Applicatic EC +v 1 u
Building Fixtures hok 0I1.1(1 tsl: ONI 1
JUN 1 8 2021 Received
h �,/ PCnnil Nu
City of Tigard Dete'B": 41-1e 24 4 L..„..124 , -Oo -
• 13125 SW Hall Blvd.,Tigard,OR 9720I Y O l IGARD Plan Review Other Penult No.:
• I Phone: 503.718.2439 Fax: 503.5 anyrwING DIVISION DatriBy:
Inspection Line: 503.639.4175 Daze Ready/By: he Ix: la See Page for
Internet www.ligard-or.gov NotificdNethod: Sup.-mental Information
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®New Construction 0 Demolition Far special i formatfon axe checklist.
Description I Qh. { Fa. I Total
0 Addition/alteration/replacement 0 Other: New I-2-family dwellings(includes 100 ft.for each utility connection)
t:'; - n0.11`. 1,1 4 w Fy+te`x "-°..l ' , '" .a s V: i ,` •, . ' c°i+i.^#.1 SFR(1)Web 312.70
® 1-and 2-family dwelling 0 Commcrcialfmdustrial
SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ❑Multi-family Each additional badtlkitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
r f s rr " `' ` e^ '* n^ �tr ' d'pt1'Vik'°qi' Site utilities:
ll i Me.. t Y N .3I''` fin`
Joh site address:10771 SW Lady Marion Drive Catch basin or area drain 18.76
Drywcll,leacftline,or trench drain 18.76
City/State/ZIP:Tigard/OR/97224
rooting drain(nu.linear ft.:20 Page 2
Suitc/bldg./opt.no.: Project name:Trillium Hill Manufactured home utilities 50.03
Cross street/directions to job site:SW 109'h AVE AND SW Lady Marion Dr holes 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 lt.: ) Page 2
Subdivision:Trillium Hill I Lot no.: Fixture or item:
Tax map/parcel no.:2SI1ODA11400 Backflow preventer 31.27
.-:.v 1' ! ,, •. m=c Ica -s,.�yt tF, ,-,' Sa Buck water valve 12.51
1- h� . x`n'x�` 0.l � „., :,' )shrk e •i clothes washer 25.02
Add water service to temporary sales trailer. Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
);r li: 00 0, 3 x-s 5 .' , °' .s. , ' ,,a'1. ar•:•w Expansion tank 12.51
Name:David W'eekley Homes Fixture/sewer cap 2S-U2
Floor drain/floor sink/hub 25.02
Address:1905 NW l69'h Place Suite 102 Garbage disposal 25.02
City/State/ZIP:Beaverton,OR 97006 Hose bib 25.02
Phone:(503)213.4415 Fax:( ) Ice maker 12.51
Nw? t ' .1 -?r 6 .',�w`r y/ n r InteTee oil ease 25.02
w�ee,e'' fi.1. J�1.. , ,�
r:�`7'ar � .,. -„'dd# IkT k'^u% 7i,ti.'�, ...[, t v pt
Business name:David Weekky Homes Medical gas(value:S_ 1 Page 2
Primer 12.51 1
Contact name:Michele Schiedkr - Root'drain(commercial) /12.51
Address:1905 NW 169'h Place,Suite 1112 Sink/basin/lavatory �1 .- 25.02 25.02
City/SlatefLIP:Beaverton/OR/97006 Solar units(potable water) 62.54
•
���� Phone:(503)213-4415 , Fax::( ) Tub/shower/shower pan 12.51
. E-mail:mschiedier@dwhomes.com Urinal 25.02
�/ 5.02 25.02
,e. �M n
. ems ^(?,_' <. -rb 1=j ±.4:;4' .% Water heater 37.52 37.52
Business name:Malmedal Plumbing Waterpiping/DWV 56.29
Address:PO Box 207 Other: 25.02
City/State/ZIP:Banks/OR/97106 Subtotal
Phone:(503)324-0759 l:ax:( ) Minimum permit fee: S72.50
CCB Lie.:102535 Plumbing Lie.no.:34-276PB Plan review (25%of permit Ike)
( State surcharge(12%of permit fee)
Authorized signature: ...) TOTAL PERMff PEE (S y ,Q9
Print name:Carolina Malmedal Date: 6/18/21 This permit application expires If a permit Le not obtained within 180 days
after it has been accepted as complete.
"Fee methodology set by Tri-Coouun�uy Building Industry Service hoard
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