Permit CITY OF TIGARD PLUMBING PERMIT
} a COMMUNITY DEVELOPMENT Permit#: PLM2021-00315
Date Issued: 7/23/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S110DD00109
Jurisdiction: Tigard
Site address: 11061 SW SUMMERFIELD DR
Project: Summerfield Condominiums Subdivision: WILLOW-BROOK-FARM Lot: 15
Project Description: Replace building shut off valve.
Contractor: ANYTIME PLUMBING& DRAIN CLEANING Owner: SUMMERFIELD ASSOCIATES LLC
PO BOX 495 BY GREYSTAR RS NW LLC
LAKE OSWEGO, OR 97034 1125 NHW COUCH ST STE 450
PORTLAND, OR 97209
PHONE: 503-894-8241 PHONE:
FAX: 971-255-1965
FEES
Quantity Description Date Amount
25 Misc Other Fee 07/23/2021 $25.02
Specifics: 1 12%State Surcharge- 07/23/2021 $8.70
Plumbing
Type of Use: MF 47 ea Minimum Fee Adjustment- 07/23/2021 $47.48
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
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
Issued By: Permittee Signature: ) ij
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 ApplicatiRECEIVED E--1 i Ile z
Building Fixtures FOR 01410. USE ONLY
Ci of Ti and JUL 1 6 Za2I Received PermitNo
t3 g Date/By:7/z i jzi .<(.'C' pal 202.1-d0 31
13125 SW Hall Blvd.,Tigard,OR 97 ry Plan Review
Phone: 503.718/439 Fax: 503.598. AO' G��IGAR� Other Permit No.:
Date/By:
Inspection Line: 503.639.4175 BUILDING DIVISION DateReady/By: ] yqs_ ® See Page 2for
11GP.RD 7722 7-1 �(1 ��1^1,T.1,.
Internet: www.tigard-oi.gov Notified/Method: Supplemental lnformadoa
TYPE OF WORK t 11.t ri.._- itsii-Z,.E FEE* SCHEDULE
❑New construction ❑Demolitionr special information use checklist
Description I Qty. I Ea. . Total
cik Addition/alteration/replacement ❑Other: New 1-2-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
SFR(3)bath 500.32
❑Accessory building [X Multi-family Each additional bath kitchen 25.02
❑Master builder ❑Other: Fire sprinkler(___sq.ft.) Page 2
JOB SITE INFORMATION'� AND LOCATION Site utilities:
Job site address: I I 11
yyLL ill q i)0 Catch basin or area drain 18.76
Ti nElI D Drywell,leach line,or trench drain 18.76
City/State/ZIP: Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I I UW I Project name: S'A�m fi16�b (- Manufactured home utilities 50.03
Cross street/directions to job site: �� Ly Manholes 18.76
_(/ r 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
DESCRIPTION OF WORK Backwater valve 12.51
//�� { 0 r y �//� `/ Clothes washer 25.02
Y'Li) I i MIpI Sh VCI O `A,I Yt. Dishwasher 25.02
Y I�I,�.C,I;I f 1.n 1" Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER 0 TENANT Expansion tank 12.51
Name: _wry!n{i 1 i 1f--f Fixture/sewer capFl 25.02
I I i 1 J 1 C W �i l O,^,- )�0 b e. Garbageoer drain/floor i so sink/hub 25.02
Address: > k) I R disposal 25.02
City/State/ZIP: -n f!I/t-� 04 01-124,4t. Hose bib 25.02
Phone:(S)3) 1p SA- 1 O A I Fax:( ) Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name: 14 "I l i t /0 I,i4 rn 0I N ii Medical gas(value:$_) Page 2
1I�,�VA� ,/� G. 1'� Primer 12.51
Contact name: A S I-1 t. I t1 f i I L Lti -(J L Roof drain(commercial) 12.51
Address: t o 6/ D1( LI t Sink/basin/lavatory 25.02
City/State/ZIP: L/t1� OS`5 a D r 0 I a 10�4 Solar units(potable water) 62.54
Phone:("5-0`h) %'GI it- g2L4 I Fax'.::( ) Tub/shower/shower pan 12.51
E-mail: S I +^e AnTh��/1 e i 1 V 1j`. a S. Urinal 25.02
A h � ) m Water closet 25.02
�n Water heater 37.52
JCONTRACTOR
Business name: kw iA'r I Y l PI,IA ( I I.(0 Water t ' W V 56.29
n -°11 "l p'Ptng/D
Address: i Q 0 OX t.1-4s Other: I 25.02 IS,07
City/State/ZIP: ',prize Osvr(I,;'•'i l t 0 1 O Q_ 110 h-- Subtotal 1IS,c07,
Phone:(SOyi D6t-_ g j41 Fax:( ) Minimum permit fee: $72.50 1/,.�✓
03
Plan review (25%of permit fee)
CCB Lie.: 1 A 1 1,01 4j Plumbing Lic.no.: Sol tt• ``��
/� ` State surcharge(12%of permit fee) S,-1 D
Authorized signature: O /1� i� TOTAL PERMIT FEE 4'I,qv
Print name: /k Sit-IU V \ I Date: I ' // This permit application expires if a permit is not obtained within 180 days
u l i `' I/l i III after It has been accepted as complete.
"Fee methodology set by Tri-County Building Industry Service Board.
I:\Building'Permils'3LMn-PermitApp.doc 10/01/09 440-461b1(10/01ICOM/WEB)
Dianna Ornelas
From: #Building Permit Technicians
Sent: Thursday,July 22, 2021 6:00 PM
To: ashley anytimeplumber.us
Subject: PLM2021-00315 - 11061 SW Summerfield Dr
Attachments: PLM2021-00315.pdf
Hello Ashley,
This permit is ready to issue and the balance due is $81.20 (see attached invoice).
The fees can be paid online at https://aca-prod.acceia.com/TIGARD/Welcome.aspx by searching for the permit record
number PLM2021-00315 under the Building tab. Payment can be made by'card' for a 3%service fee or select the
'check' payment option and there is no service fee.
Please email the permit technicians at TigardBuildingPermits@tgard-or.gov once the fees are paid so that we can
issue the permit and email a copy.
Thank you.
Dianna L. Ornelas
Building Division Services Supervisor
City of Tigard I Community Development
13125 SW Hall Blvd I Tigard, OR 97223
503-718-2430 Direct 1503-718-2439 Permits
1