Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2021-00380
Date Issued: 9/9/2021
T f G AL R Tl 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S115AB00200
Jurisdiction: Tigard
Site address: 16100 SW 113TH AVE
Project: Woodspring Apartments Subdivision: WILLOW-BROOK-FARM Lot: 25
Project Description: Replace pressure reducing valve and backflow preventer on club house.
Contractor: ANYTIME PLUMBING& DRAIN CLEANING Owner: HZ WOODSPRING LLC ET AL
PO BOX 495 BY HAMILTON,ZANZE
LAKE OSWEGO, OR 97034 ATTN GENERAL COUNSEL
37 GRAHAM ST STE 200
SAN FRANCISCO, CA 94129
PHONE: 503-894-8241 PHONE:
FAX: 971-255-1965
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 09/08/2021 $31.27
Specifics: 25 Misc Other Fee 09/08/2021 $25.02
1 12%State Surcharge- 09/08/2021 $8.70
Type of Use: COM Plumbing
Class of Work: ALT 16 ea Minimum Fee Adjustment- 09/08/2021 $16.21
Type of Const: Plumbing
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:
1-folly vcuvDe/Wege OwApplicaticv-
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 APPlieati ECEIVED d 12(2
Building Fixtures FOR OFFICE USE ONLY
r 'l ;
City of Tigard EP la ey gl6/Zl t/ > PemhNe.:'iD Lt'I '� 2t-Gt73 PO
Iiii ■ 13125 SW Hall Blvd,Tigard,OR 972 3 OF TIGARLI plan Review
• Phone: 503.718.2439 Fax: 503.598. DatdBy: Other Permit No.:
TIGARD Inspection Line: 503.639.4175 BUILDING DIVISION Date ReadyBy: 1 ® See Paget for
Internet: wKwv.tigard-or.gov Notified/Method: Gq Supplemental Information
• TYPE OF WORK FEE* SCHEDULE
For special information use checklist
❑New construction ❑Demolition
Description I Qty. I Ea. I Total
®Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
`` CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ i-and 2-family dwelling 0 Commercial/industrial
SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building Multi-family Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
' JOB SITE INFORMATION AND LOCATION Site utilities:
_.._ _. .. Catch basin or area drain 18.76
Job site address: + l 0 0 s w 11 St,
$ I I Iel A�' . 0�2 1 Wi - Footing
1,leach line,linear
trench drain age 2
Ci lStatel'LIP: � nn Footing drain(no.linear R:� Page 2
Suite/bldg./apt.no.: I Project name:WO op. ,eigei 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 it.: ) Page 2
Subdivision: • I Lot no.: Fixture or item:
Backflow preventer i 31.27 i I.Z1
Tax map/parcel no.:
Backwater valve 12.51
DESCRIPTION OF WORK
/� A r j/ ,r Q,n /�!r �/ Clothes washer 25.02
C i 141 GL!!V 4 ( �`I 4- r��1 6ie W f t1 Q N - Dishwasher 25.02
C LV O 119 u SE Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
YY 0 0 Ltrr .1�10 if-r Fixture/sewer cap 25.02
Name: 'Y
t Floor drain/floor sink/hub 25.02
Address: {Q lop SW`n I Y `
}{ y` Garbage disposal 25.02
City/StaterZlP: 11 Ei/f )t Q 4_ Ili Hose bib 25.02
Phone:(Sol) 1#72A- 1701 Fax:( ) Ice maker 12.51
0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
// Medical gas(value:S_) Page 2
Business name: A k tin m C•- f wetm oit,Ei. primer 12.51
Contact name: (AS 1(/./tia n(1Aire„ -- Roof drain(commercial) 12.51
Address: Po Vl-l/�tx-4�a- 'S" Sink/basin/lavatory 25.02
City/State/ZIP: ika, O SW(j(] 1 O - '110 Z'# . Solar units(potable water) 62.54
Phone:(SIM) g q LI- q IA'{ Fax::( ) Tub/shower/shower pan 12.51
Urinal 25.02
E-mail: AS1iyZAA yfiratfl Mb2r, us
�.i - Water closet 25.02
CONTRACTOR Water heater 37.52
Business name: AN 1tn E PW` t1N( Water piping/DWV 56.29
Address: 1 0 oDX El"i c other: f7 •-V j 25.02 Z5.02
citylstatelzlP: LA-t�� d F�(� V/�� /+ � � z Q L/NG� Subtotal S(0 r? 1
i� '�j
�� b GI& - g j4, �71f � (f j¢y fE" Minimum permit fee: $72.50 7 Z,S$
Phone:( ) Fax:( )
Iii I Z 4g07J�� Plan review {25%of permit fee)
CCB Lic.: Plumbing Lic.no.: State surcharge(12%of permit fee) Cc If) ✓/
`
Authorized signature: TOTAL PERMIT FEE g(.
jo
Date: r I This permit appfication expires if a permit is not obtained within 180 days
Print name: �S'- �'+ 1(�(/� !JA after it has been accepted as complete.
,{ ""L *Fee methodology set by Tri-County Building Industry Service Board
I:\BuadingsPermitstPLMU-PertnitApp.dee lo/a1109 4.404616T(10/02/COM/WEB)
Dianna Ornelas
From: #Building Permit Technicians
Sent: Monday, September 6, 2021 10:48 AM
To: ashley anytimeplumber.us
Subject: PLM2021-00380 - 16100 SW 113th PI -Woodspring Apartments
Attachments: PLM2021-00380.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.accela.com/TIGARD/Welcome.aspx by searching for the permit record
number PLM2021-00380 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
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