Permit iiiiCITY OF TIGARD PLUMBING PERMIT
- 2 y COMMUNITY DEVELOPMENT Permit#: PLM2022-00193
Date Issued: 5/24/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S110AD12200
Jurisdiction: Tigard
Site address: 10893 SW ANNAND HILL CT
Project: Annand Hill Partition, Lot 1, Primary Subdivision: ANNAND HILL CT PARTITION Lot: 1
Project Description: Interior plumbing for new multi-family dwelling with(2)attached ADUs.
Contractor: RAZORBLADE PLUMBING LLC Owner: BLUE PALOUSE PROPERTIES LLC
18045 SE MAIN ST 333 S STATE ST STE V452
PORTLAND, OR 97233 LAKE OSWEGO, OR 97034
PHONE: 503-550-6280 PHONE:
FAX:
FEES
Quantity Description Date Amount
40 If Sanitary Sewer 05/24/2022 $62.54
Specifics: 3 ea Clothes Washer 05/24/2022 $75.06
g ea Sink 05/24/2022 $225.18
Type of Use: MF 5 ea Tub/Shower/Shower Pan 05/24/2022 $62.55
Class of Work: NEW 5 ea Water Closet 05/24/2022 $125 10
Type of Const: 3 ea Water Heater 05/24/2022 $112,56
Occupancy Grp: 1 12%State Surcharge- 05/24/2022 $79.56
Stories: Plumbing
Total $742.55
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
1
if work is not started within 180 days of
withapprovedplans. Thispermit will expire Y
applicable law. All work will be done in accordance P
PP
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 a obtain a c of the rules
Issued By: ..Ar" Gc5 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.
•
Plumbing Permit Application
Site Utilities FOR OFFICE USE ONLY
City of Tigard ReceivedneteBy: • %sib. �� PennitNo. Lk i`�3
13125 SW Hall Blvd.,Tigard,OR 97223 tan Review s 4Fj
I 0 Phone: 503.718.2439 Fax: 503.598.19RCCC'VE I Distil
Other Permit No.id 0.�_ ,
Inspection Line: 503.639.4175 a L. V LLL... t_ r`
T I G A R D P Date ReadyBy: hms: 63 See Page 2 for
Internet: www.tigard-orgov ` t i a Notified/Method: _„� Supplemental Information
TYPE OF WORK {t• FEE* SCHEDULE
New construction ElDemolian0 (.y 3 For special information use checklist.
.DiNG DIVI`'IOM Description I Qty. I Ea. I Total
❑ Addition/alteration/replacement El Other. a.- S- New 1-2-fa dwellin_s includes 100 ft.for each utih connection
CATEGORY" OF CONSTRUCTION u SFR(I)bath 312.70
0 1-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 ❑Other: Fire sprinkler(_sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: l rs-gq pt1v\(;mod V'Al. G-t Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: -71 ( (it) 02(( od q 72Z`)
I Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name: ,4/1.1// ..14 Mt j/"4,0022011 lei/ Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
j`t.y�f 5- /o c(4/ Rain drain connector l 18.76
v 1 6 Sanitary sewer(no.linear ft.: D ) [ Page 2 (C' ..,5-27
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
DESCRIPTION OF WORK - Backwater valve 12.51
J� Clothes washer 3 25.02 7S,ex,
tie 6.) C.h 1r15t"..C '1*'' a✓ PI 1n vt,✓"5 Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER 0 TENANT Expansion tank 12.51
Fixture/sewer cap 25.02
Name:
Floor drain/floor sink/hub 25.02
Address: Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) lee maker 12.51
( ,APPLICANT,, ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name: a!!Z D�G c/i +, ik.N A, l Medical gas(value:$_) Page 2
[A- \ w) N-1 Primer 12.51
Contact name: �A n1e �A (+�, Roof drain(commercial) 12.51
Address: I �()4 5 5 /�I ai.n 3- 1 ' Sink/basin/lavatoty 1 25.02 LL5, 'r
City/State/ZIP: P02r ,/uj! U46 D f.l 11133 Solar units(potable water) 6/� !64+�.."63
Tub/shower/shower 12.51 `` ''
Phone:(�j3) ,S.SO 6'Z i D )) Fax::( ) pan .S (,.0� •53
E-mail: 't/'G�p✓FJI /ww.4-i p, I. • 1 , t.O w` Urinal 25.02
Water closet .5 25.02 42. i /a
CONTRACTOR
J I'J Water heater '3 37.52 if/a.,�
Business name: - If-. ,1 t' fZG tit,'`j1c'e` ('y+/`•'Vis") Waterpiping/DWV 56.29
Address: Other: 25.02 i '
City/State/ZIP: �r� Subtotal 6 di),a/$
Phone:(3 ') c r-,(-' Fax:( ) Minimum permit fee: $72.50
CCB Lie.: 21'S 111 d,6.1/�3 Plumbing Lie,no.: p it 0 z t' Plan review (25%of permit fee)
���/s J Statesuroharge(12%ofpemutfee)�/y( .B;,SI
Authorized signature: > �� "V i/1// TOTAL PERMIT FE�7 :
Print name: IA(on
Date: S t 3'Z 7i This permit application expires if a permit is not obtained wit n 180 ays
V'[L ti )Ni t'.�,5 after it has been accepted as complete. 74.4 5" -
*Fee methodology set by Tri-County Building Industry Servi B5ard.
I:\BuildingPPermits PLMU-PeimiiApp.d°e 10/01/09 440-4616T(10/02KAMAVEB)