Permit CITY OF TIGARD PLUMBING PERMIT
IC COMMUNITY DEVELOPMENT Permit#: PLM2022-00509
TIGAR.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/15/2022
Parcel: 2S112DA01100
Jurisdiction: Tigard
Site address: 6600 SW CARDINAL LN
Project: Spec Space Subdivision: 1995-098 PARTITION PLAT Lot: 2
Project Description: Landlord work prior to TI:(4)hose bibs and 10 ft.of piping for future grease trap.
Contractor: PMSI LLC Owner: PACIFIC REALTY ASSOCIATES LP
8295 NW EVERGREEN PKWY#204 ATTN: N PIVEN
HILLSBORO, OR 97124 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-466-2222 PHONE:
FAX: 503-466-2211
FEES
Quantity Description Date Amount
4 ea Hose Bib 12/15/2022 $100.08
Specifics: 1 ea Water Piping/DWV 12/15/2022 $56.29
1 12%State Surcharge- 12/15/2022 $18.76
Type of Use: COM Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $175.13
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:
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 RECEIV _''
Building Fixtures
City of Tigard SEP 2 6 202 "`'°°I'
)atcHy //x • yy remit No.:
■ 13125 SW flail Blvd..Tigard.OR 97223 �j1 O remit
Plan Review
!. Phone: 50 i.7182439 Pax: 503.598.1960 Other Permit No.
CIT1Y1 OF^TIGAF3BtteB) � ?n1a-av 7
Tii�:1GD Intern Inspection line: 503.639.4175 3UILDiNG DIVI�sI Rcadv'By: )iris: S Sec agc2 for
Internet: www.tieardroegov , of ificd:Metiwd: Supplemental information
1
TYPE OF WORK FEE* SCHEDULE
❑ New construction 0 Demolition For special information use checklist.
Description I Qty. I Ea. I Total
Addition/alteration/replacement 0 Other: New I-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
0 1-and •-family dwelling j -stimmercial/industrial
.. SFR(2)bath 43778 -._-
buildingSFR(3)bath 500.32
❑Accessory ❑ Multi-family
Each additional bath/kitchen 25.02
❑ Master builder ❑Other: _ Fire sprinkles( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: (.0 eQ C)U S.�) Cr„...i-Z,,ricsA 1--lnn f11
Catch basin or area drain 18.76
Urywell,leach line,or trench drain 18.76
CityState/ZIP: 'T,ey,„rd G 6_. q1 Ze�.,q
V Footing drain(nu,linear IL:_) Page
Suiteibldg/apt.no.: Project name: 2CC
SAL Z.�kp Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no. linear II.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: Lot no.: Fixture or item:
Tax maprparcel no.: Hackluw preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
�*x Clothes washer 25.02
( J t rh ci S'i- Ln.X .kk.r p �).1 \' C - -- Dishwasher 25.02
1 C7�Y YZ n (�
(� �
� 'lOS2 � b CA'i 5 � �Q T /A-'ur-i: Drinking fountain 25.02
/, �_0. Skv� Ejectors/sump 25.02
PAP PEATY OWNER s-TENANT Expansion tank 12.51
Name: pCC • FixturNsewer cap 25.02
Floor drain/floor sinkihuh 25.02
Address:62( c-.> e_u C a Cc-\ !1!.'`\ Lo,,Cl_to
Garbage disposal 25.02
City/State/ZIP: .-'1oord I 0ca__ C ❑ Z.Z<-I Hose bib l.i 25.02 /J),LT
Phone:( ) Fax:( ) Ice maker 12.51
.i2CAPPLIcANT 0 C1oN'rACT PERSON Interceptor:grease trap 25.02
Business name: Medical gas(value:$_) Page 2
A P IV\�TL _C. -
Contact name: Primer 12.51
rrli; ea_'�-1 0~C'�r S (commercial)`-� Roof drain(commercial) 12.51
Address: R24s- JU[ E /CYcy-C-C(') y2�LWV t SAC 7 Sink/basinlavatory 1 25.02
City/State/ZIP: H I I\ bU ro. r) 1'?„ a--) ,Z y Solar units(potable water) 62.54
Phone:(5Q1)L.Vo�.o_�ZZ Z I Fax::( ) Tub/shower/show er pan 12.51
/.'' Urinal 25.02
E-mail: o.r'Ls.CSG Yv'l-,l-S�f-A-e&'tS . CAM Watercloset 25.(12
CONTRACTOR
1 � Water heater 37.52
Business name: pMs� 11_L.C- Waterpiping7)WV t 56.29 I-4.21,
Address: S 2_4s- /VG rve. - -cr_rn V>k',✓.l.I s ? 2.64 Other: 25.02
City.State)ZIP: 1.4>ilSlx,rr.,I v � C�--11Z�I Subtotal />-7n 37
Phune:(CO7,)(,tom to-2. Z zZ Fax:( ) Minimum permit fee: 572.50
��y 7 Plan review (25%ofpermit fee)
Sgx�CCB Lic.: ' cp Plumping Lie.no.: 3i _4434 pp., /�' 7�
State surcharge(121 e of permit fee)
Authorized signature: ,_ _ / TOTAL PERMfr FEE /7) .13
Print name:A 2 u�( e,�.c Date: e JZ�J2 This permit application tits,been
it a permit is notcomplete.
obtained within 180 days
l 1✓✓t r "" S after it has been accepted as complete.
'Fee methodology set by To-fatuity Building Induct0 Service Board.
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