Permit (3) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2014-00255
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/06/2014
Parcel: 2S 103DD00700
Jurisdiction: Tigard
Site address: 13765 SW PACIFIC HWY
Project: Colony Properties Subdivision: MELROSE Lot: 7-8
Project Description: Replace approximately 70'of water service from meter to(2)buildings, 13675&13775 SW Pacific Hwy.
Contractor: LOVETT EXCAVATING Owner: GILBERTSON, LLOYD
PO BOX 86280 DARLENE J
PORTLAND,OR 97286 15980 SW COLONY PLACE
TIGARD, OR 97223
PHONE: 503-737-8423 PHONE:
FAX: 503-288-1630
FEES
Quantity Description Date Amount
70 If Water Service 08/06/2014 $62.54
Specifics: 1 12%State Surcharge- 08/06/2014 $8.70
Plumbing
Type of Use: COM 10 ea Minimum Fee Adjustment- 08/06/2014 $9.96
Plumbing
Class of Work: ALT
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
or direct que .•• o OUNC by calling 503.232.1987 or 1.800.332.2344.
Issue. By: Permittee Signatuk
�/✓L ! -
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.
Aug. 4. 2014 1 :48PM Lovett Excavating No. 1644 P. 1
Plumbing Permit Applica
Building Fixtures 3 $$Jfl 1(III OFFI(E 1 S U\E1
IN City of Tigard d t{ l PermitNo.: n�d-f j,�l�rs6�S�-
I3125 SW Hell Blvd.,Tigard,OR 97 G 4 2 14 Plan Phone: 503.718.2439 Fax: 503.596.19605 O1herPermitNo.:
T t r.-\r.n Inspection Line: 503.639.4175 CITY OF f IGAR D Date ReadyBy. kris: 13 See Page 2 for
Internet www.tigard-or.gov • Notified/Method: Supplemental Information
K. t01"" ? lye .', )�11,:(( ''o!>,.i.i.; ..,y:. �..;.t t4, �;,'( B 1)111)t ::,'..., , ....
❑New construction _ .._y ❑Demolition A For special information use checklist
Description 1 Qty. I Ea 1 Total
®Addition/alteration/replacement ❑Other. New 1-2-family dwellings(includes 100 ft.for each utility connection)
4, 1�`'9,'I' .1,a 3`::0) r ts7:i 1 i rrE,ti't . '! SFR(1)bath 312.70
El 1-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
• SFR(3)bath 50032
❑Accessory building - ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other. Fire sprinkler( sq.R) Page 2
` i 374, artw�u Viroro�7;�1nfi ;4, In,0t;t:i.ullul r, . Siteutllltles:
Job site address:13. W Pacific Highway /f 571C SW P i�=(_ WAY-1 Catch basin or area drain 18.76
City/Statc/zz1P:Tigard,07197223 / Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt-no,; ,Project name: 6.1.‘94,N y /9i.2P r/E 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 ft.:_) 1 a Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
-�,� s Backwater valve 12.51
r• f >` t, . fi.1 ra 11 IFi i�� 9 >e ii ..•
--�.:L. r` ` , k‘!,4 '-"� - 'f_ Clothes washer 25.02 •
Installs new 1 1'4"water service from meter to building TA.is I S Dishwasher 25.02
OtiZ W,4T (_L.NJZ GOIA-Cv lb Z SZ.P.hCA-1 - Drinking fountain 25.02
,.$�it,1- SI-S Ejectors/sump 25.02
-' �rr tom' s ti�i n ••- 11f y�q.,I I c Expansion tank 12.51
Name CO �.o N '�/AP 7-1 S � _ _ Fixture/sewer cap 25.02
Address: 5 -� Floor drain/floor sink/hub 25,02
��7 sap 5�c* Garbage disposal 25.02
Giry/StaterzIP:p( P t - c1 Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
;t-' a�a ` 'l-�` taa��r�,,��`y ,c;,.t�.',z M I 1 - ' Interceptor/grease trap 25.02
.: .+ � e4 /rS�S 1'1 t"e, i:: :n i'fF- x :'� Ll�YWt 1�41Y 'jf 1 1 (.3� w -.`.:
Business name:Lovett Medical gas(value:$ ) Page 2
Contact name:{.' 'D�A_) a,p ,l.,/..-14 Primer 12.51
c Roof drain(commercial) 12.51
Address: fl d e Q� A L2,y-r..) Sink/basin/lavatory 25.02
City/State/ZIP: P Q gn--L,A/-, (0-- 9.`1 Its Solar units(potable water) 62.54
Phone;(5133)-)4-0- I Fax::( 6 ) - f L3 p Tub/showcr/shower pan 12.51•
E-mail:(1_041,_1 (p G? ro 1 ' SLit ul a s i co„A Urinal 25.02
k, g a w r, Water closet 25.02
�.*, .,, . II M ,. � "• Water heater 37.52
Business name: L)tT Water piping/DWV 56,29
Address: 19.0 e ',v(- n a- Other: 25.02
City/State/EP: 4)a CT-e._ /Lt, 'Zg-- L Subtotal
( . ) 7 r37 �r !2 3 2.4-4---1 I 3 d Minimum permit fee; $72.50 'Ta- 'o
Phone: ! 7 -� '( Fax: lv _r .
GCB Lie.; r Plumbing Lic.no.:Z cr 7'r 3 p$ Plan review (25%of permit fcc)
State surcharge(12%of permir fee) _ 4
•
Authorized signet # /� TOTAL PERMIT FEE Vi.2e)
Print name: P�7 C(/ . 54A-( Ti Date:g.WI I This permit IpplitiIcon expires if t permit is not obloined within 1ao(toys
y'�'_ after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:1Doile ug\P onaLMara olt.+pp.00c 10/01ro9 440-4616T(10/0.7./COM/W5B)
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
13765 SW PACIFIC HWY, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2014-00255
George Heimos
ELR2014-00436 permit for electrical grounding. All else ok
Violation Summary:
Inspector Contractor