Permit CITY OF TIGARD PLUMBING PERMIT
S a'''d COMMUNITY DEVELOPMENT Permit #: PLM201000067
Fri
JE GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/09/2010
Parcel: 2S110AA01700
Jurisdiction: Tigard
Site address: 10890 SW CANTERBURY LN
Subdivision: Lot: 0
Project: Mapletree Apartments
Project Description: Replace up to 100' water service.
Owner: FEES
DECE III INVESTMENTS, LLC Quantity Description Date Amount
-
PO BOX 5668 100 If Water Service 03/09/2010 562.54
PORTLAND, OR 97228
1 12% State Surcharge - 03/09/2010 $8.70
PHONE: Plumbing
10 ea Minimum Fee Adjustment - 03/09/2010 59.96
Contractor: Plumbing
COMMERCIAL PLUMBING SERVICES
21185 NW EVERGREEN PKWY SUITE 105,
STE. 106
PHONE: 503- 439 -9999
FAX: 503 - 439 -1999
Type of Use: COM
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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: f Permittee Signature:
. V 1 C.
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
. %.033!2010 12:23 Mechanical Services, Inc. (FAX) P.001/002
Plumbing Permit Application - a I ; 7, '
Site Utilities ! l Ok O1. l SF: O;V1.1"
M AR 0 8 2013
City of Tigard Date/B Received : /_ Permit No.: Ili
• 13125 SW Hall Blvd., Tigard, OR 97223 V 411 � •
Plan Review
11 1 Phone: 503.639.4171 Fax: 503.598.196,0 Da Other Permit No.:
T I G A R D Inspection Line: 503.639 . ' 1. - . Date Ready/By: .. ' H See Page 2 for
Internet: www.tigard- or.gov I'` ''f ' •!' Notioed/Method: Supplemental Information
TYPE OF WORK FEE* S
.
❑ New construction 0 Demolition For special information use checklist
�) Description ( Qty. [ Ea. 1 Total
ddition/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 buildingu1ti- fancily 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 -+ vJ C.$�� a,_ Qy L.1.... Catch basin or area drain 18.76
i 0
City/State/ZIP: Drywell, leach line, or trench drain 18.76
ty T � v / D �� Z Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: Project name: .- S Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear R: _, Page 2
Storm sewer (no. linear R: _ ) Page 2
Water service (no. linear ft.: lS') i Page 2 tot ,s`I
Subdivision: I Lot no.: Fixture or item:
Tax map /parcel no.: Backflow preventer 31.27 I.27
DESCRWTION OF. WORK Backwater valve 12.51
' Clothes washer 25.02
2-*P‘-PcGte MR- t' 2 YI =. 15) F-Cn'-C O F `N P'e «.2-- Dishwasher 25.02
(.r•Q -J lC.- - LoG' O t+1 (:.' t eJ' Drinking fountain 25.02
L�nS 1 t.R I) R l CC Ejectors/sump 25.02
❑- PROPERTY OWNER . I ❑ TENANT Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: Garbage disposal 25.02
City /State/ZIP: Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12.51
. ❑. APPLICANT . ❑ CONTACT PERSON Interceptor /grease trap 25.02
Business name: Medical gas (value: $ ) Page 2
Primer 12.51
Contact name: Roof drain (commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/ State/ZIP: Solar units (potable water) 62.54
Phone: ( ) Fax: : ( ) Tub /shower /shower pan 12.51
E-mail: Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: cocYvMQS~ AL - fie i r dvtL ca, t N .,j «. Water piping/DWV 56.29
Address: 2UcisS +la.f.s �1 - , q¢c �t ., ..1 Pew, SSE i 0 Other: 25.02
City/ State/ZIP: 1- x L.�S �2
0L, t n IZ '\ _- 1 , Subtota
Minimum permit fee: $72.50 'x2.60
Phone: (So) £ . c Fax: (503)4�ei' 19 q ci -
Plan review (25% of permit fee)
CCB Lic.: i2ko415 Plumbing Lic. no.: (37`42Ieb State surcharge (12 %ofpermit fee) Q
Authorized signature: TOTAL PERMIT FEE 118 i . 20
Print name: U � � l LT, Date: 31$1 1 Q This permit application aspires if a permit is not obtained within 180 days ■ after it has been accepted as complete.
i *Fee methodology set by Tri County Building Industry Service Board.
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