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Permit CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit #: PLM2010 -00065 T tGKkD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/09/2010 Parcel: 2S112DA01400 Jurisdiction: Tigard Site address: 6650 SW REDWOOD LN 210 Subdivision: Pacific Corporate Center Lot: 0 Project: NuScale Project Description: Install (1) break room sink, (1) d /w, and (1) on demand w /h. Owner: FEES PACIFIC REALTY ASSOCIATES Quantity Description Date Amount 15350 SW SEQUOIA PKWY #300 PORTLAND, OR 97224 1 ea Dishwasher 03/09/2010 $25.02 PHONE: 503 - 624 -6300 1 ea Sink 03/09/2010 $25.02 1 ea Water Heater 03/09/2010 $37.52 1 12% State Surcharge - 03/09/2010 $10.51 Contractor: Plumbing ADDISON PLUMBING 27425 S BEAVERCREEK RD MULINO, OR 97042 PHONE: 503 - 740 -8116 FAX: 503 - 632 -1168 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $98.07 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 • - • • OUNC by -fling 503.246.6699 or 1.800.332.2344. Issue. By: /;/ Permittee Signature: eijAp • 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. Plumbing Perm Applicatio R �jpjj� r- :, ;Cr", ,- Building Fixtures -�1 FOR OFFICH. •ust or\LY I . - 1 `. � Y I 1 VAIt(�` City of Tigard MAR 0 9 2013 Received / !x C�(.J Permit Na.: PO/112d b G ■ 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review C n ".° < Phone: 503.639.4171 Fax: 503.598.19{ OF (f ARC Date /By: Date /By: Other Pennit No.; ] / I1a� • 'G611. Inspection Line: 503.639.4175 1 p y �+ /+A Date Ready/By: ® See Paget for TIG'A 3UILDIlNG DIV IS1p D d/B �� Internet: www.tigard- or.gov s Notif ied/Method: ( (C) Supplemental Informat - - TYPE OF WORK - - - FEE* SCHEDULE_: - . ❑ New construction ❑ Demolition For special information use checklist. Description Qty. 1 Ea. Total Addition /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 1q 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. It.) Page 2 ,JOB_ "SITE INFORMATION AND LOCATION Site utilities: l3�lp i S w J it i'� Catch basin or area drain 18.76 Job site address: ��In1Ur�r h ' *t Drywell, leach line, or trench drain 18.76 City / State/ZIP: Of1 o2. g O°�y Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: 210 Project name: /� )� SCE - \/J Manufactured home utilities 50.03 Cross street /directions to job site: UO I CL P k W y 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.: _) Page 2 Subdivision: Lot no.: Fixture or item: Tax map /parcel no.: Backflow preventer 31.27 :DESCRIPTION. OF WORK Backwater valve 12.51 Clothes washer 25.02 (_AC`A OA C___ � r cO h n St A LC CMS Dishwasher I 25.02 © ASK,o et t J 51,".v..K.1. r.r GV.14_ Drinking fountain 25.02 1 - Gn �,, ( w 't , L -4- P Ejectors sump 25.02 .D PROPERTY-OWNER ER Y - ' - "` 1 ` ❑ TENANT - Expansion tank 12.51 Fixture /sewer cap 25.02 Name: 1 f� c\- - Floor drain/floor sink/hub 25.02 Address: 15 3S0 Sk) . t,tJZ„ f c - PV.W1' 1O Garbage disposal 25.02 City /State /ZIP: 90 r4-i(.vct ©f_ ei 3 .22_Li Hose bib 25.02 Phone: ( 503 (9..24 0:300 Fax: ( ) Ice maker 12.51 ❑APPLICANT -' CONTACT. PERSON Interceptor /grease trap 25.02 (� Medical gas (value: S ) Page 2 Business name: ©kArt. n��� - ( C.4 Of Primer 12.51 Contact name: Gh r i ` ' `�l7�t ve Roof drain (commercial) 12:51 Address: // ` S% , t,1 ie.t'� -S f' <ic Sink /basin/lavatory 7 25.02 City /State/ZIP: J 0S p c i Q31)3.5 o Solar units (potable water) 62.54 Phone: (503) 37 ,4 : -5(013 I Fax: : ( ( � l L j 4.1 Tub /shower /shower pan 12.51 • _ . E -mail: / I . Urinal 25.02 x✓' x n �l� 5 ��' f'p Y✓� Water closet 25.02 CONTRACTOR Water heater I 37.52 Business name: Rari tsG N t,` ..,,-\” vv.; LLL Water piping/D W V 56.29 Address: 2?4Ls S. 13e.k.,yr - 2_t - r=1 Other: 25.02 City /State /ZIP: t■a,kwe ,- 17c, 4 Z Subtotal Phone: r Fax: Minimum permit fee: S72.50 (s_ ) Gs - z - /GSA (5 )C.ca / / U 4 Plan review (25% of permit fee) CCB Lic.: / S./ 7 S Plumbing Lic. no.:? -44TIT State surcharge (12% of permit fee) Authorized signature: H y TOTAL PERMIT FEE U -, Print name: l Date: This permit application expires if a permit is not obtained within 180 days 0....... �. k (i; 3 �D after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. I:ABuildingVPerm its VPLMU -Perm itApp.doe 10/01/09 440 - 7616x(10 /02 /COM,WEB)