Permit PLUMBING PERMIT
CITY OF TIGARD
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:; COMMUNITY DEVELOPMENT Permit #: PLM2010 -00166
TI GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/26/2010
Parcel: 1 S 136DC04400
Jurisdiction: Tigard
Site address: 11945 SW 70TH AVE
Subdivision: DARTMOUTH SQUARE Lot: 30
Project: TVF &R Command Center
Project Description: Plumbing for TI
Owner: FEES
TUALATIN VALLEY FIRE & RESCUE Quantity Description Date Amount
20665 SW BLANTON ST
ALOHA, OR 97007 1 ea Expansion Tank 05/26/2010 $12.51
PHONE: 503-649-8577 2 ea Floor Drain /Floor Sink/Hub 05/26/2010 $50.04
1 ea Garbage Disposal 05/26/2010 $25.02
2 ea Ice Maker 05/26/2010 $25.02
Contractor: 4 ea Primer 05/26/2010 $50.04
ENDEAVOR PLUMBING & CONTRACTORS INC 7 ea Sink 05/26/2010 $175.14
PO BOX 28037 4 ea Lavatories 05/26/2010 $100.08
PORTLAND, OR 97228 4 ea Tub /Shower /Shower Pan 05/26/2010 $50.04
PHONE: 503-504-6846 4 ea Water Closet 05/26/2010 $100.08
FAX: 503-477-9159 1 ea Water Heater 05/26/2010 $37.52
1 12% State Surcharge - 05/26/2010 $75.06
Plumbing
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Total $700.55
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
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 5• -.• .800,3 344.
Issued By: Permittee Signature: / /
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.
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Plumbing Permit Application o LA 1 auto DO6 70
Building Fixtures FOR OFFICE USE ONLY
City of Tigard Date Received v Permit No.: , l�
�otD�OD eD
IIN a 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit No.: o - - e 7 6
Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for
T I G A IZ D Internet: www.tigard or Notified/Method: I Supplemental Information
nXM T OF WORK 5 FEE * .: !=
-,. £ - , •
w ❑ Demolition For special information use checklist
El New construction Description 1 Qty. 1 Ea. 1 Total
0 Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
x i ; - CATEGORY O,F CONSTRUCTION , ` . ; ., SFR (1) bath 312.70
...._« >:�. SFR (2) bath 437.78
❑ 1- and 2- family dwelling 0 Commercial /industrial
SFR (3) bath 500.32
❑ Accessory building ❑ Multi - family Each additional bath kitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler L. sq. ft.) Page 2
..''''..'-Z JOB :SITE INFORMATION =AND °LOCATION:; Site utilities:
Catch basin or area drain 18.76
Job site address: 11945 SW 70 Ave.
Drywell, leach line, or trench drain 18.76
City / State/ZIP: Tigard, OR 97223 Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: Project name: TVF &R C.B.O.C. 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.: ) Page 2
Subdivision: //��11 Lot no.: Fixture or item:
//
Tax map /parcel no.: / 5 / 3 �' DC ,, 0 v-/g00 Backflow preventer 31.27
Y t Backwater valve 12.51
g;.
Wi DESCRIPTION OF.)VORK'_
Clothes washer 25.02
Add two bathrooms and a couple of break room sinks. Dishwasher 25.02
Drinking fountain 25.02
Ejectors /sump 25.02
r r,mow TENANT... Expansion tan 1
Expan � k 1 51 12.51
PROPERTY OWNER
Fixture /sewer cap 25.02
Name: Floor drain/floor sink/hub g 2 , 25.02 50.04
Address: Garbage disposal 1 25.02 25.02
City /State/ZIP: Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker .Oc - r)04 ii4 2, 12.51 25.02
ti --; = Interceptor/grease tra 25.02
���y ',� ® PTJR trap ❑ APPLICANT. � .
§a .. �..: >. Medical gas (value: $ ) Page 2
Business name: Primer 4t' 12.51 50.04
Contact name: Roof drain (commercial) 12.51
Address: Sink/basin/lavatory 5ia Li'3 11 , 25.02 275.22
City /State/ZIP: Solar units (potable water) 62.54
Phone: ( ) Fax: : ( ) Tub /shower /shower pan `7t A - - j 4, 12.51 504
Urinal 25.02
E Water closet 4 25 (0�
':-' # .;,-.CONTRACTOR > - Water heater 1 37.52 37.52
Business name: Endeavor Plumbing, Inc. Water piping/DWV 56.29
Address: PO Box 28037 Other: 25.02 , Lie? ��ee:a3'
City /State/ZIP: Portland, OR 97228 Subtotal
Minimum permit fee: $72.50
Phone: (503) 504 -6846 Fax: (503) 477 -9159
Plan review (25% of permit fee)
CCB Lic.: 173692 Plumbing Lic. no.: PB269 State surcharge (12% of permit fee) 75. 05
Authorized signature: y` TOTAL PERMIT FEE Ar73 d8'
Date: 05/25/10 I This permit application expires if a permit is not obtained within 180 days
Print name: Steve Houston after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board/
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