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Permit CITY OF TIGARD PLUMBING PERMIT q a '_ COMMUNITY DEVELOPMENT Permit #: PLM2010 -00247 -rjGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date . Issued: 07/28/2010 Parcel: 2S110DC01000 Jurisdiction: Tigard Site address: 11165 SW SUMMERFIELD DR 8 Subdivision: SUMMERFIELD APARTMENTS Lot: 0 Project: Summerfield Apartments Project Description: (1) clothes washer. Owner: FEES SUMMERFIELD ASSOCIATES, LLC Quantity Description Date Amount BY HSC REAL ESTATE, 1500 SW FIRST AVE STE 1020 1 ea Clothes Washer 07/28/2010 $25.02 PHONE: 1 12% State Surcharge - 07/28/2010 $8.70 Plumbing 47 ea Minimum Fee Adjustment - 07/28/2010 $47.48 Contractor: Plumbing TRITON PLUMBING & MECHANICAL P.O. BOX 1904 WOODLAND, WA 98674 PHONE: 360 - 740 -7701 FAX: 360 - 573 -2041 Type of Use: Class of Work: 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 OU , by calling 503.246.669332.2344. 4 f Issued By:` • / � Permittee Signature /MD CaII 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. 08/09/2000 03:50 3607407701 TIM CONKLIN PAGE 01 Plumbing Perinit Application ``9 Site Utilities C ` ,. (, �< < , r , i (,. 1 City of Ti rd � - � � remit 140.: p 13 SW Hall Blvd., Tigard, OR 97223 FE M11111 ►1 Pao l) J UG �l 7 Phone: 503.639.4171 Fax 503.598.1960 , �_ Other Permit No. .� j - rYl36 y Inspection time: sox 10 See Page 2 ter Internet: www.tigard.or.gov (' �. �t�? 11 : 77'6 Supplemental tbbvaation TYPE OF WO 4 e� PEE" SCHEDULE r V construction _❑ Demolition Foraperidletfo laswiecho itiom/ahafatlonreplacta nt C1 Other: - dwellings 2- family dlings (includes 1008 or �n utility CATEGORY OF CONSI'RUCFION SFR (1) bath 312.70 ❑ 1- and 2- family dwelling �CommercitU>ndustrial SFR (2) bath 437.78 • o Accessory building CI Multi-family SFR (3) bath 500.32 Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler (_,.,__ sq. R) Pap 2 JOH SITE INFORMATION AND / LOCATION Site edibles: Job site address: I I i ! - . S W S (401/14,a L T/t-lq P g Catch basin or area drain 18.76 City/State/ZIP: ,fd (' Dowell, leach line, or trench drain 18.76 � i g 4 0 2 9 7 Z'z T Footing drew (ea. linear s.: ___) Page 2 Suit_ r/bldgJap no.: I Project mama: Su_ 4 � rat Manufactured home utilities 50.03 Cross stied/dined= to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer (no. linear R.: ,_-_-) Page 2 Storm sower (no. linear R.: _) Page 2 Water service (no. linear 8.: ) • Page 2 Subdivision: 1 Lot no.: Fixture Of Item: - - Tax map /parcel no.: Back low prevetmr 31.27 � - r DESCRWrION /( OF WORK f /� Backwater valve 12.51 T 'V � l s lam b `e, v" 6 AC.4. c t'�C71 At-sre Clothes a washer ' 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 Lii- PROPERTY OWNER I ❑ TENANT . Expansion tank 12.51 p / Fixture/sewer r Gap 25.02 Name: cc�l.f4 (. -CtlL� 1 g s'QCs,1) ,e es itV a ,T Floor drain/floor sink/hub 25.02 Adds:as: i :Z©O � G✓ 1 Ayr ,, F I 0 Z-0 Garbage disposal 25,02 Cit/ : Hose bib 25.02 Phone: ( ) Fax: ( ) Ice maker 12.51 C APPLICANT ❑ CONTACT PERSON - /gr rap 25.02 Business name: Triton Plumbing & Mach., LLC M Bat (value: S ) 2 Primer 12.51 Contact name: Tim Conklin Roof drain (commercial) 12.51 Address: P.O. Box 1904 Sink/basin/lavatory 25.02 ., City/State/ZIP: Woodland, W'. 98674 Solar units (potable water) 62.54 Phone: (360)'556-4892 Fax: : (360) 573 -2041 Tub/shower /shower pmt 12.51 E-mail: rrt mail: ooplmmbiagJhaghes.net Urinal 25.02 Water closet 25.02 CONTRACTOR - steamer 37.52 Business name: Triton Plambiog & Mech., LLC Water pipiog/DWV ' 56.29 Address: P.O. Hon 1904 .. Other: ` 25.02 City/StataIZlP: Woodland, Wa. 98674 Sobtomi Phone: (360) 556 -4892 Fax: (360) S73 -2041 7 9 ) / Minimum permit fee: 672.50 1 CCB Lie.: 147599 j '/ //I Plumbing Lie. no.: 37 -505 7/) //t - Plan review (2556 of penult fa) State = c h a r g e (1296 of permit f o e ) g - 7 L> Au*boriaed Print name: 7,....- TOTAL PERMIT FEE S� , 2-t, This permit application :spin!, it a pawn b ot obtained within 1 days . fl C c c t �, 1 Date: � 1� , 1� n 1 apex It a baem u i1ed as ampt a ter. aria. aNA.vinan.nr .p, 1,, Tw:.r,.,..... A 'I/aw. InAsorm c.+.IM. m.NM