Permit J
CITY OF TIGARD PLUMBING PERMIT
i I DEVELOPMENT SERVICES PERMIT #: PLM2005 -00354
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 8/9/2005
• PARCEL: 1S135DC-02000
SITE ADDRESS: 11905 SW 91ST AVE * ** BLDG 1 ZONING: R -7
SUBDIVISION: GREENBURG OAKS APARTMENTS LOT: JURISDICTION: TIG
Project Description: Repair /replace interior waste and water supply lines. Replace toilets, sinks, tub valves, water
heaters, dishwasher and GD in selected apartments.
CLASS OF WORK: ALT GARBAGE DISPOSALS: 12 MOBILE HOME SPACES:
TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R1 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: 5 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 0 URINALS: GREASE TRAPS:
LAVATORIES: 24 OTHER FIXTURES:
TUB /SHOWERS: 12 SEWER LINE: ft
WATER CLOSETS: 12 WATER LINE: ft
DISHWASHERS: 12 RAIN DRAIN: ft
Owner: FEES
VILLA LA PAZ LIMTED PARTNERSHIP Description Date Amount
BY COMMUNITY PARTNERS FOR
AFFORDABLE HOUSING INC [PLUMB] Permit Fee 8/9/2005 $1,278.82
TIGARD, OR 97281 [TAX] 8% State Surcharl 8/9/2005 $102.30
Phone : Total $1,381.12
Contractor:
CROMWELL PLUMBING
30855 S. KAUFFMAN RD. REQUIRED ITEMS AND REPORTS
CANBY, OR 97013
Phone : 503- 266 -4790
Reg #: LIC 44712
PLM 34 -167PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by
calling 503 -246 • -99 or 1- 800 - 332 -2344.
Issued By: � L� 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.
Plumbing Perniit ° Appliaun ElVEI '
OFF
I OIZ OFFICE i. tie: ONE)*
City of Tigard Received ce Jr `� Permit No.: ° •0G
Tigard, 13125 SW Hall Blvd., Ti AUG 8 20 Date/By: A o
, OR 972 Plan Revie 3O
Phone: 503.639.4171 Fax: 503.598.1960 44,0 ,,, • A , � y . Other Permit No
24- Hour Inspection Line: 503.639.4175 CITY OF TI ... „4. 1 "7.1 1 1 Date Ready/By: runs: la See Pag 2 for
Internet: www.ci,tigard.or.us BUILDING DID , `_ Notified/Method: Supplemental Information
TYPE, OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist
Description I Qty. I Ea. I Total
® Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
❑ 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
• ❑ Accessory building ® Multi - family SFR (3) bath 399.00
❑ Master builder ❑ Other: Each additional bath/kitchen 45.00
Fire sprinkler ( sq. ft.) Page 2
JOB 'SITE :INFORMATION AND LOCATION Site utilities
Job site address: 11905 SW 91 AVE Catch basin or area drain 16.60
City/ State/ZIP: Tigard, OR, 97223 Drywell, leach line, or trench drain 16.60
Suite/bldgJapt. no.: Bldg 1 I Project name: Greenburg Oaks Apartments Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: Greenburg Road
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) • Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Water service (no. linear ft.: _ ) Page 2
Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
Repair/ replace interior waste and supply lines Backwater valve 16.60
Replace toilets, sinks, tub valves adlate, Clothes washer 16.60
"D (,Q t a t r ) Dishwasher rt 16.60 J O ,A V
® PROPERTY OWNER ❑ TENANT Drinking fountain 16.60
Ejectors /sump 16.60
Name: Villa La Paz Limited Partnership Expansion tank 16.60
Address: PO Box 23206 Fixture/sewer cap 16.60
City/State/ZIP: Tigard OR, 97281 Floor drain/floor sink/hub 16.60
Phone: (503)968 2724 Fax: (503)598 8923 Garbage disposal 1 't 16.60 / 9%,A 0
® APPLICANT ® CONTACT PERSON Hose bib 16.60
' Ice maker 16.60
Business name: LMC, Inc.
Interceptor /grease trap 16.60
Contact name: Kyle Anderson Medical gas (value: $ ) Page 2
Address: 4915 SW Griffith Dr. Suite 301 Primer 16.60
City/State /ZIP: Beaverton OR 97005 Roof drain (commercial) 16.60
Phone: (503) 209 3450 c_a Fax:: (503) 64606823
Sink/b nAava 2t4. 16.60 ,3 [,Lo
Tub /shower /shower pan / Z 16.60 / C C , .
E -mail: kylea @Imcincorporated.com Urinal 16.60
•
CONTRACTOR Water closet i Z 16.60 `e / 2O
Business name: Cromwell Plumbing Inc. Water heater �/ 16.60 6.. p f)
Address: 30855 South Kauffman Road Other:
City/State /ZIP: Canby, OR, 97013 Subtotal `I -7 g, g,
Moor (503 266 4711i Fax: (593) 246 0798_ Minimum permit fee: $72.50
Residential backflow minimum permit fee: $36.25
CCP UV.: 4-Fl I.2 , Plumbing Lie. n t: l3 F Plan review (25% of permit fee)
- Aly�iyed Biglt*tar PO - State surcharge (8% of permit fee) `aa Q
-_ -.-� TOTAL PERMIT FEE
Print name: Greg W. Cromwell Date: 8/3/05 This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
is\ Building \Permits\PLM- PermitApp.doc 06/05 440-4616T(10/02 /COM/WEB)
CITY OPTIGARD I
BUILDING DIVISION PERMIT #: p71m-D ac- 00 wit
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUEI:
Phone: (503) 639 -4171 1 ° 44111 0101#
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Inspection Requests (24 Hrs.): (503) 639 -4175 --«i
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INSPECTION WORKSHEET FOR DATE: l [2,- /0 (l/ IME: A/14 _ - PAGE:
SITE ADDRESS: ) I �j o S)- ! , v e CLASS OF WORK:
SUBDIVISION: ` 1 ! LOT #: TYPE OF USE:
PROJECT NAME: f e L
DESCRIPTION:
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• OWNER: PHONE #:
CONTRACTOR: Grc,✓✓ PHONE #:
Inspection Request Scheduled For: Date: S -.2_, — Pour Time:
Code # Inspection Description Confirm # Contact # Message
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Corrections /Comments /Instructions:
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❑ FAIL I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
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Inspector: t Date: v Phone #: (503) 718 -
CITY OF T I G A R D ,, ,
BUILDING DIVISION PERMIT #: 1
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: mom
Phone: (503) 639-4171 t
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Inspection Requests (24 Hrs.): (503) 639-4175 J —
INSPECTION WORKSHEET FOR DATE: 202006 TIME: 7:01AM PAGE: 52
SITE ADDRESS: 11905 SW 91ST AVE ''''' BLDG 1 CLASS OF WORK:
SUBDIVISION: GREENBURG OAKS APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: GREENBURG OAKS APTS,
DESCRIPTION: Repair/replace interior waste and water supply lines. Replace toilets, sinks, tub valves, MACAU
heaters, dishwasher and GD in selected apartments.
OWNER: VILLA LA PAZ LIMTED PARTNERSHIP, PHONE #:
CONTRACTOR: CROMWELL PLUMBING PHONE #: 503-2664790
Inspection Request Scheduled For: Date: 2/0/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message .
399 1.41 1 026454-01 503-969-3279 Y
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Corrections / om ents Astructions: I
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ISII 0 PARTIAL APPROVAL El CANCEL - 0 NO ACCESS
I I FAIL 0 CALL FOR INSPECTION E] ADDITIONAL FEES ASSESSED
Inspector: tr Date: ).--
1166 Phone #: (503) 718-