Permit CITY TIGARD PLUMBING PERMIT
T ,, I DEVELOPMENT SERVICES PERMIT #: P -00569
DATE ISSUED: 6/29/20029/200 6
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
q PARCEL: 2S 110AA -01500
SITE ADDRESS: 1 S CANTERBURY LN BLDG 25 ZONING: R -12
SUBDIVISION: CANTERBURY CREST CONDOS LOT: 010 JURISDICTION: TIG
Project Description: Building 25, new 4 unit condominium. Addresses: Units 1 thru 4. Other fixtures: (4) expansion
tanks & (4) hose bibs, 200' footing drain.
CLASS OF WORK: NEW GARBAGE DISPOSALS: 4 MOBILE HOME SPACES:
TYPE OF USE: MF WASHING MACH: 4 BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: R1 FLOOR DRAINS: TRAPS:
STORIES: 3 WATER HEATERS: 4 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 4 URINALS: GREASE TRAPS:
LAVATORIES: 14 OTHER FIXTURES: 8
TUB /SHOWERS: 8 SEWER LINE: 100 ft
WATER CLOSETS: 12 WATER LINE: 100 ft
DISHWASHERS: 4 RAIN DRAIN: 200 ft
Owner: FEES
CANTERBURY PLACE, LLC Description Date Amount
109 EAST 13TH STREET
VANCOUVER, WA 98660 [PLUMB] Permit Fee 6/29/2006 $1,388.40
[PLMPLN] Plan Review 6/29/2006 $180.49
Phone : 360-695-7700 [TAX] 8% State Surchan 6/29/2006 $111.07
Total $1,679.96
Contractor:
CROMWELL PLUMBING
30855 S. KAUFFMAN RD. REQUIRED ITEMS AND REPORTS
CANBY, OR 97013
Contact # : PRI 503- 266 -4790
FAX 503- 266 -4792
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 3- 246 -6699 5r...1-
Issued y: ) Permittee Signature: o.... /
� / I
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 Permit Application Folz OFFICE USE oNi.i
City of Tigard Received ` /I - � ( _ Permit No. ?; % x.� i 9
13125 SW Hall Blvd., Tigard, OR 97223 p ( r Plan Review I Id 4.t r �`
7 �� B 11N Plan Re
Phone: 503.639.4171 Fax: 503. 598.196 l9 //watvd�M; ° � Date/By: j j b� �erPermit No�
24- Hour Insp Line: 503.639.4175 J uris
Internet: www.ci.ti ard.or.us .. Date Ready/By: 0 See Page 2 for
g rim 1 A 70(15 Notified/Method: - -7 iv Supplemental Information
TYPE OF WORK t FEE' SCHEDULE ® New construction CITY ` F special information use checklist
Q .P I
S,tON Description Qty. Ea. I Total
❑ Addition /alteration/replacement l�'Oter� 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 ❑ Commerciallindustrial SFR (2) bath 350.00
❑ Accessory building ® Multi- family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other: Fire sprinkler ( sq. ft) Page 2
/6 76/ JOB SITE INFORMATION AND LOCATION Site utilities
Job site address. f ' SW Canterbury Lane Catch basin or area drain 16.60
City/ State/ZIP: Tigard, OR 97223 Drywell, leach line, or trench drain 16.60
Suite/bldgiapt. no.: BLDG45 - I Project name: Canterbury Crest Footing drain (no. linear ft.: 200 Page 2 I o I y 0
Cross street/directions to job site: Canternury Lane off HWY 99 S of SW McDonald Manufactured home utilities 110.00
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: 100) I Page 2 5s , 0
Storm sewer (no. linear ft.: 200) I Page 2 101 , y 0
Subdivision: Canterbury Place Lot no.:
Water service (no. linear ft.: 100) I Page 2 S S , 0 0
Fixture or item
Tax map /parcel no.: WCTM 2S110AA, 01500,01400 Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer * Page 2 . C /0
. New Construction of Condominium Units Backwater valve 16.60
Clothes washer 14 16.60 (D(, , 4 10
Dishwasher 14 16.60 GC, , N D
1:0 PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60
Ejectors/sump 16.60
Name: Canterbury Place LLC
Expansion tank t- 16.60 (p( , y 0
Address: 109 East 13 Street Fixture/sewer cap 16.60
City/State/ZIP: Vancouver, WA 98660 Floor drain/floor sink/hub 16.60
Phone: (503)221 -1920 Fax: (360)693 -4442 Garbage disposal 4 16.60 t (, , go
® APPLICANT 00 CONTACT PERSON Hose bib I 16.60 (p (o , 0
Business name: Canterbury Place LLC Ice maker 16.60 /",Q.,
Interceptor /grease trap 16.60
Contact name: Dave Gutschmidt Medical gas (value: $ ) Page 2
Address: 11624 SE 5th Street Primer 16.60
City/State/ZIP: Bellevue, WA 98005 Roof drain (commercial) 16.60
Phone: (360) 695 -7700 Fax: : (360) 693 -4442 Sink/basin/lavatory ( $ 16.60 C , gp
E -mail: Tub /shower /shower pan D 16.60 13 2, g 0
Urinal 16.60
CONTRACTOR Water closet ( 2_._ 16.60 f q cl, ,
Business name: Cromwell Plumbing Inc Water heater 14 16.60 L ( , '1 0
Address: 30855 S Kauffman Road Other: Gp
City/ State/ZIP: Canby, OR 97013
Subtotal cgs. D . 4D
Minimum permit fee: $72.50
Phone: (503) 266 -4790 Fax: (503) 266 -4792 Residential backflow minimum pe it fee: $36.25
CCB Lic.: 44712 Plumbing Lic. no.: 34-167 PB ib t ' p' //i/ Plan review of permit fee) /V) . y f
/ State surcharg (8% of permit fee) / / / . O 7
Authorized signature: TOTAL PERMIT FEE • 1,/p19, 940
Print name: Greg Cromwell Date: This permit application expires if a permit is not obtained within
180 days after it has been accented as complete.
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
CROMWELL PLUMBING
RECHVg
30855 S. KAUFFMAN RD.
CANBY, OR 97013 JUL 2 1 2006
CITY Ot itutiku
Plumbing Signature Form BUIT,TIENC
Permit #: PLM2005 -00569
Date Issued: 6/29/2006
Parcel: 2S 110AA -01500
/ f' Site Address: 10757 SW CANTERBURY LN BLDG 25
Subdivision: CANTERBURY CREST CONDOS
Block: Lot: 010
Jurisdiction: R -12
Zoning: TIG
Remarks: Building 25, new 4 unit condominium. Addresses: Units 1 thru 4. Other fixtures:
(4) expansion tanks & (4) hose bibs, 200' footing drain.
Your company has been indicated as the plumbing contractor for the permit indicated above. In order for
the plumbing permit to be valid, please have the appropriate individual from your company sign below and
return this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building
Division.
No plumbing inspections will be authorized until this completed form is received
OWNER: PLUMBING CONTRACTOR:
CANTERBURY PLACE, LLC CROMWELL PLUMBING
109 EAST 13TH STREET 30855 S. KAUFFMAN RD.
VANCOUVER, WA 98660 CANBY, OR 97013
Phone #:360- 695 -7700 Phone #: 503- 266 -4790
Reg #: LIC 44712
PLM 34 -167PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X
Signatur of Authorized Plumber
If you have any questions, please call 503.718.2433.
CITY OF TIGARD
BUILDING DIVISION 0 PERMIT #: PLM200500569
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9i2006
Phone: (503) 639-4171 aPheeit
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 11/21/2007 TIME: 7:00AM PAGE: 34
•
SITE ADDRESS: 10749 SW CANTERBURY LN BLDG 25 CLASS OF WORK:
SUBDIVISION: CANTERBURY CREST CONDOMINIUM LOT #: TYPE OF USE:
PROJECT NAME: CANTERBURY CREST
DESCRIPTION: Building 25, new 4 unit condominium. Addresses: Units 101,102,103,104. Other fixtures: (4)
expansion tanks & (4) hose bibs, 200 footing drain.
OWNER: CANTERBURY PLACE, 1.,LC, PHONE #: 360-695-7700
CONTRACTOR: CROIVRAELL PLUMBING PHONE #: 503
Inspection Request Scheduled For: Date: 11/21/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 060108-01 503-313-7398
Corrections/Comments/Instructions:
Car e, c "t" •
PASS EI PARTIAL APPROVAL LI CANCEL I I NO ACCESS
FAIL Li CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
eVINA--)
Inspector: CP Date: It 1 Phone #: (503) 718-
_ .
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005.00 569
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/2R/2006
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/21/2007 TIME: 7:00AM PAGE: 53
SITE ADDRESS: 10749 SW CANTERBURY LN BLDG 25 CLASS OF WORK:
SUBDIVISION: CANTERBURY CREST CONDOMINIUM LOT #: TYPE OF USE:
PROJECT NAME: CANTERBURY CREST
DESCRIPTION: Building 25, new 4 unit condominium. Addresses: Units 101,102,103,104. Other fixtures: (4)
expansion tanks R (4) hose bibs, 200' footing drain.
OWNER: CANTERBURY PLACE, LLC, PHONE #: 360 - 635.7700
CONTRACTOR: CROMWELL PLUMBING PHONE #: 503 - 266 - 4790
Inspection Request Scheduled For: Date: 8121/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 054371 -01 503 - 572 -7015 N
Corrections /Comments/ Instructions:
•
•
K PASS ❑ PARTIAL APPROVAL ❑ CANCEL I NO ACCESS
I FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: CY11. t1.4.n..; Date: '5rI2I I in Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION - PERMIT #: PLM2005-00569
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/29/20(16
Phone: (503) 639 -4171 /�m� il
Inspection Requests (24 Hrs.): (503) 639 -4175 , ''!�
INSPECTION WORKSHEET FOR DATE: 6/13d2007 TIME: 7:01AM PAGE: 69
SITE ADDRESS: 10749 SW CANTERBURY LN BLDG 26 CLASS OF WORK:
SUBDIVISION: CANTERBURY CREST CONDOMINIUM LOT #: TYPE OF USE:
PROJECT NAME: CANTERBURY CREST
DESCRIPTION: Building 25, new 4 unit condominium. Addresses: Units 101,102,103,104. Other fixtures: (4)
expansion tanks & (4) hose bibs, 200' footing drain.
OWNER: CANTERBURY PLACE, LLC, PHONE #: 360 - 695 -7700
CONTRACTOR: CROMWELL PLUMBING PHONE #: 503 - 266.4790
Inspection Request Scheduled For: Date: 6/13/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
3 30 Water service 050128-06 503 - 545 -3654 N
Corrections/Comments/Instructions:
2 1\PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL F I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector/ Date: ,; Phone #: (503) 718-
CITY OF TIGARD ,
BUILDING DIVISION PERMIT #: PLM2005 -00569
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/29/2006
Phone: (503) 639-4171 /or�,N44 11 f,1\
Inspection Requests (24 Hrs.): (503) 639-4175 ':_
INSPECTION WORKSHEET FOR DATE: 6/13/2007 TIME: 7:01AM PAGE: 70
SITE ADDRESS: 10749 SW CANTERBURY LN BLDG 25 CLASS OF WORK:
SUBDIVISION: CANTERBURY CREST CONDOMINIUM LOT #: TYPE OF USE:
PROJECT NAME: CANTERBURY CREST
DESCRIPTION: Building 25, new 4 unit condominium. Addresses: Units 101,102,103,104. Other fixtures: (4)
expansion tanks & (4) hose bibs, 200' footing drain.
OWNER: CANTERBURY PLACE, LLC, PHONE #: 360.635 - 7700
CONTRACTOR: CROMWELL PLUMBING PHONE #: 503 - 266 -4790
Inspection Request Scheduled For: Date: 6/13/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
340 Storm drain 050128.05 503. 545"3654 N
Corrections /Comments /Instructions:
ASS ❑ PARTIAL APPROVAL I CANCEL NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: A1 'i 1 Date: i Phone #: (503) 718-
CITY OF TIGARD ,
BUILDING DIVISION PERMIT #: PLM2005 -00569
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/2W2006
Phone: (503) 639- 4171m��iif�l
Inspection Requests (24 Hrs.): (503) 639 -4175 �!:� ':_.,
INSPECTION WORKSHEET FOR DATE: 6/13/2007 TIME: 7 :01AM PAGE: 71
SITE ADDRESS: 10749 SW CANTERBURY LN BLDG 25 CLASS OF WORK:
SUBDIVISION: CANTERBURY CREST CONDOMINIUM LOT #: TYPE OF USE:
PROJECT NAME: CANTERBURY CREST
DESCRIPTION: Building 25, new 4 unit condominium. Addresses: Units 101,102,103,104. Other fixtures: (4)
expansion tanks & (4) hose bibs, 200' footing drain.
OWNER: CANTERBURY PLACE, LLC, PHONE #: 360.695 -7700
CONTRACTOR: CROMWELL PLUMBING PHONE #: 603
Inspection Request Scheduled For: Date: 6/13/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
335 Rain drain 050128-04 503 - 545-3654 N
Corrections /Comments /Instructions:
k ASS n PARTIAL APPROVAL n CANCEL 1 I NO ACCESS
n FAIL I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: 1; �� Date: . / Phone #: (503) 718 -
r - • '
CITY OF TIGARD
BUILDING DIVISION
PERMIT #: PLM2006-00569
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 612912006
Phone: (503) 639-4171
://
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 6/13/2007 TIME: 7:01AM PAGE: 72
SITE ADDRESS: 10749 SW CANTERBURY L.N BLDG 25 CLASS OF WORK:
SUBDIVISION: CANTERBURY CREST CONDOMINIUM LOT #: TYPE OF USE:
PROJECT NAME: CANTERBURY CREST
DESCRIPTION: Building 25, new 4 unit condominium. Addresses: Units 101,102,103,104. Other fixtures: (4)
expansion tanks & (4) hose bibs, 200' footing drain.
OWNER: CANTERBURY PLACE, LLC, PHONE #: 360-695-7700
CONTRACTOR: CROMWELL PLUMBING PHONE #: 503-266-4790
Inspection Request Scheduled For: • Date: 6/13/2007 Pour Time:
Code # Inspection Description Confirm # Contact # • Message
505 Sanitary sewer 050128-03 603-545-3654 N
Corrections/Comments/Instructions:
•
p ,
PASS P1 PARTIAL APPROVAL P1 CANCEL 0 NO ACCESS
FAIL I I CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: M I. 1/ Date: i 410 Phone #: (503) 718-
.-
, '
CITY OF TIGARD
i BUILDING DIVISION PERMIT #: PLM2005-00569
I 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/29/2006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 6/13/2007 TIME: 7:01AM PAGE: 73
SITE ADDRESS: 10749 SW CANTERBURY LN BLDG 26 CLASS OF WORK:
SUBDIVISION: CANTERBURY CREST CONDOMINIUM LOT #: TYPE OF USE:
PROJECT NAME: CANTERBURY CREST
DESCRIPTION: Building 25, new 4 unit condominium. Addresses: Units 101,102,103,104. Other fixtures: (4)
expansion tanks & (4) hose bibs, 200' footing drain.
OWNER: CANTERBURY PLACE, LLC, PHONE #: 360-695-7700
CONTRACTOR: CROMWELL PLUMBING PHONE #: 603-2664790
Inspection Request Scheduled For: Date: 6/13/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough-in . 050128-02 503-545-3654
Corrections /Comments/ Instructions:
El PASS El PARTIAL APPROVAL CANCEL n NO ACCESS
I I FAIL El CALL FOR INSPECTION I1 ADDITIONAL FEES ASSESSED
Inspector: Al Date: - Phone #: (503) 718-
- ,
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2006-00569
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/29/2006
Phone: (503) 639-4171 ct
u vimi
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 6/13/2007 TIME: 7:01AM PAGE: 74
SITE ADDRESS: 10749 SW CANTERBURY LN BLDG 25 CLASS OF WORK:
SUBDIVISION: CANTERBURY CREST CONDOMINIUM LOT #: TYPE OF USE:
PROJECT NAME: CANTERBURY CREST
DESCRIPTION: Building 25, new 4 unit condominium. Addresses: Units 101,102,103,104. Other fixtures: (4)
expansion tank's & (4) hose bibs, 200' footing drain.
OWNER: CANTERBURY PLACE, LLC, PHONE #: 360-695-7700
CONTRACTOR: CROMWELL PLUMBING PHONE #: 503
Inspection Request Scheduled For: Date: 6/13/2007 Pour Time:
Code # Inspection Description Confirm # Contact .# Message
306 Plumbing underslab 050128-01 503-645-3664
Corrections/Comments/Instructions:
•
I PASS 0 PARTIAL APPROVAL n CANCEL 0 NO ACCESS
I FAIL I I CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: V: .0 / / Phone #: (503) 718-