Permit CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PE
DEVELOPMENT PLM2005 -00567
DATE ISSUED: 2/14/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
/07-79- PARCEL: 2S110AA -CC001
SITE ADDRESS: 496 SW CANTERBURY LN BLDG 14 ZONING: R -12
SUBDIVISION: CANTERBURY CREST LOT: 001 JURISDICTION: TIG
Project Description: Building 14, 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
CANTERBURYYPLACE, LLC Description Date Amount
109 EAST 13TH STREET
VANCOUVER, WA 98660 [PLUMB] Permit Fee 2/14/2006 $1,388.40
[PLMPLN] Plan Review 2/14/2006 $180.49
Phone : 360-695-7700 [TAX] 8% State Surchari 2/14/2006 $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 rul or direct questions to OUNC by
calling 503- 6699 or 1- 800 - 332 -2344.
Issued B �t.,r,,J Permittee Signature: x
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.
/ 06,73 C, _.A., b ,,,, Ire
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Plumbing Permit Application FOR OFFlcl: l;st: ()NI .N• y
Ci of Ti and CEOVE �� Received - 1� d ' Y�-1 " P) /AS C O 1'
g Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.639.4171 Fax: 503.598.1960 OCT 14 2or i ' s�����,i Plan Plan Re vie // ', ( Other Permit No. S J ?7'7
24- Hour Inspection Line: 503.639.4175 --air I iDa te Ready/By: /
® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: 1I Juris: U Supplemental Information
TYPE 6FIFA TIGARD FEE* SCHEDULE' °•:'' B ® New construction [��e
WI - i vmottion i v i l ti:tl �1 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 Each additional bath/kitchen 45.00
❑ Other: Fire sprinkler ( sq. ft) Page 2
0 7 77 JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: /41 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/bldg. /apt. no.: BLDG / I Project name: Canterbury Crest Footing drain (no. linear ft.: 200) I Page 2 I O (,4(:)
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.: I Page 2 101 , '- 0
Subdivision: Canterbury Place Lot no.:
Water service (no. linear ft.: I Page 2 5 6. a D
Tax map /parcel no.: Weill 2S110AA, 01500,01400 Fixture or item
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2 - o/ , 4/0
New Construction of Condominium Units Backwater valve 16.60
Clothes washer 4 16.60 ( , '. D
Dishwasher 1.i 16.60 ( , WD
® PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60
Ejectors/sump 16.60
Name: Canterbury Place LLC
Expansion tank L-1 16.60 &G , '- 0
Address: 109 East 13 Street Fixture/sewer cap I6.60
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 L 6 ,'- 0
® APPLICANT 0 CONTACT PERSON Hose bib I-1 16.60 (y (o , y a
Business name: Canterbury Place LLC Ice maker 16.60 [►-
Interceptor /grease trap 16.60 1
Contact name: Dave Gutschmidt Medical gas (value: $ ) Page 2
Address: 11624 SE 5 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 1 $ 16.60 Xq $ , gp
E -mail: Tub /shower /shower pan B 16.60 1 2 , $ 0
Urinal 16.60
CONTRACTOR Water closet (Z 16.60 1 9 C ,2
Business name: Cromwell Plumbing Inc Water heater Li 16.60 6, ( , L i 0
Address: 30855 S Kauffman Road Other:
City/ State/ZIP: Canby, OR 97013
Subtotal /3S .tio
Minimum permit fee: $72.50
Phone: (503) 266-4790 Fax: (503) 266 -4792 Residential backflow minimum permit fee: $36.25 /s e i q
CCB Lic.: 44712 Plumbing Lic. no.: 34-167 PB 5 /AZ Plan review (of permit fee) 1 i �[
State surcharge (8% of permit fee) ; / / /• al
Authorized signature: TOTAL PERMIT FEF 1 /107 9 • 4 ((
Print name: Greg Cromwell Date: This permit application expires if a permit is not obk....cu within
180 days after it has been accented as complete.
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
RECEIVED
CROMWELL PLUMBING
30855 S. KAUFFMAN RD. FEB 2 /UUb
CANBY, OR 97013 CITY OF TIGAHU
BUILDING DIVISION
Plumbing Signature Form
Permit #: PLM2005- 0
Date Issued: 2/14/2006
Parcel: 2S110AA -CC001
/6779 Site Address: 1.067-3 SW CANTERBURY LN BLDG 14
Subdivision: CANTERBURY CREST
Block: Lot: 001
Jurisdiction: R -12
Zoning: TIG
Remarks: Building 14, 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 9866U - ,
Phone #:360- 695 -7700 Phone #: 503- 266 -4790
Reg #: LIC 44712
PLM 34 -167PB
AN INK SIGNATURE IS REQUIRED ON THIS ORM
•
X
►mot
Signatur- •f Authorized Plumber
If you have any questions, please call 503.718.2433.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM200S-00567
..-'
13125 SW Hall Blvd., Tigard, OR 97223 / ---" DATE ISSUED: 2/14/2006
Phone: (503) 639-4171 1401 041 I f i l \
Inspection Requests (24 Hrs.): (503) 639-4175 AA f '111.
INSPECTION WORKSHEET FOR DATE: 11/14/2006 TIME: 7:02AM PAGE: 33
SITE ADDRESS: 10779 SW CANTERBURY LW BLDG 14 CLASS OF WORK:
SUBDIVISION: CANTERBURY CREST CONDOMINIUM LOT #: TYPE OF USE:
PROJECT NAME: CANTERBURY CREST
DESCRIPTION: Building 14, 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: 11/14/2006 Pour Time: .
Code # / Inspection Description Confirm # Contact # Message
399 Plumbing final
q).../ 039720-04 503-572-2961 N
Corrections /Comments/ Instructions:
(
! 'ASS PARTIAL APPROVAL n CANCEL I I NO ACCESS
FAIL 0 CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: Date: lit ... 4
1 k i I ilu (Of Phone #: (503) 7182-___
/
,
CITY OF TIGARD
BUILDING DIVISION
PERMIT #: PLM2005-00567
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 21 1 4 I 2 0 0 6
Phone: (503) 639-4171 falt
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 11/13/2006 TIME: 7:04AM PAGE: 60
SITE ADDRESS: 10779 SW CANTERBURY LN BLDG 14 CLASS OF WORK:
SUBDIVISION: CANTERBURY CREST CONDOMINIUM LOT #: TYPE OF USE:
PROJECT NAME: CANTERBURY CREST
DESCRIPTION: Building 14, 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: 11/13/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 039616-13 503-572-2961
Corre e s/Co.- ents/In uc 'ens:
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I PASS El PARTIAL APPROVAL fl CANCEL I I NO ACCESS
FAIL I I CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: &' i\M- Date: t (f 4 466 Phone #: (503) 718-
•
CITY OF TIGARD
BUILDING DIVISIoN"
A ,
PERMIT #: PLM2005-00567
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2J14/2006
Phone: (503) 639-4171 kaAploti,;1\
Inspection Requests (24 Hrs.): (503) 639-4175 Ail■ 1.1'
.___ IL.
INSPECTION WORKSHEET FOR DATE: 9/11/2006 TIME: 7,00AM PAGE: 60
/672?
• SITE ADDRESS: ioem SW CANTERBURY LN BLDG 14 CLASS OF WORK:
' SUBDIVISION: CANTERBURY CREST CONDOS LOT #: 010 TYPE OF USE:
, PROJECT NAME: CANTERBURY CREST
DESCRIPTION: Building 14, new 4 unit condominium. Addresses: Units 1 thru 4. Other fixtures: (4) expansion tankE
& (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: 9/11/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough-in 036292-05 503-545-3654 N
Corrections/Comments/Instructions:
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LIOIFF •:,4-4'•"
—PASS 0 PARTIAL APPROVAL I I CANCEL n NO ACCESS
0 FAIL 0 CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
0
Inspector: 1\ 1 \ 1 -0 Date: / 0 Phone #: (503) 718- (
1 . •
CITY OF TIGARD f9L "0/ /
BUILDING DIVISIbN ' PERMIT #:2 100----- °0 7
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 �
Inspection Requests (24 Hrs.): (503) 639 -4175 ii3
•
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: // // a , l CLASS OF WORK:
SUBDIVISION: /0 77 q LOT #' TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 O G Pour Time:
Code # Inspection Description Confirm # Contact # Message
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Corrections /Comments/ Instructions:
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0 ,PASS ❑ PARTIAL APPROVAL n CANCEL n NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Pi I )'(-.1' Date: 6 / Phone #: (503) 718-
CITY OF TIGARD `
BUILDING DIVISla ' ° PERMIT #: P /IMXQ6 40o !07
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639 -4175 =��
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: g9 3 Cx 6:Li Ln CLASS OF WORK:
SUBDIVISION: / d 7-7 LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE b3�
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3,4-7-g-,-- Pour Time:
Code # Inspection Description Confirm # Contact # Message
33
Corrections /Comments /Instructions:
I PASS n PARTIAL APPROVAL ❑ CANCEL U NO ACCESS
FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: I✓ j DatO / 2/_f Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISIOV PERMIT #:pl/Vl20D5 O D5-67
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639- 4171a�ii���
Inspection Requests (24 Hrs.): (503) 639 -4175 _�� __..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: J-9 3 C(^, A( c.1 L—ei CLASS OF WORK:
-
SUBDIVISION: /b 7 -' LOT #: TYPE OF USE:
PROJECT NAME: 6
DESCRIPTION:
OWNER: PHONE #:51)3 - 70-386,s -
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: j - Pour Time:
Code # Inspection Description Confirm # Contact # Message
q , , cos —
O Corrections /Comments / Instructions:
. .441414
l-pASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: Y Date: 2 I Phone #: (503) 718-