Permit OFF
CITY OF TIGARD PLUMBING PERMIT
- COMMUNITY DEVELOPMENT Permit #: PLM2012 -00147
Date Issued: 05/31/2012
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439
Parcel: 2S112BD90000
Jurisdiction: Tigard
Site address: 14655 SW 76TH AVE
Project: Timbercrest Condominiums Subdivision: TIMBERCREST CONDO Lot: GCE
Project Description: Repair 30' of water service.
Contractor: APOLLO DRAIN & ROOTER SERVICE Owner: TIMBERCREST CONDO
2208 NW BIRDSDALE #8 OWNERS OF ALL UNITS
GRESHAM, OR 97030 00000
PHONE:
PHONE: 503 - 239 -8801
FAX: 503 - 669 -9568
FEES
Quantity Description Date Amount
30 If Water Service 05/31/2012 $62.54
Specifics: 1 12% State Surcharge - 05/31/2012 $8.70
Plumbing
Type of Use: MF 10 ea Minimum Fee Adjustment - 05/31/2012 $9.96
Plumbing
Class of Work: OTR
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 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: � Permittee Signature: nAt "fre C■1
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
May. 31. 2012 10:36AM Apollo Drain Li No. 1903 P. 1
le Plumbing Permit Application
1/1/k e 4
Site Utilities FO:: OFFICE USE ONLY
c alved $ 31 / Z
City of Tigard V r�! � Re�
Date/BY. Permit No�� /� D0/(�
h 13125 SW Hall Blvd., Tigard. OR 97223 ``�� Plan Review
C Phone: 503.7182439 Fax: 503.598.190AAY 3 LU i Datel6Y OrherPermit tio.
T t r � RD Inspection Line: 503.639.4175 Date Reedy/By Sec Page 2 (or
Internet: www.tigard•or.gov COX OF T�QA D Notlli ed/Melhod: Supp lemental I n
A ... , fotmodon
:� ., .,.,r.
.r- .rL.•r_�, - - �,ti -'s• :,'f.., 0 , . ,�3r , � 'tjKi ; ;
❑New construction 0 Demolition . aP:.,: _. ..__MI.res.- .s50: �rS_•.
ddition/Olterationlreplactmcnt ❑Other: For special information use checklist.
I Qty. I Ea. I Total ft.
I ,u.. r e t
` r = R ':i %-} G ' - . Ox ~ U - ' '`T N ew Description 1- 2- family dwellings (includes 100 for each utility connection)
El 1- and 2- family dwelling „ ❑ Commerciallindustrial x SFR (l) bath 312.70
SFR (2) bath 437.78
❑ Accessory building Multi- Really SFR (3) bath 50032
❑ Master builder ❑ Other: Each additional bath/kitchen 25.02
<)
r�,,;�. 4 r U�,;S OR1�' 1OCr1;TIp�i __ ~';�,�; Fire sprinkler ( sq. ft.) Page 2
" '.. ,ice -'• ��- ... iAlt1P1� - .i•.. e
Job site address: QS� i " 7 `f ` 1 ' Q� Site utilities:
frs ( Catch basin le or ach area drain 18.76
City/State/ZIP: LJ1 A � D rywell, leach line, or trench drain 18.
- -
76
Suite/bldgJapt. no.: I Project name; 7 ,-/ CO A/A 6 Footing drain (no. linear „__J Page 2
Cross street/directions to job site; Manufactured home utilities 50.03
. Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear R: ) Page 2
Subdivision: • 1 Lot no.: Water service (no. linear 8.4 Page 2
Tax map /parcel no.: Fixture or Item: .
d
r. -:. ,; :, . r..•,; -:_- . Y r y a Bacl�ow reverter 31.27
47; M R ? _4:-.;. _ i:CZr4! -. a!4a 0 t�V } WO � +.- '..., .' �. t�
' " �: -`Tf" r-. M. `u�.�� Backwater valve 12.5I
• = 'flik Q ((60104. wo w v'eXv ft L Clothes washer 25.02
Dishwasher 25.02
a c o SO V9/1, V , I C1 Drinking fountain 25.02
_a; «. rrs :--,- ..:u "'� ` 25.021
M ,a Ejectors/sump
+��.A;.S�:rr;:t❑ ROPER!F1'��QW�.�1'r��-�.�'"�• ` �'a�� � �� �� a
Expansion tank 12.51
Name: -
Fixture/sewer cap 25.02
Address: Floor drain/floor sink/hub 25.02
City/State/ZIP: Garbage disposal 25.02_
Phone: ( ) Pax: ( ) . Hose bib 25.02
1y'"'; = ® s °r ` 4� ` ,,,, f s � -�
=;�' ��. IiIC `IV���;o"� i��. � ,�.�'C'.QF!��4!9��a>�..)�d Ice Maker 12.51 ��'�'
r Interceptor/grease trap 25.02
,, + • • • t . a t . it a
Medical acts (value: ...._ _.. Page 2
.Cbntana
i me: -.- _ _ _.
YLQ n f:..pr ' -' - -- - -:.: _:
. . . . _ • _ ....Puner - - ' -- - --- • - 12.51.. . •
Address: 'Z • i_ _ _ . ttr • • . 1 / • Roof drain (commercial) 12.51 4.
City /State/ZIP: P Ai A l i I S 0 Sink/basin/lavatory 25.02
Phone: / Fax; ; r ) i ..._- 90 Solar units (potable water) 62.54
E-mail: NM: (i 03 -.. Tub /shower /shower pan 12.51
Al ' , 11A Urinal 25.02
• 'g' �.•�z� ".,:- f:. -� �°� � j'�'^"" Water closet 25.02
Business name: 1 10 Th- In Q It I ne In CCC/// i Water heater • 37.52
Address: /22 I • ` \ ` 1 ` ± t , . 1 piping/DWV 56.29 -
City/State/ZIP: 6 a �� '� 113 Other: 25.02
I r Phone: ) aii - 4.1 1 Fax: hp) I mum Subtotal
Minimum permit fee: $72.50
tri CCB Lie.: 0 AI • Plumbin: Lie no.; • " I. Plan review (25% of permit fee)
Authorized signatu ' / 1 1 _�+1•1111` State surcharge (12 %ofpermit fee)
Print name: �/ NO Mill pate: Alai= TOTAL PERMIT FEE ft. .
M1Bul ldlnelfermi rarPLMlI- PermlrApp.doe 10/01/09 •46167(10/011COM/wEa)