Permit •
CITY OF TIGARD PLUMBING PERMIT
° COMMUNITY DEVELOPMENT Permit #: PLM2012 -00160
T I G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/11/2012
Parcel: 1 S135ACO2500
Jurisdiction: Tigard
Site address: 9256 SW MANDAMUS CT
Project: Longstaff Apartments Subdivision: ASHBROOK FARM Lot: 25
Project Description: New MF. Building 6 (6 units).
Contractor: WOLCOTT PLUMBING Owner: J.T. SMITH CO
1075 W HISTORIC COLUMBIA RIVER HWY 5285 MEADOWS RD SUITE 171
TROUTDALE, OR 97060 LAKE OSWEGO, OR 97035
PHONE: 503 - 667 -1781 PHONE: 503-975-7639
FAX: 503 - 667 -9891
FEES '
Quantity Description Date Amount
•
100 If Sewer Service 07/11/2012 $62.54
Specifics: 100 If Storm and Rain Drain 07/11/2012 $62.54
100 If Water Service 07/11/2012 $62.54
Type of Use: MF 6 ea Clothes Washer 07/11/2012 $150.12
Class of Work: NEW 6 ea Dishwasher 07/11/2012 $150.12
Type of Const: 1 ea Expansion Tank 07/11/2012 $12.51
Occupancy Grp: 6 ea Garbage Disposal 07/11/2012 $150.12
Stories: 2 ea Hose Bib 07/11/2012 $50.04
6 ea Sink 07/11/2012 $150.12
14 ea Lavatories 07/11/2012 $350.28
10 ea Tub /Shower /Shower Pan 07/11/2012 $125.10
10 ea Water Closet 07/11/2012 $250.20
6 ea Water Heater 07/11/2012 $225.12
1 12% State Surcharge - 07/11/2012 $216.16
Plumbing
Total $2,017.51
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 N. ' enter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or dir- t questions to I • C by calling 503.232.1987 or 1.800.332.2344.
Issu • By: Permittee Signat •
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.
Plumbing Permit Application
Building Fixtures
City of Tigard " 7 /,Z, Permit Nyea y� /a -ea /4a
l iht •
13125 SW Hall Blvd.. Tigard, OR 97223 Plan Review // f Q
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Outer P ermit N 4S!!�/ c /o - //j
I i t _ ` I i) Inspection Line: 503.639.4175 Date Ready/By: runs: 1 ® See Page 2 for \
Internet www.tigard - or.gov Notified/Method: Supplemental Information
•'r: , • 4 C. ;. ?r,.`, ° ;2S k. tiiir tvwc-s , !. °.. - : _c:A,T;s ; .. FEE* SCHEDULE'
NI New construction ❑ Demolition For special infonnarion use checklist
Description I Qty. I Ea. I Total
❑ Addition/alteration/replacanent ❑ Other. New 1- 2- family dwellings (includes 100 ft. for each utility connection)
- ;-3.- 3y.n'Y :4;' r ole- r ' . a:at . ,`, .,.';x4 .- a' "" N p:s;" SFR (I)bath 312.70
❑ I- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 437.78
SFR (3) bath 500.32
❑ Accessory building 01 Multi- family
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 .
+ , t ; { %40L i�NllR. 0 *-0.44 4:a; -7..:,1--." Site utilities:
Job site address: a 22S4' el i , qZ 0 i 92.1 Z 5 m dvL d a �S Catch basin leach area drain 1 8.76
City/State/ZIP: 1 ca a a 9 S� O Footing drain (no. linear ft.: P
leach line, or trench drain Page 2
1 Footing _ ) age 2
Sui IdgJ t. no.: 6 I Project name: LerenS 9a _Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
1' � 2 I i p /� re e _� w,i gat / s h & r Rain drain connector 18.76
tt l fC "�" Sanitary sewer (no. linear ft.: Un i Page 2
_ Storm sewer (no. linear R.: ( Page 2
4 ci Z (D i ci ZS 1p sc.() iM a-n ti°-vv a Water service (no. linear R: (�) t Page 2 (p .6
Subdivision: " 1 Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer - 31.27
„�j , � Backwater valve 12.51
r t't' .r : < - <`* ..,,�
r " -'�" - ' =
. ' s .�.R e : � : � c``a
Clothes washer (t) 25.02 � 50'
1�,
T��eitia►
Y- aer e�ul�w.\p.•►� \O CT Dishwasher ( 25.02 j 6012-
Drinking fountain - 25.02
Ejectors/sump - 25.02
r ' L ". f -t' '.." -'i:•7; 12.51 6
Expansion tank
C.,�,� Fixture/sewer cap - 25.02
Name:
T ��_ C � v k! ' Floor drain/floor sink/hub - 25.02
Address: .62_8S. i, • ` M`� yvpnj \.. S1/4,1/4.lte_' \\ Garbage disposal (,0 , 25.02 ISO. P2 -
City/State/ZIP: Lc e . USV.\O m ` 0la Cl t - AC 3S Hose bib 2. 25.02 SO.04
Phone: (503) 308 - 1 32,4-1 v Fax: (S )(o O\ CZ Ice maker - 12.51
' ,. .' T'�t Interceptor /grease trap - 25.02
Business name: LIB t LA, L Meth gas (value: S ) Page 1
Contact name: 4„.I-I 1 PJ { l c) -4 r
tor f drain (• • - 12.51
Address: 5 Z 85 M -e azl a.o ( t, St 1 asi avatory a 20 25.02 S pp `41:)
� O • lar u nits (potable water) 62.54
City/State/ZIP: '[ �,L �5 t,c�R.� O � � '"j. �j S (po )
Phone: ( '5b) q - 7 $11 (p I Fax: : (60* & t-{-- D ) D2_ Tub /shower /shower pan 1C) 12.51 1 . 10
E -mail: (,a 0 r (. t. LR-r Q J'(' 5 w. Litt GO, C O M Urinal 25.02
`. N `• Water closet 1 0 25.02 ?60.
�T ? .,, -'- ," (Q 37.52 p.,25 12.
-- . . .... .1Y��t�'�R -3• .. ,� - �.- , � water heater
Business name:' e� �. vvei1T f . (j. 1�NAC _ C , Water piping/DWV 56.29
Address: i OS" \Al . W y L, (L( Ally Other Subtotal �1
City/State/ZIP: -VC ov,�Cd I QQ �1 OkOQ _ 1(,11a .
-
Phone: (So; ) (.( V t % 302. Fax: (Sol)001 - \ Minimum permit fee: $72.50
CCB Lic.: \` �,Q Plumbing Lic. no.a( -gay Plan review (25% of permit fa)
State surcharge or/. of permit fee) ,p1 , I V
Authorized signature: -x~ +�.,r TOTAL PERMIT FEE y81
Print name: - - r e _ t c w ? e c 1 I Date: LJ - ak a _ 121 This permit application expires if a permit is not obtained withi days
after it has been accepted as complete
*Fee methodology set by Tri- County Building Industry Service Board.
1'1 BuildingWermii *WLMU- PermitApp.doe 10101/09 440-4616T(10/02/COMIWEB) /1..C/
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