Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2012 -00159
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/10/2012
Parcel: 1 S 135ACO2500
Jurisdiction: Tigard
Site address: 9304 SW MANDAMUS CT
Project: Longstaff Apartments Subdivision: ASHBROOK FARM Lot: 25
Project Description: New MF. Building 5 (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 07/10/2012 $62.54
Specifics: 100 If Storm and Rain Drain 07/10/2012 $62.54
100 If Water Service 07/10/2012 $62.54
Type of Use: MF 6 ea Clothes Washer 07/10/2012 $150.12
Class of Work: NEW 6 ea Dishwasher 07/10/2012 $150.12
Type of Const: 1 ea Expansion Tank 07/10/2012 $12.51
Occupancy Grp: 6 ea Garbage Disposal 07/10/2012 $150.12
Stories: 2 ea Hose Bib 07/10/2012 $50.04
6 ea Sink 07/10/2012 $150.12
• 14 ea Lavatories 07/10/2012 $350.28
10 ea Tub /Shower /Shower Pan 07/10/2012 $125.10
10 ea Water Closet 07/10/2012 $250.20
6 ea Water Heater 07/10/2012 $225.12
1 12% State Surcharge - 07/10/2012 $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 . ication -rater. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952- 001 -0090. You may obtain a copy of the rules
or dire- questions to O NC b ailing 503.232.1987 or 1.800.332.2344.
Issue By: , / /,, Permittee Signa re:
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
O
City of Tigard ma G ( /Z, Penult No./OL/o26/02 - eV/59 3•
114 • 13125 SW Hall Blvd., Tigard. OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.196 Other Permit N
Date/By: uJe�I /d2 ?J //0 D
Inspection Line: 503.639.4175 Dale Ready/By: )urn: 0 See Pe 1
r i c_; n r. n Internet: wtvw.ti and -or. ov e � y Page 2 for
g g Notified/Method: /76 SuPPlemeatal Information ei
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New construction ❑ Demolition For special information use checklist
Description Qty. Ea Total
❑ Addition/alteration/replacement 0 Other: New w I- 2- family dwellings (includes 100 ft. for each utility connection)
."- ' ,a ';; ;: . s:idq!t , its" y I ' °< SFR(1)bath 312.70
❑ 1- and 2- family dwelling ❑ Commercial/industrial
SFR (2) bath 437.78
SFR (3) bath 500.32
❑ Accessory building cid Multi - family
Eadt additional bath/kitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page.2
�)l ) � N ,;,,` fi * ,)e a
, - :�LR�+' =vc � :�•r � :w.rr x.� :M 'its :,. � :i.. :;!�� :. Site utilities:
....y- Job site address: R 54-12,, ei 3 3 g9 , 332, ei 3 Z 5 IA vvl out c rvl S (,f Catch basin or area drain 18.76
City/State/ZIP: 1 a. D2 q i 2, �3 93/ 4 , 3 Footing drain line, or trench drain 18.76
Footing drain (no. linear ft.: ) Page 2
' Sui Id t. no.: Project name: L-anS Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
t t i t it 1 ( C re � U � k Let-Li L K Rain drain cotmector 18.76
� Sanitary sewer (no. linear IL (poi 4 Page 2
3l I a(3 b Storm sewer (no. linear f .: 20_,) r Page 2
r - S cO WI d e u , . . . � S v , Water service (no. linear ft: L ) ` Page 2 Ga • 6- y
Subdivision: I Lot no.: Fixture or item: -
Tax map/parcel no.: Backflow preventer - 31.27
�� �j ` ,� . Backwater valve - 12.51
; t - v i n k ,`` ..0 r. - , :;! � "�73 " r n . i F 2 tC ` // ice.
' Clothes washer Ip ®' I SC .
Tv\�c.....3c.;40(.. C w.w.�O. \O CS s'''
Dishwasher ( 25.02 16 o ix
Drinking fountain -- 25.02
Ejectors/sump - 25.02
+ � } L Expansita tank t 12.51 1a. .61
�+{ :� ,...:� � `}` "may ,`; '��:�c: ;
Name: S `tch C..ann t:t�■ Flo dJsewer cap - 25.02
Floor drain /floor sitlk/hub 25.02
Address: 52Eit5 'R f Sv1.rre_ VA
Garbage disposal 6 25.02 Igo. yZ
City/State/ZIP: Lc _ Os Oa QrkO3S Hose bib a 25.02 So . 0t.4
Phone: (s0'3) 3 - 1 32.4 r
x: (803 )( 0•0 Ice maker -- 12.51
7c�'. Y ; 7'" Interceptor/grease trap -- 25.02
Business name: --f'4 '- L LG Medical gas (value: S ) Page 2
l Primer - 12.51
Contact name: CAA a-*- a e ? rLcAwr Roof drain (commercial) - 12.51
Address: 5 z1-5- IM i_a_O,,, eGL 5■-L t-, I Sink/basin/lavatory a p 25.02 50
City/State/ZIP: L ilia._ Os r.(-le-1 o , O2 4 1 D 35" Solar units (potable water) - 62.54
Phone: ( 5DD 415 , -I t 3ei I Fax:: (5 ,) (Q 0 t f O l D 2 Tub/shower /shower pan 1 Co 12.51 ‘2,„5.. I ce
E -mail: e_,(6) rl[-(1 -s' @ J i'Sn.. L +L . CD ii"
Urinal -- 25.02
:. : 'w ` _EQ %,s:. r y c 7 r� 3 ' iii Water closet ' O 25.02 260 22z
: . . ' - :,I :; s, 7'.. ' --„ `it" , x. ? a'�,( %* ._ it, p31;
; Water heater 37.52 S ,
2,2 2
Business name:
04eXae full A • 1 j • - xv___C Water piping/DWV 56.29
Address: io1S J , 14,st? cv... cov....w.It vv.ki Other: _ 25.02
City /State/ZIP:'-- c-cov.�cL.,t._ QL C i °to° Subtotal (61( �
1 ?
Phone: (5o3 ) ( ;- -` z\ X Spa_ Fax: (SO;) 4j61-°l$Ci Minimum permit fee: $72.50
Plan review (25% of permit fee)
CCB Lic.: \`^ ^ �Q \ Plumbing Lic. no.aG _8.L -, p , State surcharge (12%ofpermit fee) g t
Authorized signature: ..._ a� TOTAL PERMIT FEE %g
Print name: �e. c v 3 - I Date:9 -ab- - I This permit applicaaRtion er it pircs if bee a acc permit epted is u not rnmpk pi inc4 te. withi days
ez h as
'Fee methodology set by Tri- County Building Industry Service Board.
ISuilding \PenniMPLMU- PermaApp.doc IOIOI/09 440.4616T(I0102/COM/WFB) J i / /
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