Permit CITY OF TIGARD PLUMBING PERMIT
a.. COMMUNITY DEVELOPMENT Permit #: PLM2012 -00162
T IG ARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/23/2012
Parcel: 1 S 135ACO2500
Jurisdiction: Tigard
Site address: 9160 SW MANDAMUS CT
Project: Longstaff Apartments Subdivision: ASHBROOK FARM Lot: 25
Project Description: New MF. Building 8 (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 07/23/2012 $62.54
Specifics: 100 If Storm and Rain Drain 07/23/2012 $62:54
100 If Water Service 07/23/2012 $62.54
Type of Use: MF 6 ea Clothes Washer 07/23/2012 $150.12
Class of Work: NEW 6 ea Dishwasher 07/23/2012 $150.12
Type of Const: 1 ea Expansion Tank 07/23/2012 $12.51
Occupancy Grp: 6 ea Garbage Disposal 07/23/2012 $150.12
Stories: 2 ea Hose Bib 07/23/2012 $50.04
6 ea Sink 07/23/2012 $150.12
14 ea Lavatories 07/23/2012 $350.28
10 ea Tub /Shower /Shower Pan 07/23/2012 $125.10
10 ea Water Closet 07/23/2012 $250.20
6 ea Water Heater 07/23/2012 $225.12
1 12% State Surcharge - 07/23/2012 $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 • tion 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 rect question o OUNC by calling 503.232.1987. or 1.800.332.2344.
Is ed By: Jo. a, Permittee Signature:
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.
Plumbin2 Permit Application N
Building Fixtures FOR 01.1 l'SI: 1/N1.1
0
City of Tigard Received
: 13125 SW Hall Blvd., Tigard, OR 97223
Phone: ..ax: ..
ii Date/By: 6/02_ 4: Permit Nt > 19 ZAA20/ 4 2 - OD /62, S) rit
Plan Review
Date/By: Other Perm bigredA9 '''
Inspection Line: 503.639.4175 Date Ready/By: .... M See Page 2 for til
1
Internet www.tigard-or.gov Notified/Mediod: / / 6..Supplemental Information k
. , . _ , : j . - : 7 . - 3 4 , 4 p z i o v . : . - - . . . 7 , 4 - M a i t t i i r - . . * * 0 „ , _ . 4 4 - : , = 7 : L . - - . - : - . . . : _ , , , ; „ i i 4 ; 4 : t ! ' - - , . . , : . ; ; . 1 ::::-,::?V4: , . ,, , - - • F m ' •
til New construction 0 Demolition For special information use checklist
Description I Qty. I Es. I Total
0 Addition/alteration/replacement 0 Other. New 1-2-family dwellings (includes 100 It for each utility connection)
: SFR (1) bath 312.70
0 1- and 2-family dwelling 0 Commercial/industrial SFR (2) bath 437.78
SFR (3) bath 500.32
0 Accessory building til Multi-family
Each additional bath/kitchen 25.02
0 Master builder 0 Other Fire sprinkler ( sq. ft.) Page 2
Site utilities:
Catch basin or area drain 18.76
¥ -lob site address: q iii,qica.61I1174 5“) r CA-
Drywell, leach line, or trench drain 18.76
City/State/ZIP: -r lax Al p 1 og 9 -7 12,3 Fth s , 9/6, 0
Footing drain (no. linear ft.: ____) Page 2
Suite k&p/ t. no.: 4 47 I Project name: Lans-Nckik Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
14 i in e Grte.,,t(v - 1 (2_0415 ha_cit LtA Rain drain connector 18.76
Sanitary sewer (no. linear 11: le) I Page 2
Storm sewer (no. linear It: 100 ) 1 Page 2
4. C l I ( 41 L20 5 a.) VV1 ea-rk pia. evt Lk S a
Water service (no. linear ft.: OLL: _r ) 1 _ Page 2 _ G
Subdivision: I Lot no.: Fixture or item:
Backflow preventer - 31.27
Tax map/parcel no.: -, 1151
- "ItaleigAllt, ' 0? - 400/70:-.. 1 46t - '1.4 , tta a BackwiMr „ es vhalerve 6 25.02 I ge, . 12 '
"' r‘re 4 4...) 4 4:VC - ?■u..v..f..\...•.k (..," '''3 Dishwasher GI 25.02
Drinking fountain 25.02
Ejectors/sump - 25.02
Expansion tank
, FT*::-'4'. Or, , W,11"-re!,,t1 1 .r 1 -.•:,-, . f`,74 L10_4,4;:-.,',1-9-.4,c--: I . 12.51 ta,sk
Fixture/sewer cap - 25.02
Name: - %;X: SINV"v■ Cc:v.-Qv:pr.: e.., Floor drain/floor sink/hub •-• 25.02
Address: SZE:15 itA 9 %40. , k '5%,),:et,c_ VI \
Garbage disposal 6 25.02
City/State/ZIP: 1...coN„j2_, Osu,,,.\es C: C)IR C rt0 - 3.5 - Hose bib 2 25.02 So . 04
Phone: SOI) 3012, - 1 32,4 Fax: (501 )(GSM- CA 0 Ice maker - 12.51
..: 0 Interceptor/grease trap - 25.02
Medical gas (value: S ) ■-• Page 2
Business name: 1 Li ‘ L L. C,
Primer Mimil• 12.51
Contact name: einA..ri t G.- br Lc.„Ldzi"
Roof drain (commercial) 12.51
Address: 2, 7 - 5 - Nit L.41 ei si-e_ I-1 k Sink/basin/lavatory 20 25.02 e5
1
City/State/ZIP: I, 4-1/-e__ f; ,.0i 0 , 02- 4 - 103 5 Solar units (potable water) 62.54
Phone: (5 -1( 51 I Fax: : (67)) (a S4.0 I D2. Tub/shower/shower pan
% 0 12.51 12,4, 10
Urinal ----. 25.02
E- mail:(', ir L c,(L.c.rd j .1-5 kv, L fl.A.C.-0, Ccwv
I.
Business Ilanic e.Welo r Ys■icriv 14.L6. Water piping/DWV 56.29
Address: 1615 \AI . I4elt C-JaWav01%44.4 \ACI.1 Other. 25.02
i
City/State/ZIP: - c ce ,,.. x. ...,\„ ... _ 04 cc-taco Subtotal
Phone: (*)1 ) (A;i_k y 302_ Fax: (Sol ) U -CS,13(A Minimum permit fee: S72.50 - . \
Plan review (25% of perrnit fee)
CCB Lic.: \\D.....),,,,co Plumbing Lic. no.616 -8a44
State surcharge (12% of permit fee) ,451 . 84 to
Authorized signature: \ -0\- -... ,..,/.4S TOTAL PERMIT FEE k inveS
Print name: "T v 1 vsa jW ck.s 4(. 4 . 3 . = .--(c I Date:I- I -at kzi This permit application expires if a permit is not obtained witbitf days
after it hu been accepted as compkte.
'Fee methodology set by Tri-Counry Building Industry Service Board.
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hBuitcling■Perenits\ PLMU-PennilApp doc 10/01/09 440-4616T(10102/COWNEB)