Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2013 -00230
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/03/2013
Parcel: 1 S135DD00700
Jurisdiction: Tigard
Site address: 11710 SW WARNER AVE 1 •
Project: Nelson Apartments Subdivision: HOFFARBER TRACTS Lot: 38
Project Description: This permit is to complete work previously permitted under PLM2013- 00020. This is a 4 -plex with a communal
laundry room. In addition to previous work, adding (4) tub showers to scope of work.
Contractor: 1ST CALL PLUMBING & DRAIN CLEANING LLC Owner: NELSON, SHERRIE
6615 SE 42ND AVE 9712 SW ALABAMA ST
PORTLAND, OR 97206 TUALATIN, OR 97062
PHON 971 409 -7463 PHONE: 503 - 804 -0262
FAX: 97 T- 961 -7108
FEES
Quantity Description Date Amount
4 ea Sink 07/03/2013 $100.08
Specifics: 4 ea Lavatories 07/03/2013 $100.08
4 ea Tub /Shower /Shower Pan 07/03/2013 $50.04
Type of Use: MF 4 ea Water Closet 07/03/2013 $100.08
Class of Work: ALT 1 12% State Surcharge - 07/03/2013 $42.03
Type of Const: Plumbing
Occupancy Grp:
Stories:
•
Total $392.31
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 ' ' suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility .. I !cation 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 •• ect questions to OUNC b • • g . : .232.1987 or 1.800.332.2344.
I sued By: / r / /Pi ) Permittee Sig ure: i, LS_
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.
To: Paga 1 or 2 2013 -07 -03 03:23:22 (GMT) 100396'17'106 From: First Gall Plumbing
Plumbing Permit Application RECEIVE ,
. ,.
Site Utilities
JUL FOR OFFICE USE ONLY
City of Tigard 3 2013 Received
.Permit No.,
i:a 13125 SW Hall Blvd., Tigard, OR 97223^/��/ ; Dale /Bv 7� ��N��3 - �}��
, ,f/I 1 1 OFT i Plan R
.� " / Phone: 503.718.2439 "Fax: 503.598195
'�N lD : llatelRy eview Other Permit No.-
TICiaRD Interne Inspection Line: 503.6394175 �H // 11 Internet: www Itgarrl -or gov
BUILDING L!1 y iii iur
V I V I� Date Re See C 2 r
v t �1 Notified/Method: Cnpplenten to Information
TYPE- ,OF W ORK N'l El'* •SCRE'DLILE
[-j New construction ❑ Demolition For special information use checklist
❑ Addition /alteration /replacement ❑ Other. Description Qty. Ea. Total
Newt- 2,family dwellings (includes 100 tt. fen each utility connection)
- `.Ce1TECORY OF',CONSTRUCTION J. - SFR (1) bath 312.70
❑ I- and 2-family dwelling ❑ Commercial industrial SIR (2) bath 437.78
SFR (3) bath 500.32
❑Accessory building ® Multi - family
❑ Master builder Each additional bath /kitchen 25 02
❑ Other: Fire sprinkler ( sq. 0.) Page 2
JOR iINFORM&TION.AND LOCATION Site utilities:
Job site address: 11710 SW Warner Ave. Catch basin or.area drain 1 18.76
W
/� CitviSlaleJZIP Tigard, OR 97223 Dlywell, leach line, or trench drain 18.76
- / - - Footing drain (no. linear ft.: _) Pag 2
Suite /bldgJapt. no.: Project name:
Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18 76
Rain drain connector 18.76
Sanitary sewer (no. linear ft.: _) Page 2
- Storm sewer (no. linear ft.:. ) Page 2
Page
Water service (no. linear ft.: _) Pagc 2
Subdivision: Lot no.: Fixture or item:
Tax map /parcel no.: Ilacktlow preventer 31.27
DESCRIPTION OF'WORK' - Backwater valve 12.51
Remodel Clothes washer 25.02
Dishwasher 25.02
Drinking ibuntain 25.02
t Ejccloi s/sump 25.02
_ -_ ❑ -PROPERTY OWNER' C1' TENANT - " Expansion tank _ 12.51
Name: Dave Nelson Fixture /sewer cap 25.02
Address: Floor drain /floor sink /hub 25.02
City /State /ZIP:
Garbage disposal 75_07
Hose bib 25.02
Phone: (503)804 -0262 Fax: ( ) Ice maker 12.51
. - .❑ APPLICANT= - , „ _ .,- ❑' ,CONTACT PERSON, Interceptor /grease trap 25.02
Business name: Medical gas (value: $ Page 2
Contact name: Primer 12.51
Address: Roof drain (commercial) 12.51
Sink/hasiltilavatory 8 1 25.02 200.16
City /Stale /ZIP: _ Solar units (potable water) 62.54
Phone: ( ) Fax:: Tub /shower /shower pan ( ) p 4 12 51 50.04
E-mail: Urinal 25.02 eq
CO NTRAC I ' OK - Water closet 4 25.02 ZQA. -ITr 1
Water heater 3752
Business name: 1 Call Plumbing & Drain Cleaning LLC -
Water pipi ng/DWV 5629
Address: 661 SE 42 " Ave Oilier: �-
25.02
City /State /Z1P: Portland, OR 97206 Subtotal . 35 . 0
Phone: (971) 409 -7463 Fax: (503) 961 -7108 Minimum permit fee: $72.50
CCI3 Lie.: 195480 / /A/ f/ 3 Plwnhino - ,Lie. no.: 13131126 Platt review (25% of permit fee) 11 * °1j
Authorized sig»attLr \ 7i/b y
t i___
State surcharge (12°./..Of permit fee) 54704• /
( 7 {iL( C�':r I'OT 10.4,49' 1
I riot name: t_ginie Shinn I Date: 07/02/13 1 his permit application expires if a permit is not obtained within ISO days G 2.
atter RIMS been accepted as complete.
`fee methodology set by Tri- County Building industry Service Board.
1 \11uiidLlod' uuk,1PLMU- PermilApp doe 17,01 /e19 4 40- 9616TO 0 /02 /CO\t:14•P11t