Permit CITY OF TIGARD PLUMBING PERMIT
is COMMUNITY DEVELOPMENT Permit#: PLM2013-00301
T EGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/28/2013
Parcel: 2S110AD08801
Jurisdiction: TIGARD
Slte address: 10695 SW MURDOCK ST OFC
Project: Pacific Crest Apartments Subdivision: LANG HILL NO.2 Lot: 77G
Project Description: Replacing 120 ft.of water service from office to pool room.
•
Contractor: ANYTIME PLUMBING&DRAIN CLEANING Owner: PACIFIC CREST INVESTORS LLC
3333 NW 35TH AVE, BLDG C PO BOX 62
PORTLAND,OR 97210 KENTFIELD,CA 94914
PHONE: 503-432-8275 PHONE:
FAX: 971-255-1965
FEES
Quantity Description Date Amount
120 If Water Service 08/28/2013 $100.06
Specifics: 1 12%State Surcharge- 08/28/2013 $12.01
Plumbing
Type of Use: MF
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $112.07
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: -=rmittee Signature:
ti
IT
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.
Aug. 27. 2013 12:50PM No. 8055 P. 1
Plumbing Permit Applic
Building Fixtures ._ .VFIVED FOR OFFICE USE UNIX
City Of Tigard Received Permit No.: /,
1 i 1-0
n 13125 SW Hall Blvd.,Tigard.OR 9G 2 7 2013 Date/i3 cwt • , , "� 1
Phone: 503.639.4171 Fax: 50 '�FTIGARD Date/By' Other Permit No.:
Inspection Line: 503.639.4175 Date Ready/By: ent: &I Sea Page 2 for
1 IGAItD Internet: www.tigard•or.gov BUILDING DIVISION y H
Noli6ed/Method; 'fir Supptetnenfnt Information
❑•Now construction ❑Demolition For speclnllnfornrmlon use checklist
I Description I Qty. I Ea. I Total
Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
`: •. .'CATEGOR'Y'.OF.COPISTItUCTION;. .- SFR(1)bath 31230
❑1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
❑Accessory building [Multi-family SFR(3)bath 500,32
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler(,__,.sq.ft.) Page 2
JOB•. Lr:'�NFORMATIO. AND 1ti.0CATlON
` . ; Site utilities:
Job site address: le W g Jc S 11 M u kbo f Catch basin or arcs drain 18.76
City/State/ZIP: Q�Q �(�1 Drywell,leach line,or trench drain 18.76
11(1'1 N'► 0 i G �r� Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: ()Kite I Project name: �'�Et L &KJ•� Manufactured home utilities 50.03
Cross atreet/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
Water service(no.linear ft,: y Page 2 100,0 W
Subdivision; I Lot no.: Fixture or item: 1
Tax map/parcel no.: Bacldlow preventer _ 31.27
' ' "` • ... •DESCRIPTION:-; }r Q *G ft', / ater valve 12.51
eate ��N11 I4 I VV tTra SIl V f IZOn I Of F-W wD`ishwasherh� 25.02
11 POOL 1Y1 CI4a�I L/CL �I I 1 Drinking fountain 25,02
Ejectors/sump 25.02
.", <.:C'PR-OPLRTY ONNvR .•;..•� I ••••:�;IL.NANT ' P ansin tank 12.51
Name: ( 0 / Pixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 1 cogs ff. &&bbl rTh
Garbage disposal 25.02
City/StateJZIP: -1-14 I O 1124 _Hose bib - 25.02
Phone:(�() )ID q- 1 _Fax:( ) Ice maker 12.51
'L"1APPLICANT: .:d'CONTAACT::P.ERSON; . Interceptor/grease trap 25.02
Business name:/k4(y'rI M P141MOIN"1 'l' bRl-IN CGER'NIN/] Medical gas(value:$ Page 2
/ s A IVt I bbez Primer 12.51
ASE.1A
Contact name: _i
,t Roof drain(commercial) 12.51
Address: �'J� NW 'h4 kVg e*I I bJ ua G Sink/basin/lavatory 25.02
City/State/ZIP: pp pry/LAND, 0 0112/0 Solar units(potable water) 62,54
Phone:(5V )4''2• $2-/t%-5 1 Fax::(q1 I)7%- 1 GI li5 Tub/shower/shower pan 12,51
I?-mail:
IN FO /Ny11mi nun/Jeep. u 5 Urinal 25.02
Water o
;CONTRACTOR::.. :: .. . s _ ,
• et 25 02
All Water heater 37.52
Business name: A"N�i I pa C y1,14,!I LS1 Al r D1&WN CG&ANI N if Water piping/DWV 56.29
Address: N� Fl 4-v I3 i i q7 Other: _, 25.02
City/State/ZIP: P19 TWkN DJ _Oft 4'1?.l O Subtotal IQ 0 ,00
(� 3) p Minimum permit fee: $72.50
Phone: ��� D�i7� Fax:(4/l) 2�5- Iq(/,� Plan review (25%of permit fee)
CCB Lie,: I t I�u Plumbing Lic.no.: pe,$t' 4 r�
I --,. State surcharge(12%ofpetmitfee) (Z,
Authorized signature: Aar t t V ki TOTAL PERMIT FEE 11'.01
�6'hey ey �r LL I q i jt f I i}„ This permit opplimtlon expires If a permit Is not obtained within 180 days
Print name: t� Date: p ,(j 1 I �a/
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Servico Board.
1;\aiIldina\PermpuwLMU•PwmIApp,deo 10/01/09 44D-46i6T(10/02/COM/WED)