Permit CITY OF TIGARD PLUMBING PERMIT
i,1 COMMUNITY DEVELOPMENT Permit#: PLM2013-00412
Date Issued: 11/14/2013
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S110AD08801
Jurisdiction: Tigard
Site address: 10695 SW MURDOCK ST
Project: Pacific Crest Subdivision: LANG HILL NO.2 Lot: 77G
Project Description: Replace 120'of water service for Building A.
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:
PHONE: 503-432-8275
FAX: 971-255-1965
FEES
Quantity Description Date Amount
120 If Water Service 11/14/2013 $100.06
Specifics: 1 12%State Surcharge- 11/14/2013 $12.01
Plumbing
Type of Use: MF
Class of Work: OTR
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 tto/,O/UNC ailing 503.232.1987 or 1.800.332.2344.
Issued By: i(1 / Permittee Signature: O� dO6JL/e --�0Ai
�lX� 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.
Nov. 14. 2013 9: 13AM �C����� No. 8291 P. 2
Plumbing Permit Applicatio
Building Fixtures roll OFFICE USE ONLY
City of Tigard NOV 14 2013 Received r/ /1/ 3
N..,..
Date/By: Permit No.;pL/y„ff,3 OO //sZ
13125 SW Hall Blvd.,Tigard,OR 97223 Plao Review
Phone: 503.639.4171 Fax: 5o3.59�1��y OF TIGARD Date/By: Other Permit No.:
Inspection Line: 503.639.4175 -
Tl`'AK" BUILDING DIVISION Dateed/ etho Lurie SeePepe2fer
Internet: www.tigard-or.gov e r of
-or.g Notified/M off or
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❑•New construction ❑Demolition Far special ir(fonnatio,r use checklist.
- Description I Qty. I Ea. Total
ril Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
. Y•t,7, . s' .. ° d , ` T t ,u •. .a.. SFR 1 bah 31270
0 1-and 2-family dwellin g ❑Commercial/industrial Uindustrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building _ KI Multi-family Each additional bath/kitchen 25.02
❑Master builder ❑Other; Fire sprinkler( sq.ft.) Page 2
„.,.,. SIT :Pg.,AM,TI.,, AI D LOCAFtON - Site utilities:•
Job site address: IQ(p t1 S ON rl1'V,00/24 4 Catch basin or area drain 18,76
r �� Drywall,leach line,or trench drain 18.76
City/State/ZIP; 1 1(4 1 f W lJ r Footing drain(no.linear ft.:`) Paget
Suite/bldg./apt.no.: Project name: l�t( G�l 6rgr-r Manufactured home utilities 50.03
. - v
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(nor linear ft.: ) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.: IR 1 'L Page 2 100,O b
Subdivision: Lot no.: Fixture or Item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION.OF WORK Backwater valve 12.51
■;;. j Clothes washer • 25.02
t • 14) I W'( , / d v / di Dishwasher 25.02
( 1-DL'` A Drinking fountain 25.02
Ejectors/sump 25.02
a](P�,ROPEJ1RTY ciiiv`/ ii �',T]NANT_ Expansion tank 12.51.-
Name:
y I'1 L t Y 1 c c9,645` Fixture/sewer cap 25.02 `
Address: t to u S SW Vl 1..b o G J 0.--, Floor ge disposal siuWhub 25.02
w ��f` e--. M1 iii ni Garbage disposal 25,02
City/State/ZIP: 11 r,t A-� 0 !� Hose bib 25.02
Phone:(Sp?jj VA- ( /1, Pax:( ) Ice maker - 12.51
" '..., ",;.-. Interceptor/grease tra 25.02
APl'L1CtANTr" "®' CONTAL'Y PIi I03 trap
Business name:ANYii M6 P w(M Of Nti -F bp.4-f N C1 v+N awl/ Medical gas(value:$ ) Page 2
Contact name: A5kLry M Iii Primer 12.51
Roof drain(commercial) 12.51
Address: '1. Sink/basin/lavatory 25.02
City/State/ZIT': pp0-LAN b, Df?„_. di121 p Solar units(potable water) 62.54
Phone:(5V3) - r DI Fax;;(R'1 I) _. I q 115 Tub/shower/shower pan 12.51
Urinal
2 E-mall f N l fV - ` i r���� ��
Water 25.02
QIIXODO '
��/ Water Ileeter 37.52
Business name: a'NV f f 6 pLGf 01O1N tN De/N CU'WNIK Water piping/DWV 56.29
Address: . 1H 4 V - (i Other: 25.02
City/State/ZIP: P121211,0 1)L OK- 41210 Subtotal
Phone:(0•50 )4z- 2246 Fax:('r f 11) .. 5° l o(P S Minimum permit fee: $72.50 I 00,O(/,
Plan review (25/Q of permit fee)
CCB Lie.: f q l vii Plumbing Lic.no.: pPJ�1 State surcharge(12%of permit fee) 12, 00
Authorized signature: 1`1/1//' ()VII TOTAL PERMIT FEE l 12,0
Print name; AS f4'LY T m I l.L�!2- Date: I l (1*h�j This permit application expires If a permit is not obtained within ILO days
after It has been accepted es complete.
"Fee methodology set by Tri-County Building Indusay Service Board. O
t:lB ullding lfermilsWLMU.PermilApp,doc 10/01/09 440-46I6T(ION1/COMIWSB) /r 2- ,