Permit CITY OF TIGARD PLUMBING PERMIT
lig : COMMUNITY DEVELOPMENT Permit#: PLM2014-00087
T(G A O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/27/2014
Parcel: 2S110DC01000
Jurisdiction: Tigard
Site address: 11015 SW MEADOWBROOK DR 6
Project: Summerfield Apartments Subdivision: WILLOW-BROOK-FARM Lot: 17
Project Description: Units 6&8. Rough-in(2)clothes washers.
Contractor: MODERN PLUMBING Owner: SUMMERFIELD ASSOCIATES, LLC
11120 SW INDUSTRIAL WAY BY HSC REAL ESTATE
TUALATIN,OR 97062 1500 SW FIRST AVE STE 1020
PORTLAND,OR 97201
PHONE: 503-691-6166 PHONE:
FAX: 503-691-6771
FEES
Quantity Description Date Amount
2 ea Clothes Washer 03/27/2014 $50.04
Specifics: 1 12%State Surcharge- 03/27/2014 $8.70
Plumbing
Type of Use MF 22 ea Minimum Fee Adjustment- 03/27/2014 $22.46
Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct que .•• to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued 4, Permittee Sign ture:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
lisMar; ,,,.., 1 ,a 9,21A e35,Mod,,,�n Plumbing CITY OF TIGARD No. 3897 �Ht /361/19
Plumbing ermlt application 'EIVEI)
Building Fixtures FOR tUFI ICE I SE ()N1.1
City of Tigard 1,? 2 5 2014 a6 i �'� .,_. -Oe64►
• 13125 SW Ha Blvd.,Tigard,OR 2 v,Review
` 111 Phone: 503.7182439 Fall; 59c1 S li`i DaicfBy: Orlrerraren;t No.:
I I t;A R.I1 Inspection Line: 503.639.4173(,]�Y �( TIGARU Data Rcody/9y: xwr: 13 Sec Page 2 for
Internet; www,dgard•or.ger>S,i,f, ,,!Nr pIV. N Notiacd/Mctbod; - Supplemental Information
0 New construction ❑Demolition For 8Iecial In°motion ride checklist.
Dtteription WM Ea- Total
AdditioiValtor11on/replaeement ❑Other: New 1.2$amlly dwellingslincIudc9100 R for each utility connootlolt)
c,,: � -:CifTEGO r k - - SFR(I)both 312.70
[] I-and 2-feinuly dwelling WOommoraial/nduOrkil SFR(2�tralh 437.78
❑Accessory building b Multifamily SFR
(3)both 500.32
Each additional bath/kttohcn 25.02
❑Master builder ❑Other: Fire sprinkler( sq.n.) Pagc 2
% : . =•:.,-: . _. - 1[. ._-'n4it+- 4CA170N - -- ; Site uNIINes:
Job site address U� Yuf _ rlickIA_)1•'t�QpOK D1R.1>/6 _'_e Li Catch basin pr area drain 18.76
CltylState2lP: Drywell,leech line,or vend,drain 13.76
"C.( /kt2.•(.� D X17').ati
LcgtinR drain(no.linear A.:- ) Page 2
Suite/bldg.apt.no.: Project name. Manufactured home utflltlel r 50.03
Goss ytrcet/dircetione to job site: Manholes 18,76
4 o ",t- OF 1�O' Il KI A M �� Rein drain connector 18.76
;/ Sanitary sewer(no.IlnUtr fl.: ) Pagc 2
Storm 3cwor(no.linter A.; ) Page 2
Water service(no,linear fl,;_„_ ) Page 2
Subdivision: tot no.: Fiiturc nr itcml
Tax map/parcel no.; Bockfow presenter L 31.27
,- Backwater valve 12,51
. ;.,`.' �� -• .-._-=-- -_,.:•_.;Dy ,CR�TIdNt'OP WdRt€. •:..-
. -L t __. - -- - -
1 2--- LLI�YH -'• ------ -- - - - - Clothes washer Z 25-02 �,0 y
R 4 u j ES IA)AS H-E'YZ6 Dishwasher 25.02
Drinking fountain ~-25,02
Ejectors/sump 25.02
- ,l`I,]PROPE>IiTY d'S121 Et:.. - •:• 0•TVIAN>c . Frpanslon tank 12,51
Name; _Fixture/sewer cap 25.02
Floor drain/Floor sldr/Itub 25.02
Address: -
Garbage disposal 25.02
City/State/ZIP: - Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12 51
_ -• :'•EriilPlItIcCi1,NT.. '..-_ ,:-0'CON1I'ACT PF,RSO,N• ^lnterocptor/grca,+o trap I 25.02•
Business Franc: Medical gas(value;fi_) Prtgo 2
Primer { 12.51
Contact name:
-
Roofdraln(commercial) 12.51
Address: Sink hasinllavatory 25.02
City/State%!_iP: Solar units(potable water) 62.54
Phone:( ) [Fax: ( ) s Tuh/shower/shower pan 12.51
E-mail: Urinal 25.02
..__..._.. _...._..'__..... .... _ . ..- �
' • ' c- 151.i o_R_.. .. . . - •.
. Water cloe 25.02 - -
Water heater 37.52
Business nnma:M Dr10 n 1 �,V M Rik) 4.C(� _ Water piping/014V 56.29
Address' I I Il l .''L-)� ifJ O .)sae-1 Al, LJA-Y .. .3 Other 25.02
City/Stoterl_IP:Mtift/AT/A) CI i t -)06 .51'W/id 5004
Phone;( ;) Lett (911 (0 Fax:( rte) (0 C•t(inaay Minimum permit(be: 572.50 7y.so
CCB Lic,: 9`7 i 0(i, Plumbing Lie.no.:31.,f�- Plan testes (2S%of permit fee)ee
G� State surcharge(12Yo Of Itcrrnit fee) $70
Authorized 9lgnatu . o c- / r- r TOTAL PERMIT FEE e31,'2-0
Print name: /1444-I/ s k _ I bat:; RE= This permit appllcaden erplroe if a permit ii not obtained within 180 days
KU/ 4 aRcr i/b■a wren nrccp1“I au c.ompTctp
•Pct recthodolopy re,by 11l-County Building Industry Service Board.
CA alImaokernmiuUt,t4u.PermNatvdee tnro1M9 440,48I61(10/02/COM/W119I
L1 s.�, ,J J. 1 143 9 J 2 2 A 5035(Modern L Plumb n g CITY OF TIGARb N o 3 8 9 7 ru .2/3 02/03
Plumbing Permit Applicatiol - City of Tigard
Page 2-Supplemental Information
Fce Schedule: Residential Fire Su t t ression S stems:
Site Utilities - •Q�-. .,...Are_.)_ Total .S r care Footage:'. Permit Fee: - •-•,,-_-. ,
Footing drain-i"100' So.o3 0 to 2.000 121.90
~Footingdrain-cosh additional 100' 37,5y 1 2 .01 to 3.600 $169.69
_ 1 601 to 7,200 $233.20 _
Sa+vcr• let 100' 62.54 7,201 And seater -$327.54
Sewer-each additional 100' 57.52
r -
water 5orvlcc-to 100'u 62.54 Nledieal Gas Systems:
Water Service-each additional 100' 37.52
' .VaIti -
at>torc: '; Permit Feet - - -
$term&Rohl Dr to• I st 100' 67.54 31,00 to 55,1100.00 Minimum fee 172.50
51nrm&Rain Drain-each additional In' 7152 $5,001.00 t0 10,000.00 572.50 for the first$5,000.00 and 1.52 fur
..— - each additional 1100.00 or fraction thereof,m
.-Other Inspections'Or Fees Qh'-:, ll'ee(at) Tor t
p and including 510,000.00.
(nipcctlon of existing plumbing or for $10,0.00 to 525,000.00 S 145.50 for he tirst$10.000.0(1 and$1.14 for
which no fee is specifically Indicated 90.00/hr each additional$100.00 or fraction thereof,to
(minimum charge--1/2 hour) And Including S25,000.00,
[nspccllnar outside of normal business 90,00/hr 525.001,00 to 3111,000.00 5379,54 for the first$25,400.00 and S I A 5 I--rr
hours(minimum charge--2 hours) ectnn sreo to
th [
Reinspection Fees 90,00/hr and Including 550.000,00.
Additional plan review ter rcvitions � 90.00/hr S50,001.00 and up 3742.00 for the 1'1/A S50,000.00 and$1.20 for
minimum charge 1/2 hour) each additional 100,00 or fraction thereof.—
Subrntat:
Commercial Fixture Woth:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*. Phis Review for Pinmbilg Ivsttillstionq - .
Quantity by Fixture Typq_ Plan review is required for any of the following.
Future Type for Repined Please check all that apply.
Work$ertoruud' ceptrea added Relocate 0 Any new commercial building with water service 2•'and
yspdstry/Pont greater.except systems dcilaned and stamped by licensed
Bath: -Tub/Shower _ engineer,
-Jucuzzli hiripool ❑ New exterior plum bine site utilities for any complex structure
Car Wash' -Each Stall _ es defined in OAR91 8-780-0040.
-Drive Thru
Cuspidod��o(cr A�iralor _ ❑ Medical gas and vacuum systems for health care facilities.
Dispidor r. -Commercial ❑ Any mt111iputpoto tiro sprinkler system.
-Dorncstic ❑ Any complex structure as defined in OAR918.780-0010,
Drinking Fountain
Wash Submit/eels of plans with any of the above.
Floor Dralnhlnk: -2" .
-3.. Isometric or'Riser-Diagram . .--: : .
4' - Isometric or riser diagram is required for new buildings
-Car wash Drain - _ that meet the qualifications above.
Curbage -Domecticnon•food -
Disposal: •Domcstfc food related
-Commercial food related
-Industrial food Mated
iae hlachfRcili_.Drains
Comments regarding fixture work:
Oil 5cpvator(Gat Station
Rec.Vehicle Dui ip tlnn
Shower: -Gang -
Stall
- -4
Silk -Lav/t;ar mn-food related
-Bradley
— —
-Corn/Srrvftltil food related
-Service _ *Note: If the fixture work under this permit results in an
WasheringPool FI11rr , Z increase of newer EDIJs,a sewer permIt will be issued and
Washer-clothes fees assessed for the sewer increase must be paid before the
Writer Extractor lulmbin ormit can be Issued.
WeiZ o 1ollct D g p
Urinal _
Other Mixtures: —�
I:\13tailding1PerrnitsWLMF_PormitApp.doc 08/042011 2
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11015 SW MEADOWBROOK DR 6, TIGARD, OR,
97224
Commercial - Plumbing
399 Plumbing final
2014-04-16 00:00:00
PLM2014-00087
PASS - No C of O
Violation Summary:
Inspector Contractor