Permit CITY OF TIGARD PLUMBING PERMIT
111 '' COMMUNITY DEVELOPMENT Permit#: PLM2015-00214
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/07/2015
Parcel: 2S 110AA02800
Jurisdiction: Tigard
Site address: 14055 SW PACIFIC HWY
Project: Elmer's Restaurant Subdivision: CANTERBURY PLACE,AMENDED Lot: 6A
Project Description: Installing(2)water heaters.
Contractor: RAY'S PLUMBING DBA PIPER MECHANICAL Owner: DANNA BROTHERS PROPERTIES LLC
PO BOX 685 9800 SE STARK ST
BRUSH PRAIRIE,WA 98606 PORTLAND, OR 97216
PHONE: 360-892-8700 PHONE:
FAX: 360-892-9644
FEES
Quantity Description Date Amount
2 ea Water Heater 07/07/2015 $75.04
Specifics: 1 12%State Surcharge- 07/07/2015 $9.00
Plumbing
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $84.04
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: 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.
Plumbing Permit Application
Building Fixtures RECEIVED
FOR CIFFCE, 1.1E, COINLY
Received
- City of Tigard JUL 201 DateBy: 7 7 I) Permit No.. in y:�(S`L 'S 1 Lt
e 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review �`/ (��/`
Phone: 503.718.2439 Fax: 503.598.16 • OF TIGARD Date/By. Other Permit No.:
Inspection Line: 503.639.4175
TIGARD BUILDING DIVISI ON Date Read B
y:
Internet: www.ti and-or. ov Notified/Method: Supplemental Information
t
❑New construction ❑Demolition For special information use checklist
Description I Qty. I Ea. I Total
IYAddition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ 1-and 2-family dwellingCommercial/industrial SFR(2)bath 437.78
I=1 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 SITE INFORMATION AND LOCATION I Site utilities:
Job site address: 14055 3iV pAcAnC H■ y Catch basin or area drain
Drywell,leach line,or trench drain
City/State/ZIP:'t',(.r UR q,ZZ�
"l Footing drain(no.linear ft.: )
Suite/bldg./apt.no.: I Project name:fA nAtorS 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
Water service(no.linear ft.: ) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
Backwater valve 12.51
1 Y _ Clothes washer
YNS K t t 2 VV 0,' r 1 n p Y L I�) Dishwasher
`l V\
Y k Yrsf. i - Drinking fountain
Ejectors/sump 25.02
El/PROPERTY OWNER ❑ TENANT Expansion tank 12.51
Name:
Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:1 1 Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap
-
Business name:r��(�X `..Cr� Medical gas(value:$ )
�/ 1 -"C' Primer 12.51
Contact name:
^�` • , � `e.. k�� Roof drain(commercial) 12.51
Address: q2....) k 1 )..)e. 13 Sink/basin/lavatory 25.02
City/State/ZIP: V AK+ ckitkQl..ec Solar units(potable water) 62.54
Phone:(74p,c) Yq , cis/(51:) 1 Fax::( ) Tub/shower/shower pan 12.51
E-mail: 5��/j(Q e pi Q{r,M�C/�/lr✓t z t J Urinal 25.02
Water closet 25.02
Water heater _ 37.52 5,CA
Business name:?\'EA l,x t _ • t.� Water piping/DWV 56.29
Address: G%'2:/1, Iv� 1 AA0..K., J Other: 25.02
City/State/ZIP: V CJ`. Q( WSJ`{--Y wl\-- S- Subtotal 1S•
Phone:(b..Q.0)) 5-012‘„, - g',a.> Fax:( ) Minimum permit fee: $72.50
CCB Lie.: 5));,l 7 7 31 /(, Plumbing 'c.no.: 77 pi fj pB Plan review (25%of permit f
State surcharge(12%of permit fee
Authorized signature: TrZ 1
►/��, 1 / This permit application expires if a permit is not obtained wit -HO days
V l t x.wn C)1. .1 _.. after it has been accepted as complete. 6 747
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\PermitsTLMU-PermitAppdoe 10/01/09 440-4616T(10/02/COM/WEB)