Permit (100) n CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2016-00098
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/29/2016
Parcel: 2S102BD00100
Jurisdiction: Tigard
Site address: 9905 SW MCKENZIE ST
Project: St Anthony's Church Subdivision:RTH TIGARDVILLE ADDITION,AMENC Lot: 52
Project Description: Repair-replace 100'of less of sewer service.
Contractor: APOLLO DRAIN& ROOTER SERVICE Owner: ST ANTHONY CATHOLIC CHURCH TIGAR
2208 NW BIRDSDALE#8 9905 SW MCKENZIE ST
GRESHAM, OR 97030 TIGARD, OR 97223
PHONE: 503-239-8801 PHONE:
FAX: 503-669-9568
FEES
Quantity Description Date Amount
100 If Sanitary Sewer 02/29/2016 $62.54
Specifics: 1 12%State Surcharge- 02/29/2016 $8.70
Plumbing
Type of Use: COM
10 ea Minimum Fee Adjustment- 02/29/2016 $9.96 Class of Work: ALT Plumbing
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 Notificati nter. 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 stions to O b calling 503.232.1987 or 1.800.332.2344.
Issud By: Permitteeignature:
/ r
Call 503.639.4175 by 7:00 a.m.for the next available ins ection 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.
Feb. 26. 2016 4: 56FM No. 1949 F. 1
Plumbing Permit Appinc%M"ED
Site Utilities ICV V
FEB 2 rR=ivedoCity of Tigard 2 6 q Permit No.: Llf I/ &-
■ 13125 SW Hall'Blvd.,Tigard.OR 97223 Plan Review
Phone; 503.718.2439 F WOMIGARD Date/By; Other Permit No.:
Inspection Line: 503.63 MING 01VISION DateResdyBy: fuda7 0 See Page 2for
Internet: www.tigard-0r. NotifieWedod: Supplemental Information
❑New construction ❑Demolition For s ectal hi ormaflon use cliecklin
Description E8, Total
®Addition/alteration/replacement ❑Other: New I-2-family dwellings(includes 100 R for each utility connection)
SFR(I)bath 312.70
]I.-and 2-family dwelling V3 Commercial/industrial SFR(2)bath 437.78
ElAccessory building ❑ SFR(3)beth 50032 Multi-family -- }
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler(_sq.ft.) Page 2
Site utilities;
Job site address:9905 SW McKenzie St Catch basin or area drain 18.76
City/State/ZIP:Tigard,012 97223 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_, Page 2
Suite/bldg./apt,no,; Project name:St Anthony's Chnreh Manufactured home utilities 50.03
Cross street/directions to job sire: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no,linear ft.:100) Page 2
Storm sewer(no,linear ft,;^-) Page 2
Water scrvioe(no,linear R.: _� Page 2
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
Backwater valve 12.51
Clothes washer 25.02
LMK Technologies CIDP trenchless sewer repair up to 100FT long Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
Expansion rank 12.51
Name: Fixtuto/sewcr cap 25.02
Floor drain/floor sink/hub 25,02
Address:
Garbage disposal 25.02
City/State/Z1P: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
Interceptor/grease trap 25.02
Business name:Apollo Drain&Rooter Service Inc Medical gas(value:$_) Page 2
Primer 12.51
Contact name:Kara Oltean
Roof drain(commercial) 12.51
Address:2208 NW Dirdsdale Ave Ste 8 Sink/basin/lavatory 25.02
City/State/22:Gresham,OR 97030 Solar units(potable water) 62.54
Phone:(503)389-1326 Pax;:(503)669-9568 Tub/shower/shower pan 12.51
E-mail:offiee@apoltodrain.com Urinal 25.02
Water closet 25.02
Water heater 37.52
Business name:Apollo Drain&Rooter Service Inc Water piping/DWV 56.29
Address:2208 NW Birdadale Ave Ste 8 Other; 25.02
City/State/ZLP:Gresham,OR 97030 Subtotal
Phone:(503)389-1326 Fax:(503)669-9568 Minimum permit fee: $72.50 9
Plan review (25%of permit fee)
CCI3 Lie.:49418 Plumbing Lie,no.;26-533pb a ) '6.70
State surcharge(12%of permit fee
Authorized TOTAL PERMIT FEE S 1,;tO
Print name:1(2ra Oltean Date:2/26/16 This permit Application expires if a permit is not obtainetl within 180 days
after it has been accepted as complete.
*Fee methodology act by Tri-County Building Industry Service Board.
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