Permit q CITY OF TIGARD PLUMBING PERMIT
a COMMUNITY DEVELOPMENT Permit#: PLM2016-00265
T I t;AR t) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/19/2016
Parcel: 2S110DCO2200
Jurisdiction: Tigard
Site address: 15660 SW PACIFIC HWY A-5
Project: New Sound Subdivision: 1997-016 PARTITION PLAT Lot: 2
Project Description: Relocate(1)water closet.
Contractor: NORTHWEST WATER WORKS Owner: ROIC OREGON LLC
40110 SE MEADOW SONG RD ATTN: SCHOEBEL, RICHARD
SANDY, OR 97055 8905 TOWN CENTRE DR, STE 108
SAN DIEGO, CA 92122
PHONE: 503-314-1470 PHONE:
FAX: 503-668-0375
FEES
Quantity Description Date Amount
ea Water Closet 05/19/2016 $25.02
Specifics: 1 12%State Surcharge- 05/19/2016 $8.70
Plumbing
Type of Use: COM 47 ea Minimum Fee Adjustment- 05/19/2016 $47.48
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 t - rules adopted / the Oregon
Utility Notifi - - -nter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. Yo ay obtain a •-y of the rules
or dire uestions to Ob C • a li 503.232.1987 or 1.800.332.2344.
Is ed By: / Permittee Signature:
I &- (/(,ta/ � /
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. ‘11,
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.
Plumbic Permit Alica•
EP
Site Utilities ' V
City of Tigard MAY 1 9 2016
N `� 1_ ... s%'Ball Blvd.. Figard,( y� (� �y`L Received Phone 51)3.718.2139 litlfOj fI(iilety � !o /� �j PcrrmtNo
Fax: tp4Plan Review __._910(6-Ma6S
I i, , t, Inspection Line' 503.639.417DUJbnld'1J DIVISION Dara
Internet' www.ti Other Permit
gaud-or goy Date R �ccQa-for riC3/a2
Notified/Method
ethod " ® Fite 2 far
TYPE OF WORK: Suppiemenbt Information
❑NeW eon- i
FEE* SCHEDULE
❑ Demolition
AdditiatUaltctati4tUteplac(meat For special information use checklist
0 Other: Description r(-ty Ea. 1 O(
CATEG New I.2-family dwellings(includes 100 It.for each utility connect
ORY OF CONSTRUCTI{OA
SFR(I)bath 312.70
❑ 1-and 2-family dwelling
(531 Commercial/industrial SFR 12)bath
❑ Accessory building 437.78
0 Multi-family SFR(3)bath 500.32
El Master builder Each additional bathlitchen 25.02
0 Other
JOBSRE INFORMATION AND LOCATION Fite sprinkles{ sq.ft) Page 2
Site utilities:
Job site address: 15660 SW Pacific Ilwy �" Catch basin or area drain
18.76
City/State/Z.IP:Tigard,OR 97224 Drywrll,leach line,or trench drain 18.76
Suite/bldg./apt.rto.:A-5 Footing drain(no.linear It: ) Page 2
Project name:N'• • —
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
Stone sewer(no.linear ft.: ) Page 2
Water service(no.linear ft:_) Page 2
Subdivision: IAS no.: Fixture or item:
III
Tax map/parcel no.: '�S t t(77x- baa-O 0 —
Backflow prevenrer 31.27
DESCRIPTION OF WORK Badwater valve 12.51
Drainline alterations to water closet Clothes washer 2502
�� ., Dishwasher 25.02
W , / r • r �"`o-}-- `•�', 3 Drinking fountain NENE 25.(12
' 1(.S 5 n'—' _ Ejectors/sump 23 02Mil
❑ ritorEMY OWNER r- 0 TENANT Expansion tank
Fixture/sewer cap III 25.02 El
Name: Floor dramor/flosulk/hub 23.02
tiarbage disposal
Address:
23.02
City/StatenP: Hose bib 23.02
Fax:( ) Ice maker III
phone:C _ --— — 12.31
[j .0l°1''f #( ti'.1 ❑ <'O�7*('I I'!R.()\ Intenxptor/gmasetrap 23.02
Medical ) IMEI
_ gas(value.S
Business name: Primer 12.5i all
Contact name: Roof drain(commercial/ 12 51
Siva/basin/lavatory 25.02
Add+ : Mil
Solar units(potable water) 62.54
City/SLIF: Tubfstwwa/slwwcr
Fax::( ) 12.31
J ` 25 02
25.02
15.02V . -1' vvWater cisolp}one.( 1.}.2_,,,,-1.0-1...0 G `� � �
F_tntil: '��• t (Y.
9 it t( 1 int Water heater ®�
0- -----
G, Nur I',
t>ga5luunc: \ortkMe.r vvster Waierpiplrtg/DWV 5629
BUST __
40110 SE Mead"
�+i Rood
Other' 25.02
Ate' Subtotal 02
City/State/ZIP:Saadr,OR 97953 ( Mininaim permit fte T72.30 -7,71 5-diFax: )
(503)g6"37S Plan review (lsxr oripermk tee)
pinna= _ Plumbing Iic.no.:3-3J3PB
State surcharge(I 2X afpatoit fuel .------
7D
CC S 1.k.:t 13197 TOTAL PERMIT flit? r .rte
Atpttori�siva n :". /i III ...01
— TttY Pm."
.'peksr/eu mires tf•prwM
is sot dn.i.ea wNa�fO sr.
awbart7 Doe. . 7/16 Miss a Ism byes
.:. ,.5 M e..pr.r
Printtt�t w M •F«mcUr"krk*LY tw Tnfio..ry&u W+nK Inir°uny Servs*t
APO'Inc
10,0109 ""
our os, apse roT(1�)
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Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
15660 SW PACIFIC HWY A-5, TIGARD, OR,
97224
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2016-00265
Chip Barnett
Violation Summary:
Inspector Contractor