Permit (87) ® CITY OF TIGARD PLUMBING PERMIT
IN
f COMMUNITY DEVELOPMENT Permit#: PLM2016-00435
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/11/2016
Parcel: 2S 110AC01200
Jurisdiction: Tigard
Site address: 11452 SW BULL MOUNTAIN RD
Project: Bull Mountain Heights Apartments Subdivision: None Lot: None
Project Description: Backflow preventer for irrigation.
Contractor: PROGRASS INC Owner: ANDREWS MANAGEMENT LIMITED
29895 SW KINSMAN RD 5845 JEAN RD
WILSONVILLE, OR 97070 LAKE OSWEGO, OR 97035
PHONE: 503-682-6076 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 08/11/2016 $31.27
Specifics: 1 12%State Surcharge- 08/11/2016 $8.70
Plumbing
Type of Use: MF 41 ea Minimum Fee Adjustment- 08/11/2016 $41.23
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 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 com a ion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application
Building Fixtures FOR OFFICE LSE ONLY
City of Tigard CP\*.° Received
Permit No.: {._ '1 6 ?
■ 13125 SW Hall Blvd.,Tigard,0'IP't, m rL��`Q Date/By: Wit �((, /fit f lr c Ui f(J
111111 I Phone: 503.718.2439 Fax: 50 .'..1960 '� 1 Plan Review
Inspection Line: 503.639.4175 �� +y�` t�
Date/By: Other Permit No.:
T l( ARD Internet: www.tigard-or.gov ���r`t `�e Date Ready/By: Juris: ® See Page 2 for
+,,� ac \ ® Notified/Method: Supplemental Information
. ..- TS PE OI .WOR iC^f�t'' �43- L r FEE r C t E
El New construction ❑0,Alition For special information use checklist .
Description I Qty. I Ea. I Total
®Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
ko , AT1I GOR OF QNS f '1 0 �•;., '':,,t,„, SFR 1 bath
1( O 312.70
..rr
❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
I=1Accessory building ®Multi-family SFR(3)bath 500.32
❑Master builderEach additional bath/kitchen 25.02
0Other: Fire sprinkler( sq.ft.) Page 2
rx
51
® 1 i 'i i „AND .00ATIO Site utilities:
Job site address:11452 SW Bull Mountain Rd. Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Portland OR 97224
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name:
Gd1 /'/ lKi 61,el � Manufactured home utilities 50.03
Cross street/directions to job site: CyiGkf..i �,,� v 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: Lot no.: Fixture or item:
Tax map/parcel no.: ,,,,, , Backflow preventer 1 31.27 51. 7
t: ` ` ' a, Backwater valve 12.51
Clothes washer 25.02
Backflow Device Installation
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
►4 xry.0. :,,,,re It Expansion tank 12.51
Name:Bull Mountain Heights Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:11430 SW Bull Mountain Rd.
Garbage disposal 25.02
City/State/ZIP:Portland OR. 97224 Hose bib 25.02
Phone:(503)639-0195 Fax:( ) Ice maker 12.51
t , .x es ' ,'W Interceptor/grease trap 25.02
Business name:ProGrass Inc. Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Ken Christopherson
Roof drain(commercial) 12.51
Address:29895 SW Kinsman Rd. Sink/basin/lavatory 25.02
City/State/ZIP:Wilsonville OR 97070 Solar units(potable water) 62.54
Phone:(503)682-6076 Fax::(503)682-4975 Tub/shower/shower pan 12.51
E-mail:kenc@prograss.com Urinal 25.02
Q° Water closet 25.02
. :' 'il Water heater 37.52
Business name:ProGrass Inc.
Water piping/DWV 56.29
Address:29895 SW Kinsman Rd. Other: 25.02
City/State/ZIP:Wilsonville OR 97070 Subtotal )-7
Phone:(503)682-6076 Fax:(503)682-4975 Minimum permit fee: $72.50 .j U
CCB Lic.:68445 Plumbing Lic.no.:LCB 8079 Plan review (25%of permit fee) t /O
State surcharge(12%of permit fee) ti, .
Authorized signature: .-,yam.G�- j ��
� �TOTAL PERMIT FEE
Print name:Ken Christopherson Date:8-4-16 This permit application expires if a permit is not obtained within 0 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:Building/Permits PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)