Permit (136) CITY OF TIGARD PLUMBING PERMIT
I' COMMUNITY DEVELOPMENT Permit#: PLM2016-00579
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/29/2016
TIC.,ti I..C� 9 Parcel: 2S108DB05700
Jurisdiction: Tigard
Site address: 15372 SW SEINE DR
Project: Polygon at Bull Mountain,Lot 55 Subdivision: POLYGON AT BULL MOUNTAIN Lot: 55
Project Description: Replace approximately 7 of sanitary sewer line.
Contractor: BDL PLUMBING LLC Owner: POLYGON WLH LLC
PO BOX 85 109 E 13TH ST, STE 200
CORBETT, OR 97019 VANCOUVER,WA 98660
PHONE: 503-351-3903 PHONE:
FAX:
FEES
Quantity Description Date Amount
7 If Sanitary Sewer 11/29/2016 $62.54
Specifics: 1 12%State Surcharge- 11/29/2016 $8.70
Plumbing
Type of Use: SF 10 ea Minimum Fee Adjustment- 11/29/2016 $9.96
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 stions UNC by calling 503.232.1987 or 1.800.332.2344.
Iss d By: , / Permittee Signatpre:
Call 503.639.4175 by 7:00 a.m.for the next available insp '•n 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 ...
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City.of Tigard :ReceivedT
13
boob': ///A 8 /4 4, i Peril*Ne.'125 SW.11all Blvd,Tigard,OR 9722jti O v 2 8 2016 Man Review
' ,-..i.• ' Phone:.503.718.2439 Fax: 503,598.1960 Datemy, Other Pen:Utile.:
Inspection Line'. 503.6394175 (L.f t y .(..,... - i f..f4"%:1--il) Date Roadyigy kris:. ill gee Page 2 tor
• " -''''' -"' Interrtet: .www.tigard-orgov 7-.i t i,---,11,„-c‘1` :'i ,j,i',C.:,,=(4'N NotipylVietijod.„ .....,.., _.,.._ , sup, __e,,,11,,,f0,.„!„,ir
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r lew construction 0 Deltic:filthy • • Deseription I. Qty I Ea. I Total
Igoirationlikeration/replacentent 0 Other: New I.-2-family dwelliags•(includes 100:ft.for tea utility tiomuvtion)
1.*'-',:',-:. '-' ;•'-''',77S'-'''-‘0:.?1-iitriti77W:*, ...711*Nis05;:.;7nFi ..77'..: SFR(I)bath 3127.0
El 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32 .,
0 Accessory building D MUlti4lunily
• Each additional bath/kitchen 25.02
' •
0 Master builder ]Other: . .. . Fire sprinkler( sq.II.) Page 2
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4g' ,'Sr.7- 45535,:ZI -,:.''',,'o:?,':‘:",-4--:-7'.?:T'''. Site utilities
Job site address: 1 S Catch basin or area drain
18.76
• • Drywell,leach tine,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224 . • Footing drain(no.linear ft.: ) Page 2
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•Suite/bldgjapt.no.: I Project name:Polygon at BtillMountain 'Manufactured home utilities 50.03
Cross street/directions to job site: , • Manholes 18.76
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Rain.drain connector . , • 18.76
1 . Page2 ft/ 10'
• Sanitary sewer(no.linear ft.: . .I .
. . .Storm sewer(no,linear ft,::-' .. I Page 2 )
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Water service(no,linear II.: _,) . • Page 2
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SubdiVision:'Polygon at Bull Mountain Lot no::,55 Fixture or item:
_ * 5
Tax map/parcel:no,:
' Backflow preventer 31.27
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•• - - - ---- -- -- ------.. -.-.'-'73,,M":grr-v--r-'.' ' -,..----- .P.- Backwater valve 12.5.1
.4.'i-:;',..,..-.(';'.,*;-.-:•'.'-."-.'-.2,.:'- '• ',:.,,,;:i.fi*,::;.:'. 4. -.';:.!,.: ,.',A,iiigi,'.4. 5 .',.l'...'z'.1-.':fi.::.','-',:#:-:;-L'-'r-**-,'- ',7**;`.--4,,,44.',4:4',.. Ciothcswasher 25.02
R • / ' .30,11A, . - i fiVeS . 3A2 _. Dishwasher '.
• 25.02
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• i" /701&01 1J.e* ("SE)1Aft. -
Drinking fountain 25.02,
Ejectors/Sump •. 25.02
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Fixturetsewer cap 25.02:
Name:Polygon Villa,Ll.k • -
' Floor drab:Alcor siailamb 25.02
Address.;109 East 1 • -3th Street Garbage dOPe4a1 : 25,02 •
...
City/Sta 1.e/ZIP:Vancouver,WA 9860 Hose bib 25.02
.. . .. ..
Phone::(360)695-1706 Fax ( ) Ice maker 12.5i
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.,(5,,7.--,,,-.,„;!:: ,,,Fs.7,,•-••• f, 4,-i.,, - -;- -.;'-.:=,,,nirj.' - - 'L.7,.. ':, Intercrptor/grease trap 25.02 i
Page 2
Bu.sitiess name:Polygon WLH,LLC
Primer 12.51 •
Contact.oarne Angela Grajewski • Roof drain(commercial)
1151
Address:109 East 13th Street Sinkkasintlavatory 25 02
. .. .. -..
City/State/ZIP:Vanconver,WA 98660 Solar units(potable water) 62.54
Phone:(360)695-7760 Fax::(360)693-4442 - , • Tub/shower/Omer pan 12,51
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Unset - 25.02.•,
E-mail:Angela.Grajewikig1),91Ygalthememam ,,....,_,...,_, • 25.02
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-,z ,,, ,,,t ..,: --„-_,..-..- imiter heater 37.52
Business name:BDL Plonibing 1-Le Water piping/DM' 56.29
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Address:PO Box„S5 ,Other. 25.02
City/StateiZIP:Corbett OR 97019 . . Subtotal...
. Minimum permit fee: $72.50
Phone:(503)351-3903 Fax:( ) . .
, .
CCB.LiPlan review (25%of permit fee)
Lb .:180345 Plumbing Lic,no.:TB1582 . .
State surcharge(12%of Petnlit•fee)
Authorized signature: 0.02004,.......!, 40.60.,z.„,000°- TOTAL PERMIT FEE
This permit application expires if a permit' tsnoobtai
"..-.t ned. within 180 Aare
Print name:Brandon Lanter . 'Date:.1 i 1281 I 6 atter it.has been accepted aStomplete.
.
*Fee methodology set by Tri-County Building.Industry Service Board,
TABuilcninatrrnitstiPLMU-PersitApp.doc 1001109 4404510(40/02JcOMMEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15372 SW SEINE DR, TIGARD, OR, 97224 March 20, 2018 at 8:00:22 AM
Record Type: Record ID:
Residential - Plumbing PLM2016-00579
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
PASS - NoCofO
Comments:
See Inspection dated 1/30/16.
Violation Summary:
Inspector Contractor