Permit (20) CITY OF TIGARD PLUMBING PERMIT44 8 COMMUNITY DEVELOPMENT Permit#: PLM2017-00092
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/20/2017
Parcel: 1 S 126CA00500
Jurisdiction: Tigard
Site address: 9185 SW HALL BLVD
Project: US Bank Subdivision: None Lot: None
Project Description: Backflow preventer
Contractor: CHERRY CITY PLUMBING INC Owner: PPR SQUARE TOO LLC
PO BOX 5788 BY US NATIONAL BANK OF OREGON
SALEM, OR 97304-0788 ATTN CORPORATE REAL ESTATE-TAX
2800 E LAKE ST
MINNEAPLOIS, MN 55406
PHONE: 503-371-6141 PHONE:
FAX: 503-623-6511
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 03/17/2017 $31.27
Specifics: 1 12%State Surcharge- 03/17/2017 $8.70
Plumbing
Type of Use: COM 41 ea Minimum Fee Adjustment- 03/17/2017 $41.23
Class of Work: OTR 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 Byy.:.„4e Permittee Signature: /pJ
G1/v ,/ -214)�G� Cyd%-7G
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 Applicati4p0---i .*--;',., -.., ':--f .k
.
Building Fixtures
2017 .. FOR OFFICE USE ONLY • : .
City of Tigard
.4 13125 SW Hall Blvd.,Tigard,OR 912,3. ' •- • ' 1: ' ii ,// /2 dilfirIP;;;;Ir l'ermil'N0
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: -.. 503.718.2439 Fax: 503.5981960 .. ' ;. ,'"r`.' '
Phone:
M
, Dately: Other Permit No.;
Inspection(.me: 501 619 4175 1
TIOARD' , ,,1 J; ' ' - Dare Ready,Ity: hots: la See Page 2 for .,
Internet: Nvww.tigaria-or,gov Notified/N.-Team& Supplemental Information
TYPE OF WORK , /: - , . 1 ,-..„.-.: -. -- FEE!' SCITEDULE-j/' J.., _--
1
_.
For Apecial information use checklist.
0 Neu constuiction 0 Demolition
_........,_____ ...... • Description 3 Qty. 1 Ea. 1 Total
. . . .
0 Adwnonialierationfreplacement 0 Other: NON' i 2-16 mily dwellings(includes 100 ft.for each utility connect ion)
r
, ...
CATEGORY OF - - .'.J',,J. -- - ,., SER(I)bath 312.70
SFR(2)bath 437.78
CI I-and 2-family dwelling CZ Commercial/industrial
SFR(3)bath 500.32
0 Accessory building 0 Muir i-11=4
Each additional bath/kitchen 25.02
...
0 Master builder 0 Other:
Fire sprinkler( sq.ft) Page 2
49BJSATEJITSIIJC/IIALATION AND LOCATION ' / J:, '. Site utilities:
Catch basin or area drain 18.76
Job,ate 0,1dress:9185 SW IIALL 111,N1D.
Drywell,leach line,or trench drain 18,76
('us State TIGARD,OR 97223
Footing drain(no.linear ft.: ) Page 2
i Suite/bldg./apt.no.: , Project name:US BANK SITE/f8693
Crt;streetidirections to job site: Manufactured home utilities 50.03
Manholes -
18.76
c
Rain drain connector 18.76 Pt,... ck.
Sanitary sewer(no.linear It: ) Page 2
Page 2
Storm sewer(no.linear IL:_) ,
--C'of---1-k...L„,
Water service(no.linear II.: ) Page 2
Subdivision: inS4:42k) *- 1 Lot no.:
' Fixture or item:
I ax 111,/k parcel no.: 4 it. .,.,' /cut‘, Back flow preventer 1 31.27 31.27
Backwater valve 12.51
DESCRIPTION OF WORK
Clothes washer 25,02
REPLACEMENT OF 3/4 INCI I BACK FLOW ASSEMBLY IN UPSTAIRS
Dishwasher 25.02
MECHANICAL ROOM-BOILER MAKE UP. Drinking fountain 25.02 ____
Ejectors/sump 25.02
. 'El PROPiRTY OWNER 1T1/,'/ "rj J ''' - 0 TENANT ' ' ' Expansion tank 12.51
Name: US BANK CORPORATE REAL ESTATE Fixture sewer cap
25.02
- Floor drain/fluor siniChub 25.02
Address:P.O.BOX 8837 PD-OR-3200
Garbage disposal 25.02
CuyState,IIP: PORTLAND,OR 97208
(lose bib 25.02
___....
Phone:(503)275-5089 Fax:( ) Ice maker 12.51
_____-fri.--1- ---- ------. --------------- --CONTACT PERSON,' nterceptor,g,rease trap 25.02
Business name:CHERRY CITY PLUMBING,INC. Medical gas(value:$ ) Page 2 1 .
--- ----1 Primer 12.51 J
Contact name:BRUCE ROBBINS-OR-MELISSA AVILA
- - - Roof drain(commercial) 12.51
Address:P.O.BOX 5788
i---- Sink/basintlavatory 25,02
1 ('ity/State.ZIP:SALEM,OR 97304 Solar units(potable water) 62.54
Phone: 03)371-6141 Fax::(5(13)623-6511 Tub/shower/shower pan 12.51
I' nail:C111.:RRYCITYPLUMIIING(i/J.GiVIAIL.COM --- - Urinal 25.02
-
Water closet 25.02
,... CONTRACTOR ' , ' .. ' ' '
Water heater 37.52
Busines:f name:CHERRY CITY PLUMBING,INC. ...___
' Water piping/DWV 56.29
....._
Address:P.O.BOX 5788
Other: 25.02
City,StatelZIP:SALEM,OR 97304 Subtotal 31.27
Phone:(5(13)371-6141 Fax:(503)623-6511 Minimum permit tee: 572.50 +41.23 :
-0- I('CII lac,:42231 Plumbing Lie,rim:24-152PB Plan review (25%of permit fee) - .---r
_
- State surcharge(12%of permit fee) 8.70
Authorized signature: ' " • ,e ,
''-' TOTAL PERMIT FEE 1 81,20
Print name: MELISSA AVI LA Date:03_10_2017 -1 This permit application expires if a permit is not obtained within ISO days
,„.......„„,......„
after it has been accepted as complete.
-
*Fee methodology set lix:'Fri-County Building Industry Serviec littrit.
I 11ui,ftn4 Po mg,PEAR;•PcrantApp.do,:. 10 01 09 41045161110 02,C051,WI:11/