Permit (106) CITY OF TIGARD PLUMBING PERMIT
Permit#: PLM2017-00189
COMMUNITY DEVELOPMENT
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/18/2017
T Et ,1 . Parcel: 2S106DB07700
Jurisdiction: Tigard
Site address: 13412 SW SATSUMA AVE
Project: River Terrace Northwest,Lot 77 Subdivision: RIVER TERRACE NORTHWEST Lot: 77
Project Description: Adding additional water heater.
Contractor: MALMEDAL ENTERPRISES INC Owner: WILLIAM LYON HOMES INC
PO BOX 207 109 E 13TH ST
BANKS, OR 97106 VANCOUVER,WA 98660
PHONE: 503-324-0759 PHONE:
FAX: 503-324-0580
FEES
Quantity Description Date Amount
1 ea Water Heater 05/18/2017 $37.52
Specifics: 1 12%State Surcharge- 05/18/2017 $8.70
Plumbing
Type of Use: SF 35 ea Minimum Fee Adjustment- 05/18/2017 $34.98
Plumbing
Class of Work: OTR
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: /-44• GK<7` Permittee Signature: r ar,
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.
Plumbine Permit ADPlicatioird EC E I V E r
Building Fixtures i nit 0111,1, r i �l (0.1 1
City of Tigardri
MAY 17 2017 5 / ' /7 /r. Penn"°': )/7 Q'QG�7
13125 SW Hall Blvd,Tigard,OR 91273nen Review
Phone: 503.718 �LtS_T.2G?'G G�3
.2439 Fax
503398.19 7Y OF TIGARD
Inspection Line: 503.639.4175 BUILDING DIVISION ea6)BY Inds: Sem Page for
Internet www.tigard.or.gov On Nohfiad/Metbod Soppkmeetellutormatioa
®New construction ' 0 Demolition For spade,
Wonnadva use()ty.,� I Total
DescriptionI
❑Addition/alteration/replacement 0 Other New 1-2-family dwellings(includes 100 It.for cash utility commotion)
•
CATEGORY OF CONS1RUCi701N' �(1)b� 312.70
Corrtmerciallirtdustria! SFR(2)bath 437.78
®1-and 2-family dwelling ❑ SFR(3)bath 500.32
❑Accessory building 0 Multi-family Each additional bath/lrioeben 25.02
❑Master builder 0 Other: The sprinkler(___sq.a) Page 2
;OR SITE INFORM010 "AND.LOCAT ON Site statics:
Catch basin or area drain 18.76
Job site address:J! y a sV a.1-51A ivia Ne,
Drywall,leach line,or trench drain 18.76
City/State/27P:Tigard,OR 97224 Footing drain(no.linear ft.:„_J Page 2
Suitelbldgfapt.no.: 1 Project name:R e v I?r` � �-` Manufactured home utilities 50.03
Cross street/directions to job site: W► Manholes 18.76
Rain drain mor 18.76
Sanitary sewer(no.linear ft:„___) Page 2 \_
Storm sewer(no.linear ft:• ) Page 2
Water service(mo.linear ft.:•___) Page 2
Subdivision:give (Gf"Y' ((S hila r '-f- Lot no. .1 Fixture or items
gSC)COOW preventer 31.27
Tax map/parcel no.:
Backwater valve
12.51
+ . • s OFwC. . • . . Clothes washer 25.02
C1 im t VYA �IgleY j•Omit • Dishwasher 25.02
VL5TL)f� - 00103 Drinking fountain
Ejectors/sump 25.02
❑ TiitANT Expansion tank 12.51
®. oPE> ow�tElt Fixtrae/sewercap 25.02
Name:ADVL Land Holdings,LLC Floor drain/floor sink/hub 25.02
Address:7600 E Doubletree Ranch!toad Garbage disposal 25.02
City/Statr 2fP:Scottsdale,AZ 85258 Rose bib 25.02
Phone:(602)694-4031. 1 I Fax:( ) Ice maker 12.51
• ❑ CONTACT PERSON Intercept Intereeptodgease trap25.02
• ®.APi'[:XG!►1e11
Medical gas(valuer.$ ) Page 2
Business name:Williami Lyon Homes,Inc Pia 12.51
Contact nam pteit /Aloe, .Roof drain(commercial) 12.51
Address:109 East 13th Street Sink/basinrlavatory 25.02
City/State21P:Vancouver,WA 98660 Solar units(potable water) 62.54
Fax::(360)693.4442 Tub/shower/shower pm 12.51
Phone (360)695-7700
Urinal 25.02
E-man' mar-Thaire O mayinQtyt s-CAYY1 Water closet 25.02
CONTRA Water heater j 37.52
Business name:Malmedal Enterprises Inc. Water piparg/DWV 56.29
Address:PO Box 207 Other. 25.02
SubtotalCity/State/ZIP:!Banks,OR 97106 Minimum permit bee: $72.50
Phone:( )3244759 Fax:(503-)324.0580 Plan review (25%of permit fee)
CCB Lie.:102535 flutublugl tc no.:34276PB State surcharge(1254 of permit fee)
Authorized signature: C„,.. -c TOTAL PERMIT FEE
Date:04/25/2016 I This pen apptitedoe c if a permit is not olsaia 5 win 180 days
Print name:Carolina Malmedal atter It klesr bees accepted as omp ete.
*Fee methodology set by Fri-Gouty Building Industry Service Board.
I Asp.doc t0m1109 440-46161(1002/C08110853)