Permit (107) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2017-00187
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13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/17/2017
-TIGARD Parcel: 2S106DB06500
Jurisdiction: Tigard
Site address: 13315 SW PUMPKIN VALLEY TER
Project: River Terrace Northwest,Lot 65 Subdivision: RIVER TERRACE NORTHWEST Lot: 65
Project Description: Adding second water heater.
Contractor: MALMEDAL ENTERPRISES INC Owner: WILLIAM LYON HOMES INC
PO BOX 207 BY POLYGON WLH LLC
BANKS, OR 97106 ATTN GAST, FRED
109 E 13TH ST
VANCOUVER,WA 98660
PHONE: 503-324-0759 PHONE:
FAX: 503-324-0580
FEES
Quantity Description Date Amount
1 ea Water Heater 05/17/2017 $37.52
Specifics: 1 12%State Surcharge- 05/17/2017 $8.70
Plumbing
Type of Use: SF 35 ea Minimum Fee Adjustment- 05/17/2017 $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. 5.r‘
�/Issued By: /1/6Zip � Permittee Signature: afze 4Lli/
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 AnyliRSCEIVED
Building Fixtures i(Hi 01 I I( i I
City of Tigard
i
13125 SW Ball Blvd.,Tigard,CR
MAY 1 7 2017
Phone: 503.7182439 Fax4 r".J4,:,- TIGARD
Inspection Line: 503.639.410 i ll I 1 DIVISION
inamet www.tigard-or.gov Received
Dreensy: I
Rely. Pennia4w. PIWI•te2C)/7-DO a7
Nen Review
Diteer
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Notigedttediod: °the'Permit N'AtSrla --663 H
ha. El See Page 2 for
Super:menial informedion
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• • • • , ••• . . .- • ...- , .,
El New construction CI Demolition For special infarmatie-a aseelrecklist
Description I Qty. I Es. I Total
El Addition/alterationhtplacement 0 Other: Newt.2-family dwellings(includes 100 ft.for each utility connection)
.....
, •;,.!•.:•-•••••,. • •••„. -.CATEGORY OF CQNSIRIXTRIIN' • . • SFR(I)bath 312.70
tEl 1-and 2-family dwelling 0 Commarcialcmdustrial SFR(2)bath 437.78
SFR(3)bath 50032
0 Accessory building 0 Multi-family r Each additional bath/kitchen 25.02
13 Master builder 0 Other: Fire sprinkler( ___sq.ft.) Page 2
JOB SITE DiFoRmkncel OM•LOCATION . • Site utilities:
. . , . •
ic'b size addresq 3271 C SIA rtirylpt5in VA.1 it,9 Terreme, Catch basin or area ch-ain
Drywall,leach line,or trench drain 18.76
18.76-
City/State/VIP:Tigard,OR 97224 Footing drain(no.linear ft.: ) Page 2
, -
Suite/bldg./apt.no.: i Project name:g4Ver Te rroct ift I orthhat- Mmutactured home utilities 50.03
-
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_J Page 2 ,
Storm sower(no.linear ft:_J Page 2
Water service(no.linear ft:._.J Page 2
Subdivision:goer 7e tract_ tihrti4Kes-1- I lAit no. Fixture or item:
Backeow prevent:I. 31.27
Tax map/parcel no.:
. , . . • Backwater valve 12.51
-• • '-•• -• • • DEKR1POON OF.WDBH : ' •
. , Clothes washer 25.02
0 ckiing Aikit-0046ki inkHeir kwiteAr _
Dishwasher 25.02
ittRA(0-no311 Drinking fountain 25.02
Ejectors/sump 25.02
pg.rtomery OWNER , 1 0 TENANT Expansion tank 12.51
Fixture/sewer cap 25.02
Name:ADVL Land holdings,LLC Floor drain/floor sbildlinb 25.02
Address:7600 E Doubletree Ranch Road Garbage disposal 25.02
City/StaterM:Scottsdale,AZ 85258 Hose bib 25.02
Phone:(602)694-4031 I Fax:( ) lee mai= 12.51
„ . CI corium PERSON. Interceptor/grease trap 25.02
Medical gas(value:$_) Page 2
Business name:William Lyon Homes,Inc Primer 12.51
Contact name/Oa/di 712/i0,24, Roof drain(oiranercial) 12.51 '
Address:109 East 13th Street Sink/basin/lavatory 25.02
City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54
Phone:(360)695-7700 I Fax::(360)693-4442 ,Tub/showerfshower pan , 12.51
'Urinal
E-mail: Wick& .7ha,-pr 0 Pp((.14114140Mrc,CLYY1 Wawa closet 2525..0202
coNntArroR,, kr
Water heater i 37.52
Business name:Mahnedal Enterprises Inc. Water piping/DWY 56.29
Address:PO Box 207 Other: 25.02
City/State/ZIP:Banks,OR 97106Subtotal
Phcmc(503)324-0759 Fax:(503-)324-0580 Minimum permit fee: $72.50
Plan review(25%of permit fee)
' CCB Lic.:102535 'Plumbinglic.no.:34-276PB State surcharge(12%of permit fee) i
Authorized signature: C----- - k.:-: =1" TOTAL PERMIT FEB
.. I Print name:Carolina Malmedal 1 Date:04125/2016 I This permit application expires if a permit boat obtained whine ISO days
after it has been accepted as complets.
'Fee methodology set by Tvi-County Building Industry Service Board.
LitioikroWarmitAMMU-PanilApp,doe 10/01/09 440-4616T(10/02/COMAYE5)
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