Permit (135) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#:
PLM2018-00059
T f C-A I=.i7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/15/2018
Parcel: 2S110AD08701
Jurisdiction: Tigard
Site address: 10685 SW CANTERBURY LN 1
Project: Pacific Crest Apartments Subdivision: None
Project Description: Interior plumbing:Installing water supply and waste drain for clothes washer. Lot: None
Contractor: LOVETT INC Owner: AUK-REDWOOD PC SPE LLC
PO BOX 86280 10695 SW MURDOCK ST
PORTLAND, OR 97286 TIGARD, OR 97224
PHONE: 503-737-8423 PHONE:
FAX: 503-288-1630
FEES
Quantity Description Date Amount
1 ea Clothes Washer 02/15/2018 $25.02
Specifics: 1 12%State Surcharge- 02/15/2018 $8.70
Plumbing
Type of Use: MF 47 ea Minimum Fee Adjustment- 02/15/2018 $47.48
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:
ee Signature: G4-2/110��Gt ,
Call 603.639.4175 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 Application
Building Fixtures
City of Tigard CEIVEJReceived
Permit No.:
lig ill
13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: ),.1/4-y ),.1/4- f "- Q •� i
Phone: 503.718.2439 Fax: 503.598.196 T. 2 ) Plan Review /" v'�F
EB 1 2 018 Date/By: Other Permit No.:
T t G n K D Inspection Line: 503.639.4175te/ See
1. i l( o t!IGARB Notified/Method: .7f Supplemental Information
TYPE OF W I ' j nAt Ar FEE* SCHEDULE
❑New construction 'I efili5lil`foit DIViSIOA For special information use checklist
Ni DescriptionTotl-
Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 1100 Qty.
for each utilitylconne tion)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building 11 Multi-family SFR(3)bath 500.32
❑Master builderEach additional bath/kitchen 25.02
0er Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION
Site utilities:
Job site address:10685 SW Canterbury Lane Apt A0l Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97224 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.:A01 I Project name:
Manufactured home utilities 50.03
Cross street/directions to job site:109th Ave 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: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Install water supply and waste drain for clothes washer Clothes washer 1 25.02 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Name:AUK Redwood PC SPE LLC Fixture/sewer cap 25.02
Address:10695 SW Murdock Street Floor drain floor sink/hub 25.02
Garbage disposal 25.02
City/State/ZIP:Tigard,OR 97224
Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
ti APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:HPS Inc Medical gas(value:$ ) Page 2
Contact name:Jay Bilgere Primer 12.51
Address:PO Box 23187 Roof drain(commercial) 12.51
Sink/basin/lavatory 25.02
City/State/ZIP:Tigard,OR 97281 Solar units(potable water) 62.54
Phone:(5d 3) 3 I-) -'7 7/ 5 Fax::( ) Tub/shower/shower pan 12.51
u ,
E-mail: 5 a co,N 1I cow Urinal
1 25.02
CONTRACTOR Water closet 25.02
Business name:Lovett Inc
Water heater 37.52
Water piping/DWV 56.29
Address:6920 NE 42°d Ave Other:
25.02
City/State/ZIP:Portland,OR 97218 Subtotal G2- "t,
Phone:(503)737-8423 Fax:O Minimum permit fee: $72.50
CCB Lic.:125507 Plumbing Lic.no.:26-773PB Plan review (25%of permit fee) --
Authorized signatur _ ___T,
State surcharge(12%of permit fee) -70
TOTAL PERMIT FEE ft 3'*)
Print name:Gerald Bilgere Date:z/l//45 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
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