Permit CITY OF TIGARD PLUMBING PERMIT
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COMMUNITY DEVELOPMENT Permit#: PLM2018-00077
3-[GA RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/06/2018
Parcel: 2S110AD08700
Site address: 10640 SW CANTERBURY LN 8 Jurisdiction: Tigard
Project: Pacific Crest Apartments
Project Description: Installing(1)clothes washer. Subdivision: None Lot: None
Contractor: THE PLUMBERS INC.
90 NW 150TH AVE Owner: AUK-REDWOOD PC SPE LLC
BEAVERTON, OR 97006 10695 SW
TIGARD, OR 97224R 97224 K ST
PHONE: 503-519-6644 PHONE:
FAX: 503-684-1202
FEES
Quantity Description Date
Amount
1 ea Clothes Washer 03/06/2018
Specifics: $25.02
1 12%State Surcharge- 03/06/2018 $8.70
Plumbing
Type of Use: MF
Class of Work: ALT Plumbing 47 ea Minimum Fee Adjustment- 03/06/2018
$47.48
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
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon lawequires your toiffollot ow the n rulest adoptedthby 180 days of
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: de
4/��-`� Permittee Signature:
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 ApplicationRECVIVEP
Building Fixtures
�g FON OFFICE t st: O.ALN
City of Tigard 1' G 7 CH S Received
13125 SW Hall Blvd.,Tigard,OR 972 yr1111
g Date/B : �� Permit No.: 4.1.14:„ �� ��
a Phone: 503.718.2439 Fax: 503.598.19401 /OR N Plan Review
f t C A K D Inspection Line: 503.639.4175 �8R Date/By: Other Permit N., U
Internet: www.ti ardor. ov �� �£CT Oil/NVi,DateRead/B
g g y Ready/By: kris. ® See Page 2 for
Notified/Method: Supplemental Information
TYPE OF WORK
❑New construction FEE* SCHEDULE
0 Demolition For s,ecial in ormation use checklist
IMIll Ea. Total
rAddition/alteration/replacementDescri.tion
0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath
312.70
❑ 1-and 2-family dwelling
❑Commercial/industrialSFR(2)bath 437.78
❑Accessory building El Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder ❑Other:
JOB SITE INFORMATION AND LOCATION Fire sprinkler( sq,ft.) Page 2
Job site address:10640 SW Site utilities:
�P�ace Apt C�8 Catch basin or area drain I 18.76
City/State/ZIP:Tigard,OR 97224 T�v�!
Drywell,leach line,or trench drain 18.76
Suite/bldg./apt.no.:C08 I Project name:C08 W-D Install Footing drain(no.linear ft.: ) Page 2
Cross street/directions to job site:109 th Manufactured home utilities 50.03
Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.:____) Page 2
Subdivision: Water service(no.linear ft.: ) Page 2
J 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
City/State/ZIP:Tigard,OR 97224 Garbage disposal 25.02
Phone:( ) Hose bib 25.02
Fax:( ) Ice maker
® APPLICANT 12.51
❑ 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
City/State/ZIP:Tigard,OR 97281 Sink/basin/lavatory 25.02
Solar units(potable water) 62.54
Phone:(503)317-7713 Fax:
( ) Tub/shower/shower pan 12.51
E-mail:hps@canby.com Urinal
25.02
CONTRACTOR Water closet 25.02
Business name:The Plumbers Inc Water heater 37.52
Address:90 NW 150th Ave Water piping/DWV 56.29
City/State/ZIP:Beaverton,OR 97006 Other: 25.02
Phone:(503)519-6644 Subtotal
Fax:(503)684-1202 Minimum permit fee: $72.50
CCB Lie.:177214 Plumbing Lic.no.:PB447 Plan review (25%of permit fee)
Authorized signature: State surcharge(12%ofpermit fee)
IPrint name:Gerald Bilgere TOTAL PERMIT FEE -(
I Date: 2 I Z sl i I This permit application expires if a permit is not obtained within 180 days
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