Permit (92) CITY OF TIGARD PLUMBING PERMIT
74 '' COMMUNITY DEVELOPMENT Permit#: PLM2018-00197
T I G A R O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/23/2018
Parcel: 2S1060001400
Jurisdiction: Tigard
Site address: 13223 SW 169TH AVE
Project: River Terrace East Apartments,Building G Subdivision: RIVER TERRACE EAST Lot: None
Project Description: Building G: Plumbing for new 12 unit apartment building.
Contractor: ALLIANCE PLUMBING LLC Owner: POLYGON WLH, LLC
PO BOX 386 703 BROADWAY ST, SUITE 510
TROUTDALE, OR 97060 VANCOUVER,WA 98660
PHONE: 503-899-9912 PHONE: 360-695-7700
FAX:
FEES
Quantity Description Date Amount
18 ea Rain Drain Connector 05/23/2018 $337.68
Specifics: 12 ea Clothes Washer 05/23/2018 $300.24
12 ea Dishwasher 05/23/2018 $300.24
Type of Use: MF 12 ea Garbage Disposal 05/23/2018 $300.24
Class of Work: NEW 12 ea Ice Maker 05/23/2018 $150.12
Type of Const: 12 ea Sink 05/23/2018 $300.24
Occupancy Grp: 21 ea Lavatories 05/23/2018 $525.42
Stories: 18 ea Tub/Shower/Shower Pan 05/23/2018 $225.18
18 ea Water Closet 05/23/2018 $450.36
12 ea Water Heater 05/23/2018 $450.24
1 12%State Surcharge- 05/23/2018 $400.80
Plumbing
Total $3,740.76
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: - ** 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 Applicati4ECEIVEI)
Building Fixtures FOR 01 1 It r 1..SI (r>i *3
City of Tigard APR 25 Z018Roaecelte431.y 71 0V/cp.,13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revie
- ' Phone: 503.718.2439 Fax: 503.59CITY OF TIGARD Date/BY: w 5-2.-(i5 0,k1 °die`Penn"Inspection Line.Line: 503.639.4175 , .
TiGNRD SIO th)iat;:fteVrabYo:41-7/7//ef '6/' .1uns 1 0 See Page 2 for
, Internet: www.tigard-or.gov BUILDING DIVI cti 1 d • , = Supplemental information
'ME OF WORK Ai(Co t„. ---: FL70 SaffilitE
El New construction 0 DemolitionFor special information use checklist
Description ( Qty. 1 Ea. 1 Total
0 Addition/alteration/replacement 0 Other: New I-2-family dwellings(includes 100 ft.(breach utility connection)
- - CATEGORY OF CONSIVECIION SFR(1)bath 1---312.70
' El I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
0 Accessory building 0 Multi-family ----'
Each additional bath/kitchen 25.02
0 Master builder 0 Other:. Fire sprinkler( sq.ft.) Page 2 I -
JOB SITE INFORMATION AND LOCATION Site utilities:
, . . .
Job site address: r.L-)3 30) klooltk f..-
rile_., Catch basin or area drain 18.76 ,
, Drywell,leaeh line,or trench drain /8.76
City/State/ZIP:Tigard,OR 97224
Footing drain(no.linear ft.: ) Page 2
Suiteept.no.: CD I Project name:River Te yr ace.tast ConciS Manufactured home utilities 50.03
Cross street/directions to job site: ' Manholes 18.76 .,
Rain drain connector je cr 18.76 T31,,4;6 -,
Sanitary sewer(no.linear ft.: ) Page 2 -,
Storm sewer(no.linear ft.:_) Page 2 •
Water service(no.linear ft.:___.) Page 2
.
Subdivision: RN0e"T-eirrnre East Lo-(cto‘S Lot no.: Fixture or item: _
Tax map/parcel no.: Backflow preventer 31.27
Backwater valve 12.51
DES TON OF-WORK ' ' .
--:
Clothes washer 1 '2_,„.,/ 25.02 300.;i4 -
13 )9 IA)\-1- 630.3c1 ic - It AI l -FS Dishwasher J i 2 ,/ 25.02 3 (,d 4 J,.._
Drinking fountain 25.02
Ejectors/sump 25.02
' -C;_PliCNIX),Fr qwrifix I 0 TENANT Expansion tank 12.51
Name:ADVL Land Holdings,LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02 -I
Address:7600 E Doubletree Ranch Road
Garbage disposal /4, L., 25.02 360,,)
City/State/ZIP:Scottsdale,AZ 85258 Hose bib 25.02 !
Phone:(602)694-4031 Fax:( ) Ice maker /d.. .//' 12.51 i f 5C.
- 8 ArrnehAT: , Evosuer rosoN Interceptor/grease trap 2102 I '
, J
Business name:William Lyon Homes,Inc Medical gas(value:S ) Page 2
Primer 12.51
Contact name:N.)i chi)te l'horit.
Roof drain(commercial) I .51
Address:-1 D Vyr1)ckaLoct.9 St SL-iit -‘,1) Sink/basin/lavatory i_riAl"5 V25.02
City/State/ZIP:Vancouver,WA 98661) Solar units(potable water) 62.54
, !
Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan t to 12.51 d-:).5--/r.,
' Urinal i 25.02
E-mail:0.21,C(Y)0Af.:7111\ter9ettglcyoliv)raes.C...nm 022 j, 25.02 e-79,7,, 36 I-
i,,9,, ,/ 37.52 4 50,
, - Water heater
Business name:Alliance Plumbing LLC Water piping/DWV 56.29
Address:146 W Historic Columbia River Hwy Other: I 25.02
City/State/ZIP:Troutdale,OR 97060 Subtotal
Phone:(503)492-3490 Fax:(503)912-6438 Minimum permit fee: 572.50 1
l_jkr L2)1.6 6- Plan,review (25%of permit fee) A4/17'11 1
CCB Lic.:184601 / #4 Plumbing Lic.no.:PB732
State surcharge(12%of permit fee) 00.
Authorized signature:signature: 4 TOTAL PERMIT'FEE 3940.'76,r-
•I A'.
Print name:Robert Dishman Date:5/23/2016 This permit am/imam expires if a permit is not obtained within ISO days
after it has been accepted as complete.
*Fee methodology set by Th-County Building indusny Service Board
1‘BuildingTermitePLMU-PennitApp dot 10/01/09 in'46 161(10/02/CONVWEE) \ Rilt_V%- v,.. S ‘`, \C'.= 12 s/
2.L ./