Permit (207) CITY OF TIGARD PLUMBING PERMIT
Tigard OR 97223 503.718.2439 " ',
0 -00356
COMMUNITY DEVELOPMENT
13125 SW Hall Blvd.,TiDatePermit Issued:#: 07/24/PLM2201818
Ttclr'�l�.i� 9
Parcel: 2S 115AA00100
Jurisdiction:
Site address: 16138 SW 108TH AVE 81
Project: Brightwaters at Red Hawk Subdivision: WILLOW-BROOK-FARM Lot: 36
Project Description: Installation of backflow preventer for fire line that is out of commission in unit 81. 7/30/2018: REPRINTED to
correct scope of work from removal to installation of backflow preventer.
Contractor: MP PLUMBING CO Owner: DHP BRIGHTWATERS LLC
PO BOX 393 32 MEADOW HILL DR
CLACKAMAS, OR 97015 TIBURON, CA 94920
PHONE: 503-655-9161 PHONE:
FAX: 503-655-1726
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 07/24/2018 $31.27
Specifics: 1 12%State Surcharge- 07/24/2018 $8.70
Plumbing
Type of Use: MF 41 ea Minimum Fee Adjustment- 07/24/2018 $41.23
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: R," Permittee Signature: -
"���� � U Al''/'c✓C .—j70
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 Auulicati aKEIVED
Building Fixtures rc)IZ 01.1,1( L l til_ cl.t.\
City of Tigard j U L 3 0 ?018 Received -. „N
lq ll 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: /3d AKyrp� ����� �
II Phone: 503 718,2439 Fax: 503,59elpfly
nu Ti 'ARD Review
t Other Permit No.:Inspection Line, 503,6394175c tD
.. � -... ..
Dale Ready/By:
Juin. See Page 2 for wwwti anl-or ov ING q i g
tjI1D ___ _ _ 1 Notified/Method: Supplemental Information rmaUoa
� �^,: dr :11f; . ;x
TYPE OFWWORK 'h
_ t -, 4 - R:. 1, .FEEeSCHEDT1LEpa - ,. •',: ,.._�4.... �^.
New construction 0 Demolition For speciallnjonnoBon use checklist
v?..)(
daition/alteration/replacement 0Other: Description Qty. Ea. I Total
New 1-2-family dwellings(includes 100 ft.for each utility connection)
'' ,".,. CATEGORYOF CO)HSrR C ION�,= ( ) 31_.70
�.. �, , '� � SFR 1 bath �
O 1 and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building r ulti-family r SFR(3)bath 500.32
Each additional bath/kitchen
❑Master builder 25.02
❑Other
Fire
5 7,7 .1� �II1 1' .0F SI TE$ II ORMATION AND LOCA'T'ION ; i `1 Site utilities:{ s 9Page2
ft.)srinkler
Job site address: tu1?jt3 SW I 0 fackb t1/4V�, gj4Catch basin or area drain 18.76
City/State/ZIP: '-I�;�TY } �"1 anti Drywell,leach line,or trench drain 18.76
.f Footing drain(no.linear ft.: Page 2
Suite/bldg./apt.no.: •Project name:
Manufactured home utilities 50.03
Cross street/directions to job site: 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 _
°_ DESCRIPTION OF ORK v_ . Backwater valve
1 3127 31.E
�+,, Clothes washer 25.02
'>i6texl • t� Len ao►g- a Tf✓ ~Dishwasher • 25.02
�YY\.CV& (>0 .✓f,,{{��C��-1•LOGO � Drinking fountain 25.02
c 0 (.!(•3L,1/,(3..- , Ejectors/sump 25.02
'9"41 '
0PROPERTY OWNER; 'Air--, _ 0„TFNAI,4T r Expansion tank 12.51
Name: Fixture/sewer cap 25.02 _
Address: Floor drain/floor sink/hub 25.02
Garbage disposal 25.02
City/State/ZIP: _Hose bib `
25.0_
Phone:( ) Fax:( ) Ice maker 12.51
g APPLICANT , 1�. CONT„TMACTPO ,," Interceptor/grease trap 25.02
Business name: M �l(� C h Medical gas(value:S ) Page 2
Contact name: t•, Z Q Primer 12.51
U i'�"V-' Roof drain(commercial) 12.51
Address: P O x Sitddbasin/lavatory 25.02
City/State/ZIP: ('1 a_ tC_1�O S } O S Solar units(potable water) 62.54
Phone: h2 (.0 VCc/+i�,
�JW) [DSS- `�11 u i Fax::( ) Tub/shower/shower pan 12.51
E-mail: . • •►, a a 1 a
Urinal 25.02
i l ; t_: CO C[OR t ': atercloset 25.02
i. � .�' Water heater 37.52
Business name: M P %
1' Water piping/DWV 56.29
Address: 'yo 11)C 3/A
Other 25.02 ,
City/State/ZIP: G3utc yta 5, (3t. en)
I C Subtotal
Phone:(�3) SS- �� Fax:{ _` ) J Minimum permit fee: 572.50 1 a •�
CCB Lic.: • a Plumbing Lic.no.:3-1'Z g Plan review (25%of permit fee)
Authorized signature: ) t - State surcharge(12%of permit fee) r
_ ` """"e"" . TOTAL PERMIT FEE i •'%
Print name v,ee ie 1 . i t✓\ Q�If* 7 70-1" This permit application expires if a permit Is not obtained Nit, IRO days
Date: after It has been accepted as complete.
+'
'Fee methodology set by Tri-Coumy Building Industry'ervice
I BaiWmg'Permits PLMU•PmnaApp.doc 100109 Jv s
�F10.4616T{IOObCUh!•1VEB) 1,(� 71)-1�/j
CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2018-00356
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/24/2018
T r c; Ii t, g Parcel: 2S115AA00100
Jurisdiction:
Site address: 16138 SW 108TH AVE 81
Project: Brightwaters at Red Hawk Subdivision: WILLOW-BROOK-FARM Lot: 36
Project Description: Removing existing backflow preventer from fire line that is out of commission in unit 81.
Contractor: MP PLUMBING CO Owner: DHP BRIGHTWATERS LLC
PO BOX 393 32 MEADOW HILL DR
CLACKAMAS, OR 97015 TIBURON, CA 94920
PHONE: 503-655-9161 PHONE:
FAX: 503-655-1726
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 07/24/2018 $31.27
Specifics: 1 12%State Surcharge- 07/24/2018 $8.70
Plumbing
Type of Use: MF 41 ea Minimum Fee Adjustment- 07/24/2018 $41.23
Plumbing
Class of Work: ALT
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: 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 ApplicaltECEIVEI)
_
Site Utilities
City of Tigard JU L 1 6 2018 D.RecteiciBvedr. 7 /c., 7,-
Permit No. 44,420/,--61_,,Ss'-&
01 13125 SW Hall Blvd,,Tigard,OR 97223
1,1
= Phone: 503.718.2439 Fax: spri6111cTICcy ,.. , i
ARD 'lank"'
Dote/By: Other Permit No.:
Inspection Line: 503.639.4175 s--'
TIGARDDate Ready/By: hail: Iii See Page 2 for
Uti
Internet: www.tigard-ov ft'litp IN
'C,'DIVISION Notified/Method: Supplemental Information
'',.$4':14tnitAVAM:iyikftWi:i:VtiCiMatiMff 4•,,, ,;4;kr,:,;,;.;;; :igzwa, ilptVARIpaikttgin FEE SCHEDULE
M,4*.':IV,Fi'MY:Mriikiai;.aff,:glaakalanitit4.0400.0:1% d ‘OUVRaj::wiiw7tr,-.:-;;ZAMOrg61*.i10-4:tv,iV
0 New construction 0 Demolition For special information use checklist
Description I Qty. I Ea. I Total
Ilfl)Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
,•3;.4il'I',,,,V01,,i-.2v,,,,w),,4704,4Exii660y,tireiigiiiirefitismm,
312.70
, 4: :CONSTRUCTION . SFR(1)bath
Eli-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
0 Accessory building 0•14ulti-family
Each additional bath/kitchen 25.02
0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
liditiMitgrAkiftliN.A1/11AT27„:111,04.0.70,010,011:Pg"irk" Site utilities' •
SWAN.1M6 .
Job site address )i --i -9al'--) 3 \cv?.5-'6Catch basin or area drain 18.76
1...3 AIN c,
- - Drywell,leach line,or trench drain 18.76
City/State/ZIP: 1"-c 7\Gt\b‘r(.\ 1 op. co Da L1/2 Footing drain(no.linear ft.: ) Page 2
Suite/bldg/apt,no.: 0)\ I Project name: ?),,ettyyl 0'. .W.Ar. IN 9k.,,C, . Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:„„_) Page 2
, ..
Storm sewer(no.linear ft.:. .....J Page 2
Water service(no.linear ft.:____) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 1 31.27 2,\* a 1
mg,figioto,,,MUYWiNiiiiithiiiiiiig',,,blicolifeaaniEWMARga'fF Backwater valve 12.51
.4:iivomz-A.40,,o41a5w4.14rRAV'i ' , A .,kavoNgtkla4m.img.1402:Aam•
Clothes washer 25.02
' rnONI t Q)(\96x-\(i), \in c\tcc\0133 Dishwasher 25.02
fS\CN i..)0..k. riC CCSY11-YN't.c., o•r\ ;v e, Urk e, Drinking fountain 25.02
%, Ejectots/sump 25.02
fog?eximattfokool000twamint. olagortoottogiung Expansion tank 12.51
Fixture/sewer cap 25.02
Name:
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
i:,,wAkolm,Ypoi.Lxicivertv,:erzi..W4gorogioN 40,3e:A" nz.,::••=p=r==raimpfliv 25.02
s114AVANN1i0P,',-AF,P,.94,Y, 444.4t,,,T.MAN*,,,,,- P .iNME1JAW. ',Aa,,,,,,...N1P,ofi'e. Interceptor/grease trap
Business name:MV . k,1,01\64,(It) CD _Medical gas(value:$ ) Page 2
Primer 12.51
Contact name: 'V.?i.1ktk\ lyr)\Vt V\CV.:\f
Roof drain(commercial) 12.51
Address: 17) , c) ‘S .,, L6r) )(2.. Sink/basin/lavatory 25.02
City/State/ZIP: C)t c'(,?),ityy?s, 0 g Ckl 0 6 Solar units(potable water) 62.54 T
Phone:4 -3)(.1)5 c3.. c‘\t s\ Fax::( ) Tub/shower/shower pan 12.51
• _Urinal 25.02
Ml
E-mail:-mail: f..AcktXA(061.‘1\90.41Y1b‘100C es m ck)set
25.02 ittiglaNgitaittP5i0,4WOORTINIIIiitiligilOARMIC water
water heater 3732
Business name: Mc ,‘.)\\MI%(\Q Cn Water piping/DWV 56.29
Address:\ 13,21.5) .- coac., 02_ Other 25.02
City/State/ZIP: ex a c yxy115 S, crib,S Subtotal
Minimum pennit fee: $72.50
Phone:(i:2.0 ) (s) S..(A‘(014 Fax:( )
Plan review (25%of permit fee)
CCB Lie.: 500-a Plumbing Lie.no.: 3-ripe, .
State surcharge(12%of permit fee) ..1
Authorized signature: \( 9 Q 61\ 1N0 V-1,1,15y1-- TOTAL PERMIT FEE
This permit application expires If a permit b not obtained within IRO days
Print name: 1+-ser.\e.,\x 9);A\\-me\if v, Date: after it has been accepted no complete.
"Fee methodology set by Tel-County Building Industry Service Board.
1:1Buildinecrmits\PLMU-PermitApp,doc 10/01/09 440.1616T(10/02/COWWES)
L/L 81.0Z-ZL-LO 6E:8E:60 LL
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16138 SW 108TH AVE 81 , TIGARD, OR, 97224 August 9, 2018 at 3:22:00 PM
Record Type: Record ID:
Commercial - Plumbing PLM2018-00356
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Watts backflow device model LF007M I ser#065551 approved with test report.
Device replaced old one that was broken during last test.
Plumbing final inspection created to close permit.
Violation Summary:
Inspector Contractor