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Permit (115) CITY OF TIGARD PLUMBING PERMIT 111 • COMMUNITY DEVELOPMENT Permit#: PLM2018-00482 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/11/2018 TrGA I 1) 9 Parcel: 2S1060001400 Jurisdiction: Tigard Site address: 13191 SW 169TH AVE Project: River Terrace East Apartments,Building J Subdivision: RIVER TERRACE EAST Lot: None Project Description: Building J: New 22 unit apartment building. Backflow preventer for landscape irrigation. Contractor: ANDERSEN HEATING, INC. Owner: POLYGON WLH, LLC 16285 SW 85TH AVE STE 410 703 BROADWAY ST, SUITE 510 TIGARD, OR 97224 VANCOUVER,WA 98660 PHONE: 360-695-7700 503-992-6664 FAX: 503-536-6615 FEES Quantity Description Date Amount 1 ea Backflow Preventer 10/11/2018 $31.27 Specifics: 1 12%State Surcharge- 10/11/2018 $8.70 Plumbing Type of Use: MF 41 ea Minimum Fee Adjustment- 10/11/2018 $41.23 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. Issued By: Permittee Signature: Cz� 171/ 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. , F iv i Plumbing Permit Appl `- . 1.a x ~ Building Fixtures g� FOR orricr USE ONLY �'1 of Tigard SEP fit 9 ?.018 Received A) �i �jam, v 13125 SW Hall Blvd.,Tiga 7 Date/By: f/� �� /J Pq� "6�' �`(J �(/y�� $ � Plan Review !) Phone: 503.7182439 F 8, y BARD Date/By: ,..0�G Inspection Line: 503.63 TIGARD DateReady/8y: Iuds: H Seepage for Internet' Ti,gg �g q J tvww.tlgard-o c yi 11./ii ( y3•�re.gp 6'���� NoOfiSupplemental _..__._... u.� rte ....._._-.z'7--_� �t.B ]J4 j'i ed/Method: Infarmatton -- - - ='r -- - .,. .. vs-''-1 _ -_-tv-+! - -.T0-ms=s=anti__=-==rl..� --- "'�,---'-' -_'"-•-"-^-� - --- - �.Y=_1'�L,"x0�+-:4Y� �.,' -ur,=- - -- �:�`",? t• rte ��:�;T7�; T'r _ +�' wr 2�.:. .< �`_ _ts.•'-� 4;.=y...-.� �,..4 tuso.. }� �4xer` ti. . �,�`��.'?-:� Yi'�_ ti .' -_.�. ®New construction 0 Demolition For special information use checklist Description I Qty. I Ea I Total 0 Addition/alteration/replacement 0 Other New 1-2-family dwellings(includes 100 R for each utility connection) 4 �- - 7h: 'A. .-�+-�_�^ ,-.mac s- r w, rev' 2=.ter>•,i ._... _ _ _ 5•' •-,- - SFR(1)bath -�a�� ,;� � .. GO $, ,• 7;.�_. .r.a-,��L: 312.70 ®I and 2-family dwellingSFR(2)bath 437.78 0 Commercial/industrial ❑Accessory building .Multi-family SFR(3)bath 500.32 - Each additional bath/kitchen 25.02 Q Master builder 0 Other: _- -. ,. Fire sprinkler( sq.R) Page t4a .r. : U-TM - ,O Q' � Site utilities:- - s Job site address: V 3kq t 6 G) ,( er Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: Footing drain(no.linear ft_: ) Page 2 Suite/bIdg./apt.no.: I Project name:River Terrace East Manufactured home utilities 50.03 Cross street/directions to job site:c-61_2)c'S Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 , Storm sewer(no.linear R.: ) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision.:River Terrace East I Lot no.: Fixture or item: - _ Tax map/parcel no.: Backflow preventer 31.27 e"i=„_ `-: k © "O ,P�� ,ta-, z: Backwater valve 12.51•. Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 1 Ejectors/sump 25,02 _. Fr$T °yi.$'sem nags- f y s ts. ,_� Expansion tank 1 -4 Y.�3 -, 3=_ I PiIii' ..moi. ;`w 2,51 Name:ADVL Land Holdings,LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25,02 € Address:7600 E Doublerce Ranch Road I Garbage disposal 25.02 City/State/ZIP:Scottsdale,AZ 85258 i Hose bib 25.02 li Phone:(602)694-4031 Fax:( ) Ice maker 12.51 ,a-T,- ',_+wx'.,-r-= Yvs-TM�,+>= zi2:"�:.c--may=3„�'". _..• _., .._.... _� . : ��" -' PT1LAN[Mi : _<r '' $O=CUNTs1C4-I6!SO r/ as tra 25.02 r �"'�' 'r��e'��` Interceptor/gre e p � ,,r,,.,,_..� �-,: :G+=�__sx-! nes.- -�s�-=,.:., :. �;,:;.:.•r•,..Y g Business name:Polygon WLH,LLC Medical gas(value:$ ) Page 2 & Primer 12.51 Contact name:Joleen Smith Roof drain(commercial) . 12.51 Address:703 Broadway St,Ste,510 Sink/basin/lavatory 25.02 City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54 t Phone:(360)695-7700 Fax,:(360)693-4442 Tub/shower/shower pan 12.51 Urinal 25.02 E-mail:permitsubmittals®polygonhomes.com • , a- „. 7-4-,_., - = 4: T-. Water closet 25.02 t. Business name: ` Water heater 37.52 XSe� 1°Lai ` ' ' Waterpiping/DWV 56.29 Address: U.,255C S 110 1E t Sire- L110 Other_ 25.02 Ci /State,ZlP: t t3 1 Cp� , (J1� �12Z,L/ Subtotal Phone:(<jb3) G �(Otooe/ / Fax:( ) Minimum permit fee: $72.50 G CCB Lie.: G 4'F r� Plumbing Lie.nem•/49 /, Plan review (25%of permit fee) // f State surcharge(12%ofpeanit fee) ^� Authorized signs e: . 41167/ TOTAL PERMIT FEE O"CJ E Print name: Date: This permit application expires if a permit is not obtained within 1 0 days ,after it has been accepted as comr� r r�`�'�-r 2�4 � f. "Fee methodology sat by Tri-Coenty Building 7ndpushy Service Board. • F LlaaiidoglPemiitatPLMCJPo mitApp.doe 10/01/09 440.46162(10/07/CAM/WEB) i I