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Permit (108)
CITY OF TIGARD PLUMBING PERMIT - s COMMUNITY DEVELOPMENT Permit#: PLM2018-00479 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/11/2018 TF[;A1 f? g Parcel: 2S1060001400 Jurisdiction: Tigard Site address: 13239 SW 169TH AVE Project: River Terrace East Apartments,Building F Subdivision: RIVER TERRACE EAST Lot: None Project Description: Building F: New 21 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: 503-992-6664 PHONE: 360-695-7700 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: `-f ✓ �'d4r 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 Application Building Fixtures EIV FOR OFFICE USE.ONLY City of Tigard Receives // �^ �i� p� n 13125 SW Hall Blvd.,Tigard,OR 97 DatelBY:/� !! -/O �/7'�!' P i' - Phone: 503.7182439 Fax 503.59 1 � t r1 I plan Revi v p�Py��q� Inspection Inc.L503,639.4175 Date/By; /�/C/G!� j,���� TIGARD Intemet'wn vtl d-Dr. V Date Ready/By: kris: HSee Page 2for _ _ Supplemental Saz go e �. ��, �^.��, �� �� � _ NotifiedRviethod: _ PP oration ®New construction it s01 tir. � �71i C/j y ;7;;If-i-fn;;;;Lt use checklist Description [ Qty. J Ea. I Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) _= =-�-... -- -a ��_�_'. .;�C:-;,. .s�� tet= ,� r=s SFR(1)bath _.. _ �0� _ . � ��`m .._ 312.70 ®I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath ❑Accessory building Multi-family 500.32 ❑Master but7derEach additional bath/kitchen 25.02 0 Other: �,.. 5 _ ____ Fire sprinkler( sq.ft.) Page 2 . O �i 0 1113 .CrA'T9�0:4�.. -.,_. �:� "; �'s-_ _-T, .��,_. ']V�;-,� =��;s' Site utilities: Job site address: '32 3 q S�i) /to 9 4 Catch basin or area drain 18.76 CitylState/ZIP; J Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name:River Terrace East Manufactured home utilities50.03 = i Cross street/directions to job site:re:L 2)G 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.:River Terrace East I Lot no.: Fixture or item: t Taxmap/pareelno.: Bacldlowpreventer I 31,27 '""-'-''''''''' ''''''' '''-'1-7'W'' ''''-`"' pT"--$�E ©L''.` , 4 z. _»7 Backwatervalve 12.51 ' 4 Clothes washer 25.02 Dishwasher 25.02 f 1 Drinking fountain 25,02 _ Ejectors/sump 25.02 O 0._ ar ;- __ 12.51 �„� - �•FR��'�O ���w 'LL'l�.,`. ;, �+' ;,,:�s:�'�;r'�`= Expansion tank Name:ADVL Land Holdings,LLC Fixture/sewer cap 25.02 Address:7600 E Doubleree Ranch Road Floor drain/floor sink/hub 25.02 City/State/ZIP:Scottsdale,AZ 85258 Garbage disposal 25.02 Hose bib 25.02 rr Phone;(602)694-4031 Fax ( ) # Ice maker 12.51 *`._>� ' -.laa-AilWe _,z" z -= `'WitiCItOL�Tg1'� Interceptor/grease trap 25.02 LF Business name:Polygon WLIf,LLC 4=. Medical gas(Value:$ ) Page 2 Ip E Contactname:Joleen Smith Primer 12.51 Roof drain(commercial) 12.51 Address:703 Broadway St,Ste.510 Sink/basin/lavatory 25.02 I City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54 Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51 E-mail:permitsubmittals®polygonhomes.com Urinal 25.02 .._-- -_ _- -- --9r. .�-" =mint . ._-._ Water closet E y;..__-- �f. �. - '�"-='"�=�" 25.02 saes<_ _ :3.rr.--�t. ' .g _-C _ "7---�-�-' _' `" - Water heater • 37.52 Business name: {rXsers e.o.. ►�, \ C., Water t in WV Address: `(p 2`5l SAD 15, ,x t`-•�t 5, P P P� 56.29 , T T[vt �I0 Other. 25.02 City/State/ZIP: 110_4,19\ tr . cli 2� Subtotal Phone:(56) 911..>36(06,4/ Fax:( ) Minimum permit fee: $72.50 r CCB Lie.: `6. &,,i, t Plumbing Lie,ne:ti./J ✓/`l& Plan review (25%ofpermit fee) ( , " State surcharge(12%ofpemut fee) Authorized signs e: '\ TOTAL PERMIT FEE�`(z(/ F Print name• r Date: ( 2� /el Thls permit application expires if a permit is not obtained within 180 days 7 � vs�r C after it has been accepted as complete *Fee methodology set by Tri-Comfy Building Industry Service Board 1:1Buildingipemuu;1PLMCTPamdtAppdoc 10/014)9 440.4616T(10/02/COM/{;rEa) t. 4 r. ,