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Permit (110) CITY OF TIGARD PLUMBING PERMIT _ COMMUNITY DEVELOPMENT Permit#: PLM2018-00478 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/11/2018 T t ;A R D9 Parcel: 2S1060001401 Jurisdiction: Tigard Site address: 13271 SW 169TH AVE Project: River Terrace East Apartments,Building E Subdivision: RIVER TERRACE EAST Lot: None Project Description: Building E: 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: 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. i~ iCE!. Plumbing Permit Applica , .'' Building Fixtures FOR OFFICE USE ONLY - City of Tigard SEP 2 ,a 2018 Received .' 71 V 13I25 SW Hall Blvd.,Tigard, Date/By;l v �, /i p'� UC(� � Phone; 503.7182439 Fax � r6 • J t Date/Br 4 ` Inspection Line: 503,639.4 TICARD Internet:'wrvsvtigard-or.go i r DafcReadyB ]oris; H SeePage2for _�- `� .-;42,=: y� -7:-`'`'EL,. v �) i ii- Jy, Notified/Method: d/Mcthod. Supplemental YE © O .: ` ,.:11,54,F,- r-t - matt£ . Infos ®New construction 0 Demolition For special information use checklist Description I Qty. I Ea I Total ❑Addition/alteration/replacement 0 Other. New 1-2-family dwellings(includes 100 ft.for each utility connection), T . 11 `(j CO Yl"C'L) -' JK- SFR(1)bath 312.70 ®I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building Multi-family SFR(3)bath 500.32 - 0 Master builder Each additional bath/kitchen 25.02 j ❑Other: Fire sprinkler( sq.ft) Page 2 k, : : ._._ _i .Q�� ATVI)�s.Cei_ �=�: ON� Site utilities: 1 Job site address: ‘32,-7) 5t4), /&59. VG'7'H �w Catch basin or area drain 18.76 Drytvell,leach line,or-trench drain 18.76 City/State/ZIP: Footing drain(no.linear ft.: ) Page 2 1 Suite/bldg./apt.no.: I Project name:River Terrace East Manufactured home utilities 50.03 Cross street/directions to job site: UI.2)U e Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 I Storm sewer(no.linear ft.: ) Page 2 I Water service(no.linear it: ) Page 2 q Subdivision:River Terrace East I Lot no.: Fixture or item: 1 F t Tax map/parcel no.: Backflowpreventer 31.27 1 : Wr:a' -k4rtIe;y E �,:. t; r_• Backwater valve 12.51 I f ' °s'. -:.::0nt*:r-7-s t t4ii T-._ ONLU•?�.T.._O ` sic--i f-,� �i=-.ice&:' _ ' - " Clothes washer 25.02 Dishwasher 25.02 • Drinking fountain 25.02 Ejectors/sump 25.02- i _-1:1479.148*: �_= _� - I' r -Cil._NA_d'al7:k;= Expansion tank 12.51 Name:ADVL Land Holdings,LLC Fixture/sewer cap 25.02 • 1 Floor drain/floor sink/hub 25.02 t Address:7600 E Doubleree Ranch Road Garbage disposal P 25.02 s City/State/ZIP:Scottsdale,AZ 85258 Hose bib 25.02 Phone:(602)694-4031 Fax:( ) Ice maker 12.51 +''_-'aa="...�-==xis- �...s a._ _:'. €,- _ ._p}p:;�u:s.� ss:_ : :4NT "' = "'()NrACT'•->~i C - Interceptor/grease � _. �..=.;0;��.�� !R�OI�T���4 trap 25.02 Business name:Polygon WLR,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 t City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54 E. Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51 E-mail:permitsubmittals@polygonhomes.com Urinal 25.02 r , ��sru-, �- Water closet 25.02ii,-. - µ -s.ti -h ': -..: -•7„ ---'='' Water beater - 37.52 • Business name: Avvi.ersejf, ItA( C ,\P0 •' \►^C. WaterU3 1 r ' WV Address: ttt 1..tG ' E 4A,. 1 5.-e P Pmt 56.29 t y f D other: 25.02 _ City/State/ZIP: M. Q1 Z� Subtotal 'T�c/,.aro1 , _ Phone:(Gjb3) G Z t44O�I4 Fax:( ) Minimum pennitfee: $72.50 F ¢ /�/ i., _CCB Lie.: C6 P oi„ t Plumbing Lie,nam• //J[ il Plan review (25%of permit fee) j 7 State surcharge(12%of permit fee) Authorized Signa e: , TOTAL PERMIT FEE i; F Printname: 7 A !�I i�`( Date: y��f' This permit application expires if a permit is not obtained within 100 days rJ t/(/U ���� �v ,after it has been accepted as complete *Fee methodology set by Tri-County Building Industry Service Board. h. 2maidiog1pemiitslPridr?eonitAppdoc 10/01/09 440-4616T(10/n2Jco RB) EE f City of Tigard Tel: 503.718.2439 Location: Inspection Date: 17137 SW APPLEDALE RD, SHERWOOD, June 13, 2019 at 9:08:32 AM OR, 97140 Record Type: Record ID: Commercial - Plumbing PLM2018-00478 Inspection Type: Inspector: 399 Plumbing final Aaron Cillo-Gobel Result: PASS - NoCofO Comments: 1 .5" Febco irrigation backflow device model 850 ser#H38965 located in mechanical room approved with test report. Violation Summary: Inspector Contractor