Permit (160) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2019-00169
T E cl RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/25/2019
Parcel: 2S110DB00200
Jurisdiction: Tigard
Site address: 15199 SW ROYALTY PKWY
Project: Arbor Heights Subdivision: WILLOW-BROOK-FARM Lot: 8
Project Description: Replacing backflow preventer for building L.
Contractor: ANYTIME PLUMBING& DRAIN CLEANING Owner: ARBOR HEIGHTS VENTURE LLC
PO BOX 495 BY SECURITY PROPERTIES INC
LAKE OSWEGO, OR 97034 ATTN BOB KROKOWER
701 FIFTH AVE STE 5700
SEATTLE,WA 98104
PHONE: 503-894-8241 PHONE:
FAX: 971-255-1965
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 04/25/2019 $31.27
Specifics: 1 12%State Surcharge- 04/25/2019 $8.70
Plumbing
Type of Use: COM 41 ea Minimum Fee Adjustment- 04/25/2019 $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 44.
Issued By: er"mittee Signature:
?�r+l.., ,.yam /' �►_ ... �y�x ..
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.
Apr. 23. 2019 9: 08AM No. 2410 P. 1
Plumbing Permit Application
Building Fixtures
City of Tigard RECEIVE Reaeivea
y Plan Review'
e: l/ ,; Permit erom- e
Ili13125 SW Hall Blvd.,Tigard,OR 97223 ,,/ f J�G/hv�c�f 'l
a Phone: 503.718.2439 Fax: 503.598.1960 P R pate/y a Other Permit No.:
2 2 2019
I I t;A.R 11 Inspection Line: 503.639.4175 Dale Ready/By: Julia: Iii See Pare 2 for
Internet: www.tigard-or,gov CITY OF TIGARfl Notified/Melia: Jam, SuPtilameotat Information
TYPE OF woRBUILDING DIVISION FEE* SCHEDULE
ID New construction El Demolition Foe special fulmination use checklist.
Description I Qty. I Ea. I Total
17)Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SEL(1)bath 312.70
❑ 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building [gj Multi-family .
Each additional bath/kitchen 25.02
❑Master builder -❑Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORrIATION AND LOCATION Site utllltlee:
Job site address: 1 (tA"1 sv' g-0v k-T p 'y Catch basin or area drain 18.76
� A�. ++ Drywell,leach line,or trench drain 18.76
City/State/ZIP: 1{El A -.), 0 C 1111, ' Footing drain(no.linear ft.; ) Page 2
Suite/bldg./apt.no.: I,..- I Project name: i Os . 451 441-is-
c Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Dain 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: 1 Lot no.: Fixture or item:
Tax map/parcel no,: Backflow preventer j 31,27 f 4r1
DESCRIPTION OF WORKliackwatcr valve 12.51
Clotheswasher 25.02
i24VJTif n� �PiU N ir ra,ti, Dishwasher
25.02
Drinking fountain 25.02
Ejectors/sump 25,02
❑ PROPERTY OWNER 1 0 TENANT Expansion tank 12,51
Name: K
6On- 4H-T-c Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: ISI '''l SW tali ry fa( • Garbage disposal 25.02
City/State/ZIP: 'rf(�i &-b 1 Q rL, 11 }lost bib 25.02
Phone:(5Q�7J (54- 0 Fax:( ) Ice maker 12.51
APPLICANT ID CONTACT PERSON T Interceptor/grease trap . _ 25.02
19144.ryifitkiel 4. bII IV C LNC edical gas(value:$ ) Page 2
Business name: AW ylfi (
Contact name: CU4{ rn 1,� Roorimer , 12.51
`} Roof drain(commercial) 12.51
Address: Pb 6 0$. +°tS Sink/basin/lavatory 25.02
City/State/ZIP: LAt6i ()s I , Dg1 1 O Z 4 Solar units(potable water) 62.54
Phone:(cad 1(4"L' g i4 I. Fax::(61 4)2'cs-' MS" Tub/shower/shower pan 12.51
E-mail: klittAil itn fin'I!f l Km WA-, kS Urinal 25.02
-
CONTRACTOR Water closet 25-02.
Water heater 37.52
nosiness name: AK IA-Hale PIA nil b f Nil
�bV(f/j &Li i N(Mt Water piping/DW"V 56.29
Address: fa 616A ik14' Other: 25.02
City/State/ZIP: Ltto 0IwefaO / 0 .. 0110: 4- Subtotal '1j(,1,'1
Phone:(Sa') g't(,4.. ( Fax:(0'11)��-S 1 t ro - Minimum permit fee: $72.50 ,n,0
CCB Lic.: 101 11.„G1 Plumbing Lic,no.: b go q- Plan review (25%of permit fee)
State surcharge(12%of permit fee) g.10
Authorized signature: .\--/".."-\:..1."-H.
_TOTAL PERMIT FEE ` f r`x
Print name: A,J li-1/6.1 [A, Date:4 17'N I q This permit application expires if a permit is not obtained Wilhin 180 days
1 after ft has been accepted as complete.
`Fee methodology Oct by TA-County Building Industry Service Board.
1:1Building\Pcrmi a\PLI.OU-PermitApp.doe 10/01/09 14o-616T(10/02/C0MA a)
Branden Taggart
From: Branden Taggart
Sent: Thursday, April 25, 2019 3:30 PM
To: ashley@anytimeplumber.us
Cc: #Building Permit Technicians
Subject: Arbor Heights Plumbing Permit: PLM2019-00169 - 15199 SW Royalty Parkway
Hi Ashley,
I have created your permit for Arbor Heights. The balance due is$81.20 and you can pay these fees online now through
our website: https://aca.accela.com/tigard/Default.aspx. From there, click on the Building tab, enter the permit
number(PLM2019-00169) in the Record Number field, and click Search. Once paid, please notify us at
TigardBuildingPermits@tigard-or.gov, and we will email you the permit paperwork.
Thank you,
Branden Taggart
INw City of Tigard
IA Senior Permit Technician
�`' Community Development
ricARn
a+„
13125 SW Hall Blvd
Tigard,OR 97223
(503)718-2449
brandent ti€gard-or. ov
1
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15199 SW ROYALTY PKWY, TIGARD, OR, 97224
Record Type: Record ID:
Commercial - Plumbing PLM2019-00169
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
1 . Correction is complete, plumbing final approved.
Violation Summary:
Inspector Contractor