Permit (119) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT
Permit#: PLM2019-00354
Date Issued: 09/05/2019
TEGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S 112AD00600
Jurisdiction: Tigard
Site address: 14750 SW 72ND AVE
Project: Ryder Truck Rentals Subdivision: None Lot: None
Project Description: Interior repipe of hot and cold water piping.
Contractor: D & F PLUMBING Owner: RYDER TRUCK RENTAL INC
4636 N ALBINA AVE LOC#1876
PORTLAND, OR 97217 BY PROPERTY TAX DEPT 3B
PO BOX 025719
MIAMI, FL 33102
PHONE: 503-282-0993 PHONE:
FAX: 503-288-0604
FEES
Quantity Description Date Amount
1 ea Water Piping/DWV 09/05/2019 $56.29
Specifics: 1 12%State Surcharge- 09/05/2019 $8.70
Plumbing
Type of Use: COM 16 ea Minimum Fee Adjustment- 09/05/2019 $16.21
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 Application
Building Fixtures FOR OFFICE USE ONLY
Received
Cityof Tigard CESPermitNo.:/04",742c� cy ^y
ll V� Date/By: S�� ". ���(,�)9
- a 13125 SW Hall Blvd.,Tigard,OR 97� Plan Review
• Phone: 503.718.2439 Fax: 503.59 Date By: Other Permit No.:
T I GARD Inspection Line: 503.639.4175 SE?
5 2O Date Ready/By. Tuns ® See Page 2 for
Internet: www.tigard-or.gov S` Notified/Method: Supplemental Information
,.u' W�-,,»w ...«--.- ,-<.a... ... .._..... xx �� �I�.&j��.�:� ""i iii E";<7L'... F„""i f,-- .. '. *I�".���s,"�i"md;Tiil(�'� �'� ......, F�l r
o New construction ❑ For special information use checklist.
Description Qty. I Ea. I Total
Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF",CONSTRIJCTION SFR(1)bath 312.70
❑ 1-and 2-family dwelling 'Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
"` - JOB SITE INFORMATION'ANDSwLOC'ATION Site utilities:
Job site address: /Cif 15 2 C 72 .‘i,9 (/
t v�
Catch basin or area drain 18.76
City/State/ZIP: �i , ,!:(,)
Drywell,leach line,or trench drain 18.76
r-eir Footing drain(no.linear ft.:_) Page 2
VN
Suite/bldg./apt.no.: Project name: '/ e:/ /UG-21C, Manufactured home utilities 50.03
Cross street/directions to job site: �/ Manholes 18.76
____LRain drain connector 18.76
V ' f - I 'I '- --k 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 31.27
Backwater valve 12.51
DESCRIPTIiON OF` WORE
Clothes washer 25.02
in /6-r r''-Pi.a-1 d !1 v r 66/GC erv4 Dishwasher 25.02
tO 1 P i t- Drinking fountain 25.02
Ejectors/sump 25.02
. (,j PROPERTY OWNER ] b TENANT' ‘.:;',-,',';''',.',T...,- Expansion tank 12.51
Name: Fixture/sewer cap 25.02
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
❑°APPIJCANT 0 CONTACT P> R$O.N o Interceptor/grease trap 25.02
Business name: Medical gas(value:$ ) Page 2
"' °'e el 5 L4"'2 Primer - 12.51
Contact name:
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
_.- sowers owerpan -- _-
Phone:( ) I`ax::� )
E-mail: Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: p f 11 yut (�.) Water piping/DWV 1 56.29 52,1
Address: .. 4 3 4 J, 4.1 ,„c4. A,,,,_6Other: 25.02
City/State/ZIP: 1907-sWLr ,,,t_ ,Q &lc177/ 7 Subtotal j-z4
Phone:(t", ) 2 g-2-i2?i3 Fax:( ) Minimum permit fee: $72.50 ?),,c
Plan review (25%of permit fee)
CCB Lie.: 4/4,-1"-- Plumbing Lie.no.: -'2,-' J°( State surcharge(12%of permit fee) y.,7G,�
Authorized signature: l9Alk....4(/),
_ TOTAL PERMIT FEE ) n
Print name' 9��l � Date: This permit application expires if a permit is not obtained within 0 days
A",40_, O l(/ after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
14750 SW 72ND AVE, TIGARD, OR, 97224
Record Type: Record ID:
Commercial - Plumbing PLM2019-00354
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor