Permit ..4 E-MAILED
• Plumbing Permit Application
-f 311042122.a
F., ,f-r-u-,Z- RECEIVE
City of Tigard Received �,i7/moo d Per
mit Nyo �4,1 ,20-�/4,
w APR 16 2020 13125 SW Hall Blvd..Tigard,OR 97223 Damruy:
Plan Review 1 r� 1,�QaO -0007S-
Phone: 5n Line:.5 3, Fax: 503.598.196Q ITY OF TIGARU Darr fly. Other Pcr
Inspection Line: 503.639.4175 y, El See Page 2 for
rle.Aun Internet: www.tigard-or.gov BUILDING DIVISION N`tir"/Mcthed: Jmn Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑New construction 0 Demolition For special information use checklist
Description I Qty. I fa. I Total
Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ I-and 2-family dwelling C'ommercialiindustrial SFR(2)bath 437.78
buildingSFR(3)bath 500.32
❑Accessory ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.fl.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: S2(.1 u C; 1'n. (7 Catch basin or area drain 18.76
W 11r Drywell.leach line,or trench drain 18.76
City/Stale/ZIP:-TtrrA Or ej12.'L
Footing drain(no.linear fl.:_) Page 2
Suite/bldg./apt.no.: [-Project name• A
I � +Cr� Ar.,fro 1 lAt.,i Pa W y,,
al Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear fl.:_) Page 2
Water service(no.linear It.:_) Page 2
Subdivision: J Lot no.: Fixture or item:
Tax map/parcel no.: Backilow preventer 31.27
DESCRIPTION OF WORK Backwater 12.51
Clothes washer 25.02
p {�
_e)fG'e[l.W''rGf).'a,, ?c.�4y,, .-. . 4 E rr, R ,(, ' Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER , TENANT Expansion tank 1 12.51 C2.451
Fixture/sewer cap 25.02
Name i , ,� Aritrt,,..31 1 ,1).fa1 ,f
Floor drain:floor ti
oor sinklhub 25.02
Address: Zq A
Si.,,..) FG,10,NANI ?G0�_......is7l Garbage disposal 25.02
City/State/ZIP: f• r. 1 , Cs 2 01i Zy Hose bib 25.02
Phone:( ) Fax:( ) Ice maker I 12.51 1L,s 1
At APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name: 7t1y�j� Lu' Medical gas(value:S_) Page 2
(� Primer 12.51
Contact name: Am{,r5 C\c+ 9tic.. e5 Roof drain(commercial) 12.51
Address:O'.,C J . c-nrK n t .5.1{- 2.->-t Sink/basin/lavatory I L 25.02 jeo 24
City/State/ZIP: Hl N.\4 bD i---O , OP__ C\i 1 ZLI Solar units(potable water) 62.54
Phone:Wig )l-1(p(p_223,Z Fax: :( )6,1(p/o'22\1 Tuh/shower/shower pan 12.51
Urinal 25.02
E-mail:Nt- �e'r,. Cr Si•c GCM nS.
CO RAChOR Water closet 1 25.02 is,0'
Water heater 1 37.52 3-1ac1
Business name: --�
P1 LLC:. Water piping/DWV 56.29
Address: 2-CA5 &+e- ENte c -c el \ ,j 4 I Sfe 2.04 Other: 25.02
City/State/ZIP: I ,\ �UCU (Da All 2, l Subtotal i431. j 6/
Phone:( ^ ) Fax:b..)--b.) Minimum permit fee: S72.50
D Lk/4p- aZZz L1 lOfo-7.Z 1 I
CCB Lic.: (5-g 2 Plumbing Lic.no.:f� Plan review (25%of permit fee)
Zug ' State surcharge(12%of permit fee) 5,7_ ....-
Authorized
signature: 1� �,/q S1#��y
/�yyrp � J��� TOTAL PERMIT FEE `!/�, srd �
Print name: This permit application expires if a permit is not obtained within ISO days
YW� nl�. rn_ P',..1 E'j Date:,�)3(i,r' i::, after it has been accepted as complete.t n�
`Fee methodology set by Tn-County Building Industry Scrvisv Hoard. f
I!9uiklingTermaaPLMU-PomitApp.dnc l0/a1xW 6Aa..t616TI 1a020'UM'Wr.B) //��
Plumbing Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee tea) Total Square Footage: Permit Fee:
Footing drain-I"100' 50.01 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 5169.69
, 3,601 to 7,200 $233.20
Sewer-Ist 100' 62.54 7,201 and greater S327.54
Sewer-each additional 100' 37.52
Water Service-1st 11)0' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52 Valuation: Permit Fee:
Storm&Rain Drain- 1st IN' 62.54 $1.00 to$5.000.00 Minimum fee$7250
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to S 10,000.00 $72.50 for the first$5,000.00 and 51.52 for
Qty, Fee tea) Total each additional SI00,00 or fraction thereof,to
Other Inspections or Fees and including$10,000.00.
Inspection of existing plumbing or for S10.001.00 to S25,000.00 $14R.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof.to
(minimum charge-1/2 hour) and including$25.000.00.
Inspections outside of normal business 90.0(0hr $25,001.00 to S50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including$50,000.00.
Additional plan review for revisions 90.00/hr $50.001.00 and up $742.00 for the first$50,000.00 and SI.20 for
(minimum charge-1/2 hour) each additional$100.00 or fraction thereof.
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*.
Quaatlttyy by Fixture Type Plan Review for Plumbing Installations
Fixture Type for &MacCapped Added Relocate Plan review is required for any of the following.
Work Performed: Please check all that apply.
Baptistry/Font
Bath -TubiShuwer ❑ Any new commercial building with water service 2"and
lacuzz Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru 0 New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR91 S-7R0-0040.
Dishwasher -Commercial 0 Medical gas and vacuum systems for health care facilities.
-Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain 0 Any complex structure as defined in OAR91 8-780-0040.
Eye Wash
Floor Drainrsink -2" ;•-, Submit 2 sets of plans w ith any of the above.
-3"
Isometric or Riser Diagram
Car Wash Drain
Garbage -Domestic-non-food 0 Isometric or riser diagram is required for new buildings
Disposal -Domestic-fond related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice MachiRefiig.Drains I
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station (t)LJMl1 1-tv LAB L(a) E.x3ns S)(-
Shower -Gang / t) (zs4 SY O(s)Lr..-kf S1t nM f t)Tre +..o -O,,-,S1L
-Stall
Sink/Lav -Non-food related tom✓ ( s) grr,.t. Ojer.'c 1L ,I Po-f 1�.>... S:n k_.
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes increase of sewer EDUs,a sewer permit will be issued and
Water Extractor
Water Closet-Toilet ( fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
1:\Building\Permits\PLMU_PermitApp.doc 2
' e E-MAILED
Plumbing Permit Application ZA
FFitallticlttlin F/ XTu.,2 RECEIVE
Cityof Tigard "1Vy: ! J� Ll`l� ,�n
ll APR l liDate BY: �7`� d (J Fermi ,gyp r///� t/
;1/ 13125 SW Hall Blvd.,Tigard,OR 97223 2020 Plan Review Vv �O/7
III
Phone: 503.718.2439 Fax: 503.598.I9r� patciBy. OtherP 2o•20 -40 s
Inspection Line: 503.639.4175 UITY OF TIGARD
2 for
I :u:,utu Internet: www.tigard-or.gov BUILDING DIVISIONNotir ,'! ohod: Jmir S pple Pmeenntal Information
TYPE OF WORK FEE* SCHEDULE
❑Ncw 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)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
❑ I-and 2-family dwelling Commercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler I sq.ft.) Page 2 -
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:152(10 Q,,,�,, 7 c4 ,,6t • Catchwell, h line,
area drain to 18.76
City/Stale/Z1P: �p '"'`�" y`""O'U ihYweil,leach line,or trench drain 18.76 _
TitAh�[� 0 y q-i 2 ) 1 Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: 11 Projectname:TreA Ar;�1 1,1isvp.1L.I Manufactured home utilities 50.03
Cross street/directions to job site: 0 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: I Lot no.: Fixture or item:
Tax map/parcel no.: Back Flowpreventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
}� r^ e� Clothes washer 25.02
_Sr [hNe-'rC)G,+'v t �C.A'i,)re,o v.) '�-G�tt..ra, R[1,M Dishwasher 25.02
Drinking fountain 25.02
-
Ejeclora/sump 25.02
0 PROPERTY OWNER I 79iT@NANT Expansion tank 1 12.51 a_usi
Fixture/sewer cap 25.02
Name.
�: A An'/Tla
\ ` Ps10.1 Floor drain/floor sink/hub 25.02 CnlY
Address: li �+-""i
) ZQ � F`3irk),}4 FG C)„y Garbage disposal 25.02
City/State/ZDP:Is,ir.r-r1[ O`2_ Al2.4 Hose bib 25.02
•
Phone:( ) Fax:( ) Ice maker 1 12.51 hL,�I
, APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name:pM� 1 Medical gas(value:$__) Page 2
Contact name: Q t Primer 12.51
""'^r,A0' �C..+eS Roof drain(commercial) 12.51
Address:82g5 A/E E_v'2yrce n "J^"I t,5+e 2_(>4 Sink/basin/lavatory I.L 25.02 .3AD,14
City/State✓ZIP: \\S�U o rc, j Q2 A-1 t Zy Solar units(potable water) 62.54 1
Phone:(t„.13 )u(,p(p_2_22 Z Fax::(503)igac,-2.2.\1 Tub/shower/shower pan _ 12.51
Urinal 25.02
E-mail: s..t ecs.�Vo.N,5' _',lS-1rm5.CC:M Water closet 1 25.02 2SAZ'CONTRACTOR
Water heater 1 3752 S1
Business name: ^ '
pMS� LL(:., Water piping/DWV 56.29
Addrexs:8.7-a5 A..l, Gverinrecl Pkiai4 iSi-c. 2-0Li Other: 25.02 J
city/State/ZIP: �i\\sbG(b ii o(2 Ai t 7_LI Subtotal ia-'(,
Phone:�!G�.''" ).``_ Fax ( ) " Minimum permit fee: $72.50
tJtr u.Rc,-22ZZ I q)3 t-i l0{n-LZ t 1 Plan review (25%of permit fee)
CCB Lie.: 15-R z.84,2Plumbing Lic.no.:Co 2 A25 State surcharge(12%of permit fee) S?_S ,�
/
Authorized signature: / i 2,..e. _ TOTAL PERMIT FEE ygQ,
Ff „��+�Y This permit applkadoa expires if a permit is nos obtained within ISO days
Print name: A, „,, ley Date:' 17G 1 after it has been accepted as complete. n
f •Fee methodology set by Tri-County Building Industry Service Board. /D J%7
1'\BuildingTermiir PLMU-Pttm9Aip.doe I0v0009 440-4616T(10 a2tCOM'WEa) /�I/
E AIL 0
I Plumbing Permit Application � �( 34 1 .
Site Utilities tuft oil icF: t til. OyL,
City of Tigard solved
`de/By: ; i 7 ermd Nn.:� itliii
t r 13125 SW Hall Blvd.,Tigard,OR 97223 /}� �/�''�'.�`/'�
I I Phone: 503.718.2439 Fax: 503.598.19 � ��E Plan Review
) O / Other Permit No.:
Date/By:
Inspection Line: 503.639.4175 APR 2
4
))t R[t Internet: www.tigard-or.gov ov 0 20 Date Ready/By:Mcthn Jura: See Page 2 for
a 6 6 Notified/Method: Supplemental Information
TYPE OF WORK - FEE*
FEE* SCHEDULE
0 New construction ❑Den o1:lio3 ,{„�S= For special information use checklist
Description Qty. Ea. I Total
_ ddition/alteration/replacement ❑Other: g, NO
•
New I-2-family dwellings(includes 100 It.for each utility connection)
CATEGORY OF CONSTRUCTION ��" �� SFR(1)bath 312.70
❑ I-and 2-family dwellingCommerci. lindust � .I SFR(2)bath 437.78
0' Accessorybuilding
SFR(3)bath 500.32
g ElMulti-family
Each additional balhikitchen 25.02
„j El Master builder ❑Other. Fire sprinkler( sq.0) Page 2
�ly JOB SITE INFORMATION AN!) LOCATION Site utilities:
jobt"� Catch basin or area drain 18.76
site address:
S q I.1 "t °��' lt t 'q cat"-"I
Urywell,leach line,or trench drain 18.76
City/S[atc(ZIP:'>;`ir e 09 c�--I`7 A Footing drain(no.linear It:_) Page 2
50.03
18.76
Suite Irldg/apt.no.: Project name:TlYytnb r.� ttr.rvv ) f``•� i s fG.` Manufactured home utilities
Cross street/directions to job site: Lf Manholes
Rain drain connector 18.76
4 Sanitary sewer(no.linear ft.:_) Page 2
V Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:_) Page 2
-/
Subdivision: Lot no.: Fixture or item:
.. ' Tax map/parcel no.: BackRow prevenker 31.27
- DESCRIPTION OF WORK Backwater valve 12.51
�'-"- � Clothes washer 25.02
[ rrm?v-3L.Y"{iti�-�, 1'7c,: ,rr�r',.r, i "�"Eta,, ,�r•r Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
PROPERTY OWNER '1"TENANT Expansion tank r 12.51 12A-1
Name: `` { Fixture/sewer cap 25.02
:a t 2 t�CrA A'n-i )t l t" '7F7 l`3'C.t Floor drain/floor sink/hub 2, 25.02
3 Address: 15 Z4 ry \�
S`�C�`� ) t"��r4"i-l'�y Garbage disposal 25.02
City/State/ZIP:°1--,re,.r'.x _ 0 12.. (Ai ZL1 Hose bib 25.02
I. Phone:( ) Fax:( ) Ice maker , 12.51 12...I
.a APPLICANT 0 CONTACTPERSON Interceptor/grease trap 25.02
• Business name: �L Medical gas(value:$ ) Page 2
a-.
Contact name: { Primer 112.51
A>"texrl cS� 1''tic�1 9S4
' Roof drain(commercial) 12.51
Address: 1S Er YCC ) t rj}t? Sink/basin/lavatory1'L 25.02 „Ci,2.
City/State/ZIP: tin\\5100.ro i aQ. G 1 t zi(t
Solar units(potable Water) 62.54
Phone:(� ) Fax::(� ) Tub/shower/shower pan !2.51
3 u +1a7 ZG x�j tlCo(o'�c ZS) Urinal 622.54
F-mail:(.. d-cyP� i ' 'l` � , 1 rz,vr;"r7>, CUtti't
02
Water closet l 25.02 2., 0 j,,
CONTRACTOR �`rS)
Water heater 1 37.52
Business name: ),":: "L., I L....C., Water piping/DWV 56.29
Address: .(AS ikst ever'cst'een \\W l C t-c. 20L1 Other. 25.02
City/State/ZIP: Subtotal 43 7Z3
Phone: 50 )LI Ada._ 22,-z Fax:(f. )4ta,,, -ZZ l I Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lie.: 15-8 2.8r, �Plumbing Lic.no.:f `ry.L,k-2._ 1� State surcharge(12"/"of permit fee)
501,DI
Authorized signature: 24ih..�f-,. / fL,,l:c TOTAL PERMIT PEE !t4 1
Print name: /� TTT++++ --^�� r"�� Date:'� i-. This permit application expires if a permit is not obtained within ISO days
�'[YW.rtl , a9,i(•• h koii,,:•.3 after It has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:U3aildingtPermitsNLMU-PermitApp.dot 10/01/04 440.4616T(10't25:OM,WEn)
4
Plumbing Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Taal I Square Footage: Permit Fee:
Footing drain- I' 100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 5233.20
Sewer- 1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service- 1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52 Valuation Permit Fee:
Storm&Rain Drain-1st 100' 62.54
$1.00 to$5.000.00 Minimum fee$72.50
Stone&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Other Inspections or Fees Qty, Fee(ea) i'nrxi each additional$100.00 or fraction thereof,to
Pand including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to S25,000.00 S 148.50 for the first$10.000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
(minimum charge-1/2 hour) and including$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to S50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including$50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first S50,000.00 and$1.20 for
(minimum charge-1/2 hour)
each additional$100.00 or fraction thereof.
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*.
1 Quantity by Fixture Type Plan Review for Plumbing Installations
Fixture Type for Plan review is required for any of the following.
Work Performed: Capped Added Reface
Baptistry/Font Please check all that apply.
Bath -Tub/Shower ❑ Any new commercial building with water service 2"and
-Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thm 0 New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic 0 Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" 2 Submit 2 sets of plans with any of the above.
-3"
4" Isometric or Riser Diagram
Car Wash Drain
Garbage -Domestic-non-food ❑ Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach.Refrig.Drains i
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station vs Y• r+^, S.1C.--
Shower -Gang-Stall (i) t./
.L t 51! ( ,�I ru\y S r �rrfa4 .nV O 4iL
Sink/Lav -Non-food related \ f ,�'tgrrph. f5 1 vr, S'k_ (,'Prr? L .. S nie_.
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: if the fixture work under this permit results in an
Washer-Clothes
Water Extractor increase of sewer EDUs,a sewer permit wilt be issued and
Water Closet-Toilet X , fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
1:113uilding\Permits\PLMU_PermitApp.doc 2
CITY OF TIGARD PLUMBING PERMIT
1114
• COMMUNITY DEVELOPMENT Permit#: PLM2020-00164
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/23/2020
Parcel: 2S110DB01300
Jurisdiction: Tigard
Site address: 15294 SW ROYALTY PKWY
Project: Tigard Animal Hospital Subdivision: 1996-010 PARTITION PLAT Lot: 2
Project Description: Add (1)expansion tank, (2)2"floor drains, (1)ice maker drain, (1)lay, (1)breakroom sink(1)laundry sink and (9)
various exam room sinks, (1)water closet and (1)water heater for new tenant.
Contractor: PMSI LLC Owner: TIGARD INVESTMENT PROPERTIES LLC
8295 NW EVERGREEN PKWY#204 11086 SE OAK ST
HILLSBORO, OR 97124 MILWAUKIE, OR 97222
PHONE: 503-466-2222 PHONE:
FAX: 503-466-2211
FEES
Quantity Description Date Amount
1 ea Expansion Tank 04/22/2020 $12.51
Specifics: 2 ea Floor Drain/Floor Sink/Hub 04/22/2020 $50.04
1 ea Ice Maker 04/22/2020 $12.51
Type of Use: COM 10 ea Sink 04/22/2020 $250.20
Class of Work: ALT I ea Laundry Tray 04/22/2020 $25.02
Type of Const: 1 ea Lavatories 04/22/2020 $25.02
Occupancy Grp: 1 ea Water Closet 04/22/2020 $25.02
Stories: 1 ea Water Heater 04/22/2020 $37.52
1 12%State Surcharge- 04/22/2020 $52.54
Plumbing
Total $490.38
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 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.