Permit :, CITY OF TIGARD PLUMBING PERMIT
! ••- COMMUNITY DEVELOPMENT
1 Permit #: PLM2011 -00251
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/04/2011
Parcel: 1 S126BC01500
Jurisdiction: Tigard
Site address: 9000 SW WASHINGTON SQUARE RD
Project: Embassy Suites Subdivision: Lot:
Project Description: Replace water storage tank.
Contractor: ANYTIME PLUMBING & DRAIN CLEANING Owner: NESBITT PORTLAND PROPERTY LLC
3333 NW 35TH AVE, BLDG C BY WINDSOR CAPITAL GROUP
PORTLAND, OR 97210 ATTN DELOITTE- S LEHMAN
CARLSBAD, CA 92008
PHONE: 503 - 432 -8275 PHONE:
FAX: 971 - 255 -1965
FEES
Quantity Description Date Amount
1 ea Water Heater 08/04/2011 $37.52
Specifics: 1 12% State Surcharge - 08/04/2011 $8.70
Plumbing
Type of Use: COM 35 ea Minimum Fee Adjustment - 08/04/2011 $34.98
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
issuan , or if wo • • suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
UtiIi Notification Center. 'se rules are set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or erect questions to OU ■ ) g 503.232.1987 or 1.800.332.2344.
dwi_Aa
Iss d By: 1 ii Permittee Sign. re: / �� / r i (,....e -
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.
Aug. 4. 2011 12:47PM No. 6462 P. 1
PIumbing Permit Applica,i, CEIVED
Building Fixtures FOR ohrICE USE ONLY
City of Tigard AUG - 4 2010 Received permi(No.
1111
u 13125 SW Hall Blvd., Tigard, OR 97223 Datc113 : r 1� "I
0 Phone: 503.639.4171 flax: 5 Plan Review
®F TIGARD Date/13y: ptherpennitNo.
• TIGARI) Inspection Line; 503.639.411 runs: � See 1'epe2for
Internet: www.tigard- or.gov UII,DING DIVISION N ciifie diMe� ad: Sup 'mental Information
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•❑ New construction ❑ Demolition For special ltt ormarlon use checklist
Description I Qty. I Ea. I Total
(i Addition/alteration/replacement ❑ Other: New 1 - 2- family dwellings (includes 100 ft. for each utility connection)
at bath 312,70
,.: i,i SFR 1 - ...., ..��!S;`I'Ef�bl�}��.9T G�NS?'�UGTtQ�, , .... (1) -
El 1- and 2- family dwelling Commercial /industrial SFR (2) bath 437.78
SFR (3) bath 500.32
- -❑ Aocessory building - ID-Multi-family Each' additional- bathlkitehen-- •••• -• -- • --
❑ Master builder ❑ Other; Fire sprinkler ( sq. ft.) Page 2
-;;i;y ,' - JOI3.STTt :YNFOI,MATIGN AND .LOCATION. Site utilities:
i n 0 p 1 c / `ly, n ` � r l' 1/ lirn N r ( 2 i -
Yob site address: (J U 1 Y r y tr r I Itl 1 I UI�! (ca Catch basin or area drain 18,76 Drywall, leach line, or trench drain 18.76
City /State/ZIP: •-t-r ri r O Footing drain (no. linear ft.: ) Page 2
Suite/bldg, /apt. no.: J Project name: .Ejl � S y ( CU I -FW Manufactured home utilities 50.03
Cross streeVdirections to job site: , I , Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear R,: ___) Page 2
Storm sewer (no. linear ft.: _) Page 2
Water service (no. linear fl.; _) Page 2
Subdivision: I Lot no.: Fixture or item:
-
Tax map /parcel no.: Backflow preventer 31.27
a ter valve
DEscare 10� 1 Ol' WORK >3 clove al 12 51
"
Clothes washer 25.02
raig ►d* IL 0 tat I' f■ Dishwasher 25.02
Drinking fountain 25.02
Ejectors /Sump 25.02
" Expansion tank 12.51
:,•:!' .. I :PROPEiiTy;01irt∎IER Q .TE NANT P
Name: fin f)A-s J C\ 1/' " ,c f I - Fixture/sewer cap . 25.02
1 /�� Floor drain/floor sink/hub 25.02
Address: Garbage disposal 25.02
City /State/ZIP: 1 � Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12.51
. ° .. i ; '.- ",. .. "; Interceptor /grease trap 25.02
Business name: ANY-11M C pLiAMifNq k b A-,i Cf /+NINti Medical gas (value; $_) Page2
1 Primer 12.51
Contact name: AS- l/6y JJ i. Ul
Roof drain (commercial) 12.51
Address: 72`, NW ,-(11 kw siA l t, i mil G sink/basin/lavator 25.02
City /State /ZIP: PD I:[L 4N r D Gl •� I0 Solar units (potable water) 62.54 t
Phone: ( r j f ) ) 4 2 .. %2,1 =l Fax: : ( R1 1 )7/26- 1 Gj 116 'nib /shower /shower pan 12.51
E -mail. PLIAIYl , U Urinal fill =fl ea kN y �j
,.: : ; : r: „ r ,t..,, 1i W a t er close
't"!f` ,,,,, . t 2s t)2
'. Y!. , . , "': T G'. T.Y. 4 ,. �� ' l ' 1 : : ` , :.-,,. . ,. .
%'!;s s =.., a:: "'` ` :..: r ' '� ,,. Water heater I 37.52 �1 �
Business name: 1 SI i I f t 1 1 , pow) ow !v E t 1 (U 4/t l Nar Water piping/DWV 56.29
ddreas: �j j , , r 'f1f v 8 De Other: 25.02
City/State/ZIP: Pcfl2 'LA-N t r OK, '412,10 _ Subtotal - 1, Si
Phone; ( 0)4 �7 !! - 21 6 Fax: (411) 2,61"- 1 (, Sr w Minimum permit fee $72.50 1 Z .
CCB Lic.: , q cm ej Plumbing Lic. no.: Pe) gt1 +- / (I 114 _ Plan review (25% of permit fee)
` /�� ./i State surcharge (12% of permit fee) g • `j 0 e t
Authorized signature: /1,1" r t vl/l TOTAL PERMIT FEE 71 7,
W
1
Pn71[ na ��
me: f7 L L [ 1 t �" °° f Date: This permit applicant)) exph -e& if a permit is not obtained within ISO days
after it has been incepted as complete.
111 Y1 �L ! ��� *Fee methodology eel by Tri-County Building Industry Service Board.
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