Permit r9
CITY OF TIGARD PLUMBING PERMIT
r,
- COMMUNITY DEVELOPMENT Permit #: PLM2009 -00282
1 3125 S H all Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/13/2009
�T1 G ARD Parcel: 2S 10X803400
Jurisdiction: Tigard
Site address: 9900 SW FREWING ST 63
Subdivision: Lot: 0
Project: Cypress Crest
Project Description: Replace up to 100' sanitary sewer line.
Owner: FEES
CANTAS LLC Quantity Description Date Amount
4223 GLENCOE AVE STE #A -220
MARINA DEL REY, CA 90292 100 If Sewer Service 10/13/2009 $62.54
1 12% State Surcharge - 10/13/2009 $8.70
PHONE: Plumbing
10 ea Minimum Fee Adjustment - 10/13/2009 $9.96
Contractor: Plumbing
COMMERCIAL PLUMBING SERVICES
21185 NW EVERGREEN PKWY, STE. 106
HILLSBORO, OR 97124
PHONE: 503 - 439 -9999
FAX: 503 - 439 -1999
Type of Use: MF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuanc • wor ' spended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utili otification Center. .ose rules are set forth in OAR 952 - 001 -0010 through OAR 952- 001 -0100. You may obtain a copy of the rules
o direct questions to OUNC • • callin• 503.246.6699 or 1.800.332.2344.
Issued By: Permittee ignature: in1/47
Call 503.639.4175 by 7:00 a.m. for an inspection that .. mess day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
' 10/0212009 14:43 Mechanical Services, Inc. (FAX) P.002/002
Plumbing Permit Application REC EIVED
Site Utilities
OCT 0 2 2009 FO OFFICE US ONLY, . ,
.. City of Tigard Received
III `�+ Permit No.: t • g .
n 13125 SW Hall Blvd., Tigard, OR 97223 CITY OF TIGAR IP Date/By. � ' •$
C n Review
Phone: 503.639.4171 Fax: 503.598.1 Other Pe Permit No.:
Inspection Line: 503.639.4175 ��J ILDING DIVISI�I telly:
T1 GAIYD Date Ready /By: Juns: l See Page Z for
or.gov n n
Internet: www.tigard Notified/Method: l Sapplementall Information
TYPE: OF WORK - ` FEE* SCI{EDULE:. • :
❑ New construction ❑ Demolition For special information use checklist
Description I Qty. I Ea. I Total
El Addition /alteration /replacement ❑ Other: New I- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF • CONSTRUCTION SFR (1) bath 312.70
❑ 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78
SFR (3) bath 500.32
❑ Accessory building El Multi- family
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
_' . `.- gm .SITL"` INFORM_AT1oN: ANI). LOCATION,' " _ Site utilities:
Job site address: 9Hfl9 S�� Frewing ST co Frew . �« Q 4 . Catch basin or area drain 18.76
J u Drywet), leach line, or trench drain 18.76
City/State /Z1Y: Tigard, OR 97223
Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: I Project name: Cypress Crest Manufactured home utilities 50.03
Cross street/directions to job site: Liky\` 4(l s i t 3 4 ( G - • Manholes 18.76
V) 12.4( �/'
( n )5 - Rain drain connector 18.76
Sanitary sewer (no. linear ft.: I ) 1 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.: Backfiow preventer 31.27
• Replacement of drain line DESCRTPTiON; OF;.VVORK
ac ater valve r
Clothes washer 25 -02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors /sump 25.02
PROPERTY OWNER •'` '` .' ❑T E 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
:0 APPLICANT ❑ :CONTACT PERSON ; : , . Interceptor /grease trap 25.02
Business name: Medical gas (value: $ _ ) Page 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
Phone: ( ) Fax: : ( ) Tub /shower /shower pan 12.51
E-mail: Urinal 25.02
25.02
crease
Water heater 37.52
Business name: Commercial Plumbing Service Water piping/DWV 56.29
Address: 21185 NW Evergreen Pkwy Ste 105 Other: 25.02
City/State/ZIP: Hillsboro, OR 97124 Subtotal
Phone: (503) 4399999 Fax: (503) 4391999 Minimum permit fee: $72.50 - So
Plan review (25% of permit fee)
CCB Lic.: 126015 umbing Lie. no.: 37421 pb
/ ( 1 I State surcharge (12% of permit fee) - 155E %• 70
Authorized signature: TOTAL PERMIT FEE - 96:94- 81 .2.C)
Print name: Natalie Partipilo Date: 10/2/09 This permit application expires if a permit is not obtained within ISO days
after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
1:\ Building 1 Permits \PLMU- PcrmiIApp doc 10/01/09 4 4616T(10/02/COM W1/B)