Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2013-00291
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/20/2013
Parcel: 2S102AB03600
Jurisdiction: Tigard
Site address: 12271 SW MAIN ST
Project: Rojas Market&Taqueria Subdivision:)ND ELECTRIC ADDITION TO TIGARD' Lot: 2
Project Description: Replacing 75 ft.of sanitary sewer.
Contractor: APOLLO DRAIN& ROOTER SERVICE Owner: JOHNSON TRUST"A"SURVIVOR'S TRU
2208 NW BIRDSDALE#8 JOHNSON, REES C TRUST
GRESHAM,OR 97030 JOHNSON,MARYANNE G TRUST
3112 SW SANTA MONICA
PORTLAND,OR 97239
PHONE: 503-239-8801 PHONE:
FAX: 503-669-9568
FEES
Quantity Description Date Amount
75 If Sewer Service 08/20/2013 $62.54
Specifics:, 1 12%State Surcharge- 08/20/2013 $8.70
Plumbing
Type of Use: COM 10 ea Minimum Fee Adjustment- 08/20/2013 $9.96
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:
L/ - a�✓s
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. 20. 2013 9: 10AM Apollo Drain No, 6772 P. 1
4
Plumbing Permit Application �'
Building Fixtures p\`'' unit (rrl(:r Utir. UNI.V-
ti
City of Tigard ®�_ -� PermitNo.:
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11 13125 SW Hall Blvd.,Tigard.OR 223 P�� \V�`�` �1'.lsa Review l'7P1➢ 1 - e a /
• Phone: 503.718.2439 Fax: 503.598.1960 �6 \V\� DateBr. Other Permit No.:
T I L;,11t r� inspection Line. 503.639.4175 F� ® Date Ready/By: ! RI See Pape 2 far
Internet: Www,ti gar d•or,goy 6\ * Notified/Method: Supplemental Informs tion
it if i' I� - •<5'� g 7l - .',4'i,. r kapiR.I
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•' .' ,.�-�?-iF.:r..::�.-e.�.__.,: ._ - _.gym._,.: _ ....SIC:'..-. �.:
❑New construction "4,'"`- = = -`' 1 = --1 z-ci�
El 4.�-- -_. �=�..::-_:.:�' T°°:
For special Information use checklist
is ' r r r r r : ❑Other: Description I Qty. I Fa I Total
ti .'■4.4 � r � r - .. �;._.,,a.. ; I hill �•:a�.
_;,;2•, ,t;;p',, ue j a .e y`'t y�. y u ''i;. .•i 'E,',t.(; ;,t„ ,,_ New 1-2-fancily dwellings(includes 100 R for each utility connection)
❑1-and 2-family dwelling w.Commercial/industrial SFR(I)bath 312.70
❑Accessory building SFR(2)bath 437.78
ry g ❑Multi-family SFR(3)bath 500.32
❑Master builder ❑Othcr. Each additional bath/kitchen 25.02
nt4` 'ERIRN ii fi+`ki,.. ,2' :iiv..71, 4�'0 X0[�l' I t:. 'e,a�..1,ari'74r1 t'Ry�f-'1"-+' Fire sprinkler L.1.::..�� �_ x... -.. - ��t?o°.�,e, ,d:�Vaw�tchln�':.l;jl�tF�t�.k;;: P (-sq.ft) Page 2
Job site address: 12271 , a(y st site utilittea:
1 1 , Catch basin or area drain 18.76
City/State/ZIP: jj�` Drywell,leach line,or trench drain 18.76
Suitc/bldgJapt.no.: J Project name: 4,ta5 !Vl A +c{ T t tv 9 Footing drain(no.linear fl.:^) Page 2
Cross street/directions to job site: i) Manufactured home utilities 50.03
Manholes 18.76
Rain drain connector 18.76
- Sanitary sewer(no.lutear.ft:3.0) Page 2
Storm sewer(no.linear ft.:_) Page 2
Subdivision: I Lot no.; Water service(no,linear ft.: ) Page 2
Tax map/parcel no.: Fixture or item:
t::-> :PVT cciiirilf. .- 5 srP11' Backllow eventer 31.27
1 may" "`--•'i` --P''' 4 Beekwnlervalve 12.51
Popia� '75t &) A' - Clothes washer 25.02 --
, n Q Dishwasher 25.02
Drinking fountain 25.02
S rr-Fli, ��i-7-it..... 7i - u�.I i:7 , "r?1, ., 4`•' ar,ar_� -__; Ejectors/sump 25.02
S§{i4AY Fi,'i '• Ii,Q ,�I e- �N�y it il 1.!.?. �.. ig,'..,q,4-,,t ir-t,' p
� +...r_� 't!3r-x12.
Name: c .1 , /
Expansion tank 12.51
Fixture/sewer cap 25.02
Address: Floor drain/floor sink/hub 25.02
City/State/ZIP: Garbage disposal 25.02
Phone:( ) Fax:( ) Hose bib 25.02
fiT1 a ""-
--'t a,p •:p ji B na j"r'�s�,"llttI 1111{I'a"�?IP: 1 r`l� l -- - -= Ice maker 12.51
,-..-.r-i:v,csE....._.--+3 Tit, k al.... A'.''1,r1111,ikdill ill AlUi L* ea., ..._�A/�lY_- .__
Business name: APOLLO DRAIN & PLUMBING SERV. INC Medical gas zge2
Contact name:CHRISITNE KAFEL Medical gss(value:s_) Page 2
Primer 12.51
Address; 2208 NW BIRDSDALE_4VE #8 Roof drain(commercial) 12.51
City/State/ZIP: GRESHAM OR 97030 Sink/basin/lavatory 25.02
Phone:(503) 239-8801 I Fax::(503 669-9568 Solar units(potable water) . 62,54
E-mail: OFFICE @APOLLOD RAI N.CO M Tub/shower/shower pan 12.51
Urinal 25.02+ t E 2 =-y=a dQtE l R ER 4�=.--=11
Ware rclose( 25.02
Business name: APOLLO DRAIN & PLUMBING SERV, INC Water heater 37.52
Address: 2208 NW BIRDSDALE AVE#8 Water piping/DWV 56.29
City/State/ZIP: GRESHAM OR 97030 Other: 25.02
Phone;( 503 239-8801 Fax:(503)669-9568 Subtotal
cCB Lic.: 4941$ PI - ' no' 26-533PB
Minimum permit fee: S72.50 -;�,
_�J�•�� S.�. Plan review (25%of permit fco)
AuUlOri2ed SigpaNrt; irO,ir� / (12%�.<�. /�,1.�'� State surcharge(12/e of permit fee) " f,'1 D
Print name: , , ;S i Il Date: , M TOTAL PERMIT FEE 7
t:lBuitdng\Pemiiis1PLMU.Pumirnpp.dar 10/01/09 410.46i6T(le/OLCOMIWEe)