Permit CITY OF TIGARD PLUMBING PERMIT
$ COMMUNITY DEVELOPMENT Permit#: PLM2014-00035
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/05/2014
7 E t�,A RD 13125 Parcel: 2S 1048807900
Jurisdiction: Tigard
Site address: 14300 SW BARROWS RD
Project: Albertsons Subdivision: RUSSELL'S SCHOLLS FERRY Lot: 2,TRAC
Project Description: Replacing water heater.
Contractor: COMMERCIAL PLUMBING SERVICE Owner: ABS OR-O LLC
21185 NW EVERGREEN PKWY SUITE 105 250 PARKCENTER BLVD
HILLSBORO,OR 97124 BOISE, ID 83706
PHONE: 503-439-9999
PHONE:
FAX: 503-439-1999
FEES
Quantity Description Date Amount
1 ea Water Heater 02/05/2014 $37.52
SDeciflcs: 1 12%State Surcharge- 02/05/2014 $8.70
Plumbing
Type of Use: COM 35 ea Minimum Fee Adjustment- 02/05/2014 $34.98
Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344,
Issued By: - u ittee Signature:
Call 50 .639., 75 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
02105/2014 10:53 Mechanical Services, Inc (FAX)5034391999 P.002/003
Plumbing Permit Applicatia
Building Fixtures �"� �� 1,01( I'I Il(;L IISI•: ONLY
City of Tigard Received
`J g Date/$ �+ Permit No,; f I 5 a _Ai_ ' 13125 SW Hall Blvd.,Tigard,OR 97223 - 5 2 0 V Plan Review �� t - "
II Phone: 503.718.2439 Fax: 503.598.1960 Date/B . Oder Permit No.:
I R.;v 1;L.) inspection Line; 503.639.4175 CITY OF TIGARD Date Ready/By. Jeri,: 61 See Page 2 far
Internet: www.tigard-or.gov l lI �^�"�► Tg Notit1ed/Method: - r■ Supplemental information
TYPE OF WOR FEE" SCHEDULE
❑New construction ❑Demolition For special information use checklist
Description I Qty. I. Ea. I Total
gf Addition/alteration/replacement ❑Other. New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
1-and 2-family dwelling SFR(2)bath 437.78
❑ y wellin g ECommercial/industrial
SFR(3)bath 500.32
❑Accessory building ❑Multi-family -Each additional bath/kitchen 25.02
• ❑Master builder ❑,Other: Fire sprinkler(_sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:/44300 S(AJ 13 Qjryr� A Catch basin or area drain 1 8.76
City/State/ZIP: C4.. (.27.e_ 6 7�� Footing drain line,ne trench drain 18.76
e
t l � Footing drain(no.linear It.: ) Page 2
Suite/bldg./apt.no.: Project name: /4,/ L(ons' Manufactured home utilities 50.03
Cross street/directions to job site: �� `"' Manholes 18.76
Rain drain connector 18.76
1 Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.'. ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
t Clothes washer 25.02
'' -- - '-"-' A'Y 1 ACE._Jr' Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER ❑ TENANT 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 i
Phone:( ) Fax:( ) Ice maker 12.51
APPLICANT Et CONTACT PERSON Interceptor/grease trap 25.02
Business name: a AA_AL 4;44_,I • LA r i S ,
y Medical gas(value;$ } Page 2
Contact name: ,L_,,�� �� � l,� ��
Printer 12.51
y-"'ie I d�L'� - Roof drain(commercial) 12,51
Address:�`t_Fi�_,i � 61,..,./.5 rc PAL-,y SIA.k IOF Sink/basin/lavatory 25.02
City/State/ZIP; • p'. Solar units(potable water) 62.54
Phone:(SO) y3, Cy q 941, Fax::(Sint y;5 /ff .! Tub/shower/shower pan 12.51
4 Urinal 25.02
E-mail:t IA,c4.4L1.t,c. Q GPI- .SG,"/(4_er, tof'-
CONTRACTOR Water closet 25.02
Water heater I 37.52
Business name: ' Water piping/DWI/ 56.29
Address: Other: 25.02
City/State/ZIP: Subtotal
Phone:( ) Fax:( ) Minimum permit Re: $72.50 7 t.,?'
Plan review (25%of permit fee)
CCD Lie.: d , Plumbing Lie,no.: 37 I/4 Lrp p State surcharge(12%of permit fie) 70
Authorized signature: r`I f�.+' -- �- - V TOTAL PERMIT PEE ft 2t2
Print names 6., ti�,. �a,C('�,G•L Date:{Y ./Q �(/ This permit application expires if a permit is not obtained within 180 days
TVYZ ( 777 ` after it has been accepted as complete.
"Fee methodology set by Tri-Coun:y Building Industry Service Board.
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