Permit (62) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2016-00287
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/02/2016
T[<1,4 fdJ g Parcel: 2S112BB04000
Jurisdiction: Tigard
Site address: 14500 SW HALL BLVD
Project: Edgewood Manor Apartments Subdivision: WILSON ACRES Lot: 5
Project Description: 35'of storm sewer from catch basin to storm manhole on property.
Contractor: APOLLO DRAIN &ROOTER SERVICE Owner: CIC EDGEWOOD MANOR LLC
2208 NW BIRDSDALE#8 15350 SW SEQUOIA PKWY#250
GRESHAM, OR 97030 PORTLAND, OR 97224
PHONE: 503-239-8801 PHONE:
FAX: 503-669-9568
FEES
Quantity Description Date Amount
35 If Storm Sewer 06/02/2016 $62.54
Specifics: 1 12%State Surcharge- 06/02/2016 $8.70
Plumbing
Type of Use: MF 10 ea Minimum Fee Adjustment- 06/02/2016 $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 questi UNC by calling 503.232.1987 or 1.800.332.2344.
Issued B Permittee Signatur::
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.
Plumbing Permit Applic ' Turn
Site Utilities It
City Edi 7
of Tigard Received �� �
g � ''11 1 Date/By: £o a l b `rL.11-Y] Permit No.: ,yam/6 Doo2'
NI q 13125 SW Hall Blvd.,Tigard,OR 910 Z 0 1 6 Plan Review
i Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.:
Inspection Line: 503.639.4175 ' .
� �
Date Ready/By: tuns: 0 See Page 2 for
[IMO
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
MIWNG DIVISION
TYPE. FEE* SCHEDULE
❑New 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(1)bath 312.70
❑ 1-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
buildingSFR(3)bath 500.32
❑Accessory 0 Multi-family
Each additional bath/kitchen 25.02
0 Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:14500 SW Hall Blvd Catch basin or arca drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name:Edgewood Manor Apts 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 ft.: I Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Trench from catch basin to storm manhole 351.-T long&tap into storm manhole Dishwasher 25.02
on property Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER l 0 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
Phone:( ) Fax:( ) Ice maker 12.51
'' APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:Apollo Drain&Rooter Service Inc Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Kara Oltean
Roof drain(commercial) 12.51
Address:2208 NW Birdsdale Ave Ste 8 Sink/basin/lavatory 25.02
City/State/ZIP:Gresham,OR 97030 Solar units(potable water) 62.54
Phone:(503)389-1326 Fax::(503)669-9568 Tub/shower/shower pan 12.51
E-mail:office@apollodrain.com Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:Apollo Drain&Rooter Service Inc Water pipitig/DWV 56.29
Address:2208 NW Birdsdale Ave Ste 8 Other: 25.02
City/State/ZIP:Gresham,OR 97030 Subtotal
Phone:(503)389-1326 Fax:(503)669-9568 Minimum permit fee: $72.50 7a,.
CCB Lic.:49418 Plumbing Lie.no.:26-533PB Plan review (25%of permit fee)
CC (, State surcharge(12%of permit fee) 5f.70
Authorized signature: 0l l r Ni TOTAL PERMIT FEE 1/.
Print name:Kara Oltean '` ,t Date:5/24/2016 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:1Building\Permits1Pl.AMU-PermimApp.doc 10/01/09 440.4016T(10/02/COMAVEIt)
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
14500 SW HALL BLVD, TIGARD, OR, 97224
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2016-00287
Don Sylvester
Violation Summary:
Inspector Contractor