Permit (31) CITY OF TIGARD PLUMBING PERMIT
Fri Permit#: PLM2017-00159
� . COMMUNITY DEVELOPMENT
e .,
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/01/2017
t"�'a'�tf g Parcel: 2S106DB23700
Jurisdiction: Tigard
Site address: 17390 SW SABRINA AVE
Project: River Terrace Northwest Swim Center Subdivision: RIVER TERRACE NORTHWEST Lot: X
Project Description: Change water heater to tankless water heater.
Contractor: G&B PLUMBING&SONS INC Owner: ADLV LAND HOLDINGS LLC
PO BOX 92 BY FORSUM, MICHAEL
ST PAUL, OR 97137 7600 E DOUBLETREE RANCH RD STE 1
SCOTTSDALE,AZ 85258
PHONE: 503-868-1417 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Water Heater 05/01/2017 $37.52
Specifics: 1 12%State Surcharge- 05/01/2017 $8.70
Plumbing
Type of Use: COM 35 ea Minimum Fee Adjustment- 05/01/2017 $34.98
Plumbing
Class of Work: OTR
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: � ; �` Permittee Signature:
/
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plnllnblit Perrn it Application . . .....
1111. .....
Building Fixtures
RECEIVED
C'. :_„Tigard 7°a
3 MAY 1 2017 S //_ .-- ; Pemut�ro.: /�LA���17-C 's
13123 SVi!.11410lyd:,Tiigard,OR9722,1,.
Pbone: 5.03:118.2439 Fax: 503398.1 - ;<,... .. -: 2
• Oihcst'cciniti4o• •� �(
'ouLinit::•503.6394175 QTY OF TIGARD
1 i(.;A[:.D n - BUILDING DIVISION a . ..
patexeadylsy B 5eeragezfor
l www t gard-or�`g�ov S as lnrorma iun
-r L::: :s z eli f „,5f- sem""" ak'A-O l' g"'. T ,_-� s .c. FF. :2A;:. Wi B�S i 55.5..r_ ,.-i`
111:1 4 3 � t,—.�..�,.:�s.
Fors eaaarl°information use
ewt I5cmolitioa
P New. ttchon. p Iotal
❑Mdttioa/atterahonlrepl�nent 0 Other 2-fami y Ss C !t.lot
Neer;- dWei6a i�liides 100each utility connection
°- • SFlt12)bait. 837.78
'1-an 1:2- •1y:dweliing. .. 0 C'oxnmeintah nsdustrial
SFRe3)
5032
El: idiv: c"7-4 - ti- y - - PaCiiaddit orialbati3M 25.02
..
Pli
.O Mastebildeother• J w//Y._ -P�/..' Fr °sprik '( sq:R : pip 2 .rnr:
r8 ter,Er f O'="$rcarj' rWC,- e', f :- : - Site Ilf ee
Catchbesin or Area dram 18:76
Job site:ac-1iress: i l MO S tiJ csGG Mein I'
Ilzywell,Leach:line,pr trench drain 1$.7.6
OtylState/Zi1'_Tig101,OR 97224 • • Footing drain•(no.linear ft:_,_,_) .Page 2
,Snite/bl�lg.lapt.no:: I Project name:Northwest River Terrace •Maaufachatidbomc utilities . 50.03
•
111. :
Cross'stieet/directionis to;job site: .Manholes 18.76
l ain:ilisiit.cannecter 1.8.76 .
Santtaiyi.se4ve•(no:linearft.:, „•) 1,46:.
Storm sewer:(no:.linear ft,: ) Page 2
. Water'seivice(no linear ) -Pain
'Subdivision:Northwest:River Tem-ace: . . 1t.:. c_2
Lot no: m�r- Fizttirt`or item:
1.1:1_.. 3].27
BackSo+vpneventer
Tax nzaplpaenei no
'-t - E •.-,•.<p, r, ' -z act T BBCkWater vE1vC 12_51:
-�5 � �. 3 __t � _. ,+..._ 7. es 23.02
t: e •. IA,tZ LeA.. k k 2 Dishwasher 25.02
Ejecta&stunp 25.02
- . a- - s, . Expansion tank ....
t ,uz . , r x .>. 5.02
l
Eiic;tirclseweresp
....;_::..: ...:: - 1111
1,111,
:Nana ADV'LI indHoldings,LLC ,
,,11__,11_._.. 1111. ;_. . ... .
.. • FlooFi Siii*ibi,sukRiub 25:02
Address:7600:E Doubletree Rancli:Road d
Garbagt disposal: 25:02
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':City/StatelZIP Scottsdalea AZ 85258 •Hose!rib
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1..Page '
Business name:Vit tinn4yon Homes,Inc - .51
1111
Plimede
Coiitactnat ::Ain ::Ocajewskt Raofdtsia(i ommercial) •
12.31
Sink/basia/lava�iy 111 1.25:02
: .., ddre*.409:*set._3thty:is 54
14;1:•.;1. .
:Cit*+/StattiZIP:Vattconver,WA 98660 Sour units(potable water). 62.
T iibialioiaea/shower pan..
Fax: (360)1;43.4442 12.51
Urh4ai
23:02. ,. ..
L 440.44400,1.*Bl 04 to e0mes'com • *sitar closet 2 :02
. fF1; K :z"` u ~M- . _ 37.52
eater
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.Busnnest"'oatne:: 6::111 w. '.tx,Ci y,ii•t Waterpsping!DWV 36.23 -
Other:� •1. 1.11..
. _1111 �
tRdditiss:: P:��•;�. A. • —' .. Subtotal
.. 5T� :P.011(31 .. . . _ .
umpettnitfee '72'50
. A�fiiiim .. ,�
Phone: $b3:+-' (4' :14L"1 Fax:(til V•..-70-4:110 — plan zeview 05°4 of:pensdt fee)_
GG'B vies1 0„�_.. Piiriaibirig.I.ic.#0. q -.... State surcharga.(12Yo Of Ormitfee).
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*Fee mogy
set by Tri-Couoty'Boilding Industry'S&Mce Board.
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