Permit (22) CITY OF TIGARD PLUMBING PERMIT
II COMMUNITY DEVELOPMENT Permit#: PLM2017-00208
Date Issued: 05/31/2017
T t G y e D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S110AD08700
Jurisdiction: Tigard
Site address: 10700 SW CANTERBURY LN 3
Project: Pacific Crest Apartments Subdivision: None Lot: None
Project Description: Building H,unit 3-Installation of clothes washer
Contractor: WESTERN SPRAY FOAM& PLUMBING Owner: AUK-REDWOOD PC SPE LLC
PO BOX 3703 10695 SW MURDOCK ST
GRESHAM, OR 97030 TIGARD, OR 97224
PHONE: 503-661-3645 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Clothes Washer 05/31/2017 $25.02
Specifics: 1 12%State Surcharge- 05/31/2017 $8.70
Plumbing
Type of Use: MF 47 ea Minimum Fee Adjustment- 05/31/2017 $47.48
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.
•
Issue B 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.
25 May 17 02:05 Western Spray Foam&Plum 503-4825853 p.1
Plumbing Permit Application uLif`u'i '�I� 1,,' 1 F -' �%,C. `\ �.
Building Fixtures RECEIVED FOR OFFICE USE ONLY
Received ,,,,,it NO.:
/7_06
City of Tigard Date By: 4- 17 �� 1� b
III 13125 SW Hall Blvd.,Tigard,OR 9 r;y 2 ) 2017 PlanReview aG�jj�
Phone: 503.718.2439 Far 503.59:. imi
Date/By: OtherPetNo.Aube/7
Inspection Line: 503.639.4175 CI-�/o f I y Rn Date Ready/By: tuna: H See Page 2 for
! 'h Internet: www.tiggard-or.gov V T 1 UH Notified/Method: Supplemental Information
CYP &WIRING.DIVISION: >fE:" ua.E _._
CI New construction ❑Demolition For special information use checklist.
Description I Qty. I Ea. I Total
Addition%altcration/replacement 0 Other: New]-2-family dwe.Yings(includes l0011.for each utility connection)
CATEGORY OF GO1 STRUCI'IION SFR(1)bath 312.70
0 1-and 2-family dwelling ❑Com.•• . r •ustrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building I`4►,Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler L-sq.ft.) Page 2
JOB.sin I .ronmATION:.AND LOCATION Site utilities:
Job site address ")�p !t 1N J/ -,gf/ 1/+ /IV"-- Catch basin or area drain 18.76
,'i 1 !•}1 ; /( t, :,.tDrywetl,leach line.or trench drain 18.76
City/State'7IP: '1( j ` ., ...,:i--1.7)--f-4.) Footing drain(no.linear ft.: ) Page 2
SSuite/bldg./apt.no.: Project name: Manufactured home utilities50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear IL: ) Page 2
Storm sewer(no.linear R.: ) Page 2
Water service(no.linear IL:_) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27 ,
DESC IPTTON OF WORD Backwater valve 12.51
Clothes washer ` 25.02
/1.1•6T14-2.-/_ l t) g/2- A0/. Dishwasher 25.02
Drinking fountain 25.02 ,
Ejectorsisump 25.02
PROflRTY OWNER 0 TENANT Expansion tank 12.51
Fixtureisewer cap 25.02 •
Name:
Floor drain/floor sinktbub 25.02
Address: Garbage disposal 25.02
City/State'ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
0.APPLICANT ': [ CONTACT PERSON Irnerceptor!grease trap 25.02
Medical gas(value:S ) Page 2
Business name:
Primer 12.51 1
Contact name: Roof drain(commercial) 12.51
Address: Sink/basimlavaiory 25.02 '
City:State/ZIP: I Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tubisbower/shower pan 12.51
E-nrait: 1 •-� '\ t�7� Ce,Pl e Urinal 25.02
�`-�� r�� ° Water closet 25.02
CON'l'i�ACTOR
Water heater 37.52
Business name 1.N^?C,4.1�'ilk ,r'a`m' ; 1, ,IA 1 1 lle,1 ,`/1P t' It Water piping/DWV 56.29
Address:.f,{ ' li' 'j,,, J;L t1)-1p,% 0 _) Other: 25.02
City/State/ZIP: E;:,t2\,t.�,(IAA. t C.1 ('l r
L' I tom`) Subtotal .
Phone: . ?t ( i -�? r fie, '�^` - Minimum permit fee: 572.50 ,7a,S()
,s �)sEi.{t-1i '�/ltd! Fax (17� )i"'fC o
Plan review (25%of permit fee) - --
CCB Lia: l ;� '[_� Plumbing Lie.no.:7N2}7 -A 1
State surcharge(12%of permit fee) 4j.70
Authorized{signature: n( 1U L'i r' TOTAL PERMIT FEE 15(•:9-6f s 1 r F' Date: This permit application expires ifa permit is not obtained within 180 days
Print name:` Lit i ,i �s 1 ��at_ti t� atter it has been accepted as cemplete.
• •� L S 'Fre methodology set by Tri-County Building Industry Service Board.
L\Butding\P.aniils'.Pt,MU-PcnnitApp.dec 10(01/09 440-4616T(l0/02/COW EB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10700 SW CANTERBURY LN 3, TIGARD, OR,
97224
Record Type: Record ID:
Commercial - Plumbing PLM2017-00208
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor