Permit (102) ,, CITY OF TIGARD PLUMBING PERMIT
1111
: COMMUNITY DEVELOPMENT Permit#: PLM2017-00299
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/26/2017
Parcel: 25101 BC01000
Jurisdiction: Tigard
Site address: 12291 SW KNOLL DR
Project: The Knoll Subdivision: KNOLL ACRES Lot: 5
Project Description: Replace 4"gate valve at#1 check in vault
Contractor: DETEMPLE COMPANY INC Owner: KNOLL AT TIGARD APARTMENTS LP,TH
5636 NE HASSALO STREET BY COMMUNITY PARTNERS FOR
PORTLAND, OR 97213 AFFORDABLE HOUSING
6380 SW CAPITOL HWY#151
PORTLAND, OR 97239
PHONE: 503-227-2641 PHONE:
FAX: 503-274-7686
FEES
Quantity Description Date Amount
25 Misc Other Fee 07/26/2017 $25.02
Specifics: 47 ea Minimum Fee Adjustment- 07/26/2017 $47.48
Plumbing
Type of Use: COM 1 12%State Surcharge- 07/26/2017 $8.70
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: ( am— 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.
Plumbing Permit ApplicaRt1ECEIV
Building Fixtures FOR OFFICE 1.{SE O\GY
II City of Tigard jjj 2 4 20�7 Received 7/Z .J �►, PermitNo.: s.� �1 C�
13125 SW Hall Blvd.,Tigard,OR 97)11L
Date/By. %7 f� �� / /7-f/��s��7
>e Plan Review
Phone: 503.718.2439 Fax: 50RD Other Permit No.:
Inspection Line: 503.639.4175 IL� a� � Date/By: •
3 I G A I t f7 DateRead)By: Jura: B1 See Page 2 for
Internet: www.tigard-or.gov NG��yyyy�{{jj11�� Not fiedlMethod Supplemental Information
' t l so .Ll'L Y 1 � ` �r ;s Pp - ' I
❑New construction 0 Demolition For special information use checklist
Description I Qty. I Ea. ( Total
Z Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
TEGORY E)FN (TSI SFR(1)bath 312.70
❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building 0Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
,,,,, JOB a ®RMATION A 1 O', pQN.R Site utilitiies:
Job site address:12291 SW Knoll Dr Catch basin or area drain 18.76
City/State/ZIP:Tigard 97223 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: 1 Project name:The Knoll Manufactured home utilities 50.03
Cross street/directions to job site:double-check vault located on Hunziker R Manholes 18.76
at fire hydrant Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
a: o , ,°�; Backwater valve 12.51
q,,,,7 , .. � C tl1?TTUN OF O ._.'mplivi Clothes washer _ 25,02
replace 4"gate valve at#1 check in vault Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
-'ii A,ii a'PRWPER (i utr 1R m_
��» TENANT : Expansion tank 12.51
_ten! ill: ... t)� '�
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
a cU r '$UN Interceptor/grease trap 25.02
Business name:DeTemple Co. Medical gas(value:$ ) Paget
Primer 12.51
Contact name:Suzanne Postula
Roof drain,(commercial) 12.51
Address:5636 NE Hassalo St, Sink/basin/lavatory 25.02
City/State/ZIP:Portland,OR 97223 Solar units(potable water) 62.54
Phone:(503)471-5267 Fax::(503)274-7686 Tub/shower/shower pan 12.51
E-mail:s.postula@detemple.com Urinal 25:02
rl t . Water hcloset
Mi ,,bC, Co , nwt1101 r 25.02
37.52
Business name:DeTemple Co.
Water piping/DWV 56.29
Address:5636 NE Hassalo St Other:gate valve 1 25.02 25.02
City/State/ZIP:Portland,Or 97223 Subtotal 25.02
Phone:(503)471-5267 Fax:(503)274-7686 Minimum permit fee: 572.50 72.50
Plan review (25%of permit fee)
CCB Lie.:2510 Plumbing Lie.no.:26-25PB
State surcharge(12%of permit fee) 8.70
,,
Authorized signature: i yzt fes:U /17&).:: TOTAL PERMIT FEE 81.20
Print name:Suzanne Postula Date:7/20/2017 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.Building‘Permit.PLMU•PermitApp.doc 10/01/09 440.4616T(I0'02,COM/WEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12291 SW KNOLL DR, TIGARD, OR, 97223 August 10, 2017 at 2:53:53
PM
Record Type: Record ID:
Commercial - Plumbing PLM2017-00299
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Backflow test report received. Contractor on site with key. New valve verified.
Violation Summary:
Inspector Contractor