Permit (106) 1111 CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2017-00353
TLRD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/31/2017
S.
Parcel: 2S102CA01300
Jurisdiction: Tigard
Site address: 9915 SW FREWING ST 1
Project: Orchard Park Apartments Subdivision: FREWING'S ORCHARD TRACTS Lot: 21
Project Description: Repairing 30 ft.of sanitary sewer.
Contractor: RIVER CITY ENVIRONMENTAL Owner: ORCHARD PARK JARA LLC
PO BOX 30087 16225 NE EUGENE CT
PORTLAND, OR 97220 PORTLAND, OR 97230
PHONE: 503-252-6144 PHONE:
FAX: 503-288-3658
FEES
Quantity Description Date Amount
30 If Sanitary Sewer 08/31/2017 $62.54
Specifics:, 1 12%State Surcharge- 08/31/2017 $8.70
Plumbing
Type of Use: MF 10 ea Minimum Fee Adjustment- 08/31/2017 $9.96
Class of Work: ALT Plumbing
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 503.232.1 o,r 11.800.332.2344.
Issued By: Art.06:7 Permittee Signature: *C0)1,-v-t_4_,,
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 Application
Building Fixtures FOR OFFICE usF oNLti'
Tor
City of Tigard "V �` Received
13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: �/ i f 7 477-- PermitN .1)4 i 7- 3r 3
INIPhone: 503.718.2439 Fax: 503.598.19 �\
Plan Review
D. y: Other Permit No.:
TIGARD Inspection Line: 503.639.4175 c.1'' 1`. •
Internet: www ti and-or. ov ' r y/By: Juris: ® See Page 2 for
g g �
/� ������ �j �• ti,Method: Supplemental Information
3 ,�j3 % iii/ i ' ' / ® ,.
❑New construction ❑Demolitio ,!�°!+ For special information use checklist.
ACAddition/alteration/replacement Description Qty. Ea. Total
❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
' °� '" 1 SFR(1)bath 312.70
❑ I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
0 Accessory building 0 Multi-family SFR(3)bath 500.32
0 Master builder Each additional bath/kitchen 25.02
❑Other:
moi Fire sprinkler( sq.ft.) Page 2
%; ,,AM!%' ,ff i , 1 A ' I 1 %iA Site utilities:
Job site address: 4r)* f J() Ti l(lV 6r cip�. Catch basin or area drain 18.76
City/State/ZIP: # Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Pae 2
Suite/bldg./apt.no.: 1 Project name:() cµe k j:•3 ?,Arie ,t}L1;S g
11� '� Manufactured home utilities 50.03
Cross street/directions to job site: Manholes
18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:,V) I Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: 1 Lot no.:
Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
4i ,/ % � z . ' „ , , / i/� Backwater valve
12.51,-0,,,'!',P;., Viw° *%� % t.- /" / /
Clothes washer
,k-C- amu +� t'.e 0- . .�YY+ > C 25.02
_ Dishwasher 25.02
`..° :r'� i ,'�- t.'' t" ', 3�1
Drinking fountain 25.02
Ejectors/sump 25.02
"-" !14 %% j`® Expansion tank 12.51
Name: ...,Y e lJ� PC �. Fixture/sewer cap 25.02
Address: 99 t i C (A) .I-"re tt�l,�'t c' '
Floor drain/floor sink/hub 25.02
i �^, t Garbage disposal ■ 25.02
City/State/ZIP: Il9 0,_ X1_,2
(q�3) �- l e Hosecbib
25.02 Phone: '` 00 � Fax:( )
Ice maker
l %//,: / /�-,v, �, 12.51
<,i ., ,%j4,;0/ %%/ / "0.0/0,,felefici*Wfddkeir" 1 ' ff Interceptor/grease trap 25.02
Business name: ,,;�i li`+e'1r , �- &,,.? ,--lor1 Medical gas(value:$ ) Page 2
Contact name: r a cant_ L k Primer 12.51
Address: �, /�J e )0 2 (i,,�y
Roof drain(commercial) 12.51
/ " _J Sink/basin/lavatory 25.02
City/State/ZIP: poo)-1„,,,,t4 l ) 1-z 2.0 Solar units(potable water) 62.54
Phone:(A / ) 40t f3 0 Fax::( ) Tub/shower/shower pan 12.51
Urinal
25.02 E-mail: yzj I✓ L-JSS-1- I ioerc-W w5 -c
/��i '%/��/� Water closet Mil
,,, .�. //g ii., r /// %%%;i/ v , ° / 25.02
. Water heater 37.52
Business name: 6.0,,,,r-,tt t � 60,,,e
Water piping/DWV 56.29
Address:
Other: 25.02
City/State/ZIP:
Subtotal
Minimum permit fee: $72.50
Phone:( ) Fax:( )
CCB Lic.: /41- Lic.no.: Plan review (25%of permit fee)
�� g Z1�`� ��rap
� � State surcharge(12%of permit fee)
Authorized signature: j/ l., 7 (yJ , y9---
TOTAL PERMIT FEE /I,�,
Print name: " i t jj s,i/%- Date: /, 1,.- This permit application expires if a permit is not obtained within 180 days
,, " 7� / after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I.\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)