Permit (187) CITY OF TIGARD PLUMBING PERMIT
111. COMMUNITY DEVELOPMENT Permit#: PLM2018-00097
T I(--,ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/13/2018
Parcel: 1S135CD00300
Jurisdiction: Tigard
Site address: 11485 SW GREENBURG RD 1
Project: The Birches Apartments Subdivision::HERS ADDITION TO GREENBURG HE Lot: 4
Project Description: Replacing 30 ft.of water service.
Contractor: MP PLUMBING CO Owner: VHR CO LLC
PO BOX 393 PO BOX 66362
CLACKAMAS, OR 97015 PORTLAND, OR 97290
PHONE: 503-655-9161 PHONE:
FAX: 503-655-1726
FEES
Quantity Description Date Amount
30 If Water Service 03/13/2018 $62.54
Specifics: 1 12%State Surcharge- 03/13/2018 $8.70
Plumbing
Type of Use: MF 10 ea Minimum Fee Adjustment- 03/13/2018 $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 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
c0„:„."c, ZZC-,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.
11 z 10:40:17 03-08-2018 1/1
Plumbing Permit ApplicatioiRI t ' i--0A-ca \n 1 1`o -C
Site UtilitiesroE011OFFICE USE ONI.l
M A ccjj R 8 2 01 Received permit No.: t
City of Tigard t]ate/B: /acf/fl . --- 100)2eI-t` l: i7
13125 SW Halt Blvd.,Tigard,OR 9 u ,, , ,,, pbm Review
. s y fi -�-� Other Permit No.:
II Phone: 503.718.2439 Fax: 503.59&1968 _, �p �,�oatdBy: plin 16 j 7-t" 3;;I.
TIGARD Inspection Line: 503.639.4175 ( 7; M k IA„ 1 Read/B j Anis Q1 Sed Page 2 for
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Internet www.ttgatd-or.gov r � tfiedlMethod J I,� 6� -EV-L„ supplemental Information
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TYPE'OF'WORK . .,..,, c ,: ,...., .kr:::f :ti .f,, e .,.b, ,
For special information use checklist
❑New construction ❑Demolition 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 CONSTTION SFR(I)bath 312.70
:; � : RUC
❑ 1 and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ®Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler(_sq.ft.) Page 2
`,, 0B SITE'I1#ORMATION AND LOCATION .` . , ' Site utilities:
Job site address:11485 SW GREENBURG RD Catch basin or area 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.: Project names BIRCHES APT 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.: ) Page 2
Water service(no.linear ft.: ) 30 Page 2 62.54
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF,4VQRK _ ;. Backwater valve 12.51
' 4, 7 11
i Clothes washer 25.02
RUN APPROXIMATELY 30'WATER SERVICE Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
p PROPERTY,OWNER '= 'l,r ". „';' ❑ TENANT ' ' Expansion tank 12.51
Fixture/sewer cap 25.02
Name:
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
AQ.ZIR.1100:414,*;12gENV: g ® CONTACT' PERSON 1 Interceptor/grease trap 25.02
Business name:MP PLUMBING CO Medical gas(value:$_) Page 2
Primer 12.51
Contact name:CINDY CRIVELLONE Roof drain(commercial) 12.51
Address:PO BOX 393 Sink/basin/lavatory 25.02
City/State/ZiP:CLACKAMAS,OR 97015 Solar units(potable water) 62.54
Phone:(503)655-9161 Fax::(503)655-1726 Tub/shower/shower pan 12.51
E-mail:CINDYC@MPPLUMBING.COM Urinal 25.02
t Water closet25.02
CONTCI OR
.. ., .. .v t �,>z.i t _z?. .. Water heater 37.52
Business name:MP PLUMBING CO Water piping/DWV 56.29
Address:PO BOX 393 Other. 25.02
City/State/ZIP:CLACKAMAS,OR 97015 Subtotal 62.54
Phone:(503)655-9161 Fax:(503)655-1726 Minimum permit fee: $72.50 72.50
CCB Lic.:3-17PB Plumbing Lic.no.:5002 Plan review (25%of permit fee)
State surcharge(12%of permit fee) 8.70
Authorized signa - TOTAL PERMIT FEE 81.20
Print name:CINDY CRIVELLONE Date:3/8/18 This permit application expires if a permit is not obtained within 1811 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:1Building\P muits1PLMU-PnmitApp.doe 10/01/09 440.461614 10/02/COMIWEB)