Permit (28) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2018-00137
Date Issued: 03/28/2018
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1 S126CA01100
Jurisdiction: Tigard
Site address: 9009 SW HALL BLVD 100
Project: Target Subdivision: None Lot: None
Project Description: Repair 6'of sanitary sewer line to remove a main line clog and add a cleanout.
Contractor: MCKINSTRY COMPANY LLC Owner: DAYTON HUDSON CORPORATION
16790 NE MASON ST., STE. 100 BY TARGET CORP T-0345
PORTLAND, OR 97230 PROPERTY TAX DEPT/TPN-0950
PO BOX 9456
MINNEAPOLIS, MN 55440
PHONE: 503-331-0234 PHONE:
FAX: 503-331-6907
FEES
Quantity Description Date Amount
6 If Sanitary Sewer 03/28/2018 $62.54
Specifics: 1 12%State Surcharge- 03/28/2018 $8.70
Plumbing
Type of Use: COM 10 ea Minimum Fee Adjustment- 03/28/2018 $9.96
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: 4 + , Permittee Signature:/ 1N ,/31-"Pe le -- 0 ,/
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.
t
Plumbing Permit Application..,.
``
Site Utilities
# LIFOR OFrICE USE 01L4'
City of Tigard MAR 2 8 2018 Received - t+ �f 7
gDateBy er1 �cL Permit N4,l yko j,' j7/
Pr 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax 503.59 : tf ° DateBy; Other Permit No.:
Inspection Line: 503.639.4175 ToF
�`fir t
TJ R D B U LD r''' r-+,1,j1g Date Ready/By: �Z14„�.,turis: QI See Page 2 for _Internet www,tigard-or.gov *• Notified/Method: �. /� Y'
Supplemental information
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F.
❑New construction ❑Demolition 6:7;"/7/,__ 1-e / For special ht ormation use checklist.
Description I Qty. I Ea. ( Total
®Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) .
•
w " t ` , -.4eeli y r-•^ SFR(1)bath 312.70
❑1-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
0 Accessory building ❑Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler( ft.)
,s . Page 2
'',.4 .--7 i ( @ia Site utilities:
Job site address:9009 SW Hall Blvd Catch basin or area drain 18.76
City/5tate/ZIP:97223 Drywell,leach line,or trench drain 18,76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name:Target store 345 sewer Manufactured home utilities 50.03
Cross street/directions to job site:SW Palmblad Rd Manholes 18.76
Account number R1450726 Rain drain connector 18.76
Account number 8236630 Sanitary sewer(no.linear ft.:6) 1 Page 2 62.54
- Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear It:_) Page 2
Subdivision:ZWSQ 1 Lot no.: Fixture or item:
Tax map/parcel no.:1S126CA01100 Backflow preventer 31.27
cBackwater valve 12.51
s - s a ;s a yrs ` , � - ",... ---
; "- ,.t __ S.r.;�. ? : ..._,^r'..- Clothes washer 25.02
Repair sewer line for purpose of clearing a main line clog.
Dishwasher 25,02
Add a cleanout for bettter access for future clogs. Drinking fountain 25.02
Ejectors/sump 25.02
pt„ o-s� a'a 1 t>iti x: Expansion tank I2.51
,7:4:-,„ a_�13,1,EG+» , : ._z ._.._-_ _ - -..., " rt
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:( ) lee maker 12.51
' r ° g -^ `!_` Interceptor/grease trap 25.02,,,-:- .4,!4",.., ` � __
Business name:McKinstry Co LLC Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Lorl Larson
Roof drain(commercial) 12.51
Address:16790 NE Mason St.,Ste 100 Sink/basin/lavatory 25.02
City/State/ZIP:97230 Solar units(potable water) 62.54
Phone:(503)331-0234 Fax::(503)331-6906 Tub/shower/shower pan 12.51 ,
E-mail:dispatchl@mckinstry.com Urinal 25.02
Water closet 25.02
A... �•,.. Water heater 37.52 •
Business name:McKinstry Co LLC _ - Water piping/DWV 56.29
Address:16790 NIl Mason St. Other: 25.02
City/State/ZIP:Portland,OR 97230Subtotal 62.54
Phone:(503)331-0234 Fax:(503)331-6906 Minimum permit fee: $72.50 72.50
Plan review (25%of permit fee)
CCB Lie.:172811 Plumbing Lie.no.:37-22PB
/�`� State surcharge(12%of permit fee) 8.70
Authorized signature: ,1A' et „�J' i0C�1 __ TOTAL PERMIT FEE 81.20
Print name:Lori Larson �C - _ Date:3/28/2018 This permit application expires if a permit is not obtained within 180 clays
after it has been accepted as complete.
*Fee methodology sat by Tri-County Building Industry Service Board.
raBuilding\t'errnitAPGMU-PennitApp,doo 10/0I109 440-4616T(l0/02/COMIWED)