Permit (106) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2018-00474
) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/16/2018
T t G A ,T 9 Parcel: 2S 102AA00600
Jurisdiction: Tigard
Site address: 11940 SW PACIFIC HWY A
Project: Pacific Plaza Subdivision: TIGARD HIGHWAY TRACTS Lot: 12
Project Description: 75 ft.of sanitary sewer for units A and B.
Contractor: APOLLO DRAIN&ROOTER SERVICE Owner: ALPROP LLC
853 NE HARLOW RD 4905 SW GRIFFITH DR STE 205
TROUTDALE, OR 97060 BEAVERTON,OR 97005
PHONE: 503-239-8801 PHONE:
FAX: 503-669-9568
FEES
Quantity Description Date Amount
75 If Sanitary Sewer 10/11/2018 $62.54
Specifics: 1 12%State Surcharge- 10/11/2018 $8.70
Plumbing
Type of Use: COM 10 ea Minimum Fee Adjustment- 10/11/2018 $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
stttoOODUUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: �� az.VrC'?,77f.7. ./
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 ApplicattECEIVED
(3 Site Utilities
Received �/
City of Tigard OCT 3 2 01 Date/BY: i bii//et ,,/ • Permit No.: !''�c iii i/7�l
4 13125 SW Hall Blvd.,Tigard,OR 97223 0
Phone: 503.718 2434 Fax: 5 Plan Review
t ' ' Y llY' '!IIIARD Date/By: Other Permit No.:/04(17,7,1g-,(1,17,36
A, I ,„r i Inspection Line: 503.639.4175 Date R y/By: to See Page 2 for
Internet www.tigard-or.gov B JHflI ` 1 Noufied/Method: k-litTOSuppknentallntor►nation
a+''ll{'.if ViiB Y �I.�+ia
❑ ew construction 0 Demolition Far special information use checklist.
Description � Qty. j F..a I Total
ddition/alterationh
/replacement ❑Qthei- ---- . New 1-2-family dwellings(includes 100 it.for each utility connection)
oc*y* p ). SFR(1)bath
k and 2-family dwelling 31230
SFR(2)bath 437.78
�ercla]industrial. .. . SFR(3)bath 500.32
-
Accessory building 0 Multi-
Each additional bath/kitchen 25.02
'� 0 Master builder 0 Other
Fire sprinkler(__sq.8.) Page 2
JOB bli {�11?U1lltll5A 1 li4N0 • Site utilities:
1 Job site address:el�� ��u be, • 1 _ Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/Z1P: poe4 • z 9
Footing drain(no.linear ft: ) Page 2
Suite/bldg./apt.no./7" Project name:/019G,ff C it/l i 7_4- Manufactured home utilities 50.03
ACross street/directions to job site: Manholes 18.76
-.) ' + A. • Rain drain connector i�rj 4' 18.76
i1• u - a : _ m► A 1` s �' Sanitary sewer(no.linear 8.= 1 Page 2 ‘,?.i,1
Storm sewer(no.linear ft 8: ) Page 2
+ / j Water service(no.linear : ) Page 2
Subdivision: Cc
1 f 1) ) ( Lot no.:
Fixture or item:
Taxaapip
l �(( ./N004; er A"?"-' ---.... Backflowprcwenter 31.27
Backwater valve 12.51
CB''f - �
� ^Hi, 4Clothes washer 25.02
`1 lJ_If�L/1 k- ( yam' CDishwasher 25.02
1 .) 'ZVI.
1S�1,t _ k I Drinking fountain 25.02
�' 1 jl 1`�,1 Ejectors/sump25.02? • ._._ . rte: _..P - .. Expansion tank 12.51
Name: Fixture/sewer cap 25.02
�,,n� Floor drain/floor sink/hub 25.02
Addtrss:
V� _ -_ O ��6� Hostage disposal 25.02
City/State/ZIP: �1-ITfU�II'�,.`1 ~Hose bib 25.02
Phone: Fax Ice maker 12.51
'> ... zLCAl , 0 Interceptor/grease trap 25.02
Business name. LAID 4/- INA jPk.nPrimer 12.51
Contact name: 7 /yn
jt�1-v�1� 7r-��t1 Roof drain(commercial) 12.51
Address: J �� Sink/basin/lavatory25.02
I City/State/ZIP:"�, 1-6 g 0 j �r�jL Solar units(potable water) 62.54
Phone:( t n f/�i�J0�`/��/�Fax :( ) Tub/showerlshowerpan 12.51
E-mail: 1.1,4 #.14 }L.i l,0 lY11
Urinal 25 02
. water cies° 25.02
.. . i! _v
: �„� � � . water heater 37.52
vc Business name: I.! Waterpiping/DWV 56.29
\.,,S
C Address: t Other: 25.02
., J City/State/ZIP: Subtotal 6,;.. -1-)
Phone:( ) Fax:( ) Minimum permit fee: $72.50 )L=�)
CCB Lie.: Yds`#, JO ('� Plumbing Lic.no.:6, ---.5:72/96 Plan review (25%of permit fee)
/� State surcharge(12%of permit fee) - 7v
Authorized sign 41„,,1 •l 101V CQ ,,,�-^1 TOTAL PERMIT FEE fii AO
This permit application expires if a permit is not obtained within l days
Print name J f �� � Date: after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:1BuitdinglPamitsWPLMU-PermitApp.doc 10/01/09 44046167(10102/COM/WEB)