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Permit Support Document
CITY OF TIGARD PLUMBING PERMIT 2 ` COMMUNITY DEVELOPMENT 1 Permit#: PLM2020-00318 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439©�T4 41 D. Date Issued: 8/14/2020 TIGARD ['OR/tsrc.r CO Parcel: 2S103DD00850 r'h5plt�SS Jurisdiction: Tigard Site address: 13815 SW PACIFIC HWY 10 Project: Domino's Pizza Subdivision: None Lot: None Project Description: ADD(1)clothes washer,(1)2"floor drain, (1)3-compartment sink,(1)mop sink,(3)hand sinks,(1)lay,(1)water closet and(1)water heater; REPLACE existing(1)lay and(1)water closet. Contractor: MY PLUMBER LLC Owner: D W SIVERS CO 14604 NE 129TH ST 4730 SW MACADAM AVE#101 BRUSH PRAIRIE,WA 98606 PORTLAND, OR 97239 PHONE: 360-991-9991 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Clothes Washer 08/13/2020 $25.02 Specifics: 1 ea Floor Drain/Floor Sink/Hub 08/13/2020 $25.02 5 ea Sink 08/13/2020 $125.10 Type of Use: COM 2 ea Lavatories 08/13/2020 $50.04 Class of Work: ALT 2 ea Water Closet 08/13/2020 $50.04 Type of Const: 1 ea Water Healer 08/13/2020 $37.52 Occupancy Grp: 1 12%State Surcharge- 08/13/2020 $37.53 Stories: Plumbing Total $350.27 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 calliinngg)503.232.1987 or 1.800.332.2344. Issued By: /( / Permittee Signature: QiJ -p6- e4- o _ J 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.