Permit 7
CITY OF TIGARD PLUMBING PERMIT
N a
° - COMMUNITY DEVELOPMENT Permit #: PLM2010 -00005
Date Issued: 01/07/2010
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 parcel: 2S 07/201 0201
Jurisdiction: Tigard
Site address: 8255 SW HUNZIKER RD 203
Subdivision: Lot: 0
Project: Johansen Transportation
Project Description: Relocate (1) lav /sink, install one instant w /h.
Owner. FEES
JOHANSON TRANSPORTATION SERVICE Quantity Description Date Amount
5583 E OLIVE AVE 1 ea Sink 01/07/2010 $25.02
FRESNO, CA 93727
1 ea Water Heater 01/07/2010 $37.52
PHONE: 1 12% State Surcharge - 01/07/2010 $8.70
Plumbing
Contractor: 10 ea Minimum Fee Adjustment - 01/07/2010 $9.96
Plumbing
CASCADE PLUMBING CO
2630 N HAYDEN ISLAND DR #3
PORTLAND, OR 97217
PHONE: 503 -289 -7095
FAX: 503 - 283 -9514
Type of Use: COM
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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: r.y r Permittee Signature: R, / 9p/) L , e �� 0 ,�
!!� Call 503.639.4175 by 7:00 a.m. for an Inspection that business day.
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 RECEIVE Di F0li OFFICE l'.SF. ONLY
11, _i_ , City of Tigard ' Received
w 13125 SW Hall Blvd., Tigard, OR 97223 Date/8 • Permit No.: m?� `O 00005
Phone: 503.639.4171 Fax: 503.598.1960 JAN O 4 2 O 1 O Pzao Review v.�
Inspection Line: 503.639.4175 QTY oche* Permit No.;
r
Internet: www.tigard- or.gov CITY OF TIGARD D o ttS yBy' S See Page 2 for
• ne Supplemental informs ion
TYPE OF woRIBUILDING `, . FEE* SCHEDULE
❑ New construction ❑ Demolition For s mid in emulation use checkh'sL
r.:'dition/alttmationheplacement Description Qty. Ea. Total
❑ Ot her. New I- 2- family dwellings (includes 100 ft. for each utili connection)
CATEGORY OF.:,CONSIRUCTION : SFR (1) bath 312.70
❑ 1- and 2- family dwelling • J- .. „ ercial/industrial _ SFR (2) bath _ 437.78
❑ Accessory building SFR (3) bath 500.32
❑ M ulti- fllmily
1=1 Master builder Each additional bath /kitchen 25.02
❑ Other: Fire sprinkler ( , sq. ft.) Page 2
JOB srkt INFORMATION AND LOCATION Site utilities: _
Job site address: (955' i' 1 lJn 7.1 K([1 ,., / Catch basin or area drain 18.76
City/State/ZIP: [ l I p
, �Y Drywall, leach tine, or trench drain 18.76
Suite/bldg./apt. no.. (/� /�-- Footing drain (no. linear ft.:
d 3 Project name: .17 h� ) Pa0 2
YCtll • � �� a! • • Manufactured home utilities 50.. 03
Cross street/directions to job site: Manholes
_ 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear 13.: __) Page 2
- Storm sewer (no. linear ft.: ) Page 2
-
•
Subdivision: Water service (no. linear ft.: r _, � Page 2
Lot no.: Fixture or item: _
Tax map /parcel no.: Backflow preventer 31.27
_ • DESCRIP'I'ION.•OF•WORK Backwater valve 12.51
Pl U�,; r t h h LQ. �CA L.0-11.5-112A--LA
Clothes washer - 25.02
- 1 Dishwasher 25.02
0 -L" /v t 5-1-7/1_, rcrti,x- (-12-4.- Drinking fountain 25.02
• d F o 'At •� • . A 1 h D( , Ejectors/sump 25.02
0 PROPERTY OWNER .. ' O TENANT Expansion tank
•
12.51 '
•
Name: Fixture/sewer cap 25.02
-
Address: - _Floor drain/floor sink/hub 25.02
City/State/ZIP: - Garbage disposal 25.02
Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker
12,51
0 - APPLICANT : . ; ,..0 CorrrACT.PERSON • Interceptor /grease trap - 25.02
Business name: Medical gas (value: 3 _ ) Page 2
Contact name: Primer 12.51
-
Address - Roof drain (commercial) 12.51
Sink/basin/lavatory 25.02 25.6
City/State/ZTP: • Solar units (potable water) 62.54
Phone: ( ) r Fax: : ( ) Tub /shower /shower pan 12.51
E -mail: Urinal _ 25.02
CONfRAICTOR Water closet - 25.02
Business name: Water heater 37.52 '37.
:1,S • II, 41 • - a • Water piping/DWV 56.29
Address:
a N . / . til , - 3 Other 25.02
City /State/ZIP• . a)L J a J J . 6 • 4 d/" _ Subtotal
Phone: („*...3 0i' a) 1 5 i
9 5 F ax: l56 3) A3:45/4/ Minimum permit fee: 572.50 7 .40
CCB Tic.: 1 , Plumbing Lie. no.: - ;. Plan review (25% of permit fee)
Authorized signature: %!, - State surcharge (12% of permit fee) Ir. 7 d
1 r TOTAL PERMIT FEE ii . A 1,--
Print name: , =.--
Q / _ Date: This permit application e=pirm if a permit is act obtained within 180 days
/ " �J *Ai- /� after it has been ne a uleu -iC' � ( , /(� b`tiL:l/V `Fe methodology set by Tri�ou Buil nty Buildinn Industry Industry Serviee Board.
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