Permit .
r ' ' CITY OF TIGARD
l rt PLUMBING PERMIT
. COMMUNITY DEVELOPMENT PERMIT #: PLM2007 - 00566
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
DATE ISSUED: 12/27/2007
PARCEL: 2S112BD -90031
SITE ADDRESS: 14655 SW 76TH AVE 3 ZONING: R -
SUBDIVISION: TIMBERCREST CONDOMINIUMS LOT: JURISDICTION: TIG
PROJECT: TIMBERCREST CONDOS
Project Description: Water damage repair. (7) fixtures.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SFA WASHING MACH: 1 BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: 2 OTHER FIXTURES:
TUB /SHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: 1 RAIN DRAIN: ft
Owner: FEES
DANIELLE BARRETT
14655 SW 76TH AVE. Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 12/27/2007 $116.20
[TAX] 8% State Surcha 12/27/2007 $9.30
Phone : na Total $125.50
Contractor:
MP PLUMBING CO
P.O. BOX 393
CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 655 -9161
FAX 503- 650 -7050
Reg #: LIC 5002
PLM 3 -17PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: ` Air Permittee Signature: ■
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.
' From:
. es) 12/27/2007 10:21 11051 P.002/003
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Plumbing Permit Applhcatt-)pl, OF jIG14%*
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!I� • Received
City of Tigard
CAI' MG v Dare ay: •
Permit No
13125 SW Hall Blvd., Tigard, OR 97223 % S 3 � ,_ v� /�
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5 0 6 97 1 Fax: 03 .59 8 .1 '' ~'e a I l Play Review Day: Other Permit No.:
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p 3.41 = : ? . 1 �,... Date Ready/By ke"y See Page 2 for
Internet: www.ci.tigard.or.us 7
Notified/Method: Sapptemeatal Information
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❑ New construction ❑ Demolition For special h,formarion use checklist
11 Addition/alteration/replacement [] O�� Description [Qty. 1 Ea. 1 Total
T a e zt� Jrr �y� , , New 1- 2- family dwellings (includes 100 ft. for each utility connection)
os 7f r CPa d3 4{l i 6 ' �I : ' �i ) Ilr'T1 i l r 17 ` i f
L trj ' w . e ?•1. ;.1. 7. ww�`_�Vr.- i ? �imt-u,m_c 7 1,.`.,,, ,..".s: SERI) bath 249.20
s; 1- and 2- family dwelling ❑ CommerciaUindustrial SFR (2) bath 350.00
❑ Accessory building ce Multi- family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
0 Master builder re Other
�- , r'ro ar 1 =v� �s t' t l / T e , Fire sprinkler ( sq. ft.) Page 2
t rg . .. 11 Site utillttes
Job site address: i Catch basin or area drain 16.60
Drywell, leach line, or trench drain 16.60
. • : apt. n; Project came: i It��l - � i 1� Footing drain (no. linear ft.: ) Page 2 -
/i �� Manufactured home utilities 110.00
Cross street/directions to job site: f v'�i . _
Manholes 16.60 _
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Water service (no. linear ft: ) Page 2
Tax map /parcel no.: Fixture or item
�,••z;. , , ^ } t : , y n �1 nn, isc 's L r r ..,- 1 Absorption valve 16.60
S � . ,r titi 4 5r��� s c llle, V ai 4 1 4 vr ) sR t l , .m � • t - .w 7 - ' 1 11 - F'
a .:. ;L. ;: _; l r.....__ ° . ._ y. r:. : : ::i 'ar_ a.. 'F ...2!s'?.d../1. : kt•Ij o ; :', 1.1. +�., ! ..,, ± Backflowpreventer Page 2
!Ma' / : % j jr /2/60, Backwater valve 16.60
Clothes washer 16.60 /b 11 loa
,
Dishwasher r 16.60 /d
t �. g.J a ? I � . F , t iiv:J;fk I T "g$itf y l , t v ^a � ` y,s ' . Drinking fountain 16.60 .
„ :t..._..tl:..:II4':Li+. . a. . n .3s. - 2.ns- c am. _ 4_. :i..r a _ c..r1::i..:. 'J...- Ejectors sump 16.60
RiiiifiMp !.% .� J Expansion tank 16.60
Address: S 4 A Fixture/sewer cap 16.60
City/ State/ZIP: Floor drain/floor sink/hub 16.60
Phone: ( ) A A Fax: ( ) Garbage disposal 16.60
'iji.,$' vr 3 44 + v tgde r 9 C .1 : .rta 0. '? . - `�� nK v �r j -. .., Pc j ti 7 l Hose bib 16.60
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Ice maker 16.60
Business name: MP PLUMBING CO.
Interceptor /grease trap 16.60
Contact name: TAMI Medical gas (value: S _) _ Page 2
Address: PO BOX 393 Primer 16.60
City/State/ZIP: CLACKAMAS OR 97015 _ Roof drain (commercial) 16.60
Phone: (503) 655 -9161 I Fax:: (503) 650 -7050 Sink/basin/lavatory 16.60 33.
Tub /shower /shower pan , 16.60 4,4_
E-mail:
Urinal 16.60
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*:3 ? +:cr k ..'.. s �t__ �y :_ . u:, c�ar..k wi a ?.f u xt...,i1!hw ', f" : Water closet , 16.60 / / D j Y
Business name: MP PLUMBING CO. Water heater ) 16.60 /b.
Address: PO BOX 393 Other.
City/State/ZIP: CLACKAMAS OR 97015 Subtotal ��,,
Minimum permit fee: 572.50
Phone: (503) 655 -9161 Fax: (503) 650 -7050 Residential backflow minimum permit fee 536.25
CCB Lic.: 5002 Plumbing Lic. no.: 3 -17PB
Plan review (25% of permit fee)
Authorized signature: 1,140C 1 State surcharge (8% of permit fee) q 3
TOTAL PERMIT FEE /, • 9 -
Print name: TAMI GEORGE 1 Date: // .27/7 This permit application expires if a permit is not obtained within
180 days after it bas been accepted as complete.
'Fee methodology set by Tri -County Building Industry Service Board.
L•1Bulldlag\Pamdta\PlM•PvrtolApp doe 06/03 440 -46161(10102 /CQM/WEB)