Permit ,_„„"„v,
` CITY OF TIGARD
PLUMBING PERMIT
'' °:_:- COMMUNITY DEVELOPMENT PERMIT #: PLM2006 - 00544
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.41 DATE ISSUED: 11/7/2006
PARCEL: 2S112BD - 00700
SITE ADDRESS: 14655 SW 76TH AVE 15 ZONING: R -12
SUBDIVISION: MARCIENE II APARTMENTS LOT: JURISDICTION: TIG
Project Description: Units 15,16
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R1 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
BOOTH - HEYDON LLC
PO BOX 1185 Description Date Amount
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 11/7/2006 $72.50
[TAX] 8% State Surcha 11/7/2006 $5.80
Phone : Total $78.30
Contractor:
TED RUDIGER JR. EXCAVATION
16235 TRACEY LEE CT.
OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 887 -8089
FAX NA
Reg #: LIC 162133
PLM PB201
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 ay obtain copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By:
A L
Permittee Signature: trid
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 n 11"" 4'.2 1 ; :.FOR "OI I•ICE '1.;1:-.1,-')..0 \Ll j?
4
t' City of Ti and Du � ( 7! � w 1 1�_0 /
g PermitNo.:
'1 13 125 SW Hall Blvd., Tigard, OR 97 2 � ((�1l � f 2006 Plan Review
Phone: 503.639.4171 Fax: 503.598.9950 1 2UU6 D Other Penult No.:
T IG`ARD Inspection Line: 503.639.4175 Date Ready/By: Page 2 for
'� @ a YBY Juris. ® See g
... -.:�,. -,_,. Internet: www.tigard - or.gov % jj 1 °/ Vf - ,��,( �,�.6 Notified/Method: Supplemental Information
TYPE o 1- (( -''I J °• FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist.
Description 1 Qty. 1 Ea. 1 Total
❑ Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
❑ 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building El Multi-family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other:
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: 19 & rc 5 740A-tie- Catch basin or area drain 16.60
City / State/ZIP: 'I' t O Drywell, (each line, or trench drain 16.60
• Suite/bldg. /apt. no.: pi -A,, I Project name: L A44. ' t Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street /directions to job site: �„‘.
44_ Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: I ) Page 2
Subdivision: 1 Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.: Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
•
i ak ��'� )1 / �C i �- Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
❑ PROPERTY OWNER ❑ TENANT Drinking fountain 16.60
Ejectors/sump 16.60
Name: Expansion tank 16.60
-
Address: Fixture /sewer cap 16.60
City /State/ZIP: Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
❑ A PPLICANT ❑ CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name:
Interceptor /grease trap 16.60
Contact name: Medical gas (value: $ ) Page 2
Address: Primer 16.60
City /State/ZIP: Roof drain (commercial) 16.60
Phone: ( ) Fax:: ( )
Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: '1%4 atAJ i, L2.. Ja_. g, ,T ines Water heater 16.60
Address: I ( 2 3 r 7riecce.y Lee_ c 1 Other:
City /State /ZIP: 0 2 e? p%. C i 4 t Minimum permit fee: $72.50
Phone: ( 5 cg7 'Q f 7 Fax: ( ) Residential backflow minimum permit fee: $36.25 %2-g,) CCB Lic.: ! 0 Z f '3; / Plumbing Lic. no.: 7b, le / Plan review (25% of permit fee)
Authorized signature: i If( surcharge (8% of permit fee) S
TOTAL PERMIT FEE � 30
Print name: °e j j ,. e 7 Q/nt Date: This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
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