Permit CITY OF TIGARD
PLUMBING PERMIT
4
11.41,tY
COMMUNITY DEVELOPMENT Permit #: PLM2010 -00188
t t- ,101 Date Issued: 06/11/2010
T i GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 1S134BD07006
Jurisdiction: Tigard
Site address: 11360 SW COTTONWOOD LN
Subdivision: ENGLEWOOD NO. 3 Lot: 231
Project: Ramer
Project Description: Water heater installation
Owner: FEES
RAMER, DANA P Quantity Description Date Amount
11360 SW COTTONWOOD LANE
TIGARD, OR 97223 1 ea Water Heater 06/11/2010 $37.52
PHONE: 1 12% State Surcharge - 06/11/2010 $8.70
Plumbing
35 ea Minimum Fee Adjustment - 06/11/2010 $34.98
Contractor: Plumbing
COLUMBIA CONTRACTING SERVICES INC
38197 SE HUDSON
SANDY, OR 97055
PHONE: 503 - 225 -0774
FAX: 503- 668 -3701
Type of Use: SF
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 503.246.669980033 .- 44.
Issued By: . / Permittee Signature: 4
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.
Jun 08 10 07'21p Columbia Water Heatersl 5036683701 p.3
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RECEIVED
PlumbingPermit Applicati ®n 1 t> t 1 1k 1 t i ,' i, `
JUN #04 I '
pity of rd Cq '- , -fin ... ., .
13wSwHailBivdr ragtnd.oR97?23 ITY TI AR ii aberPenni*No; - -�
none: 503.63 Pax 503998.1
i r , ; In�ectiart.;eG 3036394173 ILD DIVISI '
,,-e herniae ivvAstfigard.or.nov - � . ,•
For . • 1111167rnme theelthet 1
0 New • . . • • ;an CI Detnolition Ea Total
S< - , 0 Other; Mew / -z +mmfiid..s86� Wades too 0. l r �fi ue'1iy coance6ca)
'' = S,FR (1)both 249,
J ` "and 2 -fmmtly dwelling 0 Commasialhndusttml SR (2) bath ' 350.00
bath
t ❑ Accessory building p Mult tanuly sett (3) 399
Eachadd<ti m 1 bai i1dteheo 45.00
❑ Master builder Ooh Faasprieklcr ( ft.) Page 2
,, ._. ti p: . • . i, z :•. .,..-
: 1..�.:• >� ,.�
: - e•S• - e;•. .
Yob eta ad d r s ; 7i set) Co //O iva4. ?J r Caleb as or atm drain 16.60
City/State/ZIP: 2 400 ex- Diywcll, lad: line, or trench dram 16.60
' ' ' 3-/apl. no.: I P ax amc: � � Footing drain (no_ linear ft.: ___) _ MT
t. p, latmfactneedlm ec utilities 110.00
- Cross sirftVdiredions to job b Manholes 16.60
Rain drain connecter 16.60
Sanitary spa (0e. ling B: ) Page 2
Slam sewer(no, finger FL_ ) Page 2
Subdivision: ] let »o.: Water service (no. linear f!: ) Page 2
Future or item
Tax map/pma1 no.:
Pe e2
w - i m ' rr.. = r. : - ., .+e.. ra .. Absorption valve 1060
.riti� '� ' ...; ... • : ., :. . Vint .,�' y "?. :4 .. 4fl';- : >Zkr._ e N.: Beck.vwFreveater
l/Wr - � ' / 4/& Backwater valve 36.60
Clothes washer 16.60
Diehaasher 16.60
' r •. p: �• - J.S ..: a Drinking fountain 16.60
_: Ejectors/sump 16.630
Name: /9.444¢ 124 alr/sr _ Fusion tank 16.60
Address: Fixture/sewer cap 16.60
City/ State /ZIP: Floor drain/IIootsink/hub 16.60
Phone: ( ) O y 9 - / y r Fax: ( ) Garbage dish 16.60
,. `"grIr°r- *1 �_.e. :ft.. r t_ ir„ H SC 16.60
Business name:
Ice maker 16.60
Inhaceptorig etrap 16.60
Contact music Medical gas (vet= S ) Page 2
Address: Printer 16.60
City/StateJZIP: Ruafdtain (cnmmotraal) 16.60
Phone: ( ) / Fir:: ( ) vat` 16.60
Tubrshawer /shower pea 16.60
Banat:
Urinal 16.60
o- ry
- _ .. . _ �:: _ :- '' water closet 16.60
Baseless name: ��1f‘, d ixt G -d am - 5c= /21.,) t/r Wad beater / 16.60
Address; �CS'/ 5. 7 _5 !-- .el 'r /Y dal Other:
. City/State/ZIP: Sit 'vC/lr �• 9. 75 c Mieemum pantie fm Subtotal
Phone ( ✓.• '- ' 77 Fax: ( ) C y ..1.77e.if Rtaidarasl bactSoor minimum permit fee: S3 7)150
CCB Lie.: 45, 3 .2g. ' Ill) Plumbing 1ir- m: - ,, i Flan review (2595 of 't fee)
Au hooted si aatut 7 1 )) Slate , , : apnea! fee) y. ?t
/`�-� _` TOTAL PERMIT FEE g i , )4, r; new .%/�� Ej . e6Y.. � ..e_ 1 Datm ec /O VG- 1 'refs Permit application =pins if t permit 19 sot obtain wiMio
180 daps after lets, ben accepted es complete.
*Fee a etbeetolagy see by Tei•Comtly Baddng Industry Service Board
l''eossin¢Vb .iinp st.vo rAypd 96 4404616 OIONCOyg1EM)