Permit n
CITY OF TIGARD PLUMBING PERMIT
K = COMMUNITY DEVELOPMENT Permit #: PLM2010 -00196
Date Issued: 06/15/2010
,TIGARD; 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S110AA02200
Jurisdiction: Tigard
Site address: 10930 SW GAARDE ST
Subdivision: Lot: 0
Project: TOTONCHY
Project Description: Replace 60' water service.
Owner: FEES
TOTONCHY, MATTI Quantity Description Date Amount
2651 OVERLOOK DR
LAKE OSWEGO, OR 97035 60 If Water Service 06/15/2010 $62.54
PHONE: 1 12% State Surcharge - 06/15/2010 $8.70
Plumbing
10 ea Minimum Fee Adjustment - 06/15/2010 $9.96
Contractor: Plumbing
JOHN D PLUMBING
7472 SW FIR STREET
TIGARD, OR 97223
PHONE: 503 - 620 -7600
FAX: 503 - 598 -9355
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 503.246.6699 or 1.800.332.2344.
Issued By: ' , Permittee Signature:
•
l l
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 -15 -2010 08:20A FROM:JOHN D. PLUMING (503)598 -9355 TO:5035981960 P.1.
Plumbing Permit Application t , ,(
Budding Fixtures 0 t r r �u •, � � ft �' ,
t I ,i)1( 4 )1 IS1(g1 I �I \V, ,
City of Tigard r �, Received Pprait Na.�°L , i , 13125 SW Hall Blvd., Tigard. OR 97 v e,
.. $ �� Nen nevus ����
\\A\ Man Other Panic No.:
. Phone: 503.639.4171 Fax: 503.598.1960 U\V ) . p : :
Inspection Line: 503.639.4175 , a
I,i ��i pe •"' i K. P MadReady/By; ;, SeePass2for
$ t Internet: www.tigardor.gov r* 1 Q`�',,c ( . ,A Bu . emootrtinranaariae •
TVPFe OF WORK C i,c k ,01,. 641k i '. • . FRO SCHEDULE ..
i s for b° ' For spetfal information ute &ECkILIM
❑ New construction Q t�emoihum°
Description 1 Qty. 1 Ea. L Total
Addition/alteration /replacement 0 tither: New 1 - 2 - famUy dwellings (includes 100 R for cash utility, connection)
CAT EGOHV; CONL'R11
SCFIQN ? SFR (1) bath 312.70
tit 1• and 2- family dwelling ❑ Commercialindustrial SFR (2) bath 437.78
SFR (3) bath 500.32
❑ Accessory building Q Multi - family
Each additional bathAcitchen 25.02
0 Master builder ❑ Other: Pire sprinkler (�. sq. 11) Page 2
-
• JOB env INFORMATION AND LOCATION Site atlIltica: _
Job site address: /(19 q' 3 Q stk9 c (s ; 5- Catch basin or area drain I 18
City/State/DP: ' t`� G�� t O (e• <17'2_2_4 Drywall, teach line, m trench drain 18.76
Footing drain (no. USW R•: _J Page 2
Suite/bldg. /apt. no.: I Protect natna: Manufactured home utilities 50.03
Cross etreeildireaions to job site: Manholes 18.76
T tC PFr C - f`f UJ y 7 Su, Cii\ -A RD ST • Rain drain connector 1 8.76
Sanitary sewer (no linear f -:._ -) Page 2
Storm sewer (no. linear R.: ••_ J Page 2
Water service (no. linear R. 1 60 , Page 2 55-. • ICJ
Subdivision: 1 Lot no.: Fixture or Item:
Tax map/parcel no.: BaakRow preventer 1 31.27
naieRRIP'['tom' WORK " Backwater valve 1 } 12.51
i -t P"r � (4-A' '4' r'E
Clothes washer 15.02
_ Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
pt PROPERTY OWNER . °T I] 'fENANC Expansion tank 12.51
Fixture/sewer cap 25.02
Name:
Address: ( Q -I 3 0 $ ( D G.AA 2 b& Placer ge disposal sink/hub 25.02
Garbage disposal 25.02
City /SUtteJZWP: T(& fit e...0 1 O a • 17 22-4 Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12.51
' 4 Interceptorl trap 25.02
:.. ;. D ;� ►t�PI,1 , �AN T � CO PEilgply �
Business name: Medical gas (value: S___.) Page 2
Primer 1151
Contact name:
Roof drain (commercial) 12.51
Address: Sink/basin/lavatory 23.02 -
City /State/ZIP: Solar units (potable water) 62.34
Phone: ( ) I Fax:: ( ) Tab/ahower /ahrrwer pan 12.51
E -mail: Urinal 25.02
• - • Water closet 25.02
C9NT,R
lag ACTOR' water heater 37.52
Business name: �f/� &) 1 J. T14) M v t (3 1 bJC Water pipin8/DWV 56.29
Address: l T! 2. 5(4 FI R • Other: 2102
City /State/Z1P: T! A- te D I S e • 9722:3 subtotal 60
Phone: ( 2.0 -- 1 d Q Fnx: ( /O3 51e -q35-s--
Minimum permit fee: $72.30 C
� CCI3 UC.: 2 9 S 37 Plumbi Liu. n u.: 3tt- -z S°7p� '/ P lan review (2596 of permit fee)
Stale surcharge (12%(fpermitfee) y, -70 /
Authorized signature: TOTAL PERMIT FI I 9 (- , _0 i/
Print name: TafQ 1 e_GOM 1K , DatC: //511161 This peanut appaysden aspires it a permit is oat obtatead within ND dam
*nor It has ban accepted as complete
• Fee methodology set by Trt .Couary anlldies Industry Service Board.
t.40uildbv\Penalu MU-PenaNAI .doe 10/01K9 440-4616T(II'O2ICOMMEa)
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