Permit ��,.: CITY OF TIGAR® PLUMBING PERMIT
74
COMMUNITY DEVELOPMENT Permit #: PLM2010 00194
'.T [ GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/15/2010
Parcel: 2S112BB04000
Jurisdiction: Tigard
Site address: 14500 SW HALL BLVD 102
Subdivision: Lot: 0
Project: Edgewood Manor
Project Description:
Owner: FEES
D'ORAZIO INVESTMENTS, LLC & Quantity Description Date Amount
HFR INVESTMENTS I, LLC, 4500
BEACONSFIELD CT 1 ea Water Heater 06/15/2010 $37.52
PHONE: 1 12% State Surcharge - 06/15/2010 $8.70
Plumbing
35 ea Minimum Fee Adjustment - 06/15/2010 $34.98
Contractor: Plumbing
UNITED PLUMBING
PO BOX 971
FAIRVIEW, OR 97024
PHONE: 503 - 752 -8446
FAX: 503- 491 -8671
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. :.0.332.2344.
Issued By: Permittee Signature: r
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 -11 -2010 06:40 From: To:5035981960 Page:2
Plumbing.Permit Application
Building Fixtures
00, .k FOR 01'1:1("E 1....i I'ONLY
City of Tigard 11° C too I 4 rued � l�/
0 13125 SW Hall Blvd., Tigard, OR 97223 .. Dal �' l'�' Permit No.; - ._q) ti e
: Phone: 503.639.4I7I Fax: 503.598.1960 ` � \ 1 1 , al
T l . ' : a , Other Permit No.:
(, I; I ' Inspection Line: 503.639-4175 U\V «� '
Internet www tlg+ard�r gov ,ry See Pa 2 for
t► 7 Supplemental Information
x
. 1` Gasa ;' x A� ; 4 ^ M *: TYPE` Oil !(?��ORl s . 1 s t ' ' I.EF ."CHEDULE .,i st yk:
❑ New construction ❑ Demolition \0,,, ' For s. cia! ' ormallon use checklist
Descri.tion 1 . Ea. Total
El-Addition/alteration/replacement ❑ Other: New 1- 2- family dwelli Is (includes 100 ft. for each utili connection)
3 .7 1. *r ' : (' TECQRY OFr Riletlb14 "•,.' SFR (1) bath 312.70
Q 1- and 2- family dwelling Commercial /industrial SFR (2) bath 437.78
El
❑ Accessory building ❑ Multi - family SFR (3) bath 500.32
-
Each additional bath/kitchen 25,02
❑ Master builder 0 Other: Fire spnnkler ( - sq. ft.) Page 2
° 1 „JOB S1TE' ; 'INF'ORkA•7` i:ii∎i AND LOCATION Site utilities:
Job she address: 1 ii c „-�
AL. `ate ■ Catch basin or area drain 18.76
�l� J Drywell, leach line, or trench drain 18.76
City/State/ZIP: - 1. -- ,- - . .. (?-j1 _ c17, �
Footing drain (no. linear fl.: _) MI Page 2
Suite/bldg. /apt. no.: l , Project name: -- - , • Manufactured home utilities 50.03
Cross street/directions to job site: Manholes
18.76
r I - Rain drain connector 18.76
r6 pe trl , ; _ • ZD 10 - p o p q. 1' Sanitary sewer (no. linear R.: ) Page 2
r Storm sewer (no. linear R.: Page 2
Water service (no. linear fl.: Page 2
Subdivision: Lot no.: Fixture or item;
Tax map /parcel no Backflow prevcntcr 31.27
, ;, , ii kritP'I'1ON OF wV01R(C a ,'' - x : Backwater valve 12.51
Clothes washer 25.02
_- A T -t/ g e e-,1
._1 / Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
IL' PROPERTY OWNEli ❑ I r
' r EIgANT'" Ex t ank 12.51
Name: Fixture/sewer cap 25.02
Address:
Floor drain/floor sink/hub 25.02
Garbage disposal 25.02
City / State/ZIP: Hose bib
25.02
Phone ( ) I Fax ( ) ice maker 12.51
APPLIC n y ti :CONTACT PERSON , ! In /grease trap 25.02
7 Medical gas (value: $ _ ) Page 2 MI
Business name: (/ c� -re rl 9 / r <vt ;,..9 Primer 12 -51
Contact name: sr., v Roof drain (commercial) 12.51
Address: 170 I - 3 0 yr q7 1 Sink/basin/lavatory 25.02
City /State/ZIP: -- - v - w - 70 , Solar units (potable water) 62.54
Phone: (50 ) 7 .. Fax; : (S o , ,; 1 6, , 7 Tub /shower /shower pan 12,51
E-mail. j C C7 t' () .1 t Y G e- 4' t ° i tT H2 �ri<•� -c j 1-� � 4,.- -r Wat i 5.02
Water closet 25.02
: ; Q , , , .- CiJN - 1'RAL 1'OR
:: water heater ! 37.52
Business name:
4 r- __. Water piping/DWV 56.29
Address: Other: 25.02
City / State/ZIP: Subtotal 37,
Minimum permit fee. $72.50
Phone: ( ) Fax: ( ) D ' "i ���
1 l� �im Plan review (25% of permit fee)
CCB Lic.: Plumbing Lie. no.: State surcharge (12% of permit fcc) ' 6. GI
Authorized signature: awl - ( 11 TOTAL PERMIT FEE : 61,)-0,
Print name: Date; (� t This permit application expires if a permit is not obtained within 80 1 days
_ _ ....1 .y 1 after it has been accepted as complete
*Fee methodology set by Tri -County Building Industry Service Board.
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