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Permit CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit #: PLM2009 -00333 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Da te Issued: 11/19/2009 Parcel: 2S112BB12200 Jurisdiction: Tigard Site address: 14090 SW FANNO CREEK PL Subdivision: Lot: 0 Project: Scott Project Description: Replace up to 200' of water line between meter and house. Owner: FEES SCOTT, ROY Quantity Description Date Amount 14090 SW FANNO CREEK PLACE TIGARD, OR 97224 200 If Water Service 11/19/2009 $100.06 PHONE: 1 12% State Surcharge - 11/19/2009 $12.01 Plumbing Contractor: JACK HOWK PLUMBING /RESCUE ROOTER P.O. BOX 2830 CLACKAMAS, OR 97015 PHONE: 503 - 235 -8784 FAX: 503 - 491 -2932 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $112.07 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: 4-nVitild QiQ J yr 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. NOV -48- 2009 16:43 P.001 Plumbing Permit Application Building Fixtures CEDE , ; Y a Li? i. ` ,, h0., MI( " � � a,�° ,. • �I �/ 1 i fs tRd!tt r g A. yi 1 y 4r ' City of Tigard IV� V � Rec.) S ?t 1% � ` a 13125 \U Hall H . f lgrr d , OR 97 2 ? �'� L�� r Dare:[3 PI W Permit No . /yn ' c ® PhonC: tn3.h; ;v.J 171 Fax: 5f 5 g RcucK VlJ ' Inspt:coon Line: 503.639 -I 1 7j CITY OF TIGAR ' 1C'g' caber Pcrmn N. !'l' R +F? , c Read. (3 wit Internet. www.tigard -or go6 BUILDING DIVISI O • licd'Mcthod I c 'j S tipC 2 for — ^" t� _ TYPE OF WORT( l S�PPlememai PaKc Information FEE' SCSI 'DULE ❑ New construction 1 ❑ Demolition For special lrtformariorr rise checklist IBT \ddi[ionlalteralion/replacumcpc Description Vtt. - ❑ Ot her: J_F:a rrttal New I.2- fantil dwellings 1 includes 1 nn 0 l■n. each unlit■ coimectioa i CATEGORY OF CONSTRUCTION SFR (I) bath 312.70 - 0 1- and 2- 11imil3 dttelling [] Commercial /industrial .... SFR t 31 bath 437.78 ❑ ,\ cossstry building 11 1 Multi- tamiln SFR (3i bath _ 501).32 `- 21 Muster builder , Each additional bath /kitchen 2 5112 -- d Other: Fitt sprinkler (�_ sq. t1.1 p — JOB Sin INFORNIATIQN AND LOCATI a E e ` Sit iltllitics: -- _ h,h sil,t tdrlrpc. .� ) Catch basin or dram ean 0 � o JU/ alr Y[C,� IR — C City /State /T..IP: el 2.Z Dr)'well, leach Inc. i or trench drain 18.76 r 4O Suite /bldg.iapt. no.: Project name: Q�� C Footing drain (no. linear ft.' 1 pass 2 - / " �' c Manufactured home inflates 50 113 Cross streetrdircctionc to job site: Manhole~ — 18.76 Rain drain connector 18.76 - • Sanitary sewer (no linear It.; -•. 1 Page 2 Storm sewer (no. linear tt.. i P age 2 Water service (no, linear R. j 2Ul . P ace 2 In0 . 01. tt: f Lot no - • Suhdivisio — — f Irturc or item; Tax map/parcel no.; Backflow pi 31.27 — - DESCRIPTION OF WORK Backwater valve _ 12.51 �� l >`r 0.6 - Clothes washer 25.02 LI)A-, :7 l .t.e' Dishwasher �CCx Yli.e LZ yLG� ,sue 25,02 It..g. -i Drinking fountain 25.02 Ejectors/sump 25,02 ,Q .PROPERTY OWNER • • 0 TENANT __ • Expansion tank 12,51 Name: tep y scerr- Flxture/sew cr Cap 25.02 ' Name: Floor drain/floor sink /hub 25,02 `- - /`fQ 7 5 64 I.1vv 1'4;84 7 Pi Garbage disposal 25.02 City /State /ZIP: /62474) AR, 9 7 1- X Hosc bib -- P hone: ( I �32 ll -1 L fax: ) 25.02 Ice maker 12.51 APPLICANT • © CONTACT PERSON — Interceptor /grease trap P 25.02 Business name: ARS dba JACK 1 ROOTER Nledtcal gas (value: $ } Pace, Contact name: JOYCE, DENNIS Primer 12.51 Address: PO BOX 2830 Roof drain (tximmerciall 12.5! Sink/basin/lavatory 25.02 City /State /ZIP: CLACKAMAS. 012 97015 Solar units (potable warm.) , 6...3 t Phone: (503) 850 -3100 I Fax:: 1 5031 491 -2932 Tub /show 12. er /shower pan 5 i. _ 1 E- snail: joyceru?jackhowk eom Urinal 25.02 • CONTRACTOli — Water closet 25,02 Business name: ARS dba JACK 1IOVl'K/RESCUE ROOTER water heater 37.52 Water pipineDw, r 56.29_ Address PO BOX 2830 Other - City /State/7IP: CLACKAMAS, QR 97015 ?5 02 Subto(a► OQ. o(o Phone: (503) 850 -3100 Fax; (503) 491 -2932 Minimum permit ice: $72.50 CCI3 Lie.: 127325 Plumbing Lie. no.: 34-168PB Plan review (25% of permit fee) Authorized signature State surcharge (I2 %of permit fee) (a t 6 _ TOTAL PERMIT FEE I name: �/ ! 1 .07 L - / j'/ �, � � � r t i ` �, 0 Gy This permit appl(catien expires it a permit is not obtained within 189 dins after it has hen accepted as complete - "fee methodology set by Tn- Coimtt Building Industry Service Board. 1,\ Ru ilding ∎fttinits,PLtal!.Pcrmi)App dac IWA I,x Please FAX PERMIT COPY to: 503 - 491 -2932 2- 06A 1 -kL)k_ P-06e- —