Permit CITY OF TIGARD PLUMBING PERMIT
�''!' : COMMUNITY DEVELOPMENT Permit*: PLM2010 -00240
71C.rAkb 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/23/2010
Parcel: 1S125DB08300
Jurisdiction: Tigard
Site address: 7230 SW SHADY CT
Subdivision: SHADY DELL Lot: 56
Project: House
Project Description: Replace water piping only for (2) baths (not replacing fixtures)
Owner: FEES
HOUSE, ROBERT & Quantity Description Date Amount
7230 SW SHADY CT
TIGARD, OR 97223 1 ea Water Piping 07/23/2010 $56.29
PHONE: 503 - 297 -3132 1 12% State Surcharge - 07/23/2010 $8.70
Plumbing
16 ea Minimum Fee Adjustment - 07/23/2010 $16.21
Contractor: Plumbing
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 $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:
Call 603.639.4175 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.
J1JL -21 -2010 17:51 P.001
Plumbing Permit ApplicatiO
Building Fixtures •..OR r
2 2 JUL FI(_F. U SL O I i , 033 2Q10 0,
`'' Cih' of Tigard �.JUL li..ti�„�•a
a 131'_5 "• BallIsI,J I ,�drJ'd; 1' Plan
. a .. h, 03 •I) 71 I - a• ,n;„ .OF TIGARD { Rhvr f unn„ T ;.,
rn< B,
Inspcitn.nl. 5111 e 11' BUIL DIVISION > 5eePdeelfa
T l l t R Ll, Ddt< Rcadt'H
.. Internet „Nn.Urard•orgot td.,nlicd'Nethn,l / I 1 S .
Supplemental lnfnemrr,un
l --- TYPE OF WORK FEE* SCHEDULE
❑ Nos con5trircli. •n El Demol Demolition For special inArmmian use cGeckiist
_ .... - - -- - -- DcSert con _' nv fa_� Foy_
0\dJi1I011i tltcraI 1.m'rrplait nicnt ❑ nlhcr: Nos 1 - 2- ram4l} detains c initIoJc: IUn 1) I .r each unlit), i,.nnc,,tumn
CATEGORY OF CONSTRUCTION SFR 111 bath 312 m 1
Xf 1 -and 2•tvuil, dttel)ing [D Comm ercial!inJustri:il -J-R r_I bath _• 437 7 R
S FR 131 bath 5111)32
❑ ,1coc� n w huildinc E] Multi•family -
Each additional bathtl.nchett ...1)'
El Master builder ❑ Other.
Fire sprinkler i ).q 11.) -. t•;tA� :
JOB SITE INFORMATION AND LOCATIO Site utilities;
4.1\ site adJrass. 5. Tr' /11 Catch basin , >r area dram 18 7r) >
j�-y f)nutll. leach laic. , u trench drain � 18 71
Cit.y!Stnh21P ' 7 ^ / `'� !r - -- _ • 1
w �- Farting dram too. linear H.. Wupc
5uite'bld .•;tpt. n Project carne nlanutaoturcd boats utilities $Ii trt
1- rev . sir�ii•Jire red inn: to „h silt' ) nlanitm — IK 7r■
_— �..— Rain drain connector - 18
.7n
_- 0000..._ .:..._._........ .- . - - -...
Sanitary sewer (no. linear (t,' I I'at e 2
Storm sewer tnO. lineur H.) p 2 ...
- Water can Icc (no. )incur lt.. 1 Page 2
Sui+Jivi;i,)n: 1 1r 1 n„•: Fixture Oritem _ .. -
Back flow map/parcel no.:
11i w precentor - .
DESCR1i�l IOIY� O[i WORK — Backwater valve I 3 127 12.51
�
7 iFi L t wushcr , P� 'S.0' � �/
/-• /r �/r ..�/ r
/ r I '.' ', -7-7' _ Drshttasher ';,U2
1 ce . i ZIV • •o ,� Drinking fountain _ _'S.fh
v � /V 1 / � L •tectors ' sump ^ 255.D2
FA . PROPERTY OWNER El TENANT r. Expansion tank - 12.51
Name: Rene y c- Pt vture,'se cr cap 25.02
:Address: 7 ' �.
/' /!_L - Floor drain /t1 ,r oor sink/huh
C:/!
Garbage disposal 25.02
„ .02
"-�
City /Stale/ZIP: 4747.- 1-lose bib � -. 2 Mit;
2 . .02 ,
Phone: ( %/ o l,� _ax: l ) Ice maker 12 ,1
F. APPLICANT D CONTACT PERSON Interceptor/grease trap El 25.02
Business name RS dha JACK HOWK/RF.SCUE ROOTER Medical gas (v alue. $ ) Page 7.
Contact name, JO1•CE DENNIS Primal 12
Roof drain 'commercial) NPR 12,51
Address: PO BOX 2830 r
Sink/basin/lavatory / ' � i
1: ity /State %Z[1': CL:4ChA \[.4S, OR 970)5 _ Solar WAS (potable water) .2 54 MEI
Phonc: (503)850-3100 FON::1503) 491 -2932 Tub /shower /shower pun 12.51 errs
r
E jvyccta jackhuwk,curn Urinal 25.
Water closet r 25 - -9,r — A/
• CONTRACTOR • •
• Water heater 37.52
Business name: ARS dba JACK HOWK/RESCUE ROOTER � Rater pipingruWV - 56.29
Address: PO BOX 2830 -- Other; 111.1 25,02
City /State /Z1P: CLACKANIAS, OR 97015 Subtotal P ' ?
I Phone: (503) 850 -3100 Fax: (503) 491 -2932 Plan review 1.25 a of Minimum permit fee: 572.51)
CCB Lie.: 127325 Plumbing Lie. no 34 1G8PB permit fee . r
,___--L—
State surcharge 112%ofperm r/; ' _ ` 1.'
Authorized signature: j .r _ TOTAL PER ml ilzm
Print name: i� /l �l f1 Da . 1'hu on expires if a permit is not obi: wi in 81 da
attar een accepted as complete.
"Fee methednlngv se Bo
t by Tr- 'minty Budding Industry Serve Board.
1\13, 0r d6,g• Permn:lppdnc ,0,1"0.0 PIPacP FAX PF.RMIT c op : 503- 491 -2932 0 /i 62-0