Permit 14 ; CITY OF TIGARD PLUMBING PERMIT
' COMMUNITY DEVELOPMENT Permit #: PLM2010 00264
T t G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/12/2010
Parcel: 2S112BC09500
Jurisdiction: Tigard
Site address: 8063 SW VIOLA ST
Subdivision: Lot: 0
Project: Lien
Project Description: Shower pan.
Owner: FEES
LIEN, ROBERT A/CATHERINE L Quantity Description Date Amount
• 8063 SW VIOLA
TIGARD, OR 97224 1 ea Tub /Shower /Shower Pan 08/12/2010 $12.51
PHONE: 1 12% State Surcharge - 08/12/2010 $8.70
Plumbing
60 ea Minimum Fee Adjustment - 08/12/2010 $59.99
Contractor: Plumbing
TROY ELLIOTT PLUMBING
PO BOX 1958
NORTH PLAINS, OR 97133
PHONE: 503 - 309 -5750
FAX:
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 • • • e rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -01 -0100. Yok may o ain a copy of 'e rules
or direct questions to OUNC by calling 503.246... • • •
Issued By: / Permittee Signatu '_
/
CaII 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 completio • of the project.
Approved plans are required on the job site at the time of each inspe ion.
Plumbing Permit Application _
Building Futures
� VD'� 6 ,` CRA � It I` T1I - lti( () r f1rflt. iI A " ' :
a City of �Tigard Received
• ® P ermit No.: / 1 O -00 L
,'',
r ) y ° '' c 13125 SW Hall Blvd., Tigard, OR 97223 \ , � Date/By:
Plan Review
0 ' . Phone: 503.639.4171 Fax: 503.598.140s) ' �G�� � � Plate/8y: Other Permit No.:
s
w, « s, Inspection Line: 503.639.4175 0� l � Date R eadyBy: Juris: ® See Page 2 for
fy I'Cr U
: ,�,ti Internet: www.tigard or.gov C �� �
�, � � i Notified/Method: TJXD Supplemental Information
TYPE OF WORT . �0_, FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist
Description I Qty. I Ea. 1 Total
X Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 312.70
W - nm
and 2- family dwelling ❑ Corercial/industrial SFR (2) bath 437.78
SFR (3) bath 50032
❑ Accessory building ❑ Multi- family
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 8063 SW Viola St . Catch basin or area drain 18.76
Drywell, leach line, or trench drain 18.76
City /State/ZIP: Tigard, OR 97224 Footing drain (no. linear ft.: ) Page 2
•
Suite/bldg. /apt. no.: I Project name: / / e„ Manufactured home utilities 50.03
Cross street/directions to job site: ' v Manholes - 18.76
Bonita to 81st to Viola St. Rain drain connector 18.76
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Water service (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map /parcel no.: Backflow preventer 31.27
Backwater valve 12.51
DESCRIPTION OF WORK
Clothes washer 25.02
Install new shower pan Dishwasher 25.02
Drinking fountain 25.02
Ejectors /sump 25.02
X PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Fixture/sewer cap 25.02
Name: Bob and Cathy Lien
Floor dram/floor smnkfhub 25.02
Address: 8063 SW Viola St. Garbage disposal 25.02
City/State /ZIP: Tigard, OR 97224 Hose bib 25.02
Phone: ( ) I Fax: ( ,�,/ ) ice maker 12.51
APPLICANT gI CONTACT PERSON Interceptor /grease trap 25.02
Business name: Medical gas (value: $ ) Page 2
Doug Ziebart Construction, Inc.
Primer 12.51
Contact name: Doug Ziebart
Roof drain (commercial) 12.51
Address: PO Box 80402 Sink/basin/lavatory 25.02
City / State/ZIP: Portland, OR 97280 Solar units (potable water) 62.54
Phone: ( 503) 307 -4114 Fax: : ( 503 245 -5433 Tub /shower /shower pan 1 12.51 12.51
E -mail: zbart3 @comcast.net Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: Troy El:liott.:Pl',umbing Inc. Waterpiping/DWV 56.29
Address: PO Box 1958 Other: 25.02
City/State/ZIP: North Plains, OR 97133 Subtotal 12.51
mimic( 503) 309 -5750 Fax: ( ) Minimum permit fee: $72.50 .) ). , S)
Plan review (25% of permit fee)
CCB Lit .: 152130 Plumbing Lic. no.: 34 -402 PB State surcharge (12% of permit fee) . 7 U
Authorized signat .: 4 �I . 1 � TOTAL PERMIT FEE �. 1 ,
Ell' ott T Date: 8/9/10 This permit application expires if a permit is not obtained within 180 days
Print name: Troy y after it has been accepted as complete.
*Fee methodology set by Tri-County Building industry Service Board.
1: \Building\Pe mits\PLMU- PennitApp.doc 10 /01/09 440.46)6T(10/02/COM/WEB)