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Permit ` PLUMBING PERMIT CITY OF TIGARD COMMUNITY DEVELOPMENT Permit #: PLM2010 -00260 T I G A R I 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/09/2010 Parcel: 1 S134CB01000 Jurisdiction: Tigard Site address: 12495 SW SUMMER CREST DR Subdivision: SUMMER HILLS PARK Lot: 8 Project: BRUHN Project Description: (2) sinks, (1) shower pan and (1) water closet. Owner: FEES BRUHN, WALTER H & SANDRA LEE Quantity Description Date Amount 12495 SW SUMMERCREST DR TIGARD, OR 97223 2 ea Sink 08/09/2010 $50.04 PHONE: 1 ea Tub /Shower /Shower Pan 08/09/2010 $12.51 1 ea Water Closet 08/09/2010 $25.02 1 12% State Surcharge - 08/09/2010 $10.51 Contractor: Plumbing M D PLUMBING 939 SW WILLOWCREEK DR BEAVERTON, OR 97006 PHONE: 503 - 267 -3914 FAX: 503- 533 -2075 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $98.08 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. Issued By: • 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. f � y Plumbin Permit A lieati ,,. "` Building Fixtures I \ % 1 1 1 i,r( ,:z 1 1, r) City of Tigard �� �, z ltxeirat Pl • ■ , �DatdA p 10 / Pmmallo. • 13123 SW Hall 1314 1314 Tigard, OR 97223 T..4 ' t1 ';Plea Review ' . _• -; Phone: 503.639.4171 I'm 503.598 -19611 , [ ,:, . x �'t of ''Dataegy. Other PanwtNo.: lnt:peolion line: 501.639.4175 d o,. . 1 ∎ 11. 1 ) ; '' , Date Reedy/By. .h. 0 8w Pap 2 fur 1 I www-a8ard- or.8av A.t(k% VI" No( ediMeurod. 1 up Reades+.aaAInfoeamtIon TYPE OF WORK FEE* SCHEDULE ❑ New ctnatnxtiun [J Dmnolitinm For sperlalarforaeraiso weehtfet. Description 1 Qty. 1 Ea. 1 Total `I Addition/alterotoniroplacanatt ©Othlr New I_2-tmtlIzstne (deludes 100 ff. for =eh utilitvoameotian? CATEGORY OF CONSTRUCTION SFR (I) bath 312.70 © 1. end 2-Rustily dwelling 0 Cswrmtmoialfmduatrial SFR (2) bath 437.78 SPA ❑ Accry building C] Multi C 500.32 ca : Each adiStioeal tlnhlkitrhe 25.02 _ 0 Mnstcr builder ❑ Other Fite sprinkler (_ sq. It) Pngx 2 JOB SI'Z'E INFORMATION AND LOCATION r site utilities: Job site address: /b.'i • 5 S U/ c utiftvdr 60_,S4- d r Catch basin or area drain 18.76 City /Mato/ZIP: • ' 40 ,• rayMCn.Iweeh line. or trench drain 18.76 • L... . . v. Footing drsia (no. linear 11.: __) Page 2 Suite/bldg /apt. no.: Project name: t ic t', Manufactured home utilities 50.03 Cross stret l/difeetions to job ails :PW7r 3, S Manhole, 18.76 Rain strain awttawlnr 18.76 Sanitary sewer (no. lined ft.: ) Page 2 - Storm sews (na. linear R: ) Page 2 Water service (no. linear 9.: _ _ Page 2 Subdivision: 1 Lot no.: FistsewWait r Tax imp /parce uu.. ms's" 1e 31.27 • DESCRIPTION OF WORK I)aolcu 1251 • Clothes washer 25.02 /Q Y✓ CA , (2._) SAN Ks - I.h,1tr 4" - Dishwasher 25.02 Drinking raxgtldm Pjoctnrfi /sump 25.02 0 PROPERTY OWNER 0 TENANT i paaswm took 12.51 Name: Fixturc/eewer cap 25.02 Flax sbein/flaor sink/hub 25.02 Address: Garbage disposal 23.02 Ci s` LIP: Ilene bib 25.02 Phase: ( ) Far ( ) toe maker 12-51 ❑ APPucANT ❑ CONTACT PERSON Interoeptoi1groaae Trap 25.02 Dun in ooa mmna d P I b i Medioal Bas (value: S _ ) ) Page 2 1 Primer w 12.51 - Contact name we f L ` � S�'� -� /J Roof drnia (ooprmaial) 12.51 Addrma: de /4"/ v d- Siak/besia/bw mry ` L 25.02 ,V `{ ■ t i l l ibiii1 - ' ._ ♦ DAP _ /� Solar unit. (podble water) 62.54 !'hoed°:(Cy 247 -3y /y rare:( ) � 20 7$ 'TaWahvwerfahowerpa" 1251 1 E-mail: ,, Urinal 25.02 �y � Pv... K. Yet .. CC M water olosct 25_u2 t 4J CONTRACTOR Water heater 37.52 BulainM ream°: kid + 0 L., b; i k.:..._- %KW Dip�R�W V 56.29 Address. W 3 - 5L✓ t • me- - k `-^ te Other 25.02 any/State/LIP: L - _ A r to 6W / /fir saga' X37.67 e: ) 47_ Fax ('93 ).S' 3. ^ 2075 Minimum permit foe: $72.50 ; +''s. ,a, 1 • • r Plan review (ZS% of permit fox) CCB Lie.: st � J j �>• Lie. no.: _. 7 ! I Authorized signature: ' charge (12%of permit fee)„, " - i / C I 3r, . � - ll TOTAL i' Mrr FM - l 8r, 0 8' Print flame t- as stir , r l % �. /� 1bh gnash applintkis aspires If ■ desalt b axe added within 180 days aver it tau hen =aped as eaaptatw or *Fee methodology sat by 76-County gniWo6 lyd,.ny Service Tina t t:u1041/1 Faro Pl,MU- rim10App.doc Ip0WA9 440-4616f(1WD2RODM/W®) 2 /2'd 096T8ESEOS :01 :WONA 8t7 :22 0TO2 -1. -one