Permit CITY OF TIGARD PLUMBING PERMIT
IN
: : •:' COMMUNITY DEVELOPMENT Permit #: PLM2010 00257
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/06/2010
Parcel: 25111 CC04000
Jurisdiction: Tigard
Site address: 15990 SW CENTURY OAK CIR
Subdivision: SUMMERFIELD NO. 1 Lot: 63
Project: Thompson
Project Description: Backflow for irrigation.
Owner: FEES
THOMSON, NOREEN KAY TRUSTEE Quantity Description Date Amount
15990 SW CENTURY OAK CIRCLE
TIGARD, OR 97224 1 ea Backflow Preventer 08/06/2010 $31.27
PHONE: 1 12% State Surcharge - 08/06/2010 $8.70 .
Plumbing
41 ea Minimum Fee Adjustment - 08/06/2010 $41.23
Contractor: Plumbing
POWER PLUMBING CO
PO BOX 19418
PORTLAND, OR 97280
PHONE: 503 -244 -1900
FAX: 503- 244 -8825
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 ..y of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. ` ,
Issued By: > Permittee Signature: IN. �-�
SO. \�
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 completion of the project.
Approved plans are required on the job site at the time of each inspection.
AUG /06 /2010 /FRI 0912 AM POWER PLUMBING FAX No, 503 244 8825 P. 002
08/06/2010 08:59 50$5351544 TRFF CARE UNLIMITED PAGE 02/02
P uinb her mit A licatiof 0° - SS 6 Z
vow (0 I f(`! 1 til ()NIA. '
Building Fixtures
Received � P dmit • No.: +4/1-0. 1( j._O S 4
City of Tigard iS Date/By: ■ ��� v_
li ' 13125 $W Hu11 Alvd,, Tigard, OR 97223 Plan Review
Other Permit No,;
1 phone: 503.639 "4171 Fax: 503.598.1960 Dare/Bv:
- Inspe tl0nLinc: 503.639.4175 DtlaReady(nr
1 sperp�<3for
i! I?. ' I SaoMemexntl t retina
Internet: www.tlgard- gr,gov Notified/Monad: �
1VE'' 9i'd111t E •
For "col information rr a CAeCl
QN • . struotien ❑ Demolition Uaai. ' Nommlimpl Total
0 Addition /alteratioin/rcplacement . ❑ Other: New 1- 2- famlly dwellings includes 1001. fOr each unlit connection)
• silt(1)bath 112,70
' C co cQTtSTAUCTrt3N• — 437.78
'• ' - $FR (2) bath
and ?- family dwelling. [) Commercial/industrial $FR ( bath 500 .32 MOM
Cl Accessory building ❑ Muni- family Poch additional hnth/kitchrn MN 25.02
O MaStt:r' builder
❑ Mar: Piro sprinkler (__ 5n- ft) Pagc 2 MEM
JOu •si7'E• INIrOltMATION AND LOCX TO Catch haQOl or area drain 18,76
Job site address: '16 �� p V� 1 fly. Orywell, leach fine, or trench drain 111= 18 -76
• Pagc 2 Min
City /State/ZIP: ' ,. A QI -7 - - Footing drain (no, li ne a r ft.:
Suitc/bid4Japt. no.: id Prof CCt *MT"! I r Si, Ty1 Ma,nufsontrcdhome utilities MIMI 50,03 Mil
Manholes
Cross street/directions to job . 18.76
Rain drain connector
Sanitary sewer (no. linear 'ft.: ) Page 2
•
.._ - Storm sewer (no, linear El: ) Pagc 2
water corvine (no. linear ft.:) Page 2
Subdivision: Lot no_ P xturc or item:
- Backflow prcvcnter 31.27 7/.71 - .
Tex map/parcel no.: Aaekwater valve 1251
' . .• DeSCRIPT191 •WORK • • • ' Clothw waSher 2502
Dishwasher 25.02
Drinking fountain 25,02
~ Ejectors /sump 25.02
• . : : i :. 0 : p1•d IV - '' : J ' .. anion tank . — 72.51
-
TL1Q�41' ..
" Expansion
— c - ureacwor -cep 25 02
Name: a g w* .. Floor drain /floor sink/hub
—�-�^ 25.02
Address: .. + • 0 4 .. ' . Q � `•- - -� ' - ' Garbage disposal MI
City/State/ZIP: . �11f+ oz., `'3� Hoschib ' 25.02 —
Fax: ( ) .Ice maker 12.51
Phtmc: ( ) 2,5,02
APPLi<iCA1V'I - • _ -• 1:1' "i�Ntil�'•.f?'S1280N . . • - lntcrourtor /grcasotrap Mil
- . . • Medical gas (value: S _ ) Page 2
Business name. \ • • 4' 1. • • • Primer r
Contact name: . .1%.._ _ . .1 _ . Roof drain (commercial) 12,51
Address: ea ( 'e-_5 cam(_ t �p to (1,,, • , ntlb. * Sink/basin /iavatory 25.02 ME
2 , .. 2 _ . _
r • i7 Solar units (potable water)
City!$tate/7tP�A„_ �lr ��+�•� �.� 12.51
, Su Tub /showedshowcr pan
Phone: { ems) ° � Fax:: ( -� ,
r A G, Urinal ��
}✓•mail: S�n0N1R p1{ 1 C ( U 4 �`� Water closet 25.02
C UNTRACJ OR' , , • Water M ater 37.52 N
Business namc: 1i dai l ..LL . g • D . Water piping/OWV •
1 (
pa I Other, %5.}12 1‘
Address: / gQ� _i / - Subtotal
•
City /Stata/ZIP: do 4..,,,_.,„_ Minimum permit fee: 572.50 NM
Phone: (sA 3) �— ��� Pax: ( a5 ) 42 ��� Plan review (25% of permit fee)
Plumbing Lie, nn.: f.�- -/ ' ',
_
... 1-ic 523 stets .rehPr (1256 of permit ) , .
TOT
AL PERMIT FEE •,' g .Z 0
pnthori7.cd signature: �
1f * n p () This permPr application tq,irce it a permit is not obtained n•ithin 180 tar*
b L ! e prtrr it ham been scccpted nn connp1ct
Print name: . methodology set hyTri- county 1}anding t*nusrry •cn,ce hoard.
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