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Permit a CITY OF TIGARD PLUMBING PERMIT '� 2 COMMUNITY DEVELOPMENT Permit #: PLM2010 -00270 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/18/2010 TIGAAD'' Parcel: 2S111 CCO5100 Jurisdiction: Tigard Site address: 15930 SW CENTURY OAK CIR Subdivision: SUMMERFIELD NO. 1 Lot: 74 Project: Gander Project Description: Water piping and 40' of water service. Owner: FEES GANDER, PAUL & MARIA Quantity Description Date Amount 15930 SW CENTURY OAK CIR 40 If Water Service 08/18/2010 $62.54 TIGARD, OR 97224 1 ea Water Piping 08/18/2010 $56.29 PHONE: 503 - 620 -6831 1 12% State Surcharge - 08/18/2010 $14.26 Plumbing Contractor: CASEY'S PLUMBING PO BOX 30075 PORTLAND, OR 97294 PHONE: 503 - 253 -0030 FAX: 503 - 262 -8251 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $133.09 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. By: , / , - Perrnittee Signature: o ��L /�t� / fr i Issued B / �., i 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. CITY OF TIGARD UMBING PER IT a COMMUNITY DEVELOPMENT Permit #: PLM2010 -00270 T [ GA R. D, 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/18/2010 Parcel: 2S 111 CCO5100 Jurisdiction: Tigard Site address: 15930 SW CENTURY OAK CIR Subdivision: SUMMERFIELD NO. 1 Lot: 74 Project: Gander Project Description: Water piping and 40' of water service. 8/25/10, adding (2) tub /shower valves. Owner: FEES GANDER, PAUL & MARIA Quantity Description Date Amount 15930 SW CENTURY OAK CIR • TIGARD, OR 97224 40 If Water Service 08/18/2010 $62.54 PHONE: 503 - 620 6831 1 ea Water Piping 08/18/2010 $56.29 1 12% State Surcharge - 08/18/2010 $14.26 Plumbing Contractor: 25 da Plumbing Permit 08/25/2010 $25.02 CASEY'S PLUMBING 3 da 12% State Surcharge 08/25/2010 $3.00 PO BOX 30075 PORTLAND, OR 97294 PHONE: 503 - 253 -0030 FAX: 503- 262 -8251 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $161.11 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' • - - •ended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility N. [cation Center. •os- • les are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules or dir: t questions to OUN • ' calli g .246.6699 or 1.800.332.2344. Iss ed By: IL . " Permittee ignature: ffi, e Call 503.639.4175 by 7:00 a.m. for an inspection that • • siness 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. Rug 17 10 01:18p Case's Plumbing 5032628251 p.l Plumbing Permit Application r, fl u Building Fixtures ,? ` t Olt Or U C L i ,s> C} 1 � < City of Tigard 1 2Qti0 Davy f /e / n / - Permit Novo o /D ��2 0 13125 SW Hall Blvd., Tigard, OR 972 .., - Plan Review Phone: 503.639.4171 Fax: 503.598. 60 - t . t /, r' CAD Date/By: Other Permit No.: ` Inspection Line: 503.639.4175 ` ; ; 6 1 . 1 t o � � Date Ready/By: r See Pa e 2 for -n r InterInternet: www.tigard- or.gov / x _ 0 , , f °.. '' % , Notified / Method: f [ !7 Supple mental laformaHon TYPE OF WOltY0 t ' FEE* SCHEDULE ❑ New construction ❑Demolition For special infonnalion use checklist 7/4 Description 1 Qty. 1 Ea. 1 Total ddition/alteration/replacement ❑ Other: New I- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 4 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 437.78 Accessory building ❑ Multi family SFR (3) bath 500.32 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: 1 J6�Q 9 S �� c P y -,4,,,,,- 6ake _fde Catch basin or area drain 18.76 D rywell, leach line, or trench dram 18.76 City/State/ZIP: y ��i 1_�e ' -' N � Footing drain (no. ling ft: ) Page 2 Suite/bldgJapt. no.: Project name: (9"/A 6 Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 r`r 1( Ot. Cy l.f „ , S b. Rain drain connector 18.76 � ` 1J Sanitary sewer (no. linear R: _,J Page 2 Storm sewer (no. linear ft.: ) Page 2 Water service (no. linear ft.: 9 _ Page 2 6 ,2 ,S/ Subdivision: l Lot no.: Fixture or item: Tax map /parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 A A ar,r1 a l A S to Dishwasher 25.02 Drinking fountain 25.02 Ejectors /sump 25.02 ROPERTY OWNER // ❑TENANT Expansion tank 12.51 Name: �y�, (\I\ Q l \ L J_�Q t."t a V Fl re/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 1 Q l d 1 ( r „"\- 3o Gz-rdSL Garbage disposal 25.02 City /State/ZIP: \ �. A t � 0C\ QOf Hose bib 25.02 Phone: (%) ( p,)0 - t ?7' Fax: ( ) Ice maker 12.51 ❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02 Business name: Medical gas (value: $ ) Page 2 Primer 12.51 Contact name: 0 CASE 2 (commercial) Roof drain (commercial) 12.51 Address: Q , ` 1K --- 5 Sink/basirdlavatory 25.02 City / State/ZJP: ��-�,�� a t () c -, L Solar units (potable water) 62.54 Phone: (..1_) a /6?) - x� -} Fax: : ) a i _ $ 6 ' Tub/shower /shower pan 12.51 E - mail: r t ,,� A ,A- (I) .�e P° , C Cr ,� Urinal I 25.02 CONTRACTOR water close[ 25.02 /► �� ^� Water heater 37.52 C Business name: -- (.LSe( j"k&AYVZ\}tv1 . Waterpiping/DWV t 562 S -6 9 , ,z9 Address: ' (1 _ y ` CE-1 S Other. 25.02 City/ State/Z1P: r4-- IrA. r °f 2-9 c4 Subtotal , / /g-, 33 Phone: ( V r.J� a � _ c )(Rj Fax: (2 Q loa- '` \ Minimum permit fee: $72.50 Plan review (25% of permit fee) CCB Lie.: ) L\- N r 53 Plumbing Lic. no.: at =}Z State surcharge (12"/ of permit fee) /If, 2 6 Authorized signature: (t c ciQ �� A ff-HGt l TOTAL PERMIT FEE /33 Print name: `) ( O 1 e 4_ tA t r .1- k e Date: D -- ( - tO This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. l'C f "Fee methodology set by Tri - County Building Industry Service Board ` 11Building \PermitsWPLMU•PormitApp.doe l0/01109 440- 416T(10/021COM/WEtt) 1 /-,_'_s -1-", Plug 25 10 11:07a Casey's Plumbing 5032628251 p.l 4_J — = AUG 25 JI _ PL UMING _ AUG 25 2010 CITY b OF BUILDING To: e,�m ( From: i tote, - - Fax: � � � �f ' (�.f� �l Pages: Phone: Date: Re: CC: 0 Urgent 0 For Review 0 Please Comment 0 Please Reply 0 Please Recycle 0 Comments: a_ mhocvc).__ \3 a ve_ wh s hy 1, /e a@ ta•s 5 0� 4 9 a g . P.O. Box 30075 Portland, OR 97294 Phone (503) 253-0030 Fax (503) 262 -8251