Permit ''T. CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2010 -00389
13125 SW H all Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/14/2010
T1�ARD Parcel: 2S114AB05000
Jurisdiction: Tigard
Site address: 9420 SW MILLEN DR
Project: Carson Subdivision: KNEELAND ESTATES Lot: 37
Project Description: Replacement of 60' of water service. Note: Electrical permit may be required if replacement piping effects house
grounding.
Contractor: METICULOUS HOME SERVICES LLC Owner: CARSON, KELLY A
12518 NE AIRPORT WAY, STE. 148, #343 9420 SW MILLEN DR
PORTLAND, OR 97230 TIGARD, OR 97224
PHONE: 503 - 208 -2812 PHONE.
FAX: 503 - 208 -2813
FEES
Quantity Description Date Amount
60 If Water Service 12/14/2010 $62.54
Specifics: 1 12% State Surcharge - 12/14/2010 $8.70
Plumbing
Type of Use: SF 10 ea Minimum Fee Adjustment - 12/14/2010 $9.96
Plumbing
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 Noti *.4 Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or dir questions to DUNG by calling 503.232.1987 or 1.800.332.2344.
I sued By: / C A „ n n— `''L Permitte• ignature:
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
12/14/2010 07:57 FAX 503 208 2813 METICULOUS HOME SERVICES C1001
Plumbin Permit A I" ationl
•
Building Fixtures . 1 t12 it! 1 ii l -..1 4 11
City of Tigard Received
13i23SW Hall BIvd., Tigard, Qlt 1 4 2010
t : iz /V /0 PenaitNg. A Gil 1oto -06
Phone:
Date/13 : 503.639.4171 Fax: 503.598,1 pi view i ()tint permit No.:
inspection Line: 503.639.4175 CITY OF TIGARD 17ateReedy/Ry: °—
Unmet Rww.tigsrd (>r.g v ( Se‘ Page 2 for
Notified/mathod; So. -•• -• Ail Information a. TYPE OF ' ri : w ii 7 1 T V FEE* SCHEDULE
d New construction 0 Demolition Per ., . , etwoxtl'o,rusecirelctllst:
•
L' Additial /eiteralion/t�plticwnent p Other T Descri,tion •�y� Ea. Towl
Nee 1- 2•fitmkdwellln}tx (includes 100 ft. for cant, mill connection)
CATEGORY OF CONSTRUCIIINI ._._. _ SFR (1) bath 312.70 ME
145 1- and 2-family dwelling C Commercial/industrial SFR ( bath 437.78 MI
. .. . - __... (
SFR 3
p Accessory building 0 Multi- tit,mily - (3) ' 500 32
Each additional bath/kitchen 25.02 EIMI
p Master builder' p Other. Piro sprinkler P (.,..,....,, sq. ft.) 1.11121a :
JOE STYE INFORMATION AND LOCATION Site ad litka:
Job site address; a (' ' 0 . g -, �L
Catch basin or area drain
t $,76
City/State/7,1p: '7 i _ Dr'yweil, loth line, or trench drain 1.8.76 .
c ,,,• , , 7� )
-- t, _2o r �/ - � .. Footing drain (no, linear 8,: r 2
Suitc b!dg, /apt. no.: - Project name: (7 , ,.-.2 Manufactured home utilities 50.0 •
.
,,e,_). street/directions to job site " � 'YY_, D ) � �' - • b,e -Manholes _
1$.76
� .. - _ Ram drain connecter w l $, 74
,
_ Sanitary sewer (no. linear ft,: ) Page 2
Stonn sewer (no. linear lt.: , ) Page 2
Water soivicc (no. tinesr It: ♦ MN Page 2 r-
Subdivision: - ` Lot no.: Fixture or item: _
Tax map /parcel no.: _ - , Backflow prevcnttx
AE.9Ctti rnoN of weld( _Ileckwatcr valve
— 12 51
- Clothes washer 25.02
/ C Dishwasher _
II
25,02
. - - Drmnkimg fountnin .,.,..,, -.. 25 .02
Ejectors/sump 111111 25 -
•
ROPERTV OWNER Ca TENANT Expansion tank 1 x.51
Name: .k L a .._ Fixture/sewer cap 25.02
Address: c•? Floor drain/floor sinir/hub 25.02 MI
..I L1!' ,2 6 S-t .0 U_ '1 i 1 1 .i'�') (3arbege disposal Ell 25.02
L'ity /v3tete2TP: 1 • , 410 � Bose bib . 25,02
Phone: ( ) Fax: ( ) la maker
❑ APPIX:ANT 0 CONTACT PERSON Intercepter /grass trap 25.02
Business : n MIE is 1 Medical gas (value: $ ) IM 12.51 M.' Contact nwrie: 1 - 4 as 1 , / a Printer ....
�G R 12.51
Address: ft: G 1 Roof d ra i n (co nvner c i a l ) in !
MN
' /*� "� •
/� t. 4 . A. „-
Sink/basin/lavatory 25 2 ,51
City /State/ZIP: ( C 1 (" e' S r..\ `L t; Solar units (potable water) 62
Phone: ( 0 ) 1� x i 2 J Fax: `L7 ) _ 3 Tub /shower /shower pan , 12. 51 -
E 0 ' it Ls , . Cr, Urinal - 25.02 111.11111 ;
- Water closet
CONTRACTOR 25.02 iii :
livainass tlarll0• ---- --- --
: N\ 4 � . 11..? Water heater 37.
' '
c� water iliping/Dwv 56.29
Addtcs$: j) - A J c. i' f d. 1 F
t,.J 4 s L } other; 25.02
City /State/ZIP: p ** f ' a i -7 - p _ Subtotal Magri P (5 ./ i ; l , _ Fax: ($4 '3. ) ..0 q( ,- _ Minimum permit tae X72.50 a
CCI3 l.,ic.: •
j 4 1., Plumbing Lie. no.: j - . - „_ ^. -, Plan review (25% of permit fee) .
State surnlwrgG (12% of permit fee)
Authorized uilgaature• TOTAL PERMIT PEE 'spa
•
Print Hama: - Date: This perndt appticatio,b expires If a p.rwa 1* is not ebtaieed'vrithin 190 days
atter It >rna been accepted as complete.
"Fee methodology sift by Th- County Building Industry Service Dowd. '
I:\ nwidateeormitalFLMU •PemitApp.d twoo09 440.4616ToasUIC0M/wEB)