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Permit CITY OF TIGARD PLUMBING PERMIT xi : COMMUNITY DEVELOPMENT Permit #: PLM2010 00391 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/21/2010 TiGAR D Parcel: 2S110DCO2300 Jurisdiction: Tigard Site address: 11535 SW DURHAM RD C -5 Project: Genlog Subdivision: Lot: 0 Project Description: Adding (2) lays. Contractor: ANCTIL PLUMBING INC. Owner: HIP WILLOWBROOK LLC 16900 SW MERLO ROAD BY TAX DEPARTMENT BEAVERTON, OR 97006 -0000 PO BOX 2708 PORTLAND, OR 97208 PHONE: 503 - 642 -7323 PHONE. FAX: 503 - 642 -7755 FEES Quantity Description Date Amount 2 ea Lavatories 12/21/2010 $50.04 Specifics: 2 12% State Surcharge - 12/21/2010 $8.70 Plumbing Type of Use COM 22 ea Minimum Fee Adjustment - 12/21/2010 $22.46 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 Notification 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 direct q ons UNC by � c /i a / l / liing 503.232.1987 or 1.800.332.2344. Issued B re Y � � � A . / / Permittee Signature: ,- . - ,. (C/C74:1__—/----- 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. Plumbing Permit Application « Th '��� f 3-0�2� Building Fixtures FOR ()FIR: . li L.SI.: ONLY Si City of Tigard Received II til 13125 S W Hall Blvd., Tigard, OR 97223 Date/By. ht AIRWIRIFIL / • `0 - Q • R Phone: 503.639.4171 Fax: 503.598.1960 Plan Review ,ate/By Other Permit No.: Inspection Line; 5036394175 IG A . .. Pa 1 . I7 C Date Rea /B Internet www tigard -or goY y g 2 for : 1 a Notified/Method: @ed/Mdhod: Bu , , icane C rY i �..7 l 7 � t` {i�' �1 [I 4 t1 d ' . i -. ; s t r. �, � 1 C�� l" 4 Jf WfL^ni �p y ,r r3 +in 1i . 1 , tr , :-ff�idtr fi 1 1 ` f G 1 l f � 1 �� 1 � i f . f , v •r1 v f ,, 1 -., >e sb . , n : d, i,u 1 . To n, � i I i Y,. 1 h 4 .� ,... i t . 'I l t6 ? l it , ; #� . i 31' a {rt rEl, 41n, 1 ] � v .. 11a. . ,,rl rl, 4 ron rtaklut:u rr S 1 ,eri ' 9 i. Mai : f, :,, ❑ New Construction ❑ Demolition :1 For ormatlonusechecklist J mill • dditlon /afterat)on/replacettteat © ' �Q� Dcscri ay Ea, Mtn) 1S New 1- 2- family dweJJin • s includes 100 ft, for each utility r'"' r +fil 1 o'i E i c' ark �r tt�lNr t+y��� 711 f C r�'•� 1 + ;� ty cOntteCtlOa ) !1,1 1 3r! ': / , 301t,, 1 x ..t 4 ` iS:t wi, ' `.i SPR(I)bath NM 312.70 RI 01- and 2- family dwelling /' ottttnercial/industrial SFR (2) bath 437.78 ❑ Accessory building III Multi-family SFR (3) bath X}0.32 0 Other Each additional bath/kitchen ❑Master builder le ft.) Fire sprinkler ( sq. ft.) ,'s, +i r � !''G I! i `i ' r 1 1 r'i rill' r ' Y e A 1 ' ` r i +.f„ : ,v Ri , ,: �, a r91ri1l3itE'� ;rltdl��'���etctlaC�¢G d �o� Site utilities: Job site address; 1 1 5, j. ( ,,v ') we. , a r • 4 Catch basin or area drain _ � City/State/ZIP: Drywall, leach time, or trench drain Footing drain (no. linear ft: ) Suite/bldg,/apt. no.: Project Warne: ' — ' r C Ivlanufacturcd home utilities 50.03 Cross street/directions to job site: LIM Manholes 18.76 Rain drain conneetor Sanitary sewer (no. linear ft.: Stnrm (no. linear ft.: _. ) Page 2 M. Water se sewer rvice ( no. linear ft ; ) Pagc 2 Subdivision: Lot no.: Fixture or item: Tax map /parcel no Back low preventet j �l !' {j''Il i dir , 1 j!Il [ Y' YSl E 3? Y !I!,Ill4ig i r1, a f ' C S . ;l 1rg f3tt i liti wawa r tI,, Y }. r r' i1 '� t {l ttj! f Backwater valve W Ai,1.f1�71�a1ttRWt Aikt £t lWa I It it li m, T iu�i'.f r. �� 1 �3 �� Clothes washer 25.02 ME Dishwasher 25.02 Prinking fountain 25.02 ME r Ejectors/sump 25.02 S ?, trp.{,n ``t> 'g 3 J !TSPF .: �S !i }t�t��m Expansion tank � MIN �,rt { rf. , l aad{ lei ,,x,�' l `Eat HISS :r 1 d1 , « t,� Pdcil s �. 3l E ,lYjj i •t "G e r Fixture/sewer cap M 25.02 M Address: in • .ibov Floor drain/floor sink/hub 25.02 t, Garbage disposal 25.02 MIMI City /StatelZIP: � -�1K Hose bib IIII. 25 MEM Phone: ( ) M r j► I Ice maker �� i ! afs i i i;: . 4.f � r 3 �kt lf a a li r" p 2 - ,& .,, co f.. f �, s } t s �'' � , 4 { - �� s t � � � � '� � Interceptor /greas trap i .� �� � Eat a r t;,f i S,tilst�tl�rct�,1;:9„ 5.02 Mil Business Warne: Medical gas (value: 8 ) MIMI Page 2 Contact name: Primer Address: Roof drain (commercial) ' Sink/basin/lavatory --- 2 0 • City /State/ZIP: Solar units (potable water) 1.11 62.54 Phone: ( ) 1 Fax :: ( ) Tub /shower /shower pain 12.51 - Email 1 25.02 `, ,,,N',;'', '/,1r1r,iL,1lllf4i Ir {, }r S iv i, MATS Pr � p'i tr ? } ri4' ! WaterclOSet ME 25.02 ii � r l t r ,r i 1i i, f j II' r � • Business name: / C �L / 1111.111123. Water heater Water piping/DWV 56.29 Address: dg (] [) (A " 6 f 60 a' Other: City/State/ZIP: ' 2 �- `. • Q Subtotal Phone: , i ) ax: (3.)3) , 11 — Minimum permit fee: $72.50 ler CC13 Lic.: $ Plumbing l ic. Plan review (25% of ponnit fee) MO .Authorized signature: �..�,� State surcharge (12% of permit fee) G. e. / TOTAL. PERMIT FEE 53 ( ' ar Print name: d I.Li r• L , Dom. 6 �_ ! L 1 Tbis permit application expires if a permit is not obtained within ISO days 6 after it has been accepted as complete. *Fee methodology set by Tri -County Building Indughy Service Board, t; Buildirr glrerinitslPC PilmltApp.doc 10/01!09 440.4 616'r(10/07JCOMtM e)