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Permit CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit #: PLM2011 -00011 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/13/2011 Parcel: 2S112CA11300 Jurisdiction: Tigard Site address: 7755 SW ASHFORD ST Project: JENSON Subdivision: RENAISSANCE WOODS Lot: 39 Project Description: Master bathroom remodel. Contractor: NORTHWEST CENTRAL PLUMBING CO INC Owner: JENSON, DARYL V & BARBARA A 2870 SE 75TH AVE # 206 7755 SW ASHFORD ST HILLSBORO, OR 97123 TIGARD, OR 97224 PHONE: 503 - 642 -2067 PHONE. FAX: 503 - 642 -5954 FEES Quantity Description Date Amount 2 ea Tub /Shower /Shower Pan 01/13/2011 $25.02 Specifics: 1 12% State Surcharge - 01/13/2011 $8.70 Plumbing 47 ea Minimum Fee Adjustment - 01/13/2011 $47.48 Type of Use: SF 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 questions to OUNC by calling 503.232.1987 or 1.811 33 Issued By: / ' , .- i Permittee Signature: r ‘Z/ ^ Call 5' .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. 01/13/2011 15:55 15038425954 NYCENTRAL #1441 P.002/003 Plumbing Permit Application ' E ' / Building Fixtures I FOR OIF1C'f: [:SE ONLY JAN 1 3 201 Received ( ' 07 Per, „itNO.. ('l(h�n9� -r i I = City of Tigard nato/B ■ 13125 SW Hall Blvd., Tigard. OR 97223 Plan ReNicw Phone: 503,639.417! Fax: 503.598.1960 CITY OF TIG Other Permit No.: Inspection Line: 503,639.4175 BUILDING D11�ISIO R:1dy e/fa �y Ie ,, ET Scc Page 2 for TIGARD Internet: www tioard- or.gov Notifre&Metl _ supplcmcntri information "rr , V , + `1Cr r , i ri;H 18 Sa t 3: . F 1; au r..... 1s ... :.: .,.: , ,f .... W .:. i., ~' rnt[tAO he 0 New construction El Demolition For special info n use c eckl iaL _... Description Qty. Ea 1 Total E] Addition/alteration/replacement © Other: New 1- 2- family dwellings (includes 100 ft for each utility connection) TISSttY 4z11y; Ct3.i14Jttl> SFR (1) bath . _ 312.70 l - and 2-family SFR (2) bath 437.78 El dwelling ❑ Commercial/ ndustriat - SFR (3) bath 500 32 - [] Accessory building .. ❑ Multi family _ Each additional bath/kitchen 2. 02 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 - . r 1t , ern ) :' e .i r I f 3 :t i'» ,, $ ' .2,::6 ` ° ", Site utilities: - • Job site address: 7755 SW Ashford St. Catch basin or area drain E 18.76 Drywell, leach line, or trench drain 18.76 City/State/ZIP: Tigard /OR/97224 . Footing drain (no. linear R.: ) Page 2 Suite/bldg. /apL no.; Project name; Jenson Manufactured home utilities 50.03 Cross street/directions to job site: : manholes ' 18.76 • SW 79 Ave. Rain drain connector _18.76 • Sanitary sewer (no. linear ft.: __) Fag 2 - Storm sewer (no. linear ft.: __„•) Page 2 _- Water service (no. linear ft.: ) • Subdivision_ Lot no_: Fixture or item: ' Tax map /parcel no.: Backlit-iv preventer 31.27 Backwater valve 12.51 r �lbEg Y i OF*O .. Gti cr 25 Cloth wash _ Ni l ter Bath Remodel w Dishwasher 25.02 Drinking fountain 25.02 - - . Ejcetors/sump r° o i P t'IZ ''�k�kcr� CIF w t , i nr 7 4 , ,i i ',: i ^+7r* . - Expansion tank . Fixture/sewer Fixture/sewer cap 25.02 Name: Daryl and Barb Jenson - _Floor drain/floor sink/hub 25.02 Address: 7755 SW Ashford St W Garbane disposal 25,02 City /State/ZIP: Tigard/OR/97224 Ilosc bib 25.02 V Phone: ( ) Fax: ( ) ice maker 12.51 ". , f'P t AI' T 1 coN4 ;: Il {3 r Interceptor /d trap 25.02 Medical gas (value: $ Page 2 Business name: Primer 12.51 Contact name: „„ _ Roof drain (commercial) Ell 12.51 • Address: - __ SinWbasin/lavatory - 25.02 City /State/ZIP: Solar units (potable water) 62.54 . Phone: ( ) fax: : ( ) Tub /Shower /shower pan 1 12. 25.02 Urinal 2 502 Water clos 25,02 ""x'� �' 41^ ,•a' < :� tGO ..'� ; , � "" t ,i.r, ,, . . _ .. r. , Z.4.j;( Water heate[ Business name: Northwest Central Plumbing Co. - Water pipin WV 56.29 Address: 2870 SE 75 Ave. #206 Other: 25.02 City /State/ZIP: Hillsboro/OR/97123 Subtotal 25.02 Phone: (503) 642 -2067 Fax: (503) 642 -5954 Minimum permit fee: 572,50 72.50 . Plan review (25% of permit fee) CCB Lic.: 72253 • 7i Plumbing Lic_ no.: 34 -I97PB -" . w. State surcharge (12% of permit fcc) 8.70 • Authorized Signature: 1 5.E ■ ` - ._ TOTAL PERMIT FEE 81.20 This permit application e xpire$ if a permit is not obtained within 180 days Print name: Katy Retrial Date: 01/13/2011 after it has been accepted aS complete. A Fec methodology set by Tri -County Building Industry Service Board. BituitdwgT niMPt..MIT- Permit AM ear 10/01/09 440 - 4 616x( , 0 /02 /COM/WF.H)