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Permit
ill OF TIGARD PLUMBING PERMIT 111 _ I . COMMUNITY DEVELOPMENT Permit #: PLM2011 -00036 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/28/2011 Parcel: 2S103BA00140 Jurisdiction: Tigard Site address: 12035 SW LYNN ST Project: METZLER Subdivision: LERON HEIGHTS NO. 2 Lot: 30 Project Description: Master bathroom remodel. Contractor: ASSURED PLUMBING SERVICES LLC Owner: METZLER, ERIC G PO BOX 835 12035 SW LYNN ST WILSONVILLE, OR 97070 TIGARD, OR 97223 PHONE: 503 - 682 -3590 PHONE: FAX: 503 - 639 -7424 FEES Quantity Description Date Amount 1 ea Sink 01/28/2011 $25.02 Specifics: 1 ea Tub /Shower /Shower Pan 01/28/2011 $12.51 1 ea Water Piping /DWV 01/28/2011 $56.29 Type of Use: SF 1 12% State Surcharge - 01/28/2011 $11.26 Class of Work: ALT Plumbing Type of Const: Occupancy Grp: Stories: Total $105.08 Required Items and Reports (Conditions) A This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty /Cod s and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started ithin 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules/ ddop ed 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 1.800 . - . t lAky Issued By: l _ Pe Signature: l ill /� ` t 1 lJ 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. 01/20/2011 18:04 FAX CAMAS TRANSPORT INC a001 /002 Plumbing Permit Application �� Building Fixtures C�,� 1.4,1; ;ii Iii 1 I OM pity o F Tigard 4 11 Received 1. • 13125 SW Hall Blvd., Tigard, OR 97223 nn \ , 091033 j f permit No.: S � Rhone: 503.639.4171 Fax; 503.598.1960 IA ^� flan Rovio e t. -(. . • . • r ., Inspection Line: 503,639.4175 ,plCj raleBY Other Permit stn.: Internet: www- tlgerd- ar,gov 1 mu Roudy /By s � ��ee 2 :Ism r Q� X151 Noti6od/Memed: - /t _ `Ju lam Infoation TYPE OP' Wry ' , D1 , ' ' » scuramix 0 New construction 0 D mOlition Fora eel*/ in °mullion use checklist [ Addi lion /alrcration/replacoment boscri• KM Ea Total ❑ Other: New I- 2- family dwellings (includes 100 It. for each utility connection) � CATEGORY OF C©NSTRUCTSOIq'' '''' SFR (I) bath 312,70 le l and 2 -family dwelling 0 Commercial /industrial ~ SFR (2) bath ❑ Accessory building 0 Multi - fancily SPR (3) bath 500.32 ❑ Master builder Each additional bath/kitchen 25.02 0 Other: Fire sprinkler L. sq. ft. '`: „ ' ; JOB INi'O11tMATIO1tT' Q ) Page 2 _ ��� �N' � , , �� She utilities: Job site address: O q- 1 4 -- Catch basin or area drain 18,76 City/StatnIZIP; e..14 0 t - Arywcll leach l or trench drain 18.76 '1,'`,:t? Footing drain (no. linear ft.: ) Pagc 2 Suite/bldg. /apt. no.; Proicct name: Manu6CCtured home utilities 50 03 CrosB streoUdireclions to job silo: i K ' [ I ST, , Manholes 18,76 al Rain drain connector IS 76 Sanitary sewer (no. linear It,; Paget Storm sewer (no, linear ft.: ) Page 2 — water Service (n0, linear ft,; ) Page 2 Subdivision: • Lot no.: Fixture or item: Tax map /parcel no.; l4uckilow proventer _ 31.27 ' , O�toN . OF WORK Sackwntcr valve 12 ,SI Clothes washer 25.02 RGLk.• J '' j t`,' • / h i D ' -, ?Il Dishwasher 25.02 LL O f Q '� L ? � ,, e r '�.�x i n' di, S G�w r IllC(t/ 6 r Drinking fountain 25.02 E ectors,sump 25,02 :r.'.. 0 'PROPS TY OWNER , , '[J TENANT; i ., Expansion tank 12,51 - Name: I'ixture /savor cap 25 02 Address; Floor drain/floor sink/hub 25.02 — City/State/ZIP: disposal 25.02 Nose bib Phone: ( ) Fax; ( ) Ice maker 12.51 .5 ' .0 CANT dI CEDii*C'I' it ERS011' _ 12 , I tor captor /groue trap 25,02 Business name: Medical gas (value; $ ) Page 2 Contact name; Primer 12.51 Roof drain commercial Address: (commercial) 12.51 111111 . Roof Sink/basin/lavatory 25.02 City/State/ZIP: _ Solar unite (potable water) 62.5x1 • Phone: ( ) I Fax: : ( ) _Tub/shower /shower pan 12.5] IN : E-mail: Urinal 25.02 ME C1V7lt water closet 25.02 Water heater 37.52 Business name; r ! p 11 G 4 Water i in �a Add ress! 2 P p g/DWV irm 56.29 O Bf x 8' 3 S • k..,11 oi2 j /'rill e DR, Other: 25.02 ' City/Stare/ZIP! subtotal / i ,4, (33 7.1_ Phone: (503) ' L f Fax: ( ) 5 O 3 ) 6 !12 3 q y a _ Minimum permit fee: $72 -50 11111.111 C.: Lic.: f 12_ � Plumbing Lie, ao.: / • f _ Plan review (25% of permit fee) Authorised signature; / State surch (12% of permit foe) Wr ,! , a'(p �� a lad 7/1 TOTAL PERMIT FEE o ;f or Pilot name; i T z i , , e 7!,ot # r pl. �� Date: /,y / This permit app! cation expires it • permit it not obtained w' ■ n 180 days / I / / utter It hue been accepted as complete. * Fee methodology set by Tri - County Building Industry Service Boanl.