Permit CITY OF TIGARD PLUMBING PERMIT
; - I COMMUNITY DEVELOPMENT Permit #: PLM2011 -00140
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/06/2011
Parcel: 2S112BB02100
Jurisdiction: Tigard
Site address: 8280 SW COLONY CREEK CT
Project: Winowitch Subdivision: COLONY CREEK ESTATES Lot: 17
Project Description: Replace 70 feet of water service.
Contractor: APOLLO DRAIN & ROOTER SERVICE Owner: WINOWITCH, CAROLYN
2208 NW BIRDSDALE #8 8280 SW COLONY CREEK CT
GRESHAM, OR 97030 TIGARD, OR 97224
PHONE: 503 - 239 -8801 PHONE:
FAX: 503 - 669 -9568
FEES
Quantity Description Date Amount
70 If Water Service 05/06/2011 $62.54
Specifics: 1 12% State Surcharge - 05/06/2011 $8.70
Plumbing
Type of Use: SF 10 ea Minimum Fee Adjustment - 05/06/2011 $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 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 qu . . OUNC ailing 503.232.1987 or 1.800.332.2344.
Issued = Permittee Signatu `
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.
May. 5. 2011 12:17PM No. 5060 P. 1
Plumbing Permit Application
Site Utilities FOR OFFICE USE ONLY
n CE
EI ED Received Permit No.: City of Tigard 7ZK29'8'^', j �l jf DaIC/BY: � b J.: � (•�0� 4O NO
n 13125 SW Hall Blvd.. Tigard, OR 9
c a , Phone: 503,718.2439 Fe .; 503.598,1960 Plan Review Dale/By Other Permit No.:
TIGARD
Inspection Line: 503.639 MAY 5 Dale Ready/ y: furls: Fa See Page 2 for
Internet: www.tigard- or.gov Norit1ed/Method: SupplemenlplInformalion
TYPE OF wooly OF TIGARD • FEE. SCHEDULE .
❑ New construction 111 ,:t rFRMI v 1 1 For srMal to ormallon use checklist.
Description Qty, Ea. Total
® Addition/alteration/replacement ❑ Other: New I.2•famlly dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION • .. SFR (1) bath 312.70
® 1- and 2- family dwelling El Commercial/industrial SFR (2) bath 437.78
11 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: 8280 SW COLONY CREEK CT Catch basin or area drain [ 18.76
1W
Drywell, leach tine, or trench drain 18,76
City /State /ZIP: TIGARD OR 97224 Footing drain (no. linear R.: , ) Page 2
Suite/bldg. /apt. no.: I Project name; Manufactured home utilities 50,03
Cross street/directions to job site; Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear It: ) Page 2
`--�^ "� Storm sewer (no. linear It: ) Page 2
Water service (no. linear ft,; 9) Page 2
Subdivision: Lot no.: Fixture or item:
Tax map /parcel no.: , Backflow pieventcr 31.27
DESCRIPTION OF WORK .-
Backwater valve 12,5 [
Clothes washer 25.02
REPLACE 7QFT OF WATER SERVICE LINE
Dishwasher 25,02
Drinking fountain 25,02
Ejectors /sump 25.02
.. . 23 PROPERTY OWNER . • ❑ TENANT ; • Expansion tank 12.51
Name: CAROLYN WINO W ITCH Fixture /sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City /Slate /ZIP: Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12.51
0 APPLICANT El CONTACT. PERSON. . Interceptor /grease trap 25,02
Business name; APOLLO DRAIN AND ROOTER Medical gas (value; $ �) No 2
Primer 12,51
Contact name: CHRISTINE KAFEL
Roof drain (commercial) 12.51
Address; 2208 NW BIRDSDALE UNIT 8 Sink/basin/lavatory 25.02
City /State /ZIP: GRESHAM OR 97030 Solar units (potable water) 62.54
Phone: (503) 2398801 Fax :: (503) 6699568 Tub /shower /shower pan 12.51
E -mail: CHRISTINEtAPOLLO- DRAIN.00111 Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name: APOLLO DRAIN AND ROOTER Water piping/DW V 56.29
Address: 2208 NW BIRDSDALE UNIT 8 Other; 25.02
City /Slate /ZIP: GRESHAM OR 97030 Subtotal
Phone: (503) 2398801 Fox: (503) 6699568 Minimum permit fee: $72.50 7Z -5D
Plan review (25% of permit fee)
CCB Lic.: 49418 r bing Lic P; 26 -53 Ph
I r -'r`� State surcharge (12% of permit fee) g.71'
Authorized signature
, I A L 111• _L 1� g
TOTAL PERMIT FEE i .?Q
Print name: CHRIST - I E KAFEL Dale: 05/05/2011 This permh application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
'Fee methodology set by Tri- County Building Industry Service Board.
I: 1BuildingtPermiss 'PLMU.PernthApp. 10/01/09 '40- 4616T(10 /02/COMM'EB)