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Permit CITY OF TIGARD '.� PLUMBING PERMIT COMMUNITY DEVELOPMENT Zia Permit #: Date Issue 05/11/2011 PLM2011 -00147 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S110BC00900 Jurisdiction: Tigard Site address: 12475 SW BULL MOUNTAIN RD Project: Tigard 10 MG Reservoir Transfer Pump Station Subdivision: AMES ORCHARD Lot: 5 Project Description: (2) hose bibs. 5/11/11, reprinted to add 40' of water service. Contractor: PIPELINE PLUMBING Owner: TIGARD WATER DISTRICT 333 S STATE ST, STE. V -108 8777 SW BURNHAM ST LAKE OSWEGO, OR 97034 TIGARD, OR 97223 PHONE: 503 - 624 -1906 PHONE: FAX: 503 - 624 -1926 FEES Quantity Description Date Amount 2 ea Hose Bib 05/11/2011 $50.04 Specifics: 1 12% State Surcharge - 05/11/2011 $8.70 Plumbing Type of Use: COM 22 ea Minimum Fee Adjustment - 05/11/2011 $22.46 Plumbing Class of Work: ALT 40 Plumbing Permit 05/11/2011 $40.08 Type of Const: 5 12% State Surcharge - 05/11/2011 $4.81 Occupancy Grp: Plumbing Stories: Total $126.09 • 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 -11190. You may obtain a copy of the rules or directpilons to 01 C b allin. 503.232.1987 or 1.800.332.2344. Issued By: /, /► Permittee Si• / , 0 • 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. CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit #: PLM2011 -00147 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/11/2011 Parcel: 2S110BC00900 Jurisdiction: Tigard Site address: 12475 SW BULL MOUNTAIN RD Project: Tigard 10 MG Reservoir Transfer Pump Station Subdivision: AMES ORCHARD Lot: 5 Project Description: (2) hose bibs. Contractor: PIPELINE PLUMBING Owner: TIGARD WATER DISTRICT 333 S STATE ST, STE. V -108 8777 SW BURNHAM ST LAKE OSWEGO, OR 97034 TIGARD, OR 97223 PHONE: 503 - 624 -1906 PHONE: FAX: 503 - 624 -1926 FEES Quantity Description Date Amount 2 ea Hose Bib 05/11/2011 $50.04 Specifics: 1 12% State Surcharge - 05/11/2011 $8.70 Plumbing Type of Use: COM 22 ea Minimum Fee Adjustment - 05/11/2011 $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 questions to OUNC by calling 503.232.1987 or 1.800.332. Issued By: Permittee Signature: 4111 / / � .■••"" 40 , Call 503.6 '.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. p.1 Plumbin Permit A lication i . FOR a�l:lc�r, USE oNi.} Building Fixtures 0 .'5) City of Tigard Receive I ■ 13125 SW Hail Blvd., Tigard, OR 97223 Plan Review Other Permit Na: Phone: 503.639.4171 Fax: 503.598 9 c .,,,\ DakJB • z for Inspection Line: 503.639.417 '1 "I ` DateReady/Br it ei Serl'ag e mag e2for ormahSas T : G fl i. D Internet: . w.tjgef Or.guv �, FEE* SCHEDULE TYPE OF WORK For . • ; orntdfioa use rherlk ■ © Demo ' � 44 p csgi , w ! Ea. Total ❑ New construction G (includes 100 ft. for eah b utility • -• n) ❑ Other. 0 . no New 1 - 2- fawily dwellings ii:: Addition/alteration/replacemen _ SFR (j) bath 312-70 CATEGORY OF COl\STRtl IN .1 SFR (2) bath ❑ 1 -and 2- faanily dwelling P. Commercial/industrial S1R(3) bath 50032 ❑ Accessory ❑ Multi-family Each additi oral bath/kitchen - 25.02 de r building Other: Fire ___ ❑ Other: sprinkler (__ s4• fl-) r >' 2 MOM ❑ Master builder Siteulilities: JOB SITE INFORMATION AND LOCATION Catch to a bati or area drain � Job site address: 1 _ t 1 1i g 1 '_ �� Ury.,rrell, leach tide, or trench dram r 18.76 _ City/Stath'JZIP: --- f A • . Footing drain (no. linear ft.: �� Page 2 MN Suite/bidglapt. no.: Project name: \,.f� ' i . ' i d l Manufactured home utilities 50.03 18.76 } Manholes r (}erg street/directions to job site: Rain drain tonnes 18.76 Sanitary sewer (no. linear B-:._, _ Page 2 Storm sewer (n linear R: __._) �� � (no_ Water service (no. linear R: � 2 �/r Lot no . Fixture or item: 3127 TaX ma i . � Backliow pnwenter 1011.1 12.51 Tax maplparcPl no.: Backwater valve _ DESCRIPTION OF WORK Clothes washer 25-02 a. d , ' j !J IMIIIIELmmimillill Dishwasher 25.02 + �.ti , — • u 1 — O G 1 —1 Drinking fountain 25.02 • Ejectors/sump G . + ± y Il ►)� ►2] ; i Expansion tank Fixture/sewer 12.51 ❑ PROPERTY OWNER ❑ TEN r 1 2.52 _ ure/sewer caP Name: Floor drain/floor sink/hub 25.02 MOM Address: Garbage disposal 25.02 City/State/ZIP: Hose bib_ 25.02 Fax:( ) Ice City/State/ZIP: 12.51 Phone: ( ) interceptor/grease trap 25.02 ❑ APPLICANT RSO I Medical gas (value: $ ) 2 Business panne: `i Primer r 12.51 Contact name: Roof drain (commercial) 12.51 M. Sink/basin/lavatory 25.02 Address: 62.54 C'aty /Sts6e!LiI': Solar units (patabk water) �� MEI Tub/shower/shower pan Phone: ( ) Fax : ( ) Urinal 25.02 E - mail r i a. It 10\ NA. ik C ;.`"""T i Water closet . 25.02 CONTRALTO ' er - C-C3Y1'N Water heater r 3752 BueinetS DBrIIC: i t ip i�,'' . 1i. W11'lWEll — Waterpi = 562 1 Other 25.02 Adduess:3 tit . 't AV ' Subtotal . City/State/ZIP: 4, ` ; e 0 t3� 0 O� Minimum permit foe: $72 50 , �y� , �-[ t Fax: (6-13 `Z, �' Phone: t--�7 � a Mil Ltd Lie.: � � � Plumbing Lie no.: AM MI Plain review (25% of permit fee) State surcharge (12% of permit fee) L TOTAL PERMIT FEE Authorized S'igna . - . �tl i permit is not obtained within 180 days IL, i . 'I bis permit app ea p rr es if a peroa Print name: ! I Date: "' atterit has bees accepted as compkte- ..F.. ,,,, .,int..nv ...1, , TriJ mi,..13...lA:n I,uinelr.r Cravi"^ 14"O'rl Plumbing Permit Application RECEIVED Building Fixtures MAY 1 0 2011 FOR OFFICE i sr O\l_ city of Tigard ITY OF TIGARD ors � � r 1 PermitNo. P l T 1 ' � Z 7 1 /- CX, I v 1114 ■ 13125 SW Hail Blvd, Tigard, OR ' 49' t Phone 503.639.4171 Fax 503 a ' „, DING DIVISION '' A P No.: Inspection Line: 503.639 4175 Du : Reidy/By: kris M See Page 2 for T ICI A R D Internet w or-gtw llo• 7 Suppternrmat reformation TYPE OF WORK ' FEE' SCHEDULE ❑ Demolition ' 1 For special information use cberktat ❑ New construction ! Description I Qty- I En. I Total j Addition/alteration/replacement ❑ Other: I New I- 2- family dwellings (includes 100 ft. for each utility c000ea{an) CATEGORY OF CONSTRUCTION ! SFR (1) baits 312.70 I SFR (3) SFR (2) 6adh 437.78 ❑ 1- and 2-family dwelling Commtrcialrmdustrisl bath 50032 ❑ Accessory bta7ding ❑Multi-family I ! Each additional bath/kitchen - 25.02 ❑ Master builder ❑ Other. Fire sprinkler ( sq. IL) Page 2 JOB SITE INFORMATION AND LOCATION 1 . Site utilities: (,� ' p (� ( � / � (�`1 , • 1 R �L n G Catch basin or area drain 18.76 Job site address: 2l �jw L.11 �-4� l ` l � 1 Drywall, leach line., or trench drain 18.76 City/State/DP: v d - j t � . Cj� �'2 1 •• Footing drain (no. linear ft: ) P 2 Suite,bldgJapt no-: I'rvJecttmme, � i � t � t Mufactmed home utilRtcs 50.03 Cross street/directions to job silo 1 0 Manufactured 18.76 i I ���� 18.76 . I I Sanitary sewer (no. linear ft.: _) Page 2 I Storm sewer (no. linear ft. :._--,) Page 2 Water service (no. linear 8.: ) Page 2 Subdivision: 1Lot no.: 11 Fixture or item: 1 Backtlow preventer 3 L27 Tax map /gm c el no.: i) i Backwater Valve 12.51 (DESCRIPTION OF WORK Clothes washer 25.02 Q a 6 S & S 0 J .b ii i Dishwasher 25.02 kQ Q )� 1 ; I i Drinking fountain 25.02 Ejectors/sump 25.02 I 'Expansion tank 12.51 ❑ PROPERTY OWNER I ❑ TENANT 25.02 Fixture/sewer cap . Name: 1 Floor drain/floor sink/hub 25 Address: . I I Garbage disposal 25.02 City/State/ZIP: Hose bib Z_ 25.02 v" 1 Phone: ( ) Fax' ( ) J � ace make. 1251 . ❑ APPLICANT ❑ CONTACT PERSON : : > � ��77 Medical gas (value: S ) Page 2 Business name: p cl Bus \ Y '� _ k., .t, ,VL ��`13 —Primer 12,51 Contact name .I i Roof drain (commercial) 12.51 Address: Sink/basin/lavawry 25.02 City/State/ZIP: d Solar units (potable water) 6254 i Tub/shower /shower pan 12.51 Phone: ( ) Fax:: ( ) Urinal 25 -02 6-mail: • • s it ...t ■,,, =`. ;te r =? d „,'��,�,, Water closet 2 5 - 0 CONTRA t1 • i�.vc�'t Wafer 37.52 i Business name i 0,6 t ',� �./ ` V (i [� i Water piping/D W V 56.79 Address �� `.- _� V 'F7 Other. 25.02 City /staterzP: I e 0 C D i CDC ccl b k I - Minimum >�e $72.50 Subtotal ��- Phone: �� ` Fax U2-Lk ©( P review (25 % of permit fee) 11 CCB Lie.: j r j� �` Plumbing Lie, no 10 .: C State surcharge (12% of permit fee) g 70 Authorized si 0 � ��� ' ” / 1 TOTALPERMITFEE ��, !`- -i w -- This permit application expires if a permit is not obtained within MO days P r i n t name: , \ \ ) 1/4 \ . p_ . . ( Tc / j j' i m ( I r q �� ) Date: S 1C3/4 I I I 1 after it has been accepted as mmptete. *5....,..+6..A.4......c a IN - r a ......h. n, -I;r. I...lr.erry Groin.. Rmr+e 1 1 1, , {