Permit CITY OF TIGARD PLUMBING PERMIT
4 COMMUNITY DEVELOPMENT Permit #: PLM2011 -00202
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/29/2011
Parcel: 1S134CC01700
Jurisdiction: Tigard
Site address: 12325 SW KATHERINE ST
Project: Mary Woodward Elementary Subdivision: MERESTONE Lot:
Project Description: Gas water heater installation.
Contractor: PRO DRAIN & ROOTER SERVICE, INC Owner: TIGARD - TUALATIN SCHOOL
3300 NW 185TH AVE #213 DISTRICT 23J
PORTLAND, OR 97229 6960 SW SANDBURG ST
TIGARD, OR 97223
PHONE: 503 - 533 -0430 PHONE:
FAX: 503 - 533 -9376
FEES
Quantity Description Date Amount
1 ea Water Heater 06/29/2011 $37.52
Specifics: 1 12% State Surcharge - 06/29/2011 $8.70
Plumbing
Type of Use COM 35 ea Minimum Fee Adjustment - 06/29/2011 $34.98
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" • ;00.332.2344.
•
Issued By rermittee Signature:
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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.
Jun 28 11 07:44a Pro Drain & Rooter Srvc. 503 533 -9376 p.2
Plumbing Permit Application -_,
Building Fixtures RE 1,:..., s FOR OFFICE USE ONLY
City of Tigard Received
Permit No.: / ,_
a ]3]25 SW Hal] Blvd., Tigard, OR 97223 �� N 2 8 2011 Dare/By: ♦ `'�� V -�
Plan Review
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Phone: 503.718.2439 Fax: 503.598.1960 Other Permit No.:
Dale /By:
TIGARD Inspection Line: 503.639.4175 �/ T` � % r � }
Internet: www.tigard- or.gov C f ' O� '■1� N ot i fed/M o o d : r G S - t Supplemental l Information
TYPE OF WOI2 ' 0 p w FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist _
Description € Qty. I Ea. I Total
® Addition /alterationlreplacement ❑ Other: New 1 -2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (]) bath 312.70
❑ 1- and 2- family dwelling ® Commercial/industrial SFR (2) bath 437.78
SFR (3) bath 50032
❑ Accessory building ❑ Multi- family
❑ Master builder ❑ Other Each additional bath/kitchen 25.02
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION I Site utilities:
Job site address: 12325 SW Katherine St. Catch basin or area drain 18.76
Drywe]I, leach line, or trench drain 18.76
City /State/Z] P: Portland, OR 97223
Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: I Project name: Mary Woodward Elem. Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Water.service (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map /parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Install of gas water heater and hookup of new gas line. Dishwasher 25.02
Drinking fountain 25.02
Ejectors /sump 25.02
❑ PROPERTY OWNER
NER I 0 TENANT Expansion tank 12.51
Name: Fixture./sewer cap 25.02
Floor drain floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12.51
® APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02
Business name: Prod rain & Rooter Service Medical gas (value: $ ) Page 2
Primer 12.51
Contact name: Robin D. Grover
Roof drain (commercial) 12.51
Address: 3300 NW 185th Ave. #213 Sink/basin/lavatory 25.02
City /State/ZIP: Portland, OR 97229 Solar units (potable water) 62.54
Phone: (503) 746 -9705 Fax: : (503) 296 -2419 Tub /shower /shower pan 12.51
E -mail: plumbing prodrainpdx.com Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 1 37.52 i 37.52
Business name: Prod rain & Rooter Service Water piping/DWV 56.29
Address: 3300 NW 185th Ave. #213 Other: 25.02
City /State /ZIP: Portland Subtotal 37.52
Phone: (503) 746 -9705 Fax: (503) 296 -2419 Minimum permit fee: 572.50 i 72.50
Plan review (25% of permit fee)
CCB Lic.: 108504 Plumbing L+s.4to.: 26 -776PB St ate surcharge (12 °1° of permit fee) ! 5.70
Authorized signature. of
`� (� t ( TOTAL PERIvlIT FEE I 81.20
This permit application expires if a permit is not obtained within 180 days
Print name: Robin D. G ro cr Date: 6/27/11 after it has been accepte as complete
''Fee methodology set by Tel- County Building Industry Service Board.