Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2011 -00214
Date Issued: 07/08/2011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S112BD01700
Jurisdiction: Tigard
Site address: 15050 SW 79TH AVE
Project: Parreira Subdivision: Lot:
Project Description: Kitchen and bathroom remodel.
Contractor: DELTA PLUMBING INC Owner: PARREIRA, DANE & KATHY
12205 SE 108TH AVE 15050 SW 79TH AVE
HAPPY VALLEY, OR 97086 TIGARD, OR 97224
PHONE: 209- 604 -7348
HONE: 503 - 698 -7342
FAX:
FEES
Quantity Description Date Amount
•
1 ea Dishwasher 07/08/2011 $25.02
Specifics: 1 ea Garbage Disposal 07/08/2011 $25.02
1 ea Ice Maker 07/08/2011 $12.51
Type of Use: SF 1 ea Sink 07/08/2011 $25.02
Class of Work: ALT 1 ea Tub /Shower /Shower Pan 07/08/2011 $12.51
Type of Const: 3 ea Water Closet 07/08/2011 $75.06
Occupancy Grp: 1 12% State Surcharge - 07/08/2011 $36.03
Stories: Plumbing
5 ea Lavatories 07/08/2011 $125.10
Total $336.27
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 Noti . : Rter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -001 -0090. You may obtain a copy of the rules
or direr uestions to OU C P c:lIi•. 503.232.1987 or 1.800.332.2344.
Issu d By: t r/ 4 I Permittee gnature: ' / 11/
4.*i
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.
Jul 07 2011 10:35RM DRERMBUILDER HOMES 503 -821 6462 p.3
Plumbing Permit Application
Building Fixtures + . FOR orf•lc:I: tisl: ()NIA City of Tigard , Received 7 ��� Permit No.: I 0 - J , Rl
13125 5W Hall Blvd., Tigard OR 97223
Date/By:
Plan Review
M 503.718.2439 Fax: 503 . 598 . 1 96Q/1. 0 7 n Other Permit No.:
Inspection Line: 503.639.4175 7011 Date/By:
T I C; A r, D Internet: www.tt and -or. ov Date Ready/By: Jana: See Page 2 for
g g C . I a _ Supplemental Supplemental information
.
'IP a i m k w -c .; ..... A ". . " i�P��'TeMEI:"oY.l. $1 . ' f . i..,Y^I (I . I .4 "' .,. sit " ? 'T: 51ii Iti3KA t, .:2iFZ i °� is »' ' - 4. ,s. l'' y S,tf _. -ti:. r:
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❑ New construction ❑ Demolition For special information use checklist
Description I Qty, l Ea. ,_. Total
® Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for ea .. ity connection)
,
a 't*- , sa es 3 , r 5 n a F X l°a a17 $ t t I a it c _.e.l C t i r s li € j P ,; SFR (1) bath 312.70
v „?� � ,.�r. �� ii,. t ... " ,� �•�' � �' �. € �� �tF�.� .- .� . %�a /,l � � ii.. .
®1 -and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 437.78
❑ Accessory building ❑ Multi- family SFR (3) bath 500.32
Each additio• .ath/kitchen 25.02
❑ Master builder ❑ Other:
n �� -ra »h,* n s y „ at Z aFKb ,� - " 11 Fir , .rmkier ( sq.'R) Page 2
' ie "' z��.`"a � 1r2 -':�- g s :! @' d i " �,i;:, 7 •; ', 1 "' ,( h=# "s gg tl itrilll all ig,1
Lia;q;Siw.ea�. tiiki' ,tst'fis'.j ^e ' ivit ral;' "0� ' i!m ?.. silf .3. 11,11i , iltil llai `.1l i f �"'R Ite utllltles'
Job site address: 15050 SW 79 Ave Catch basin or area drain
City / State/Z1P: Tigard OR 97224 Drywell, leach line, or trench drain �►' 6
Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: Project name: Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer ..linear ft.: ) Page 2
Storms r (no. linear tt.: ) Page 2
. er service (no. linear ft.: _) Page 2
Subdivision: Lot no.: Fixture or Item:
Tax map/parcel no.: ry� Backflow preventer 31.27
ryT,,r TM . irn: .� Er TI ..a r'h.''�"�"" ", ,� a1 9 q7 Tf rl i s 's. 7 - Backwater valve 12.51
- W w a - w l s mss. rl } _ _ " ' : . i. Clothes washer 25.02
kitchen & bathroom remodel
Dishwasher t 25.02 ,g5.0 2.
Drinking fountain 25.02
Ejectors /sump 25.02
t x ; u.z 0 w ># ;:s.7ilFi ; i ;M a a a a aP, li r t III�1 9P , _ -� r^sr -5
e Z ta" 1 ,, s t 1 6 s e n q0• a$.si 1 @ "F ,. _s,., 4c0 C h " hli a "'4 e •" "s a. Expansion tank 12.51
r..,.,.,.� � '.G_., a.��„s:2.,<,a. M. . _.,.��Irw t„ b,`a�,ar"a e.e t��""a.. rc,;ac;;.'-,cy,f�a5.'m g
Name: Dane & Kathy Parreira Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: SAME as above
Garbage disposal , 25.02 A5. 2-
City/State/ZIP: Hose bib 25.02
Phone: (209)604.7348 Fax: (N /A) Ice maker 12.51 I A . 5'/
Interc
i tr a � .t f6 & = ll 11 ci, _ ituv ii 11 t arty I .raj (�' tor/ ease tra 25.02
lg . sRWas'.n . 4: S�ti >fr ';:411[.6 lillikillli'a Edillrallen;;Ii i ilt la i itis td 1i itg 1.4 ' eP g P
� A fr1 3V I �. ,n Medical gas (value. S ) Page 2
Business name: r
Primer 12.51
Contact name: 7 rk \NA 4lj(,r(/C Roof drain (commercial) 12.51
Address:
Sink/basin/lavatory (g 6 25.02 /56, (�.,
City /State/ZIP: 9"?-Z24 -- Solar units (potable water) 62.54
Phone: ( 5ri, ) 5 - 13 l Fax: : (S a ) W,,t - [ Tub/shower/shower pan 1 12.51 /,2.5i
E -mail: Uri nal 25.02
a+.zti:1H» " AITI i
a rINI li st I; k741xte � " P ! I lli 3 i o ili� Y>r oi, Water clOSGt i'. 4 r - V- 3 25.02 75.x¢
( _,` ti" 73. aid" raalitul, ffil i h).�.�`Irlal Water heater 37.52
Business name: Delta Plumbing INC Water piping/DWV 56.29
Address: 12205 se 108 Other: 25.02
City /State/ZIP: Happy Valley OR Subtotal oap(+�,a4
Phone: (503) 998.0683 Fax: (N /A) " Minimum permit fee: 572.50
PIan review (25% of permit fee) ._-
CCB Lic.: 182846 Plumbing Lic. no.: PB562 , 1 1 1 I State surcharge (12% of permit fee)
16 . 2 . o
Authorized signature: TOTAL PERMIT FEE 3 ? j ( .27
Print name: Bogdan Date: 7/7/2011 Thls permit application expires if permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
1. 1BuildinglPermita lPLIVlU- PermitAPp.da IO/01/09 440.46161(10/02/COM/WEa)