Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2011 -00270
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/23/2011
Parcel: 2S103DC00809
Jurisdiction: Tigard
Site address: 13630 SW 114TH AVE
Project: Watanabe Subdivision: VIRGINIA ACRES Lot: 7
Project Description: Connect existing house to sewer service, less than 100'. Septic tank is to be pumped, filled and inspected or
removed.
Contractor: LOVETT EXCAVATING INC. Owner: WATANABE, FREDERIC H
PO BOX 86280 KATHRYN W
PORTLAND, OR 97286 13630 SW 114TH AVE
TIGARD, OR 97223
PHONE: 503 - 504 -2847 PHONE.
FAX: 503 - 288 -1630
FEES
Quantity Description Date Amount
100 If Sewer Service 08/23/2011 $62.54
Specifics: 1 12% State Surcharge - 08/23/2011 $8.70
Plumbing
10 ea Minimum Fee Adjustment - 08/23/2011 $9.96
Type of Use: SF 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 otf ica io enter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or dir ct questions to • . NC by c. ng 503.232.1987 or 1.800.332.234
lssu By: k / � � Q Permittee Signature:
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.
Aug. 23. 2011 11:26AM Lovett Excavating O. 4806 P. 1
tow 2.5/ ZELL 1 1 2:1.1 5035 y bt7 CITY 0� TIGAR1J rHUE (31/01
Oki n_lUnighriatzipijkitta
Building Fixtures
1 )j{ c1t'l if r IItil.; f) \1,�.
City of Tigard Itoee+vcd d
f 3125SWIIa1 AIvd.,Tigard,OR 972 DaIdB : O p`pG 1 �rmitNo. / � l �
k1` Phone, 503.718,2439 Fax; '503.5913.1960 Plan Rov;ew `
In ectfonL►no; 503 (?ete/Oy: Other Penh No,: ,Q,�l/ -oola5-
Tit; . 1: I'i Date Rol /g
Internet; www.dgard•or.gov el r . a rle: RI see page 1 ter
Notificdthlethod: SnEolootenlal reformation
TYPE OF WORK ' _ _ FEE* SCHEDIAZ,,
❑ New construnt(on ❑ Demolition Fors odd In men,' on cherklleit:
Addrlion/altenadonheplacemen a Other: — Dc` seript� nn Qty. 6a. Total
New 1- 2 - famllydwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION sent (1) bath
312.70
"pi- and 2 thmlly dwelling ❑ CommentlaVindt>strial SFR(2) bath 43718
b Accessory building SFR 3 bash EMI
❑ Multi-family
() 50D.32
❑ .Master builder ❑ f?ftch additional bath /kitchen 25,02
Other: _ Flro sprinkler ( sq. R) Page 2 ME
J0 AiT JIVrORM►TIOt� AM LOCATIpr( Rs
Site utilities:
Job site address: 3 e2 (, J griGIENNEM COO basin or arca drain 111.76
city/State/ZIP: -1-1 Z 1 Dtywcll, load lino, or trench drain 1$,76
lino,
Sulte/bldgJapt. no.: Project name; Footing drain (no. linear f1.: Page 2
Cross sireet/directigtls to job site; Manufactured home utilities 50,03
Menholer; 11.76 MI
Rain drain connector 1/3.76
Sanitary sower (no. linear ft.: At - , Page 2
Storm sower (no. linear it.: ) Pagc 2 —
Subdivision: Water service (no. linear ft.: `) Page 2
Lot 110.! Ft i a ri nr
Tax map /parcel no.;
Back flow prowler
31.27
DESCRIPTION OF WORK
valve MB
G0 AJ AJ t .T 1- S ,-w ,t. II (-NM Clothes weaker 25,02
r te` r✓ iq C TA A) Dishwasher 25.02
Drinking fountain 25,02
—
Ejectors/sump 11111p CI PRQrEurt.0 vrsu , ' 0 TENANT l3xpansion hulk
Name;
_ Fixture/sewer cap
29,02
Address: _Noon dreln/floor skit/huh 25 02
Cily /Stttte/Jlp: Gorbago disposal — 25.02
Phone: ( ) Hose bib MO 25,02
Tex: ( ) Ice maker
12.51
0 APP)LxC
CI CONTACT' PERSON lntcrceptor/grease trap 25 02 IN
Business name: L„-ov ar' AJ ( Medical gas (value: $
) Po " o 2
Contact natrl0;
4, o N Owl d Printer tz_st
Address: °I0 �J d I
Roof drain (commercial) 12 51
t Sia klbm Maya c ry OM
•
City/StnteiZfP: b 7 •.- 6 23,02
Phone: () Soler soils (potable waxer) 62.54
� ■ • , 3 Fax: : 0V3 )'. ► 8 , 1 t) Tub/showethhower pan 12,51
• &marl: (M 4u , . • r , L.r'WA Urinal
25.02
CONm ctoR Water closet 22
Business name: `� d y Water heater 37,52
r1d _
Address; — Water prping/pWy 96.29
Clly /State/T,lp; biker,
25.02
Thom ( ) • Subtotal
Fax: ( ) Minimum permit fee: 572,50 'NIP
C C J 3 L i o , ; _ , C D Plumbing Lie. no.: 24 ..— 3 r Plan review (25 % ofpermit tee) -.
Authorized signature; Slate surcharge ( Ito) , .70
---�
Print yy TOTALPl31tMrr.1788
P) b tM. bate: nis ernrir a rcation y
'O `z 3 � P rr �cplret irA permit ]s no! obletncd within MO day.
Satyr It has been
'Pee methodology let by Til- County B Icta
Building n Oro roo l �Y;micv6nbrd.
44Mdtct(IeIovc0Miw_ j