Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2011 -00279
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/02/2011
Parcel: 1S 135CCO3100
Jurisdiction: Tigard
Site address: 10085 SW KATHERINE ST
Project: KTM Properties Subdivision: GREENBURG HEIGHTS ADDITION Lot: 11
Project Description: Replacing (2) water closets, (1) tub and (1) sink.
Contractor: STANDARD PLUMBING & HEATING Owner: KRASAUSK, PAUL
8318 SW SPRUCE MACHARG, JOE JR
PORTLAND, OR 97223 TOTORICA, CAROL E
PO BOX 23638
TIGARD, OR 97281
PHONE: 503 - 641 -9444
HONE: 503 - 246 -3338
FAX:
FEES
Quantity Description Date Amount
1 ea Sink 09/02/2011 $25.02
Specifics: 1 ea Tub /Shower /Shower Pan 09/02/2011 $12.51
2 ea Water Closet 09/02/2011 $50.04
Type of Use: SF 1 12% State Surcharge - 09/02/2011 $10.51
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $98.08
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 1.800.332.2344. .
Issued By: 410 Permittee Signature: _ //�,A/
Cal 3. -175 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.
Plumbing Permit Application_. �°"
Building Fixtures � � % ti \\
Cit of Tigard C 3 ,,r,4, + "�.-,c �i.Received (...1 Perm No.:
q 13125 SW Hall Blvd., Tigard, OR 97223 ,,g DateBy:
'1111 _ ol f �/ �� / / -(jQ�7 q
V Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 f,` s'c:} Date/By:
Permit No.:
Inspection Line: 503.639.4175 V Date Ready/By: Ju ris ® Se Pa e 2 for
TIGARD \0�� Y Y g
Internet: www.tigard �� + Notified/Method: Z ; 76, Supplemental Information
- . ' TYPE: OF WORK • FEE* SCHEDULE ,
❑ New construction ❑ Demolition For special information use checklist
Description I Qty. I Ea. I Total
® Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
. CATEGORY OF _CONSTRUCTION SFR (1) bath 312.70
1- and 2- family dwelling
Accessory building ❑ Commercial/industrial
❑ Multi- family SFR (2) bath 437.78
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: 10085 SW katherine St Catch basin or area drain 18.76
City/State /ZIP: Tigard , OR 97223 Drywell, leach line, or trench drain 18.76
Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: I Project name: KTM o ,
`I 2 �° ir-h\c, S Manufactured home utilities 50.03
Cross street/directions to job site: Off Tigard St , 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.: J 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
Demo flooring due to dryrot... replacing existing (1 ( Tub Dishwasher 25.02
(2 ) w /c's & (1) Lay Drinking fountain 25.02
Ejectors /sump 25.02
® PROPERTY OWNER - 1 - • ❑ 'TENANT Expansion tank 12.51
Name: KTM Properties Fixture /sewer cap 25.02
Floor drain/floor sink/ 25.02
Address: PO Box 23638
Garbage disposal 25.02
City /State /ZIP: Tigard, OR 97281 Hose bib 25.02
Phone: (503 )641 -9444 Fax: ( ) Ice maker 12.51
. , -. O. APPLICANT • . ❑ CONTACT PERSON Interceptor /grease trap 25.02
Business name: Standard Plumbing & Heating Co. Inc. Medical gas (value: $ ) Page 2
Primer 12.51
Contact name: Don Alton
Roof drain (commercial) 12.51
Address: PO Box 19205 Sink/basin/lavatory 1 25.02
City /State /ZIP: Portland, OR 97280 Solar units (potable water) 62.54
Phone: (503 ) 246 -3338 Fax: : ( ) Tub /shower /shower pan 1 12.51
E -mail: Don9er @comcast.net Urinal 25.02
- - , , . Water closet 2 25.02
CONTRACTOR •,
Water heater 37.52
Business name: Standard plumbing & Heating Co. Inc. Water piping/DWV 56.29
Address: Po Box 19205 Other: 25.02
City/State /ZIP: portland, OR 97280 Subtotal
Phone: (503) 246-3338 Fax: ( )
Minimum permit fee: $72.50 87.57
CCB Lic.: 07309 I n /4 Plumbing Lic. no.: 26 -72PB Plan review (25% of permit fee) -- � � C �a i V,/ State surcharge p fee)
Authorized signature' TOTT AL L PERMIT FEE EE 98.08
Print name: Donald E. Alton Date: 10 - - 2011 This permit 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:\ Building\Pennits\PLMU- PermitApp doc 10 /01/09 440- 4616T(10 /02/COM/WEB)