Permit CITY OF TIGARD PLUMBING PERMIT
''1 COMMUNITY DEVELOPMENT Permit# PLM2011 -00321
Date Issued 10/27/2011
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439
Parcel 25111 BC01200
Jurisdiction Tigard
Site address 10190 SW VIEW TER
Project Williams Subdivision GREENBRIER Lot 6
Project Description Connect existing house to sewer service, less than 100' Septic tank is to be pumped and filled or removed
Contractor LOVETT EXCAVATING INC Owner WILLIAMS, GRANT & LANA
PO BOX 86280 10190 SW VIEW TER
PORTLAND, OR 97286 TIGARD, OR 97224
PHONE 503 - 504 -2847 PHONE 971- 404 -5385
FAX 503 - 288 -1630
FEES
Quantity Description Date Amount
100 If Sewer Service 10/27/2011 $62 54
Specifics. 1 12% State Surcharge - 10/27/2011 $8 70
Plumbing
Type of Use SF 10 ea Minimum Fee Adjustment - 10/27/2011 $9 96
Class of Work ALT Plumbing
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 que s o NC by calling 503 232 1987 or 1 800 332 2344
Issued e. / Lr_ P _ , , n C Perm ittee Signe re
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
Oct. 27. 2011u 9:57AM503ELovett Excavating CITY OF TIGARD No, 5918 P. tE 01/01
luin bin Per it licatio ECEIVso
Building Fixtures
City of Tigard sD OCT Q7 2011 rim r r, rsi gulf)
, phony �- ^ I9123 SW Hall Blvd., • Ilgard, Dk �i�APSSIC /tae / /-O ?
3.7182a39 Fax: sod OFT1CARb Plan ROwaa
l
`I'I l U!n (woollen Line $03,639 d175 t GIN 151 Dams • ah4Teelmn cro� Internet, Mvtv,rlgardorgov ON D.deReady/Dy 4 /S/
Nollriad/Melhod- M See Peer i [nr
TYPE OF WOR1t' 6uprtemeatalr nilmlen
Q Now construction FEE' 9CItE,by1,�,'
LI
Demolition Fans n! In Ormvt!On urd checklist.
❑ Additionioltcrasinn /ropbmine Bescrl.uan
❑ Olhcrt Now d_ <7l Eu, Total
CAT &GORY OF -COMB 2•fRmil dwellings (includes 100 fl for each ut connection)
TRUCTION SFR (I) both
0 1• and 2•family dwelling 312.70
❑ Commcrciallrnduatd
Accessory building 43 5.02
Li
❑ Multi-family
50022 Illa
❑ Master builder 25 02
[] Other:
JOB SITE INFORMATION AND LOCATION
lob site address: ii 96 5 l 1 / /,!v 7 a
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Ig 76
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DESCRIPTION OF WORK Baclrwatervalvo =�a
Dl z5.02�
shwn gfou � �—
Drinking fountain
25,02 —
El PROPERTY O WNER J ❑ TENANT = 2
Nerve; , _id 7. .. 15. 01
Address: ,4'Jf# 54 -� r 25 - 02
/lam 7.e-`ta"t .. — esahimmit u, .11/ 25.02 -
_, Garbage supsel NM Phone; ( 97/1 25 02
Chy/Stnte/ZIP: ' C4 P
Y 3 � s 2502 Ma
El APPLICANT ❑ C0117ACT PERSON ���
25 02 an
Page 2 la
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nosir en ~
coNT 25.02 a
9ueinese name 25,02 NMI
~' I L_n,_� i C r 37.52
Address: --Po —.7C�K / nO Water pipmg/DWV 56.29 al
city/swim ' ei - • 0 other, 25
p 04 . 4''7�g ,
Phone: ( (5 � '^ l ' 1'ax (
1 .. % e /4 M1n[mum permit fee: 372,50 W
CCB Lie,: (x_5 if Plumbing Llo. no: ,sir_
" Authorized signatu ,L� ��
` � / �� I , TOTAL PERMIT FEB I
MEW It. Y r Date /0 0_*- � 7Tla permit eppbcfiloh caprrce fta WA( if not obMlnpd MtAlr .a de;m
flier it ber been accepted as complete.
"Pea mnhodolo3y sat by Trl - County nmistne Indusny gsryisa gaud,
110 .4elripn'(TYCOMAVaa)
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391
13023 NE Hwy. 99 *7
VEncouve , WA 98685
(366) .,• 7 -249 Oa) 2133.5€
TCUSTOMER'S ORDER NO. PHONE _ _ C:" _ �;
DATE _
NAME
ADDRESS 0
• SOLD " CASH 6.O.D. CHARGE ON,ACCT _MDSE.,RETD. PAID OUT
QTY. DESCRIPTION PRICE AMOUNT
dry 6
•
P. 14 Days. A Finance Chao Of 11% Per Month
(t.8 - 12erinur 3T+lfba w ed un urrp:d n . _
Deflection fees Will be assessed tf n cesseyy. TAX
RECEIVED BY
TOTAL 4 L
All claims and returned goods MUST be accompanied by this bill.
6752 `Thank`You