Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit# PLM2011 -00323
Date Issued 10/28/2011
T [GARD 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 Parcel 1 S136CD00401
Jurisdiction Tigard
Site address 7910 SW PFAFFLE ST
Project Subdivision 2006 -016 PARTITION PLAT Lot 3
Project Description 20 ft of water service from street to building
Contractor PRO DRAIN & ROOTER SERVICE, INC Owner E &S HOLDINGS LLC
3300 NW 185TH AVE #213 8020 SW PFAFFLE ST
PORTLAND, OR 97229 TIGARD, OR 97223
PHONE 503 -533 -0430 PHONE
FAX 503 - 296 -2419
FEES
Quantity Description Date Amount
1 If Water Service 10/28/2011 $62 54
Specifics 1 12% State Surcharge - 10/28/2011 $8 70
Plumbing
Type of Use COM 10 ea Minimum Fee Adjustment - 10/28/2011 $9 96
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 1987 or 1 800 332 2344
aisa Issued By - Permittee Signature 51X-etr)-1
•
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 11 08 42a Pio Drain & Rooter Srvc 503 533 -9376 p 2
Plumbing Permit ApplicationNOISIAIQONIt '. '.
Site Utilities QNdDLLJOA.L.,, I Ho oFrleF, •
cs cY •
,
City of Tigard ILQZ L L Received
IN " DalclB AS1 I Pemul No t� ! L ) / --CAff
- - • 13125 SW' Hall Blvd , Tigard. OR 9722 i Plan Review / (JO CI t Phone 503 718 2439 Fax 503 598 r7 Dale/By Other Parisi No
TIGAR
Inspection Line 503 639 4175 � 13�'.j y, Dale ReadyBv Joss " ® See Page 2 for
Internet: www tigard -or gay �i .I ll.• NonFed/IVte:hod 'yey Supplemental Information
TYPE OF WORK FEE* SCHEDULE
11 New construction ❑ Demolition
For sperm! rnforneatian use checAtist
Description I Qry 1 Ea I Total
® Addition/alteration/replacement ❑ Ot New I - 2- family dwellings (includes 100 ft for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath I 31270
ID I- and 2- family dwelling ® Commerclai/ ndustnal SFR (2) bath 437 78
❑ Accessory building 11] Multi- family SFR (3) bath 500 32
—
❑Master builder Each additional bath/kitchen 25.02
❑O ther. Fire sprinkler (_ sq ft) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address 7910 SW P£aflle St. Catch basin or area dram 1376
Drywell, leach line, or trench drain 18 76
City /State/ZIP Tigard, OR 97223
— Footing drain (no linear ft ) I Page 2
Suite/bldg./apt no Project name Manufactured home utilities I 50 03
Cross street/directions to job site Manholes , l876
Rain drain connector 1876
Sanitary sewer (no linear R ) Page 2
Storm sewer (no linear 11 ) Page 2
Water service (no linear ft 1 Page 2 62 54
Subdivision Lot no .
Fixture or item:
Tax map /parcel no' Backflow preventer 31 27
DESCRIPTION OF WORK Backwater vatic l2 51
Clothes washer 25 02
Extend water service from street to building_
Dishwasher 25 02
Drinking fountain 25 02
Ejectors/sump 25 02
❑ PROPERTY OWNER ❑ TENANT Expansion tank 12 51
Tame Fixture/sewer cap 25 02
Floor drain/floor sink huo 25 02
Address
Garbage disposal 25 02
City /State/ZIP
Hose bin
25.02
Phone ( ) Fax ( ) Ice maker 12 51
E APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25 02
Business name ProDrain & Rooter Service Medical gas (value $ _) Page 2
Contact name. Lisa 3olke Primer 12 51
Roof drain (commercial) 12 51
Address 3300 NW 185th Asc.*213 SmkPoasiNlanuory 2502
CityiStatel7lP, Portland, OR 97229 Solar units (potable water) 6254
Phone: (503) 5330430 Fax: - (503) 2962419 Tub /shower /shower pan 12 51
E -mail plumbing ®ProDrampdx coin Urinal 25 02
CONTRACTOR Water closet 25 02
Water heater 37 52
Business name' Probrain & Rooter service Water piping/09v V 56.29
Address 3300 NW 185th Ave #213 Otha 2 502
Ci tyiStateZlP: Portland, OR 97229 Subtotal 62.54
Phone (503) 5330430 Fax. (503) 2962419 Minimum permit &c $72 50 72.50
CCB Lic 108504 Plumbing Lie no 26 -776PB
Plan review (25 % of permit fee)
State surcharge (12% of permit fee) 870
Authorized signature i TOTAL PERMIT FEE V,h
Pant name Lisa Bolke Date 1027111 The it perm application expires if a permit a net obtained %IIhin 80 days
after it has been accepted as complete.
`Fee methodology set by TT-County Budding industry Service Board