Permit CITY OF TIGARD PLUMBING PERMIT
' ° ' COMMUNITY DEVELOPMENT Permit# PLM2011 -00318
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 Date Issued 10/25/2011
Parcel 25111 BC01400
Jurisdiction Tigard
Site address 10145 SW VIEW TER
Project Buehler Subdivision GREENBRIER Lot 4
Project Description Installation of less than 100' of sanitary sewer line
Contractor LOVETT EXCAVATING INC Owner BUEHLER, GREGORY J & SARA L
PO BOX 86280 10145 SW VIEW TER
PORTLAND, OR 97286 TIGARD, OR 97224
PHONE 503 -504 -2847 PHONE
FAX 503- 288 -1630
FEES
Quantity Description Date Amount
100 If Sewer Service 10/25/2011 $62 54
Specifics: 1 12% State Surcharge - 10/25/2011 $8 70
Plumbing
Type of Use SF 10 ea Minimum Fee Adjustment - 10/25/2011 $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 Specially 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 Notif • 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 direr .uestlons to Oil k C by . • 503 232 1987 or 1 800 332 2344 �1 ,f
Issues By / 4, , Permittee Signature k y� n � // 1 ��
Call 503 639 4175 by 7 00 a m for the next available inspection date
AAww..�'���
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. 25, 2011 10:46AM Lovett Exeavatloa No, 5865 P. 1
in/ ,car41011 11:32 50353nsvan CITY OF TIGARD rr�uE 01/01
numbing Permit Application
Building Fixtures
City oflygald r‘"o /A/ q
I. �. DaleBM m� ' e-// - W
7/ 13125 SW Hall Blvd, Tiger 50 'i.
Received J Permit No; , 3iS
�' Phone. $03.71 243Q Fag: �J i r o
r Plan RaNaw
i
I Ii1Au 13 Inspection tiny 901619.0175 q C rA` '"� DatN9_ ghaPem,h No; �'plhO��f� _ea lnlomer www.0gard•or.gov .,v_> ; �w`
V h^ `\� - Date Ready/IV .io le' Ed Sce Pag,e2 ter •
ri f'E OF w011 \1-`,�,V du .Iemeafal Information
D Now conetruodon rm kaituULE
❑ D um For r, ed:d i ormarfnn use chcalice
❑ Addlllon /alterreionkcplacement 0 Otha: bescri . tion et Ea. Total
New 1 -2. @mil dwellln;s includes 100 ft. for each unlit connection)
CATEGORY OF CONBTRUCf,JON SPR(I) bath _
D ❑
1- and ',family dwelling 417,78
COmmeroial/lndnstrial SFR (2) bath MEI 437,78
Accessory building Q Multi-family (3) both
32 ME
D Master builder other, additional bathhdtchen a 25 02
Fite sprinkler( sQ ft) NM Page 2
Jon SITE 1 NfORMA1lON • i
LOCation site utilities:
Job site address:
Q S a E_� Catch co
basin or ca drain 18.76
Cdr /Slate2lp: q77,2 Drywall, leach line, or trench drain a 18 76
Footing theta (no, linear It ) _ Page 2
Manufactured home ufhties _ 50.03
Manb0lw r 18.76
Rain drain connector , --
Sannary sewer (no linear ft.' /. /, Page
Storm sewer (o, linear ft.:_) Page 2
Water sorvIce (no, Uncut �) _ Page 2
Lat no.• hex inn or item:
dackflnw pro/otter 31.27
Mill
DpSCRIP OF WORK Backwater valis
RP b-T - It "' 4, ire+ i , — Eta Clothes washer 25.02
f Olsllweah<r 25.02
II Drinking fountain 25.02
, ❑ PROP6R'IV O{YNER expansion tan le MM 25.02
❑ TENANT Expansion wa 12,51
Name.
-t4 IC_.. PlxtorMeowrn asp r 2902
Address: pl seta) �e Floor dram /ftoorsinnk/hub 02
7J • t . . Dn Hose nec CaMINEMEMEMO 25 02
Jtx maker _ 12 51
0 APPLICANT 0 CONTACT PERSON Interceptor /grease tea, _
ZS o
Medias) gas (value; S) ME P402
Primer 1251
" Roafdmin (commercial)
City /State/ZI SlnArbadMavotory 25.02
Eras Solar units (potable water) WEI
Far : ( ) Tub /shower /shower pan _
1251
Urinal l� soz
CONTRACTOR Water closet 25
' r Water heater _ �
Addres lib. * , P , to Other; iping/DWV Elie
Cily/S!MeJZTP: ' OR.TLe ab 0 - Other; ` 2502
Phone: r) 7 8 sub.,
•+Y � i a Fax: ( s a. , g . 't (p „ Minimum permit fee: 371,50 • 3
GCB Lie.: i 2SJ� Plumbing Lie, no: ,_ I r, Planrcvlew(25a /,ofpcmlit
- skttthoriscdsignblure: • Y' '
State surcharge (I ofperpiit fee) �•
TOTAL PERMIT FEE lit i t , - IF
Print name: di L,vt 6 0 Mr. This Pascoa'vpl4adOn explrca permle 1. not Obmlaad .rhhlnf e dgy,
after It bqa been lIs ouaplcd an wmplele.
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