Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2011 00373
TIGARD 13125 SW Hail Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/14/2011
Parcel: 2S110DA06200
Jurisdiction: Tigard
Site address: 10509 SW NAEVE ST
Project: CARVER Subdivision: ERICKSON HEIGHTS Lot: 23
Project Description: Repairing fire sprinkler.
Contractor: CRAFTWORK PLUMBING INC Owner: CARVER, ROBERT A & TRACY J
7737 SW CIRRUS DR 10509 SW NAEVE ST
BEAVERTON, OR 97008 TIGARD, OR 97224
PHONE: 503 - 644 -8698 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Water Piping /DWV 12/14/2011 $56.29
Specifics: 1 12% State Surcharge - 12/14/2011 $8.70
Plumbing
Type of Use: SF 16 ea Minimum Fee Adjustment - 12/14/2011 $16.21
Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: / -•ermittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
12/14/2011 07:36 5036445989 CRAFTWORK PLUMBING PAGE 01/02
P III unbiug Perm A licat I CEIVED
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Building Fixtures DEC 1 2011 1 a ii iii A ,sm permitNo. i;v4_ 3 ,
City of Tigard Receivr'
13125 SW Hall Blvd., Tigard, OF., !!�' 3 Plan Review Other Permit No.:
T1GARD
1< Phone: 503.634.4171 ];ax: 5 8. 9wU DateBy. I11fIA: F3 Bee Page Z ter
Inspection Line: 503.63 DIVISION Dion Ready/By —lam Su e emcrtta , ( n r ormat , on
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, rl , u ".1�15� co ...il l' ? e6.+ 9L� .14J3�$R ol'C� � J:.��t �r. t 171i' tXc 1 ,,. io ,'`,_rf ,..r• For s'ra in armal use. checkl
d New construction 171 Demolition Dcscri.tion Mill Fa. Total El Fri in, Other New 1- 2- family dwellings (includes 100 each utili connection)
Addttton/alteration/rcplocemcnt F� n was, i n k �r tt+ p } 312.70
r I i� 1j�S41.1i 1 1� � 8, telfrOpfAiItl � tti r r�ITO iiiigl4t .�1 ia:kC.:25'^ haelildlt- aihr4d,A ,0 * no
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,_+ 1- and 2- 11rmily dwelling ❑ Commercial /industrial
SFR bath 500.32
iD Accessory building ❑ Multi- family Each additional bath/kitchen 25.02
❑ Master builder 0 Other
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�, ';?' asir site d res s : * "^ " Catch basin or area drain 18.76
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Job site address, �,tii� /. Dryweil, teach line, or trench drain IIIIII 18.76
City /State /ZIP: T f , dr.AMIO Footing drain (no. linear ft.: ____) Orallaall
Manufactured home utilities 50.03
Cross street/directions to job site: ldg./apt_ no.: Project na a: 18 76 MI
Manholes Cross 18.76
Rain drain connector
Sanitary sewer (no. linear ft.: ,___)
Storm sewer (no. linear ft.:, .)
Water service (no. linear ft.: ___) Page 2
Subdivision: Lot no.: Vixturc or Item;
Aaekflow pi- venter 31.27
Tax map /parcel no.: Backwater valve 12.51
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Mt 0 II if r Dishwasher
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� Drinking fountain Mill
Ejectors /sump 25.02
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17. a + ij pl . rr i kt , I117171.0i,; {bni ,IG;;r��a utp..4 ,,,vtt +m, „ ,r , ,,. . ,,o ,? 25,02 fs.,,.11ttYUi66,1 r, „�1? rf4ih�S d•�r, ,Stir Fixture/sewer cap
Name: Floor drain /floor sink /hub 25.02 IIM
Address:
Garbage disposal 111111 25.02
City /State /ZIP
Hose bib lin 25,02
12.51
1a maker
Phone ( ) y � ' ,I, ^rsx r rnm y l 25.02
t .� t 1 ai ca ! "'t i nr S n'TN " + r 1 f k h 5, .��a Interco trap
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Business name. Primer EM
Contact name; Roof drain (commercial) �
Address: Sink/basin/lavatory
City/State/ZIP: Solar units (potable water) VIIIESIIIM
Tub /shower /shower pan ���
Phone: ( ) Fax:: ( ) Urinal
E-mail: Watcrclosct 25.02 anal
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e a 14a ,n i � t � , r 9 t� . lu w ,a1 � � NM I 1Business name: Craater piping/ WA; J 56.29
ftwork Plumbing inc Tnc 25.02
Address: 7733SW Cirrus Dr. Other: Subtotal
City /State /ZIP: Beaverton, OR 97008 Minimum permit fee: 872.50 I
Phone: (503) 644-8698 P lan review (25% of permit fee)
CCB Lie.: 79666 # Plumbing Lie. no.: 20- 148T'B State surcharge (12% of permit fee) 'g. 7?
TOTAL PERMIT' rrr - -.
Authorized signature: J / /�
// / this permit x nptiontinn czPiYeg It n permit it not obtained FEE
wi4hfi 1,R0 day!
Print name: Peter Pollard Date: ' `"'/ "" after It has bete accented ie [nmDtO�
"Fee methodology set by Tri -County Building industry �ervioo Banrd,
410- 4el6TI1DMO2/c0MPN17)