Permit 1 _ n CITY OF TIGARD PLUMBING PERMIT
11 COMMUNITY DEVELOPMENT Permit #: PLM2009 -00089
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/14/2009
Parcel: 2S111CB01708
Jurisdiction: Tigard
Site address: 10260 SW HOODVIEW DR
Subdivision: Lot: 0
Project: Skach
Project Description: Replace piping to (1) clothes washer, and (2) lays.
Owner: FEES
SKACH, JOSEPH R & Quantity Description Date Amount
SKACH, MARY ANN, 10260 SW HOODVIEW DR 1 ea Clothes Washer 04/14/2009 $16.60
TIGARD, OR 97224 2 ea Lavatories 04/14/2009 $33.20
PHONE: 1 12% State Surcharge - 04/14/2009 $8.70
Plumbing
Contractor: 23 ea Minimum Fee Adjustment 04/14/2009 $22.70
A BETTER PLUMBLING CO. - Plumbing
6455 SW 90TH AVE
PORTLAND, OR 97223
PHONE: 503 - 232 -1664
FAX: 503- 477 -3621
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952- 001 -0100. You may obtain a copy of the rules
Issued By: a - . ( , I L Permittee Signature: Q n/ / / '
A9p1A
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
.,''04i'14/2009 10:17 9712550406 A BETTER PLUMBING CO PAGE 03/03
Plumb' ' 2 Permit Application
Buildin Fixtures FOR OFFICE_ LSE.. ONLV
APR 1 2009
- City of Tigard Received
; . Pelxuit No.: lA�e
'+ 13125 SW Ball Hlvd., Tigard, OR 9722 CARD :::: t � O N24 � ®F 1'I l ew Otktcr Permit No.:
:.Phte: 503.639.4171 Fax sa.59 ®ING DIVI SION
[ Ins Inspection Line: 503.639.4175 .
TI1 :1 A-- Internet: wlvw.tigard- or.gov DatcReady/$y: • Os: s Seepage Ifor
Mtn a$ t } Notrhedagtthod: su , lementalInformatio�0
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❑ New cons action ❑ Demolition For special information use checklist
Description I Qty. 1 Ea _f Total
:J Addition/a1 auon/replacement ❑ Other: New i- 2- family dwellings (includes 100 ft. for each utility connection)
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ta ys tPs ac�]11 I 1 a
1 l i n Jj� t tra t it 1? prott r tea 1 1 I t l�tt 4:it +l�f 1 1� t.f (
1 in a : }A 1 , � I,1. . ' r . t , it til,iln1 t . li . :,1 :.:r ttt l,hlt ..pit ! . i, 0 , r..rlt i I � .,. SFR 1 ) bath 249.20
1 1- and 2 -f5 r ily dwelling ❑ Commercial /industrial SFR (2) bath - 350.00
❑ ,accessory 1 iilding • III Multi-family SFR (3) bath 399,00 •
❑ Master bull r et• Each additional bath/kitchen 45.00
I ❑ Other
.� l ` ` `t, try , Y t { t1 t p lxl tkRagt= lsl.�, " " 'Ht� i g I 1It } tin 1 , �ttN tlf {y tt F r 1 }i } t' I F ire sprinkler ( sq. ft.) Page 2
it r Il ;tl r a dl il5 .Tf1 t a1lii ll,"sYt �'��t\'4 .IJfIti' arty hi I I t �. } F?1.+ 1 l R ii�tllNt :,I,j : 11Ft l . sil l i ?t.t�
I : a.l W e ut
Job site addres t 101100 ' W • • r V U e • g. Catch basin or area drain 16,60
City /State /ZIP: 11 c, 4g•` 1 O �i r 1 Drywcll, leach line, or trench drain 16.60
Suite/bldg. /apt.ino.: 1 Project name: � .114 Footing drain (no, linear ft.: ) Page 2
Cross stieeUdi ctions to job site; Manufactured home utilities 110.00
., Manholes 16.60
Rain drain connector Y 16.60
Sanitary sewer (no. linear ft.: ) - Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: Lot no.; Water service (no. linear R.: � ) Page 2
Tax map/puree no m_ Fixture
( Fixture or item
f Mi s t t � 1 ' l#! TIVIRI l fi {1 ��� Absorption
g t I ` : t t � #',3latil r R I } i t .Iti t i > t rp 16.60 gc
�t7J�� } � r l, �rlil�� �t�� �I��{ �. .El.+i }I}IIN�trl�d�}I!} {l�YfarY art .tt[I:�'1 ?tltf?�t tf.. i ii.t r ,'s�'''�ror`at e.:. *.1 f Silt Ha Pagc2
r "Q L'Pl C.E CO - go ► li► )3ackwater valve M 16.60
1 loP 1 hi . Clothes washer 16.60 S1C3t:l o
Dishwasher 16 -60 Mill
i["" ft
E tta 1111 Ir t a r
l a' r � t ! h t' 4 " Ili�lml l ,t '' tl 1 / iifl t i t . ,' ` 1 � � �," ' SI Il ' 1, G } k a f � } #1 { r z i Dnnktttg fountain
16.60
h , li i .rtia x�1iiill: tiiu. ilt..itht lrit. t is t liti �..: tii Ij iI ,;n t �1;; :Blinn ° 'ttili ■ .. I411 ' Ejectors /sump 16 -60
Name: X10 - K�
Expansion tank 16.60
Address: 0 to o S W 1 0 p V S w a. - Fixture /sewer cap 16 -60
City /State /ZIP: 1 . t4- 12 0 G 11 ,0a Floor drairt/floor sinkJhub 16.60
j Phone:: ( !fit L S �j 3- g F ( ) Garbage disposal 16.60
lit NIMI T I llr141h1 CI alai � txrl, h a�'}I� i li xi fr tril( ti �#ltla" trr337at t' H ose bib
l i t t ...: I i 1 1, S t � t u sG1..,slii t .. VII u t t x d YI aT { i ��e tit ;l< t t r. r 16.
I t4;: (: ri �� � +' ttrliza'.1ll a k ti� 111 Ice maker 16.60
Business name: . 2, LU e) 1 N G, 'b � se A' k
Interceptor /grease trap 16.60
Contact name: J - ,D 1 Y ` 1 � • j RR-0 1 Medical gas (value: $ ) Page 2
,address: IV SW OLD j{ SD ■ , : Primer 16.60
City /State /ZIP: i �p�1 L- � t n 019 Roof drain (commercial) 16.60
Phone: (13) , 4M, ' I t. (p L - Fa x:: (�> ) 47 g7 iota Sink/basin/lavatory 16.60 j •
) mull Tub /shower /shower pan 16.60
i ` i - v .1�i t o . \100 corn- Urinal 16.60
Elrl llll { fa� N EIREr t l +` �a 91.111 r tl1!1}l . i:.. 1�' if 'il: 1r ll Water closet
16.60
t
Business name.. b - 1 .4,- l '- b� t. A, `N C r o la -P � T � _ Water heater 16,60
Address: 1 o W 01` td V N { i"`tJ $ ` c l : � Other:
City/State /ZIP: ; "pO'2' C • N t 1) ci i �2� Subtotal • . r 'Q
Phone: ` t 1 Minimum permit fee: $72.50
�-?Q3 - • 4_ F ax: ( • 1f -1,ta i Residential backflow minimum permit fee: $36.25
CCB Lie.: I - • Plumbing Lie. no.: 3 Plan review (25% of permit fee)
Authorized sign lute: • State surcharge (12% of permit fee) • -p
,r
.r ' t TOTAL PERMIT FEE 0
te
Paint name: 1 R 0 i1 ] t.� 1 µ
1ti(. � Date: 1 �
If 1 This permit application expires if a permit is not obtained within
�.. p PP P
1 1 iSO days after it has been accepted as complete.
-�` *F methodology set by Tri- County Building Industry Service Board.
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