Permit •
CITY OF TIGARD . PLUMBING PERMIT
I N • COMMUNITY DEVELOPMENT Permit #: PLM2009 -00212
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/05/2009
Parcel: 1 S136DB02601
Jurisdiction: Tigard
Site address: 11606 SW PACIFIC HWY 100
Subdivision: Lot: 0
Project:
Project Description: Replace shower pan.
•
Owner: FEES
HWY 99 LLC Quantity Description Date Amount
2655 MARYLHURST DR
WEST LINN, OR 97068 1 ea Tub /Shower /Shower Pan 08/06/2009 $16.60
PHONE: 1 12% State Surcharge - 08/06/2009 $8.70
Plumbing
56 ea Minimum Fee Adjustment - 08/06/2009 $55.90
Contractor: Plumbing
UNITED PLUMBING
PO BOX 971
FAIRVIEW, OR 97024
PHONE: 503 - 752 -8446
FAX: 503- 491 -8671
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports (Conditions)
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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
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Q t Ir n (, JJ Permittee Signature:
JAI) p .
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.
. S AUG -05 -2009 10 :15 AM P. 2
Plpmbbjn2 Permit An r li il,,,, .. EivED
Building Fixtures
City of Tigard AUG 0 5 2009 Received
Date/By, Permit No.:
• 13125 SW Hall Bivd., Tigard, �P�rnZQO9 4 t
4 -I • Phone: 503.639.171 Fax nark TIGARD Data /B Other Permit No.;
1 } ;� is r, InspectionL.ine: 503.639 . 41 BUILDING DIVISION Date Ready/By:
adyBy: , B See Pese2for on
lnternet: www.tigard- or.gov Npt1&ed/Method:
..
•
,
❑ New constructicm (0 Demolition Forapedal infomnwllon we checklist.
Description 1 Qty. 1 Ea. 1 Total
Addition/alteration/replacement ❑Other
dwellings (includes 100 ft connection)
Cml'L'EG1D
. YtY
SFR (1) bath I i 24910
❑ 1- and 2- family dwelling Commercial/industrial SFR (2) bath 350.00
ID Accessory building ❑ Multi-family SFR (3) bath 399.00
Q Master builder O�� Each additional bath/kitchen 45.00
. , ..- . .. . Fite sprinider (_ sq. ft.) 1 Page 2
81,,E INIF'ORMA'I /iN 'ANQI .i0041ON Site ntilitiee
Job site address: I j / Ue /_ 5� �.� r�i L , r � Catch basin or area drain 16.60
City /State/ZIP: r { t[� 0 y�
Dryw ll, leach Use, or trench drain 16.60 ,
2
Suite/bldg./apt. no. : Project name: Footing drain (no. linear R: „_) Page
Cross street/directions to job site: Manufactured home utilities 110.00
// Manholes 16.60
R.; j p l J rJ rot lOi r 1 . . Pe.,,-,44; CD 1l cyst/ Tr rt q Rain drain connector 16.60
i/�.4nt . 'L.-..tr.aPwi � � ,ra d°.� Sanitary sewer (no. linear R: � Page 2
D . h rP 3 ` l e S t o r m sewer (no. linear ft : _, _�) page 2
Subdivision: no.: Water service (no. linear ft.: _) Page 2
Tax map/parcel no.:
Fixture or item
a. . , .; r•:.. on valve 16.60
. : . D ES C RIflIOrt , :. , O
... . . .:•.:.:....:... Bat3cflow preventer Page 2
- rA t4'Tat (I P rt Of J,l e .1 S14 e AP,rf' pj4 Backwater valve 16.60
Te) x _/ e rot r iA j . Clothes washer 16.60
tQ yi S t .1441., !7. Dishwasher _ .
16.60
(`!E<ItOi!>1 °'+fj . . . . Drinking fountain 16.60
. .... . , •...:I `...... `:0:
• 13jectors/sump 16.60
Name Expansion tank 16.60
Address: _ Fixture/sewer cap 1 6.60
City /State/ZlP: Floor drain/floor sink/hub L 16.60 / t too
Phone: ( ) Fax: ( ) Garbage disposal 16.60
i. ►1$0*t;N.t ::. 01N rA l ERS.ON Hose bib 16.60 •
� be make 16.60
Business name: (Jb4 - i - d ( Pit r v1 p interceptor /grease trap 16.60
Contact name: o M Medical gas (value: $ ) Page 2
Address: P Q f 4 o 9 7 t ..) Primer - 16.60
City /State2TP: A s v ; e4, � 17 i - 5 70 ay Roof drain (commercial) 16.60
Phone: (ro Q 7�. sd ! Fax: : (5b, ) A/4/ _ 6 71
Sink/basin/lavatory or /s .. 16.60
Tub/shower /shower pan 16.60
E- mail ::.:r4 sov■ e ail' rec('P1Q.16im+tgt !-c • ix-.c Urinal
16.60
.. RACl R `., ' . , j Water closet 16.60 _
Business name: • . .. 0 • • + Water heater 16.60
Address: P[ z2 r): Gi 7 I outer:
city /State/ZIP: Subtotal
J s , °e. 0 g7r, ? If
.
Minimum permit fee: $71.50
(5b3) 75-19.- 7 f Pax (m•2)) l a/ 9 / -4 ( Res backflow ,j q
Phone: minimum permit the: $36.2 .'"71,7 CCB Lie.: 1 LI S- / s Plumbing Lic. no.: p , y Plan review (25% of parrs fee)
�• State surcharge (12% of permit foe) g� 00
Authorized signature:
d4.2, ITOTAL p ti FEE � f
Print name: < D >!1, t�a e . 1 i Date: g,,3 _. - This permit application expires If a permit Is not obtained within
1110 days after se hes been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
I:1 BuldlorPermlta \PLMP- PermitApp•dcto 12470 440- 48167(I0/02/COMAvBB)