Loading...
Permit CITY OF TIGARD PLUMBING PERMIT • m. ' COMMUNITY DEVELOPMENT Permit #: PLM2012 -00087 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/19/2012 Parcel: 1 S 134AD05500 Jurisdiction: Tigard Site address: 10825 SW BLACK DIAMOND WAY Project: HAWKEN Subdivision: BLACK BULL PARK Lot: 24 Project Description: Tub replacement. Contractor: MP PLUMBING CO Owner HAWKEN, NICHOLAS J & MARY A PO BOX 393 10825 SW BLACK DIAMOND WAY CLACKAMAS, OR 97015 TIGARD, OR 97223 PHONE: 503 -655 -9161 PHONE: FAX: 503 - 655 -1726 FEES Quantity Description Date Amount 1 ea Tub /Shower /Shower Pan 04/19/2012 $12:51 Specifics: 1 12% State Surcharge - 04/19/2012 $8.70 Plumbing Type of Use SF 60 ea Minimum Fee Adjustment - 04/19/2012 $59.99 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. Issued By: � Permittee Signature: it 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. • FROM MP Plumbing (THU)APR 18 2012 8:24 /ST. 8: 23/Ho.8308284880 P 2 Plumbing Permit Application Building Fixtures \NV i (r i< (rim i I , i ().1% City of Tigard g V,CV � 1 , M Pe:mtNo-: + ! i a , 0- - 4 6 lvd. 13125 SW Hall B, Ti OR 9 9 Plan Review Phone: 503,718,2439 Fax: 503.598.1960 Q a - 0 p gt& gy . Other Permit No.: Inspection Line: 503,639.4175 P ,. . to >�YBY lode B See Page 2 for • Internet www.Uga1d ot.gnv , �� 11 : eWo rp.. - . Information ?d � i�r?'�' 1 � �JI�,,W YI .� rl'S�'�.+iri/J�.s d:,r.9' . ��.. .,� . f t w wr '•g �' � ill' .i. 1t' j y' 'Y,f . . i i. ^�.T ,Y .. �! i Y ; ' 4, : , A:r 3 1.t' y:s ' r Wit It . g am,_ ��i 27€. t. t l N,{�,�I ,�,t� 5, ! ', 1' a a`x rl � g g y e yu b r. 3x. ' F..- 4 r;. : tY1: � P c C JK ,t�S � ^ ^`•V.PYN r •17 / °�l�fifl:�k!'iYw�i:� � � :tl. ,; ,Y .A.- � ar�Y'YL5ax J<Dy �.�. i.r.. ❑ New Cdnstfuction 0 e `,3.1 on For Tidal Wbnstatioa use checklist Description I Qty. J Ea L Total ® Addiliom/alteration/replatement ` *.� �`gy f�' ❑ Other; New 1- Mornay dwellings (includes 100 ft. for each utility connection) .: ,4"R• `ify� i::��:�rr�rp>�Ji.�= q� :r1� O'Y'�"N.1 V ' A I�Il[Y ? t ela 1) bath ,.. u:Yl. ?if,:a,`sY`Mraiir :r a:ft>y........... �............. .... �.. _ _,..., _ � "�.�h. � sal. , . , . -. -.r. -. ® I - and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78 1:1 Accessory building ❑ Multi - family SFR (3) teeth 500.32 In Master builder Each additional bath/kitchen 25.02 © Ot her Fite sprinkler sq. ft.) Page 2 . v , ;Ov a ,_ . A a m s� ? ' ? 3 ' ;' _site er: ... h .. _ Catch basin or area drain 18.76 Job site address : 10025 SW BLACK DIAMOND WAY City /State/ZIP: TIGARD, OR 97223 Ihywell, leach line, or trench drain 18.76 . Footing drain (no, linear f.: Page 2 Suito bldgJapt. no I Project name: #295 OB I 744)„ ;vfenufnatrneal teethe tltiliti® _ 50.07 - Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer (no. linear R: ,) Page 2 - Storm sewer (no. linear R.: _) Page 2 Water service (no. linear ft.: __) Page 2 Subdivision: 1 Lot no.: Flzture or team: • Tax map/pa cel no.: BerJttlow presenter 31.27 n.: '.t a , -:. � ' �.. 7,'..�,;k„D a . �rd',,rcti f4fi,,y��� c w,mr {ja�.4� fig 1 �; Badcwatel. valve 12.51 :` ti' �' �. .tIa: A7` �F�iri•:> N:•`:;:e'r°."�:')n. +,�r,�ur"i.' �-..,..... ��., � r . 1 -.•+ • �:'.'!: 47ZxJ /11t�Si "fS�1�k?;.YrP1t�i9i��� Clothes washer 25.02 TUB TIP TOE BEING REPLACED Dishwasher 25.02 Drinking fountain 25.02 Ejectota/srnap 25.02 ' p4�} r1 �y l :a r� 1 jS�, 12.5 "�� .'i''l Z: F�C. ��• Y+•;.,:.r1..$P4 It �10. . ra .lit. k.:,:..: n • . rok ti Expansion lank 1 Name: HAWKEN RESIDENCE Fildure/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City /State/ZIP: Hose bib 25.02 Phone: ( ) Fax: ( ) Tee maker 12.51 /,���� t1 ga a ��pp,M W ylNTO F �' .. QF y .•.., r.� r t Inter"pto /grcasc trap �; Tj�+. i��4�' �i,; l?' J' �i. �4�lpl. ��'!!! �':!!.' d:" ��. IL' �d�'>r�V,Ydlyt':{�a }�ia.,':'r� .1 " °" ^" 25.02 Business name: MP PLUMBING CO Medical gas (value: $ ) - Page 2 Contact name: CINDY CR1VELLONE Primer 12.51 Roof drain (commercial) 12.51 Address: PO BOX 393 Sink/basinMvatory 25.02 City /State/ZIP: CLACKAMAS, OR 97015 Solar units (potable water) 62.54 Phone: (503) 655 -9161 J Fax: ; (503) 655 -1726 Tub/shower/der pan ...._ 1 12.51 12.51 E-mail: CINDYC®MPPLUMBINC.COM Urinal 25.02 . y. �.... r .•'l,: • f �I j �y r' � r', y ! ah�.� r y� ,h��,�. , � Water CI(ISat 25.02 ' S x »�a ' '.'f�Y� ..h.;�1 g$, . r\1 tN311x;N� 7 r x! ..:00 A IANA �:"� JJ•t tifi!pr! OWS - - orator heats 37.52 Business name: MP PLUMBING CO Water piping/OW V 56.29 Address: PO BOX 393 _ Other. I ' 25.02 City/State/ZIP: CLACKAMAS, OR 97015 Subtotal 12.51 Phone: (503) 655 -9161 Fax: (503) - 655 4726 Minimum permit fee: $72.50 72.50 Plan review (25% of permit fee) CCB Dec.: 5002 Plumbing Lie. no.: 3-17PB State surcharge (12% of permit fee) , 8.70 Authorized signature: TOTAL PERMIT FEE 81.20 Print name: CINDY CRIVELLONE J Date: 4/19/12 This permit X00 mini It a permit b not obtetaed wlthln 180 days after h bas bees taooepted as eamplerin •Fee methodology set by T . ounty Building Industry Service Board. • r:\Ataldin enniNTLMU- PeenkAre.aoe 1WOU09 440-4616T(10/97/CCLWWEB)