Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2012 -00097
T [ G A.R O 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/27/2012
Parcel: 1 S136AA07100
Jurisdiction: Tigard
Site address: 7081 SW LOCUST ST
Project: Tanz Subdivision: AUM DOWNS Lot: 5
Project Description: Kitchen remodel, replacing sink, disposal, dishwasher & ice maker.
Contractor: RUPP FAMILY CONSTRUCTION Owner: TANZ, GUY H AND
29030 SW TOWN CENTER LOOP #202 -443 BADZIK, KATHLEEN M E
WILSONVILLE, OR 97070 7081 SW LOCUST
TIGARD, OR 97223
PHONE: 503 - 201 -5038 PHONE:
FAX: 503 - 682 -5056
FEES
Quantity Description Date Amount
1 ea Dishwasher 04 /27/2012 $25.02
Specifics: 1 ea Garbage Disposal 04 /27/2012 $25.02
1 ea Ice Maker 04/27/2012 $12.51
Type of Use: SF 1 ea Sink 04/27/2012 $25.02
Class of Work: ALT 1 12% State Surcharge - 04/27/2012 $10.51
Type of Const: Plumbing
Occupancy Grp:
Stories:
•
Total $98.08
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 q - on : • UNC by calling 503.232.1987 or 1.800.332.2344.
Issued : :y: Permittee Signatur .
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.
04 -23 -2001 15:49 CHRISTOPHER EUANS 503 235 9553 PAGE:1
Plumbing Permit Application
Building Fixtures RECEIVED I .,a ()l I 11 i I sd (,.l 1
City of Tigard Re01y''ed t+armitTlo.: 1
131 SW Hall Rlvtl., Tigard, OR 97223 ix,,,,,, m gre . •... N / ...av
'
q Pla Revie
Phone: 503.7182439 Fax: 503.598.1960 ), 2Utt 7 (kbaPRtnittwo.:
C. - -.1:
1 Line: 503 D y
i I i) �� on Date ltrndY/11y: hie: ® See Page 2 for nternel: www.bltnt-or.gov 15upyleme>opl ..
TYPE OF W D I TG DIVISION > - sc DUlr� •
El New constnu:titn Demolition For special ittforrtmdotr are c/ter _
Dcsctiptiwt I city. 1 Ea. I Total
a Addition/altctatiun/repl ❑ Other: New 1- 2- family dwellings (includes 1011 IL for each utilittconncdwn)
CATEGORY OF CONSTRUCTION .. SFR (1) bath 312.70
1- and 2 - family dwelling ❑ Cotnmercial/industrial SFR (2) bath 437.78
I
❑ Accessory building ❑ Multi family SFR (3) bath 500.32
,.. Each additional bathAcitchen 25.02
❑ Master builder ❑ Other Fire sprinkler (_ sq. IL) Page 2
f
• • JOB SITE INFORMATION ORMATI AND LOCATION _ Site utilities:
Job site address: )oak 'old List- , Catch basin or area drain 18.76
Drywall, leach line, or trench drain 18.76
City/StatcfZIP: 1 ,rem (70 ail Footing drain (no. linear R: _) Page 2 .- -
Suite/bldg./apt. no.: J Project name: Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 1836
e. �ov' % 1<1 ` LhG Main drain connector 18.76
, VS ,..., Sanitary sewer (nu. linear R: ) Page 2
0!0 X (l t7r ks .. _ Storm sewer (no. linear R.: _) Page 2
Wafer service (no. linear 11 _) _ Page 2
Subdivision: + 1.01 no.: Fixture or item: - • -
Tax map/pareel no.: Baldctlow ptevenler 3127
9
. DESCRIPTION OF wOix Wonder valve 12.5)
• � • Chillies washer 25.02 •
r�JIGC_tN5 Vc�'1� 6%tA i t•ct o St"k G1wd L. Dishwash
ct ll raal c1 (C i is ail f1.rn ade.1. Jug blest' Drinking fountain 25.02
-)a,'^d. 68V1i Fred Pi1e.: -er F.i 25.02
rttorERTY owNF.R I ❑ 1124 NT tank 12.51
Name. V h a 1
k �c, �t 1 ►v1 L
Fl dr ewer cap
_ Tc
] Floor draio/tioor sink/hub .25.02
Address: r•)Of 1 S,3 1,ci oWt k''• Garbage disposal I. 25.02 5 0 2'
- city/Statd7.TP: - 1-‘„ CI r u ral oa ei •OQ 3 1-1Me hill 25.02
Phone: ( ) , Fax: ( ) Ice maker 1 12.51 /9-.
. . It APPLICANT ❑ COPITAETIkliBON • Intcrecptor /grctne trap 25.02
n
Business name: �p Con- k- lur1 - .., Medical n � 1 gas (value: $ _ ) - Page
t� v 1'GtMt
Contact name: A rhdrw ..1. ,g \- cvc
no .-. Roof drain (commercial) 12.51
Address: ::v..aro.,hA CAvIteC I.,p. lr Sts. 202. bpX ■-0-13 - Sink/basin/lavatory 1 25.02 025,07
City/State/ZIP: ( ( 1 Q Salar units (patablc water) 62.54
Phone: (S03) 2,01 - 6038 1 rax:: ( Sol, ) 1..' e . Tit/shower/shower pan 12.51
E- mail: C, e,c)c.Ar+ 1 i tr Ql J,vtlatrhe nn Stn. crw
oh Urinal 25.02
. CONTR Water closet 25.02
_- _ ._... Water healer 37.52
Business name: Lop 1 _ gM i 1 Gave S %TOL:4 \ Water piping/DW V 56.29
Addmss:25b30 Sul Tay:lC.,gini L(a• Li Ste. 202 Yam( L•1, -(3 Other: 25.02
City/State/ZIP: (.,0 � so✓1 ✓h 1 14 0Q G 1 D1 i _ Subtotal
Fax: ( 603) (9 Sa - 5 o 5! _ Minimwn permit fee: $72.50
Phone: (' ) Zd I •�W Plan mew (25% of permit iix)
CCBLic.: ^ l p v ag p t0 r9 Plumbingt.ic_no.: 3a33 P ` t
State surcharge (12% of permit foe) /p • .S1
Authorized slgnantre: '� 9 _ wires TO'T'AL PERMIT FEE 7 1/ ,75
Print name: ,,//����� J Date: I ibis hermit application ires de penult is not °Maimed within 1 days
T1Ylq i . W V 1 � 1 Ja11� yl ' 1 L after it him beds scripted as eampkte.
*Fug methodology set by Tri•Cir mty Building Industry Service Huard
d.
ruwiIdinp\PemiUUPLMU- Pam+uurm+e MUM 44.46tsr(to/o7/COWwIa)