Permit CITY OF TIGARD PLUMBING PERMIT
•. ' COMMUNITY DEVELOPMENT Permit #: PLM2012 -00148
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/04/2012
Parcel: 2S102BA02103
Jurisdiction: Tigard
Site address: 9965 SW JOHNSON ST
Project: Hotchkiss Subdivision:RTH TIGARDVILLE ADDITION, AMENE Lot: 45
Project Description: Repipe waterlines to (2) toilets, (2) lays,(1) tub, (1) washing machine, (1) kitchen sink (1) hose bib
Contractor: PLUMBING CONCEPTS INC Owner: HOTCHKISS, SEAN P & KRISTENA D
PO BOX 1068 9965 SW JOHNSON ST
CLACKAMAS, OR 97015 TIGARD, OR 97223
PHONE: 503 - 658 -5232 PHONE:
FAX: 503 - 658 -5232
FEES
• Quantity Description Date Amount
1 ea Water Piping /DWV 06/04/2012 $56.29
Specifics: 1 12% State Surcharge - 06/04/2012 $8.70
Plumbing
Type of Use SF 16 ea Minimum Fee Adjustment - 06/04/2012 $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: Permittee Signature: Q AP O / u ` r�- 0 b k)
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.
May 31 2012 4:03PM PLUMBING CONCEPTS INC 5036585232 P.2
5
Plumbing Permit Application 4 •1 a *' di-
Building Fixture r ! : a -:
.111 City of Tigard MAY 3 12012 R ' / ' u
it 13125 SW Hall Blvd.,Tigard,OR 97223 Day- �f ((a �1 PG1��crt 0�e1- i9
' n Phone: 503.718.2439 Fax: 503.598.1960 Pia" Review
C OF TIGAR D Dam• Other Permit No.: Ins
FICA 1; D
Inspection Lute: 503.639.4175 Date Rea B : r
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Internet: www.tigar U G
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❑ New construction ❑ Demolition _ For 'pedal information use checklist&
. Description I Qty. ( Ea. I Total
® Addition/eheretion/replacanent
:.._M.. , _.,.. ;�� • _ y dwellings (includes ft. for connection)
_ ;,,, _ _ _ - _ _ .,�,., Other _ New 1- Z•famil d Ilo inc es ]00 each utility co •nn
; .. h}i r3' u �.:; : ;; . i SFR
,..._ :;ifs €� �i�:`�.: ,:'C�. �';r� '•:-i��:.. (])bath 3127
® 1- and 2- family dwelling ❑ Commercialfmdustrial SFR (2) bath 437.78
❑ Accessory building ❑ Multi - family SFR (3) bath 500.32
❑ Master builder Each additional bath/kitchen 25.02
❑ Other:
- - -ru. �� Fire sprinkler sq. ft.) 1 Page 2
:.. :0... _.._'tom` -,na ___ - .. -. , .#10, : ? TI0! *1 =iii e;;: = .: "- Site utilities:
Job site atidtes„ '
s: 9965 S.W. &W Johnson St. Catch basin or area drain I 18.76
City /State/73P: Tigard, Or, Drywall, leach line, or trends dram + 18.76
Footing drain (no. linear ft.: _1 Page 2
Suite/bldg./apt. no.: I Project name: Hotchkiss Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear ft.: 1 Page 2
Storm sewer (no. linear ft.: _) Page 2
Water service (no. linear ft.: _ Page 2 i
Subdivision: I Lot no.: Fixture or item:
Tax map /parcel no.: Baddlow preventer 31.27
_ .: : -: ate: = : ;= _ - a _ _,1:, - - : r _ _ - -- Backwater valve 12.51.
- =c ;,.•: , ., Clothes washer 25.02
Re -pipe waterlines to (2) toilets, (2) lava, (1) tnb, (1) washing machine, (1)
Dishwasher
25.02
kitchen aink, (1) hose bibb. Drinking fountain 1 25.02
Ejectors/sump 25.02
s0 11 = ": - -::j'� - ' =r " , { IG r F� ?t , ': r 1 Ex anion tank _... ��.,...�,�_„ ..���� - - `��a 1`;a acs::.::::-::;: -. -•: P 12.51
Name: Sean Hotchkiss
' Fixture./sewer cap 25.02
Address: same Floor drain/tloor sitik/hub 25.02
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone: ( ) Fax:(
_ -- ,,. „'�... Ice male
r .i..E, i'=.,` Iran 25.02
rr,: r t: _..._ : r i.x :;-'��_'- '--..-- .,== ' - `' Y` �.fi. ^.:! ;- . �� vl� �'� ; t��.l� 'mss; ?: � y lnter CL'ptOr /grease
Business name: Medical gas (value: $ ) Page 2
Contact name: Primer 12.51
Roof dram (commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State/ZIP: Solar units (potable water) 62.54
Phone: ( ) Fax: : ( ) Tub /shower/shower pan 12.51
E -mail: Urinal 25.02
.E pis;' "' p = _c_, ;ail = = r ,:r� :. _ _ .., csx: _ WeterCloset 25.02
.:C:. _:Ali = ,- � :ii:4G::l ` 1� , :- _.,.2" -
. Water heater
37.52
Business name: Plumbing Concepts, Inc.
Water piping/DWV / 56.29
Address: P.O. Box 1068 Other. ( 25.02
City/State/ZIP: Clackamas, Or. 97015 Subtotal
one: (503) 658-5232 Fax: (503) 658-8553 Minimum permit fee: $72.50 ' Sd
CCB Lic.: 97587 ,,�lumbing Lie. no.: 3 -239P8 Plan review (25% of permit fee)
Authorized State surcharge (12% of permit fee) f, 7j) /
�Z PERMIT f
TOTAL PERT FEE / . ad - /
Print name: Lisa Zamudio Date: 5 - 2012 This permit application espirea if a permit is not obtained within 180 days +++"'
after It has been accepted as complete.
*Fee methodology set by Tri -County Building industry Service Board.
r: l &rilding1Pvmih1PLMt1_PanatAppdoe 16/01+89 440- 4616T(10k02lCOM/wSB)