Permit CITY OF TIGARD PLUMBING PERMIT
• COMMUNITY DEVELOPMENT Permit #: PLM2012 -00174
T t G A R O 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/19/2012
Parcel: 2S110DD06800
Jurisdiction: Tigard
Site address: 10525 SW GREENLEAF TER
Project: Fugey Subdivision: SUMMERFIELD NO.5 Lot: 294
Project Description: (1) shower replacement
Contractor: REED PLUMBING LLC Owner: FUEGY, BILL
PO BOX 2603 10525 SW GREENLEAF TER
OREGON CITY, OR 97045 TIGARD, OR 97224
PHONE: 503 - 572 -3784 PHONE:
FAX: 503 - 656 -1374
FEES
Quantity Description Date Amount
1 ea Tub /Shower /Shower Pan 06/19/2012 $12.51
Specifics: 1 12% State Surcharge - 06/19/2012 $8.70
Plumbing
Type of Use: SF 60 ea Minimum Fee Adjustment - 06/19/2012 $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 1.800.332.2344. ,0
Issued By: , "I Permittee Signature: c r ( A 4O ( /4-/-70 . 1 "IPLIAL/
Call 503.639.4175 by 7:00 a.m. for the next available Inspection date. I 1�
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.
06/19/2012 03:45 5036561374 REED REED PLUMBING PAGE 01
Plumbing Permit Application CE 1
Building Fixtures JUN 1 ?012 FOR OFFICE USE ONLY
l CI Of T 11 ATd Deteivcd is D„.....50( D„.....50( Permit ..List de ia -19012 l „
tt 131 SW Hall Blvd„ Tigard, OR r T��A� DatdB :
I Phone: 503.718.2439 Fax: 503.: r�� 1 WING DIVISION Plan Review
Date/fly: Other Pcrmil No.:
r r G n r c? Inspection Line: 503.639.4175 Date Ready/By: u 'R B See Page 2 for
Internet: www.tigard or.gov Natificd/MM
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...�..........: : '.:... A... I II I..1... II. Ir •I.n Y'61'd'n i�l.' � ��'�
❑ ew construction ❑Demolition ors' da in rmarion use checklist. ri
Addition /„Iteration /replacement ❑ Other: N w I. t 2- family dwellings (includes 100` each Ea.
connection)
.... ..., . tiR"i'EoijR'V w Oosit1t , :, ,.; ° : :: ; ::1't. ` :::: ;t; : : ;; • :;•, sFR (I) bath 312.70
I• and 2- fancily dwelling SFR (2) bath 437.78
❑Commercial /industrial
- SFR (3) bath 500.32
❑ Accessory building ❑ Multi family
T - Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler (__ sq. R) • -
Pagc 2
, ..,. � >F(i1tt� : : ;1�i'�'�6Nt;; i:;:i i, � : :� "':i :;;: :: ! : ' �,';,;:
Site utilities:
C �/� (:arch basin or arcs drain 18.76
.lob site address:
/ �5 ��n Drywell. leach line, or trench drain 1$,76
C :ily /51ate/7IP: 1L / OJ Page 2
Footing drain (no. linear R
,: �)
SOite/bldg./apt, no.: Project name: Manufactured home utilities 50.03
•
Cross street/directions to job site; Manholes 18.76
• Rain drain connector 18.76
Sanitary sewer (no. linear It.: _) , Page 2
Storm sewer (no. linear ft.: � ) Page 2
.. Water service (no. linear R,; _) Page 2
Subdivision; Lot no.; Fixture or Item:
Tax map /parcel no.: Backllow preventcr 31.27
......... : . ate v, e
�y2 /� � �� [' �j �;'•t� : :. :� : : .;: Cloth , h 25 02
' i 2 `� tS `i 1 • • //A /. /1 /4.., . y Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25,02
; ' plioPERT':OWNFR 'Ct i
. • . .. Expansion tank N ame: d ,.. , •, „ .• :..,
. „,,, I Fixture/sewercap 25.02
- -6-I , y e �/+� Floor drain/floor sinkTuh 25.02
Address; /6/ 6 J'r e/"eo ? �� Garbage disposal 25.02
City/State/ZIP: L a.r OR- '7 '7 z 2 ,3 Hose bib 25.02
Phone: ( 03 Fax: ( ) Ice maker 12.51
0 ,,AP1PL• 14 ANT.1 ,:0 'CON1`AC'L;;:P I'KStlly,.;: Interceptor /grease trap 25,02
Fusiness name: Medical gas (value: S ) Page 2
contact name: Primer _E
Roof drain (commercial) 12.51
Address:
Sink/basin/lavatory 25.02
City /Slate /ZIP: Solar units (potable water) 67 „54
Phone: ( ) I Fax: : ( ) Tub /shower /shower pan / 12,51 1? .5/
E-mail: Urinal 25.02
Closet
. ;C01YT1Yi1CIOR..
cr
• Wat : DWV r 37,52
Business name: /� � Water 56,29
Address: _ y b Other: 25.02
City/SO - 0 i 6 . el 9 p y5 Subtotal
Phone: ( fi b) 41157.x .51 5 Fax: 3 ) 0-' Minimum permit fix: 572.50 _
C'B Lic.: • 1 C robing Eie. no.: Pa ary7� Plan review (25% of permit fcc) 1 _�
S tate surcharge (12% of permit Fee) 9. 7)
Authorized signature: / ��J / TOTAL PERMIT FEE . , J
Print name: �ub
'" ✓!� This permit application expires if a permit is not obtained with' IRO day. 127 � Date: f q��-
after It has been accepted as corn Wee_
*Fee methodology act by Tri- Comity Boildiu p Indnsiry Service Baardj5A- /
, ; 1 a, I; ld;npOrcrmilevn,mu- rormilnpo.fkx le/also 440.1616TODM /COM/WGMI f�7�