Loading...
Permit CITY OF TIGARD PLUMBING PERMIT ° • COMMUNITY DEVELOPMENT Permit #: PLM2012 -00198 T l G A.R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/18/2012 Parcel: 1 S125DB05400 Jurisdiction: Tigard Site address: 7255 SW SHADY LN Project: Koeber Subdivision: SHADY DELL NO.2 Lot: 28 Project Description: (1) sink, (1) shower and (1) toilet for 2nd story addition Contractor: PIPELINE PLUMBING Owner: KOEBER, ROBERT 333 S STATE ST SUITE V -108 7255 SW SHADY LN LAKE OSWEGO, OR 97034 PORTLAND, OR 97223 PHONE: 503 - 624 -1906 PHONE: FAX: 503 - 624 -1926 FEES Quantity Description Date Amount 1 ea Sink 07/18/2012 $25.02 Specifics: 1 ea Tub /Shower /Shower Pan 07/18/2012 $12.51 1 ea Water Closet 07/18/2012 $25.02 Type of Use: SF 1 12% State Surcharge - 07/18/2012 $8.70 Class of Work: ALT Plumbing Type of Const: 10 ea Minimum Fee Adjustment - 07/18/2012 $9.95 Occupancy Grp: Plumbing Stories: Total $81.20 Required Items and Reports (Conditions) • This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: tall ,t Permittee Signature: O , 1 /A !CVO CVO 64T7Dk /' )(ILA/ Call 503.639.4175 by 7:00 a.m. for the next available inspection date. t'' This permit card shall be kept In a conspicuous place on the job site untifcompletion of the project. Approved plans are required on the job site at the time of each inspection. Feb 16 01 12:39a Adam Faren 5036241890 p.1 Plumbing Permit Apjplicatti ;$VED Building Fixtures City of Tigard JUL 17 2012 B 7 11..81 i z s r PenmtNo.: ' 0 a© / 3 . OD/9 : • 13125 SW Hall Blvd., Tigard, OR 97223 p i Review Phone: 503.718.2439 Fax: 503.598Ci y OF TIGARD ��y: Other Permit No.: T 1 G A R D Inspection Line: 503.639.4175 BUILDING DIVISION Daz � J 6 ® See Page 3 for interne: www.tigard -or.gov GLJI IJi1Vlit DIVISION Si g pl emeate ll°fo rma tion TYPE OF WORK FEE* SCHEDULE ❑ New construction ❑ Demolition For special inforfimdort use checklist Description I Qty. I Ea. I Total ® Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 It for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 312.70 i ® 1- and 2- family dwelling ❑ Commercialrrndustrial SFR (2) bath 437.78 SFR (3) bath 50032 ❑ Accessory building ❑ Multi- family Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other Fire sprinkler ( sq. R) I Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 7255 SW Shady Ln Catch basin or area drain 18.76 Drywell, leach line, or trench drain 18.76 City / State/ZlP: Tigard OR 97223 Footing drain (no. linear ft.: ) Page 2 Suite /bldg. /apL no.: 1 Project name: Koeber Manufactured home utilities 50.03 • Cross street/directions to job site: East of SW 74 Ave, West of SW Shady P1 Manholes 18.76 Rain drain connector 18.76 Sanitary sewer (no. linear IL: ) Page 2 Storm sewer (no. linear R.: _) Page 2 Water service (no. linear R.: ___) Page 2 Subdivision: Lot no.: Fixture or item: Tax map /parcel no.: Backflow pimento 3127 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer j 25.02 2 story addition. All plumbing for shower, toilet and vanity sink. Dishwasher I 25.02 Drinking fountain j 25.02 ' Ejectors/sump 25.02 ' ® PROPERTY OWNER ❑ I TENANT Expansion tank I ; 12.51 Name: Bob Kocher I Fixture/sewer cap 25.02 • • Floor drain/floor sink/hub 25.02 I Address: 7255 SW Shady Lo Garbage disposal 25.02 City / State/ZIP: Tigard Or 97233 Hose bib 25.02 Phone: ( ) Fax: ( ) lee maker 12.51 I ❑ APPLICANT ® CONTACT PERSON Interceptor/grease trap 25.02 Business name: Medical gas (value. $ ) Page 2 Primer 12.51 Contact name: Bob Swan Roof drain (commercial) 12.51 I Address: 408 NE 110 St Sink/basin/lavatory 1 25.02 25.02 I . City /State/ZIP: Vancouver WA 98685 Solar units (potable water) 62.54 Phone: (503) 804 -0128 Fax: : (360) 573 -1452 Tub/shawer /shower pan • 1 12.51 12.51 E -mail: Urinal 25.02 Water closet 1 25.02 25.02 CONTRACTOR Water heater 37.52 Business name: Pipeline Plumbing Water piping/DWV 56.29 Address: 333 S State St fV -108 Other. _ 25.02 City / State/ZIP. Lake Oswego OR 97034 Subtotal 62.55 Fax: (503) 624 -1926 Minimum permit fee: $72.50 72.50 Phone: (503) 624 -1906 �CB Lic.: 158260 Fax: Lic. no.: 3 . S! o P, Plan review (25% of permit fee) r r� State surcharge (12% of permit fee) Authorized signature: 7N), t � )�� l 1 ^vv yI VPLd t(� . TOTAL PERMIT FEE g(, pp ./ 1 I Print na a Terra Vickeraoan Date: 07 -17 -2012 Ibis permit application expires If a permit is not obtained within 180 days after it bas been acocpied as complete. *Cos ...riwi..in.... e-, 1... Tri- rnn..w. u..a.nn.. i..,i..,.... Car..:.... I••o..i •