Permit 7 CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2012 -00201
T1GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/23/2012
Parcel: 2S114BB04800
Jurisdiction: Tigard
Site address: 10080 SW PICKS CT
Project: Vandervoort Subdivision: PICK'S LANDING_NO.I Lot: 25
Project Description: Replacement of 80' of sanitary sewer line
•
Contractor: ROOT EXCAVATION Owner: MARCHANT, DEBORAH DEWIT
10824 E OAK ST PO BOX 152
MILWAUKIE, OR 97222 WHEELER, OR 97147
PHONE: 503 - 656 -6610 PHONE:
FAX: 503 - 656 -6625
FEES
Quantity Description Date Amount
80 If Sewer Service 07/23/2012 $62.54
Specifics: 1 12% State Surcharge - 07/23/2012 $8.70
Plumbing
Type of Use: SF 10 ea Minimum Fee Adjustment - 07/23/2012 $9.96
Class of Work: OTR
Plumbing
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: aAi ,974 O/\
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.
Jul 19 2012 16:29 UPSSTORE 313 LRSERJET FAX 503 - 794 -5929 p.2
Plumbin Permit A lication
Building Fixtures 11VED t ( )l•Z I 11 I l .l: I)\IA
13125 of Han B l a . Tigard, OR 97221U 1- 19 2012 7 / 7 2//.12- f ir• - tNapvyaa .o� - 40#0q o? 0/
Plim Review
•�_. i • Phone: 503.7182439 Fax: 503.598.1960 DataBy- Other Pamit No.:
1 . Inspection Line: 503.639.4175 CITY OFTIGARD
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o New conshnction 0 Demolition For special heonnanwr rue checklist
Description I Qty. I Ea. I Total
® Addttton/alterattonhepla°ement o Other New 1- 2 -hmlly dwellings (includes 100 it for each utility amnection)
' L � � � 1, , . t 'S , SS . � � n � �•idl - ,+ y f;' , + ,�&.'- r ° �'" �A'•,� �: n r�;
:.i'.. a ic, ,A:iiiu.r 14 . t,., :}1ds�. ;�1 3413• .i..r. ?
,� . A. , �_ ' ` t',_ _s SFR (1) bath 312.70
® 1- and 2- family dwelling 0 Commercial/mdustriai SFR (2) bath 437.78
o Accessory building 0 Multi - fatuity SFR (3) bath 501 132
❑ Master builder Each additional barb/kitchen 25.02
1 r.. r J' a� n3 r " p G, bes;F �n Fire sprinkler t sq. ft) Page 2
B tfi it 7 <� 5 . '3`tSYD tax '' .n + ?. 'Sr' X. !
4: ''"" 1 t° tliM &� 3 Y' 14+ r4 RLIt. r5l ,5 i J1§` 1,�t(� tl. Yt SS "•;.4 1 site nt111t11S:
�..� A.. C...t'w..'}.�{`i.3..11� n..Jt�
Job site address: 10080 SW Piths Court Catch basin or area drain 18.76
City/State/ZIP: Tigard OR 97224
Dry well, line, or trench dram 18.76
Suite/bl J Pouting drain (no. linear ft: _) Page 2
dg apt no.: Project name: Manufactured home utilities • 50.00
Cross street/directions to job site: SW Durham Rd Manholes 18.76
1
Rain drain connector 18.76
Sanitary sewer (no. lineartt: IN) I Page 2 62.54
Storm sewer (no. linear R: r ) Page 2
Water service (no. linear ft.: _) Page 2
Subdivision: I Lotno.:
F'Exterr or Item:
Tax map /parcel no.: Bacddlow pm-venter 31.27
: ,c r 41 .ft €, q s� S' 4 a.; s '"rn . .F •6x1 te insttEl it �` a, Backwater valve 12.51 •
•, t?3 mil./, �r `,,4,.&' .�,tg _tn .v.--re � tzrill -si 4VVi.. 61 i;t3 ,y t. n Clothes washer 25.02
Replacement of sanitary sewer line
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
'lies : {y'S l'il �ni Z w < 'K(' iF' � ;I e : rP� - l-i ;�' ; tile ,k_+ '1' Expansion ^2`/ ,'4 : y. ,.JL:3..i'x' ; 4 } g,.1,,%f .. ' . ,a'bir, {;n. t+, ■ .4 : T r 4 t 4 S -'+ ' t Expo` °ion tank 12.51
L_._. ask al9� a.+ � .n i , 1.. r
Name: Deborah Vandervoort Fixture/sewer cap 25.02
Address: 10080 SW Picks Court
Floor drain/floor sink/hub . 25.02
Garbage disposal 25.02
City/State/ZIP: Tigard OR 97224 Hose bib 25,02
Phone: (503)724-1608 Fax: ( ) Ice maker _ 12.51 1t
lire Y:.' M 4M a=' 1
' , ; l. ;: y} li g pp 0
; �,-+ t1t LL ;,� t " var ' " ' "• 7. ' '' ti °? interceptor /grease trap 25.02
Business name: Root Excavation Medical gas (value: $ ) Page 2
Contact name: Bridget Wilson
Primer 12.51
Roof drain (commercial) 12.51
Address: 10824 SE Oak St _322 Sink/basiMavet°ry 25.02
City/State/ZIP: NTrlwaukie OR 97222 Solar units (potable water) 62.54
Phone: (503) 666 -6610 Fax: : ( 503) 65666625 Tub/shower /shower pan . 12.51
E -mail: brbiget@raglandsitte.com
Urinal 25.02
Ya, if t � ti c .., L rSb 71:6 4 7a7 F "R ! i ce' a y Water Closet 25.02
+d. t s ?r ' ., 4:8 iikn� i ...i t .. 7e i 'a dl ti 446 T a tf,: ahf.
Water neater 37.52 1
Business name: Root Excavation Wafer P4Mng/DWV 56.29
Address: 10824 SE Oak St 8322 Other 25.02
City/State/ZIP: Milwaulde OR 97222 Subtotal _ 62.54
(503) 656 -6610 Fax: (503)656-6625
haiku= permit fbe: $72.50 72.50
' CCB Lic.: 134498 / //j Plumbing Lin. no.: 3 -433pb 71,4y Plan review (25%ofpermit tlx•)
Authorized signature
surcharge (12%ofpermit fee) ®
TOTAL PERMIT FEE ®1
Mb name: America Brown Date: 07/19/7912 b lit app&etlaa expires its permit b set obtained within 180 days
otter tt his bees accepted es complete. 1/ .....-- 'Foe methodology see by Tit- County Building Industry Service Board