Permit y CITY OF TIGARD PLUMBING PERMIT
`' I COMMUNITY DEVELOPMENT Permit #: PLM2012 -00289
Date Issued: 10/08/2012
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503.718 2439 Parcel: 1S136CA02206
Jurisdiction: Tigard
Site address: 7945 SW THORN ST
Project: Yechley Subdivision: MARG TERRACE Lot: 6
Project Description: Replace 90' of water service.
Contractor: HOLLENBACH & HURD, INC Owner: YECHLEY, SEAN & MANDY
3430 A SW 209TH AVE 7945 SW THORN ST
PORTLAND, OR 97007 TIGARD, OR 97223
PHONE 503 - 591 -5987 PHONE
FAX. 503 - 848 -6832
FEES
Quantity Description Date Amount
90 If Water Service 10/08/2012 $62 54
Specifics: 1 12% State Surcharge - 10/08/2012 $8.70
Plumbing
Type of Use: SF 10 ea Minimum Fee Adjustment - 10/08/2012 $9 96
Plumbing
Class of Work: OTR
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: /
Call 503.639.4175 by 7:00 a.m. for the next availab e 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.
Plumbing Perm ApplicationD
Site Utilities FOR OFFICE l'SE ONLY
III City of Tigard 0 f T 08 2012 Date/By. /D/r /2 Pem ut No n/420/0 - 0,002e 1
• 13125 SW Hall Blvd., Tigard, OR 97223
0 Phone: 503.718.2439 Fax: 503.59 t�1W Date/By e/By Review Other Pet No :
T I G n R D Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By. See Page 2 for
Internet: www.tigard - or.gov Notified/Method• 1 s pplemental Information
TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. I Total
® Addition/alteration/replacement El Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 312.70
0 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 437.78
SFR (3) bath 500.32
❑ Accessory building ❑ Multi - family
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 7945 SW Thorn St. Catch basin or area drain 18.76
Drywell, leach line, or trench drain 18.76
City/State/ZIP: Tigard, Or. 97223
Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: I Project name: Manufactured home utilities 50.03
Cross street/directions to job site: SW 179 Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Water service (no. linear ft.: 90) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map /parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Replace water service line Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name: Mandy & Sean Yechley Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 7945 SW Thorn
Garbage disposal 25.02
City/State/ZIP: Tigard, Or. 97223 Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02
Business name: Hollenbach & Hurd Inc. Medical gas (value: $ ) Page 2
Contact name: Joe Hurd Pnmer 12.51
Roof drain (commercial) 12.51
Address: 3430 A SW 209 Ave. Sink/basin/lavatory 25.02
City/State/ZIP: Aloha, Or. 97007 Solar units (potable water) 62.54
Phone: (503 ) 591 -5987 Fax: : (503) 848-6832 Tub /shower /shower pan 12.51
E -mail: handh20 @juno.com Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37 52
Business name: same as above Water piping/DWV 56.29
Address: Other: 25.02
City/State /ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee: $72.50 7 SO
CCB Lic.: 121807 Lf`i[�//y Plumbing Lic. no.: 34 -421PB 2f / // ` I I/ Plan review (25 % of permit fee)
// // / 1 State surcharge (12% of permit fee) cf"i 7D
Authorized signature: TOTAL PERMIT FEE l'/ 0 . t )
Print name: Joe Hurd Date: 10 - - This permit application expires 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.