Permit f
1 r CITY OF TIGARD PLUMBING PERMIT
1 - 1 1 COMMUNITY DEVELOPMENT Permit #: PLM2009 -00225
Date Issued: 08/14/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503 639 4171 Parcel: 2S 101 CA00200
Jurisdiction: Tigard
Site address: 7904 SW HUNZIKER RD
Subdivision: Lot: 0
Project:
Project Description: Install (1) lay, (1) sink, (1) tub /shower, (1) water closet 0.8 EDU increase
Owner: FEES
WALL STREET INDUSTRIAL LLC & Quantity Description Date Amount
7000 SW VARNS ST 1 ea Sink 08/14/2009 $16.60
PORTLAND, OR 97223 1 ea Lavatories 08/14/2009 $16.60
PHONE 1 ea Tub /Shower /Shower Pan 08/14/2009 $16.60
1 ea Water Closet 08/14/2009 $16 60
Contractor: 1 12% State Surcharge - 08/14/2009 $8.70
EDWARD MULLEN PLUMBING Plumbing
1601 SE RIVER RD 6 ea Minimum Fee Adjustment - 08/14/2009 $6.10
HILLSBORO, OR 97123 Plumbing
PHONE: 503 - 640 -0113
FAX 503- 640 -4483
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Total $81 20
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100 You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: ru Permittee Signature: )e
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
08/12/2009 08:48 FAX 5036404483 THE MULLEN COMPANY I2001 /001
-A -
PlumbinE Permit Application
Building Fixtures } FOR OFII( t' Utit? ()NIA' 1� J Received
DatelBy Penn" t
City of Tigard i C,7' +, ; f ,,,_,n) Penn" ' ' No 1 9.0o 2�
a 13125 SW Hall Blvd., Tigard, OR 97 :-) -
' a • Phone: 503,639 4171 Fax' 503.598.1960 Plain R
G 200 Date/B
y Other Permit No „� t0
Inspection Line: 503.639 4175 1`11 v/ 61 T i G A tt I:) Av Date Ready/By. Jur ®$ee vrr�e Z for
I nternet: www tisard- or,gov , , ,. Naifred/Method Supplemenral
U Inrormaden
” y� , „ - , ;','"7;;T. OF " bRK I '1 CO v FEE*' SCH RULE l' , „
csk 1:1 New y conswction 16; 1 W ID } s U ��c�� For special irlforntruton use checklist
Description I Qty I Ea J Total
ddition/alteration/reptacement ❑ Other: New 1- 2- family dwellings (Includes 100 ft. for each utility connection)
• ®, "' 01}<I Bil71l, '',I et. „, SFR (1) bath 249,20
0 1- and 2- family dwelling 2 ommcrcial /industrial SFR (2) bath 350 00 _
Accessory building SFR (3) bath 399.00
❑ ry g ❑ Multi - family
Each additional bath /kitchen 45.00
❑ Master builder ❑ Other:
qy , , Fire sprinkler ( sq. ft.) Page 2
'' ; • •. ,Skr 7 FORMATIO:1!1 AND LOCATION
Site utilities
—
Job site address: 7904 SW HUNZIKER ROAD [retch basin or area drain 16.60
City /State/ZIP: TIGARD, OREGON 97233 Drywcll, leach line. or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: — Footing drain (no, linear ft.. _) Page 2
Cross street/directions to job site:
Manufactured home utilities 110,00
Manholes 16 60
Permit# BUP2009 -00142 Rain drain connector 16.60
Sanitary sewer (no, linear ft.: _ ) Page 2
Storm sewer (no, linear ft.: Page 2
Subdivision: , Lot no.: Water service (no. linear ft.: ) Page 2
7 ax map /parcel no.. ` ■ Fixture or item
�. Absorption valve 16,60
Aackflow prcventer Page 2
PLUMBING Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60 I
' ,T,.7, '' : ii7nr ' :• . ', ti, , ' Q TENANT r Drinking fountain 16 60
Name: Ejectors /sump 16,60 _ ,
Expansion tank 16.60 �
Address: Fixture /sewer cap 16.60
City/State /ZIP: Floor drain /floor sink /hub 16.60 J 1
•
Phone: ( ) Fax: ( ) Garbage disposal 16.60
4
+', ' ;..::^i - ?adp .rte" �``�� 7&', .� Hose bib 1660
fi r„ a "te r' «:',,.:' o.,'..... ACT PERS0JIF
�" Ice maker 16.60
Business name: EDWARD MULLEN PLUMBING
Interceptor /grease trap 16.60 I `
Contact name: RA I' MULLEN Medical gas (value: $ ) Page 2 , r
Address: 1601 SE RIVER ROAD Primer 16.60
—
City /State/ZIP: HILLSBORO, OREGON 97123 Roof drain (commercial) L ' 16.60
Sink /basin/lavatory 2 16.60
Phone: (503—) 640 -0113 Fax:: (503) 640 -4483
! se_
Tub /shower /shower pan 1 16,60
E- mail: ray@edwardmullenplumbing,com
Urinal 16.60
' � ;,
' 172 , 'CO TR)S T'OR Water cl oset
_ [ 16,60
Business name: EDWARD MULLEN PLUMBING Water heater 16.60
Address: 1601 SE RIVER ROAD Other,
City /State/ZIP: HILLSBORO, OREGON 97123 Subtotal
Minimum permit fee: $72.50
Phone: (503) 640 -0113 Fax: (503) 640 -4483 i� it Residential backflow minimum permit fee: $36,25
CCI3 Lie.: 92689 ✓ .-0` Plumbing o.:34 -260PB OP Plan review (25% of permit fee)
AO' Authorized signature: �� AA. 'I ` ' State surcharge TOTTAL AL of permit PERMIT FEE EE
I.
Print name: RAY 1b LLE ' ' Date: 8 -12 -2009 This permit application expires If a permit is not obtained within
/ 180 days after it has been accepted as complete.
a C I tL ( - ZO *Fee methodology set by Tri -County 13uilding Industry Service Board,
I \a lIIdlnawermii ,\PLMF.permicA 12/27/06 4404616T(10/02/COM/WF,y) 1
( 0 1 OA) 6 ) Kii Cdle\ %i'l t- ct-r-