Permit CITY OF TIGARD PLUMBING PERMIT
u • COMMUNITY DEVELOPMENT Permit #: PLM2012 -00313
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/29/2012
Parcel: 2S 111 BA02400
Jurisdiction: Tigard
Site address: 14350 SW 100TH AVE
Project: C & L Properties LLC Subdivision: INGEBRAND HEIGHTS Lot: 29
Project Description: Replacing 10 ft. of sewer line to existing septic tank
Contractor: LIL STINKY ENVIRONMENTAL SERVICE, INC Owner: C & L PROPERTIES LLC
19631 KOLAR DR 14350 SW 100TH ST
OREGON CITY, OR 97045 TIGARD, OR 97224
PHONE: 503 - 939 -2310
HONE: 503 - 351 -8715
FAX: 503 - 722 -7186
FEES
Quantity Description Date Amount
10 If Sewer Service 10/29/2012 $62.54
Specifics: 1 12% State Surcharge - 10/29/2012 $8.70
Plumbing
Type of Use: SF 10 ea Minimum Fee Adjustment - 10/29/2012 $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: old A f9 //t J'f -
ALIILLA AL. Call 503.639.4175 by 7:00 a.m. for the next available inspection date. r (�
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 Permit A.ppli REC 1 1i _ < _ .
„...
Site Utilities ! F(IIt 01 1- ICE t �l. ()NIA
City of Tigard 0C OCT 2 9 2012 lo/ - f 2..- �� Paflnit N ....... ;- a r .
■ 13125 SW Halt Blvd., Tigard, OR 972 23 flan Rtyiow (>therPcrmit
C Phone: 503.7182439 Fax: 503.598.1960 CITY OF T • II p 0 s avta.ovl
Inspection Line 503.639,41 T5 BUILDING a Ready/By: 21 See Page 2 fat
I':l1KI) Internet: www.ligard- or.gov 11.''' t oti f ylN
ed h u d : kapplemmtsllnformation
TYPE OR WORK WEE* SCHEDULE . •
il+emolition For sped fl onrrallart we chewekllst
❑New eorhatnrztilM 0 Do t j qty. I Oil. '
-a. -.. I Total
.fil Addition/alteration/replacement 0 Other: New 1- 2- family dwellings (includes 100 ft. fur each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath 312.70
SI +k (2) bath 437.78
I- and 2-family wcllin ❑ Commercial/industrial
y b SFR (3) bath 50032 =
0 Accessory building ❑Malti- faintly Each additional bath/kitchen MEM 25.02
❑ Master builder ❑ Othea7 Fire sprinkler (_ sq. R.) Pape 2
JOIB SITE INFORMATION AND LOCATION Site utilities:
Catch basin or area drain 18.76
Job site address: - 5' (�/(� Drywcll, leach line, or trench drain 18.76
City/Statc/ZIP: 7 . „ • ' 0 i ,, Footing drain (no. linear ft.: Page 2
Suite/bldgJapt. no.: Project mu ne: Manufactured home utilities 50.03 -
��
Crass street/dircctiors to job site: Mu hoks 18.76
. Rain drain eon nxtor 18.76
Sanitary, sewer (nu. linear It,: /,O ) Page 2
Storm sewer (no, linear ft.: _) Page 2
Water service (no. linear ft.: _) Page 2
Subdivision: 1 Lot no.: Fixture or item:
Ilackflow preventer 31.27 .
Tax map/parcel nu.: r - t If r 12.51
Backwater valve
DESCRIPTION OF WORK Clothes washer 25.02
_..- -Lila t rC C ,a 3.At'u'� , . I?ishwashcr 25.02
IL I .' /. - ,, I l ' "[ 0 , L-44.- Drinking fountain 25.02
1 L • ' Ejectors/sump 25.02 •
❑ PROPERTY OWNER T ❑ TENANT Expansion tank _ 1151
r � Pixttue%wci cap 25.02
Name: ° - VIA '41 Floor drain /floor sink/huh 25
Address: 0 d u.) ■ D1' / _ Garbage disposal 25,02
City /State/21P: O • Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02
' Medical gm (value: $ ) Page 2
Rusiuexs name: r Primer 12.51
Contact name: Roof dram (exrrnmercial) NM 12.51
Address; Sink/baxin/luvatory MI 25.02
City /State/7IP: _ Solar units (potabk water) 62,54
Phone: ( ) l Fax: : ( ) Tub/shower /shower pan 12,51 l tri 25.02
nid
E-mail: Water closet 25.02 •
CONTRACTOR heater 37.52
Business name. 4--Y(' f G uC Water piping/DWV 11111 5629
Address: % g f f< p/ r O her. 25.02 MINN .
City /SWLcJZI - it g() 7 e- f C n D i, , Subtotal
Minimum peit fee: $72.50 74 .50
Phone: (5,3 ) _ ' rm
Fax: (5.. ) Z4.,. . .�
Plan review (25% of perms fcc)
CCD Lic.: L. r ,9-‘1' I Plumbing Lic. no.: Stutz surcharge (12% of permit fix) 5 I v.
Authorized signature: OIl_,Edal, TOTAL PERMIT FEE ; _ S.0
'I h application tapir= If a penult is mot obtained wiihla IRO days .
Print name. 1 ; flab:: - Zq �. after it bas btu accepted as completer
V 1 w:fti� MF...w. 4.Mnln.w e.11... T,41'n.mly Astil.li -.. TwAua.., S►w Annr.
2 . d 9B1L 22L -EOS R11a>1 e90t60 21 62 BOO