Permit REVISED
CITY OF TIGARD I / .°2 3' /.3, , PLUMBING PERMIT
a • COMMUNITY DEVELOPMENT Permit#: PLM2013-00026
T LGAAD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/17/2013
Parcel: 2S103BB02500
Jurisdiction: Tigard
Site address: 12115 SW 124TH AVE
Project: Howson Subdivision: BROOKWAY Lot: 25
Project Description: (1)water closet,(1)water piping/DWV,(1)lavatory and(1)shower 1/23/13 REPRINT Add 60'water service
Contractor: ANCTIL PLUMBING INC. Owner: HOWSON, BRIAN C&GRACE A
16900 SW MERLO ROAD PO BOX 4017
BEAVERTON,OR 97006-0000 BEAVERTON,OR 97076
P
PHONE: 503-432-3657
PHONE: 503-642-7323
FAX: 503-642-7755
FEES
Quantity Description Date Amount
1 ea Lavatories 01/17/2013 $25.02
Specifics: 1 ea Tub/Shower/Shower Pan 01/17/2013 $12.51
1 ea Water Piping/DWV 01/17/2013 $56.29
Type of Use: SF 1 ea Water Closet 01/17/2013 $25.02
Class of Work: ALT 1 12%State Surcharge- 01/17/2013 $14.26
Type of Const: Plumbing
Occupancy Grp: 60 If Water Service 01/23/2013 $62.54
Stories: 0 12%State Surcharge- 01/23/2013 $7.51
Plumbing
• I
Total $203.15
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: ,1 ,/1 t �C,6017 0kf
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.
lumbin Permit Application `'�°� 1''-)t- �6 5—t 24
Buiidiug Fixtures EIVE ruiz a�i.l.'ia"t_ a. c (:)NI.v
``City of Tigard Permit No.:
IN
JAN 2 3 2013 Re
icy:
-tilt 13125 SW Ball Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.71 8.2439 2439 az_-. F-ax: 503.598.19-—,, T R r a, Other Permit No.:
,.
:Inspection Line: So3.639.417s CI 1 X OF IGAD Da�eB
:•: y, GI See page a ear
17nterna wwv Rgatd-Or goV , D �� ON Notified/Method: Sappioneedel Informed=
. rte•
rrt ,!,1:),,,,2 �t� t , �\ �x . .,..Sy..-;z i \ r :
b"
;,.w, \ .„,.-t ..,: . .;\ ?_ < `N-=A. . . �4,...,ai Ce.mN.. d.,a,•1\-:z.;-;-, _ ^ x.;v: .'h... ._.a . V_��.ti ..a'. ..-
r
0 New constT cNon ❑Demolition
For eda!JbimatIon lee cheeklisV.
A' Addition/' o lace neat Other.
Description l I I Total
�P Q New 1-Z-lismily tiwellii�s(includes 100 ft.for each iirnity connection)
, ` . ' 4 \ " � " )wyh,,,,.-.3.--.,,<t. rr > - i ;` n T\ �^ SFR(1bath 312:70
j$1-and 2- h ily dwelling ❑Commercialfmchistrial SFR(2)bath •. : 437:78
. SFR(3)bath 500.32
CI Accessory wilding Multi-family .sue additional bath/kitch u 2$:02
❑Master b i ,a GI Other: F ire sprinkle
—s4 R) Pagc.2
\ \Y ,:,, v,:z., c
\.y s r ,.'.. '4 \v' v. ti a-\e Site utilities:
4
1 Catch basin or area drain 18.76
JO site addregs: f I"Zy"f'� ,yew
City/StetclZLQ,`' Drywall,leach line.or trench drain 1$:76
Footing drain(no:linear 13.: • ) Pa
77.7.
',7.4 043•9uitc/bldg./ap so.: Project name: � �` , Manufactured home utilities _ 5 _
Cross street/diieclions to job site: Manholes 18:76
2 It. J f `! 410— .41 Ram drain connector 18;76
•;r • . Sanitary sewer(no.linear$ _) PagZ 2
'• Storm sewer(no.linear t3: 1 Page 2 .
Wrier service(uo.linear$.:J 'f Pam 2
Subdivision: .. 1 Lot no.: Fixture or item: -
ax map/parcel`no.: Back low preventer 3;t27•
.,VP:s. er..- .a x:: :.,.�•�.^�-sr,�^..� :- urea a -- ....._.`.7s::, - .vr.
..,;•c,, v.-�:.K;,..Cah.,�... ..�:^ ;_.v;�+:.SW':A\",Ct2 - - '_ksi]:e-: Backwater valve
.r1.,..:»A1Sc..v:.s,.::.k,:,._+.:mot.-_.,::;'\a.:....:4;. ...,4..a.�.._._ J,.ca,:,;f--.5:nAt'n2\� ;.-ek,.av?,'="c• 1. Clothes washer r 25:.-02
1. 4 ,- ..( /17. .e,�I;i`,/ j �.�,.L ]'— Dishwasher 2J:02
I'r ?O I L✓✓C,�r v f( prinking fountain .. 202
t• 4
EEjectors/sump .
-
.W . ..a��.._t_......,:...;,~A -.4`_ -s'- �-.:;h, _ Ex.w.,cionnwk lx 1
:�Ch ...,..L.`. -,,a. .vim_-_.,_..t:,.........:__-: .;�:.x,�,� � ^ .�.l+,c � r�.r, .,`;Y.xx•,? .`�..
err,:.._ .z� v... �. �
e FiiaiureJsewer cap • 2$.02
Name:,..�_ ,,;i.� .... • .::�.::-•''�r _. ,: —
r. .
Floor drain/floor sink/hub . 25-_Q2
Address: - Garbage disposal 25.02
City/stgtrlZI)x.' . • 'Hose bib 242
2
Phone:( .'). Fax ( ) ice maker 1251 —
.........
. _ . . : :.r. ..r .... ,......__.. .. . ., ; '. ..
... ii.. Y `-[
x.ra..ti._aT L....,.....,.,`.;>............,...__. ._.:<..e ....d-T.a__., r�<� ac.i_s..;<..C_.._..:tiiL::,`Eq-�(f: -....-x.ti. 4ti.:.
,.
Business name:• Medical (Value:$ ) Page 2
,, .. ,. Primer 1241
Contact name: ' .'
Roof drain(commercial) 1241
Address: Sink/basin/lavatory 25:02
city/State/ZIP; Solar units(potable water) . 4154
)than:( ;.r) Fax::( ) Tub/shower/shower pan • COI
B-mail: 'r '
Urinal 25.02
ra.r ;. r:..:,:..;::............,7;.;,.. .,• :;f:1u -- ='.1',.,"!:,.4;;;;---=:=;c•-,.',".. . Water closet . 25.02
c•,aC..,A try-"\ v . = C c A d _ ,� dv,k �vv� � \i v- - -
.`^`-vn"n?` • •;f"`' ?.r �.....? _�, v_4 »',4\. "2::.:,-:-....•,x4-tTC ._ .�hv ,,, `,1:`' Water heater 37.52
usiness name �,.� J �.• ; Waiter piping/DW V 5629
Address: ' ';p 1�q gUi Jr/ Other 2502
City/State/Z }' - 4 On' x-1^7 4 Subtotal .
Fax r r_ ) 2 — .Minimum permit foe: $72:50
Phone: �;')(�L:.r• Z —
CB Yic.: ::-_C! t Plumbing Lic.no.: �.,/6L? Plan review (25°ib of pami Ere) .
FT ! State surcharge(12%of permit';- )
Authorized signature: TOTAL PERMIT, 41‘. /J
Prmt name: i w' �� This permat applimtioe a>opi.ei if a permit b eat obtained'Vithln 180 days
" 4.1_4` f. ,/ � Date:/--23._�y after it has been accepted as complete;;+
1 V- *Pee methodology set by Tri-County Building Imocr)!Si vice Board
r: 'mglPer t11.1MU-ParattApp.doe tolOUO) 440.46161(10/07/002d/WP8) t !— f '•'e"`_ ,/ S/
70.0
q CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2013 00026
T [(ARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/17/2013
Parcel: 2S103BB02500
Jurisdiction: Tigard
Site address: 12115 SW 124TH AVE
Project: Howson Subdivision: BROOKWAY Lot: 25
Project Description: (1) water closet, (1) water piping /DWV, (1) lavatory and (1) shower
Contractor: ANCTIL PLUMBING INC. Owner: HOWSON, BRIAN C & GRACE A
16900 SW MERLO ROAD PO BOX 4017
BEAVERTON, OR 97006 -0000 BEAVERTON, OR 97076
PHONE: 503 - 642 -7323 PHONE: 503 432 -3657
FAX: 503 - 642 -7755
FEES
Quantity Description Date Amount
1 ea Lavatories 01/17/2013 $25.02
Specifics: 1 ea Tub /Shower /Shower Pan 01/17/2013 $12.51
1 ea Water Piping /DWV 01/17/2013 $56.29
Type of Use: SF 1 ea Water Closet 01/17/2013 $25.02
Class of Work: ALT 1 12% State Surcharge - 01/17/2013 $14.26
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $133.10
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: 4^ e 6 Permittee Signature: 014 /� .l�/�� `/ Jl R j
)4,M10 � V� (.L /fib d_ cam( (�/
' �-{
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.
Plumb Permit Application p 1 tY9 gEfal
Building .. Futures -EC�F I FI D E
��. r�>ii err! i( E. rr. ci.i.ti
r City of Tigard 1 7 13 I / 7 lit N Pai do l 3., evp,,
: I3125 SW Hall Blvd., Ti gard, OR 97223 Phil Review
_ .. % :`. Phone: 503.718.2439 Fax: 503.598- 1969.
mn, 0
r � Inspection Line: 503.639.4175 �•Il A ' Permit No.: ,
�, > ra BUILDING fi
� ternet www ' dD
'�• � ®ti xotScd/M - B Sae1'a
P.. "'.-.c k..:. :;?7,,r;:art.,�''1`r=,,rs: - ,`,-'.F t ?r xy:�r 'i? -G : :x��,[4��1 :2;r > ' . - , - .m-,.,. 4 . •"'=x - !-*FP: Supplemental I11f0.m8ti00
, ?i�a'Kt"Fi:�'4sa+xv�� c _ ,Y°. :::r! r ,.:Z5::;-:%'-' .i .<;i a � ,s. r� .••�'� ^� �' ^ cam �c �„
r
v,... .. -i, , _, .. :k _ .3..- ..._.
0 New construction
Demolition .P rix, • use ehrr
""" ' on
so 1 Ea, Total
¢Addlhon/a teration/replacement ❑ Other: _
R x , , New Z f dwekl3 ly odes each ... oollnectieo)
(includes 100 R for
r.r .: w ti 1 r >a .7-.7:i-4_, e '. S" SFR 1)ba91 - 31270 —
'4 ....r t. :f.» - -r._ , xc.,....__ - a?i�t•,x. .f`..'. _
j< 1- and 2- fafltily dwelling 0 Commercial/industrial SFR(2) bath • : 437,78
Q pcceseoi3; mlding 0 Multi - faintly SFR (3) bath 500;32
Q Master butlldea ❑ Eachaddittiaual bar chen 25.02
r r 5 ,. _Y• ,, a ' 9 k it r ,r .;', r , Fire tlld sprinkler • (' S4' ft.) Psis . 2
' . a:`` .. w - _-r .., - 2 ti.-. 7!... etr.' -„ _.?'fxa:ar: , ' :,c4 :; ..: 5 :1 :7 R Sit Dtill�le A
Job site address: - , = Catch basin or area drain 106
City /Srate/ZIF "' ~�-� q Drywall, leach line, or trench drain
! l y - , �{ ` -' Footing drain (no..l new ft.: ^) P
Suite/bldg /anti °no.: Project aamc: J4 I SD Manufactured home utilities 50;3 .
cross street /dial ions to ith site:
Manholes 1$x16
Rain drain c m:lectar 18.76 —
'.4 ! Sanitary. sewer (no. linear: ft.: _) Pa ` e 2
, ) Stomp sewer (no. linear R : ) Page
Water service (no. linear 141111 ilia Page y
Subdivision: Lot no.: Fixture or item:
ax map/patrel no BackOow prevent= 31.27
�` ;y W 'M1 "'` %,,:. ,74. ti ",' s v'' n t 5t . , ..: i r 7»';^.'^ s r Bavkwatar.valve
12:SI
N-J �j Clothes washer
202 II
6c F ; - lam ^ " it gj tp4 — : , i . 6 Al Dishwasher ®' 25 :02
r.
Drinking fountain • _ 25.02
Ejectors/sump 402
, - <. '-4. t 7 <, '' r , yL�,., c r x i r:> .',: ,?" ' . .„-e .. " r • ��
a x . _ d' :1 ;7.:. ,:<i r x Expansion
� '+�_ _.-� L'.5: :'�FS. -ri , dc»,..S.r.,• -. '�• ii�1f _ %x�.- .'�':._: _s < .nC .r. .. d
:7:
Nine l'`i �� 1L . ,.. Fixture/sewer cap 25102 •
4ddj . 1 , L,f ` l 3 1 2.. _ Floor drain/floor sink/4ulz ' 2 51 0 2
' 7_20 H bib d 23 Q2
City/State rLIPr' 7' - - OA Bose bib
P
IIIM
hone: , ) r jr Fax. ( )
y Ice maker III. 12.51
i - t�q:+f,` "I �. V ""- Y"' r ' a•,xr�r--R Fi ° ,�•.. -Fifii. V 4 Sj °' = 1`x'+' :5 , .k
E'i� .._ :� .1- :1:: : :.. ` "� `� .; _ �_ : x . M.l " : ` -._� : .. 5. i Interceptor /ewe 25.02
Business Medical gas (value: $ • : ) Page 2
Caaxtact name P 12,51 •
Address: Roof drain (..: -� 12;31
Sink/b ill : . , — ," / 25:02 Bril
City /Star fZIR . Solar (potable water) ' 6254
Phone: ( )% Fax:: ( ) i1 ii�iYi:dCi . wer pan .-37 -, 12:51 BMW
E W t MI 25.Q2
�F3 e ` y i p , , , zt y [ 1C X ., ' r e . " " 7k-' g -« ^'` r. , xr fr Wab cl oset • - 225'02 $nSi>a6S91naCte.�Iµ��.r : .., � , x.;';r, � ��- �'r'_ :r !g :y ..'far 4.... W heater 37,$2
i~� w k aAt y ) aY
�'�}1 1,10 t, :ti, 4• Water p�€�� �� I.
Address: r e• i .
Other 25.02
City /State/Z?:•: F. or G -r Subtotal „N ig
Plzo": ( ' ); Z— '732.3 Fax: (3 ' f Z 7753~ Minim= permit fe 572 :50
ME 1. Plumbing Lie. uo.: Plan review (25% of peimit,fee)
Authorized 9igp stlue: Q (' "� i State surcharge (12% of petmi : -) e
TOTAL PERMIT FEE i 3 3,p
c This permit a ear
Print name: r L 1 1 • _ �l L Date �� PQ pp+► expires if a� permit not obtained :'thioo 180
after it has been accepted as complete
°Fee methodology eat by Tri-County Building ]adash}!`Service Bond
in suuthorTumitsSM.V1/- PamaArr.deo 10 440 46167(1692,1COM/WEB)