Permit - CITY OF TIGARD PLUMBING PERMIT
2 COMMUNITY DEVELOPMENT Permit #: PLM2013 -00051
T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/14/2013
Parcel: 2S104DA02000
Jurisdiction: Tigard
Site address: 13400 SW 128TH PL
Project: Voegtlin Subdivision: QUAIL HOLLOW - WEST Lot: 6
Project Description: Install tub /shower
Contractor: D & F PLUMBING Owner: VOEGTLIN, DAVID
4636 N ALBINA AVE 13400 SW 128TH PL
PORTLAND, OR 97217 TIGARD, OR 97223
P
PHONE: 503 - 332 -1901
PHONE: 503 - 282 -0993
FAX: 503 - 288 -0604
FEES
Quantity Description Date Amount •
1 ea Tub /Shower /Shower Pan 02/14/2013 $12.51
Specifics: 1 12% State Surcharge - 02/14/2013 $8.70
Plumbing
Type of Use SF 60 ea Minimum Fee Adjustment - 02/14/2013 $59.99
Plumbing
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 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
eztveze
Issued By: / r �O" Permittee Signature: ei '
Ca1L503.639.4175 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.
Feb 13 13 11:04a D & F PLUMBING CO 5032880604 p.1
Plumbing Permit Application RECEIVED
Building .Fixtures FEB 1 3 21 FOR OFFICE USE ONLY
City of Tigard Received 3- , ffir �/ -dev5
13125 SW Hail Blvd_ Tigard, OR 97223 CITY OFTIG' 'i F " '
Phone: 503.718.2 439 Fax a' ) )8.195( � UILDING D Other Pa•ma No.: A, , j , , roe403,
TIGARD Inspection Line: 503.639 ll ?5 ' l7 ,endy /Bv: lute's RI See Pitee 2 for
Inteniet. ww'w.tigard or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE'' SCHEDULE
❑ Nl,w co"struttiun ❑ Demolition For special infisrrrratimi rise checklist.
Description I Qty. I Ea. I Total
..Additiu:l /a]ter tern /rep.acement ❑ OC:e-: New I- 2- fancily dwellings (includes 1C0 Il. for each auLLy con:lce(:on;
CATEGORY OF CONSTRUCTION SFR (I) batl•, ! 312.70
id 2- Rattily d•.velling ❑ Corn .acrcialiindustria. SFR (2) bath 437.78
SFR (3) both 5r0C.32 •
❑ \ccess ry i'ui'.dinc ❑ Multi- family
ach additional bsth;ki:chen 25 02
❑ Muster builder ❑ Ot',e-. Fl-_ sprinkler (_ sq fr) Page 2
-
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: / 3 c/Qv)W / 2_ P� Catch basin or urea than 15.76
�- Dryitxll, _each line,. or trench drain 15. -76
C':ty%StatuLIP ,
3t / " Footing drain (no. linear 0 : _} Page 2
Su ite•1i:dg.:apt. no.: I Project name: , // / . ft4 , ' i )e.Sj5 - Manufxturcd home. utilities 50 03
Cross itreeildireclions to joie site: Manholes 18 76
Ruin drain connector 18 76 I
Sanitary sewer (no. linear ft.: _) Page 2
Starto sewer (no. linear 0.: _) I Page 2
• Water service (no. linear Il; `) j Page 2 I l
Stlbdivisior.: Lot no.: I Fixture or item:
Fax nialz'parcel no.: Baektlow preventer 31.27
DESCRIPTION OF WORK. Backwater valve I 51
Clothes washer 25.02
7' /J i r 14.5741/ Dishwasher 25.02
Drinking fountain.. 25.02
Cjcctory pump 25 02
❑ I'IiOPEIt'fl' OWNER I ❑ TENANT ! Expansion tank 1 12 51 I I
Fi■turelawcr cap 25.02 I I
Name: i
Fluor draiitilloor sink.7lub 25 02 j
Adcress'
' Carcase c:sposal 25 02 j I
City /StaleiZlP: Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02
Il,lsincss name: Medical gas (value: S ) Page 2
Primer I 12 -SI I
Comae: nine: •
I 1 . Root drain (commercial) I 12.51 I
Address: t p 2
Sink basin tavalory 5.0_
C Iry /State) lI': 'i Solar units (Violable water) 62.54
P tome: ( ) I f'as:: t ) I TubLishowtr /shower pan / 1251
I I mail Ur'.na( 25.02
Warr closet 25.02 1
CONTRACTOR
. i - Water heater 37.52
13aslncssname: J,r fl l /,t Waferpiping/D\VV 56_''5. I
Address: Y‘ 36 � 10 1 ei / 4 1 /e Other: 25.02
5.
City /Slate/ZIP: , / eLy � 4 F /7 Subtotal
Phone: (• ) 0.- - ) 3 Fax: (027 ) 2 $ - p4c ( Minimum rennn fee. $72.50. 72 St
Plan :eciew (25%orpenni : :iec) �!
C (.13 l.te.: (f' 61 / 3 o /Py Plumbing Lie. no.: 2...4 -Z3 P6
//(434r----. State sttrel or permit `ee) 9'. 7Z:11 Authorized signature: '�
TOTAL PGRM',T FFF. ,' 7 2
% .� 'P his permit npplientinn expire: if permit is not nht.lined %Ohi t ISO days
I rint halite 4A/(��J R Date. :,2, - 1.3 -%y a it has been accepted as crumple ie. /4.1
(/ (((/ "Fcc methoaski�y set by Try - County Bu:ldin1i Industry Service 'Intent.
I•. auddity :'rraid'Lh1U- P.rmitapp.dnt I O'OJ.t9 .i.t0.461 nT(IN'ovCONAULe)
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
13400 SW 128TH PL, TIGARD, OR, 97223
Residential - Plumbing
399 Plumbing final
03/08/2013 00:00
PLM2013-00051
PASS - No C of O
Violation Summary:
Inspector Contractor