Permit CITY OF TIGARD PLUMBING PERMIT
111- COMMUNITY DEVELOPMENT Permit#: PLM2013 00326
Date Issued: 09/17/2013
T i{5AAD 13125 SW Hall Blvd.,Tigard OR 97223 503 718 2439 parcel: 1 S126DC03200
Jurisdiction: TIGARD
Site address: 9350 SW LEHMAN ST
Project: Greco Estates Subdivision: LEHMANN ACRE TRACT Lot: 7
Project Description: Installation of private water services for future lots 5-8. Approximately 800'
Contractor: WOLCOTT PLUMBING Owner: LF 8 LLC
1075 W HISTORIC COLUMBIA RIVER HWY 5285 MEADOWS RD, STE 171
TROUTDALE, OR 97060 LAKE OSWEGO, OR 97035
PHONE: 503-667-1781 PHONE
FAX: 503-667-9891
FEES
Quantity Description Date Amount
800 If Water Service 09/17/2013 $325 18
Specifics: 1 12%State Surcharge- 09/17/2013 $39 02
Plumbing
Type of Use: SF
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $364 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 i!cation enter Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or rect questions to OUN by - ling 503 232.1987 or 1.800.332.2344
I sued By: / i Permittee Signature: ,
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.
Plumbing Permit Application
Site Utilities RECEIVED FOR OFFICE USE ONLY
)/
City g Date/By 9 /2 / /�''/ P J 32`
1 . Ci of Tigard Permit No
a 13125 SW Hall Blvd,Tigard,OR 972Q3. 1 a 2213 3 Plan Review Other Permit No
Phone 503 718 2439 Fax 503 598 1960 y Other o is9007-c ey,5,
T I G A R D Inspection Line' 503 639 4175 CITY OF TIGARD Date Ready/By lulls ® See Page 2 for
Internet www tigard-or gov Notified/Method Supplemental Information
TYPE OF r'! II , f . w FEE* SCHEDULE
®New construction 0 Demolition For special information use checklist
Description I Qty. I Ea I Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312 70
Z I-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:
Catch basin or area drain 18.76
Job site address: Q35-0 .,� LEA 4,1440 5r-
Drywell,leach line,or trench drain 18.76
City/State/ZIP: t t L34+4+.) at2
1 Footing drain(no linear ft• ) Page 2
Suite/bldg./apt.no.: 1 Project name: vQe40 aa-11-2$ Manufactured home utilities 50 03
Cross street/directions to job site: L. .ryl 1 „4„ILp,L 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..V00 t Page 2 3as•'
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31 27
DESCRIPTION OF WORK Backwater valve 12 51
-- / Clothes washer 25 02
I t�$t 4LL vO.4t tfr/ - 'e.�.e -S Dishwasher 25 02
1-0 LOTS s--... g Drinking fountain 25.02
Ejectors/sump 25 02
❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12 51
Name: Fixture/sewer cap 25 02
Floor drain/floor sink/hub 25 02
Address: Garbage disposal 25.02
City/State/ZIP: Hose bib 25 02
Phone:( ) Fax:( ) Ice maker 12 51
❑ APPLICANT 1B<ONTACT PERSON Interceptor/grease trap 25.02
Business name: Medical gas(value.$ ) Page 2
IpoL"-er 7tvm3,•JC,
Primer 12.51
Contact name: F I 13p y tr/t4J _
Roof drain(commercial) 12.51
Address: 107 t v 4,,% Cpwr...FIR ..i 44 Sink/basin/lavatory 25 02
City/State/ZIP: I: t)4.L4. I 0L CrioI o Solar units(potable water) 62 54
Phone:(-‘7;W J) (Q`7--l t%l K'%8 I Fax: :(hp'& (Q`"7-418Q 1 Tub/shower/shower pan 12 51
E-mail: C_L.t FF& UVO4.corr.P4iJivi6.#.(v. owyi Urinal 25 02
CONTRACTOR Water closet 25.02
Water heater 37 52
Business name: biL)OLCprT ?(,).0.1 is..0 Lo Water piping/DWV 56 29
Address: I 0'1'b t.L) 1-1,02,1--e,444 pL,_,.,yLZ S - ...Ji.L !`Lo*j Other 25 02
City/State/ZIP: I n0..Yt't}4LLT ' oVt ?plot) Subtotal 7j35--./g
Minimum permit fee $72 50
Phone:('�0 46Z-M I I y 3 t/ Fax:( 5-1 (e/...7-161/
CCB Lic.: / 1 2_2.1.C) Plumbing Lic.no.: Z(o-g r(t't S Plan review (25%of permit fee) �'-
State surcharge(12%of permit fee) ,•3q'.02
Authorized signature: `-1:::5-4ak3-j+,‘,"^ TOTAL PERMIT FEE 364..?.e
Print name: GL 1�f (3 o...9M Date: 9/t /� This permit application expires if a permit is not obtained within ISO days
r after it has been accepted as complete.
*Fee methodology set by Tn-County Building Industry Service Board
1\Buddmg\Permits\PLMU-PermiAppdoc 10/01/09 440-46161(10/02/COM/WEB)