Permit CITY OF TIGARD PLUMBING PERMIT
NI 8 COMMUNITY DEVELOPMENT Permit#: PLM2013-00371
TIGARD 13125 SW Hall Blvd,Tigard OR 97223 503.718 2439 Date Issued: 10/22/2013
Parcel: 1 S135AA00904
Jurisdiction: Tigard
Site address: 10170 SW 90TH AVE
Project: WILLIAMS Subdivision: METZGER,TOWN OF Lot: PTS 3-4
Project Description: Replacing interior water piping
Contractor: ADVANCED PLUMBING LLC Owner: WILLIAMS LIVING TRUST
PO BOX 593 BY DONNEL&STEPHANIE WILLIAMS,TRS
PORTLAND, OR 97207-0598 13865 SW FERN
TIGARD, OR 97223
PHONE 503-241-4945 PHONE
FAX. 360-571-4188
FEES
Quantity Description Date Amount
1 ea Water Piping/DWV 10/22/2013 $56 29
Specifics: 1 12%State Surcharge- 10/22/2013 $8.70
Plumbing
Type of Use: SF 16 ea Minimum Fee Adjustment- 10/22/2013 $16 21
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.
Issued By: 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.
• Oct 21 13 04:53p Advanced Plumbing LLC 3605714188 p 2
Plumbing Permit Applicat'� .Ii CEIVED
Site Utilities FOR.OFFIC'E LSE ONLY •
City of Tigard D ce �d m �" Permit No.: / -.1 _`�
14 q
13125 SW Hall Blvd,Tigard,OR 97�T 212 013
C ' Phone: 503.7182439 Fax: 503.598.1960
Plan Review Other Permit No-
Datdey:
T I G A R D Inspection Line. 503.639.4175 Date Ready/By Juris H Sec Page 2 for
Internet: www.tigard-or.gov l I�I ®I TIGARD Notified/Method: 7(p Supplemental Information
TYPE oddliibkOING DIVISION FEE"' SCHEDULE
❑Niy construction ❑Demolition For special informatlon use checklist
Descnption I Qty. 1 Ea_ 1 Total
Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 IL for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
13 Accessory building ID Multi-family SFR(3)bath 500 32
Each additional bath'kitchen 25.02
❑Master builder ❑Other:
Fire sprinkler(_sq fl) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: /0/ 7 d 5 q0 -t-k Ave, Catch basin or area drain 18 76
�` ✓ , l9P 'J 72 Z 3 Footing 1, mach line,lior near trench ft. drain 18.76
e
City/State/ZIP:
Footing drain(no.Linear ft. ) Page 2
Suite/bldg./apt.no.: Project name: + _ 'l I I �. kV\ S _ Manufactured home utilities 50.03
Cross street/directions to job site: w 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.: ) Page 2
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
Backwater valve 12.51
DESCRIPTION OF WORK
Clothes washer 25.02 '
1Ze?LpLe ,'N4ev`i0C W,1 r- 1INHS Dishwasher 25.02 ' -
f i kp eo v-- I X� Drinking fountain 25.02
l� `T Ejectors/sump 25.02
giliTIOPERTY OWNER / . ` rr ❑ TENANT
` Expansion tank 12.51
Name: �r-�' W N 4- S U OAk L�i 1 I I t`n MS Floorrdlscwfloor 25.02
3 1 Floor drain/floor sink/hub 25.02
Address: ' Q 170 SL� 1(o"+h Al L__ Garbage disposal 25 02
City/State/ZIT-T.1 9 p)r-d L P. 47 2.Z.3 Hose bib 25.02
Phone:(-Sej3 214 = le 3C-Fax:( ) Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25 02
Business name: A A i.,/c__a s 1 f S. Medical gas(value:$ } Page 2
� Primer 12 51
Contact name: J�. L.,
Roof drain(commercial) 12.51
Address: FLO t)y 51'3 Sink/basin:lavatory 25.02
City/State/ZIP: (_A t,}w� , OR_ 7 2(� Solar units(potable water) 62.54 -
Phone:( 3 2, I (1.9 I.� Fax::(3&20 s 7r) �� Tublshowcdshowerpan 12.5!
E-mail: 5..�-L. �'b owc..e_4 LU 19l^A/n_ r 1 to Urinal 25.02
"`' �G 1Vater dosct 25.02
CONTRACTOR
Water heater 37.52
Business name: /A . A !• r Water ptping/DWV / 56.29 514_2 7
Address: Other -{ 25.02
City/State/ZIP: --- Subtotal S(Q..7.1•
( ) Fax: NO S 7/ / //r I8 Minimum permit fee: $72.50 5
Phone: ( Plan review (25%of permit fee) I
CCB Lie.: 78386, 'V)7j Plumbing Lie.no.: �D 0
/ /o`" �s � 1� State surcharge(12%of permit fee) �jr �
Authorized signature. ,'4, 7/I �� DOTAL PERMIT FEE
.! .
Print name. • / This permit application expires if a permit is not obtained within 180 days
L� .! 'I D°f G► 1 after it has been accepted as complete.
1 ee methodology set by Tri-Canty Building Industry Service Bowe.
I1 Building\Permits1PLSU•Permitrlppdx 10101109 440-46I6T(I0102./COMIWEB)