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Permit
CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit#: PLM2013-00389 T I G AR O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/30/2013 Parcel: 25111 DC10200 Jurisdiction: Tigard Site address: 15575 SW OAKTREE LN Project: Hargis Subdivision: SUMMERFIELD NO.10 Lot: 0 Project Description: (2)lays,(2)showers&(2)water closets for a 2 bath remodel Contractor: ALL SCOPE PLUMBING&CONSTRUCTION LLC Owner: HARGIS,CAROLYN A 18859 SW BUTTERNUT ST HARGIS, ROGER L BEAVERTON,OR 97007 15575 SW OAKTREE LN TIGARD,OR 97224 PHONE: 503-927-0713 PHONE: FAX: FEES Quantity Description Date Amount 2 ea Lavatories 10/30/2013 $50.04 Specifics: 2 ea Tub/Shower/Shower Pan 10/30/2013 $25.02 2 ea Water Closet 10/30/2013 $50.04 Type of Use: SF 1 12%State Surcharge- 10/30/2013 $15.01 Class of Work: ALT Plumbing Type of Const: Occupancy Grp: Stories: Total $140.11 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 direc uestions • 'UNC b calling 503.232.1987 or 1.800.332.2344. Issu d By: / Ali Permittee Signal e: 1 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. EPlumbingPermit Applies .o.�,- td Bullding Fixtures I i�- - ,`c,-� boll ral�l(:I: tist: ()NIA City of Tigard OCT 30 2013 Received /3 / Permit No.: i3�Allep. Sii)9 Y 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review O Phone:.503.718.2439 Fax: 503.5®iliN°OF TIGARD Date/By: Other Permit No.: T I G A It D Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov BUILDING t1 IVl2!Jd Notified/Method: • Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑New construction . ❑Demolition For special information use checklist Description I Qty. I Ea I Total NILAddition/alteration/replacement ❑Other. New 1-2-family dwellings(includes 100 ft.for each utility connection) _ CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ...VI-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: Job site address: S S +re Ia�e� Catch basin or area drain 18.76 �S .- City/State/ZIP: /� Drywell,leach line,or trench drain 18.76 le ir I.A (t gi 2l1 Footing drain(no.linear ft.: ) Page 2 Suite/bldgiapt.no.:`''' I Project name: 4-10 ts, Manufactured home utilities 50.03 Cross street/directions to job site: - 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: I Lot no.: Fixture or item: Tax map/parcel no.: . Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 44.4 km...eu- 12- 14f L/ L. 4►tv,n. Dishwasher 25.02 . Drinking fountain 25.02 Ejectors/sump • 25.02 .PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: /n� FixtureJsewer cap 25.02 Kn� �¢' H9fS%;15 Floor drain/floor sink/hub 25.02 Address: - S S�. OTC Tree, I RI-e Garbage disposal 25.02 City/State/ZIP: 7:16,,,,„!, p T?? Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 ❑ APPLICANT CONTACT PERSON Interceptor/grease trap 25.02 Medical gas(value:$ ). Page 2 Business name: -ri Q t.�n l •f�' Primer 12.51 Contact name: Ticr% 4.419&I 13� Roof drain(commercial) 12.51 Address: p, az,x jot CZi . Sink/basin/lavatory ,L 25.02 )C•Oy City/State/ZIP: 1:,...(00i4 J C/ c)baS . Solar units(potable water) 62.54 Phone:(C6?) illy . Z?ig.J I Fax::( ) Tub/shower/shower pan 2. 12.51 4;1_5-.09- E-mail: Ti-RQ�(Ad �k,a,• Urinal 25.02 to Water closet 2 25.02 50..Ur/ CONTRACTOR Water heater 37.52 Business name: 4 e/_ (yr,,;p p7)/.U,C� ex ei,^6r f�b/V Water piping/DWV 56.29 Address: ' /fJ C�! `-ca�iL L' 11 1/ UT AT'• Other: 25.02 . City/State/ZIP: platill ne, ��-� Subtotal Mc-0C� Phone:(j )e27 ©7A3 Fax:( ) Minimum permit fee: $72.50 CCB Lic.: le311,6 Plumbing Lic.no.: piizim _ Plan review (25%of permit fee) State surcharge(12%of permit fee) j,5 °/ ' Authorized signature: C.aZ( - TOTAL PERMIT FEE /yo,t l Print name: - // ��,�q[� Date:/0/ .9,/,8,i� This permit application expires if a permit is not obtained within 180 days 577 4. hic f`-/`r 84e V"' +� after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)