Permit li fhl . e 4 CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2014-00015
Date Issued: 01/21/2014
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 25110DD10500
Jurisdiction: Tigard
Site address: 10960 SW HIGHLAND DR
Project: Kuhnhausen Subdivision: SUMMERFIELD NO.6 Lot: 321
Project Description: (2)lays and(1)tub/shower for master&powder bathroom remodels
Contractor: ALL SCOPE PLUMBING&CONSTRUCTION LLC Owner: MURRAY-KUHNHAUSEN. PAT A REVOCAB
18859 SW BUTTERNUT ST LIVING TRUST
BEAVERTON, OR 97007 10960 SW HIGHLAND DR
TIGARD. OR 97224
PHONE. 503-927-0713 PHONE
FAX
FEES
Quantity Description Date Amount
2 ea Lavatories 01/21/2014 $50 04
Specifics: 1 ea Tub/Shower/Shower Pan 01/21/2014 $12 51
1 12%State Surcharge- 01/21/2014 $8.70
Type of Use: SF Plumbing
Class of Work: ALT 10 ea Minimum Fee Adjustment- 01/21/2014 $9.95
Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total 581 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 py of the rules
or direct 4q,OUNC by 'ng 503.232.1987 or 1.800.332.2344.
Issued y: ( 1t [ `/ Permittee Signature:
—t c ( —
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
Building Fixtures RECEIVE FOR OFFICE. t sl. tl\l ,
City of Tigard Received / /y ( yJ Permit No: °L1/11)/4/-e049/5-
Iii I 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 JAN 21 2014 Date/By: Other Permit No.:
l I G A R D Inspection Line: 503.639.4175 Date Readyfgy: ions: ® See Page 2 for
Internet: www.tigard or.gov CITY OF'FICA a oeclMeflxd: _ Supplemental Information
TYPE OF WORK BUILDING DIVISION FEE* SCHEDULE
❑New construction ❑Demolition For special information use checklist
Description I Qty. I E - 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
,14 1-and 2-family dwelling 111 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 50032
❑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:
0960 SU ,,L,lc-4,A df Catch basin or area drain 18.76
Job site address:
J Drywell,leach line,or trench drain 1 8.76
City/State/ZIP: I,�arA ,O r22`i Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: f Project name: Tr.+ t< Manufactured home utilities 50.03
Cross street/directions to job site: 3- (4s(s,,, b,- . 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
DESCRIPTION OF WORK Backwater valve 12.51
L Clothes washer 25.02
N('iSte,./ PO4 ' b^,fi, (G..-.o.44( Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
17_3 PROPERTY OWNER l ❑ TENANT Expansion tank 12.51
n Fixture/sewer cap 25.02
Name:
Y�.,F k l..k N lilt,y-E,/"". Floor drain/floor sink/hub 25.02
Address: �D C? stt N L a,i n!_ Garbage disposal 25.02
City/State/ZP:' ;`„,.ti 6t.
_
e'f 2 f Hose bib 25.02
Phone:( ) I Fax:( ) Ice maker 12.51
❑ APPLICANT Yi` CONTACT PERSON Interceptor/grease trap 25.02
Business name: -17 �[ L►�pr�1F'_� Medical gas(value:$ ) Page 2
Contact name: Primer 12.51
1 ,N" `ah rA►iS Kl, Roof drain(commercial) 12.51
Address: PO 199( Sink/basin/lavatory 1- 25.02 ,-5C c 9
City/State/ZIP: L.,.a (:)5%,„-c/o0 f( Solar units(potable water) 62.54
Phone:(503 ) q 2,ii, .2,.. t 3 3 Fax::( ) Tub/shower/shower pan 1 12.51 /A S/
E-mail: -yy (� Urinal 25.02
1 ['<:_Gi^'viO'(Gl U?riG4,4„V• CLO~ Water closet 25.02
CONTRACTOR
/��[J�y�/) ,(!' Water heater 37.52
Business name: Writ- ! ' /A eik/ Water pipingfDWV 56.29
Address: / c 4] &r77i cTT' 7 • Other: 25.02
City/State/ZIP: t; �^R (T2 d` Subtotal
Phone:ee )qr�-y 07i,? ! ax:( ) Al/A-- Minimum permit fee: $72.50 7�.5O
/`�/ Plan review (25%of permit fee)
CCB Lic.: • Plumbing Lie.no.:
State surcharge(12%of permit fee)
Authorized signature: �_ ... TOTAL PERMIT FEE gi,a,0
Print name: /�M %�'r r"' Date:/0970
This permit application it b if a permit is as not complete.
within 180 days
(/. 7 ! after it has been accepted ac complete
'Fee methodology set by To-County Building Industry Service Board.
I.\Building\Pc nuts\PLMU-PennitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)