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Permit
p CITY OF TIGARD PLUMBING PERMIT IN —8 COMMUNITY DEVELOPMENT Permit#: PLM2015-00140 T I GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/06/2015 Parcel: 1 S134AC01100 Jurisdiction: Tigard Site address: 11408 SW IRONWOOD LP Project: McDonald Subdivision: ENGLEWOOD Lot: 39 Project Description: Kitchen remodel-install sink,garbage disposal,ice maker and dishwasher. Contractor: A ABOVE ALL JOHN D PLUMBING Owner: HORTON,GAYLE S 7472 SW FIR STREET 899 PARKMEADOW NE TIGARD, OR 97223 KEIZER, OR 97303 PHONE: 503-620-7600 PHONE: FAX: 503-598-9355 FEES Quantity Description Date Amount 1 ea Dishwasher 05/06/2015 $25.02 Specifics: 1 ea Garbage Disposal 05/06/2015 $25.02 1 ea Ice Maker 05/06/2015 $12.51 Type of Use: SF 1 ea Sink 05/06/2015 $25.02 Class of Work: ALT 1 12%State Surcharge- 05/06/2015 $10.51 Type of Const: Plumbing Occupancy Grp: Stories: Total $98.08 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. c Issued Permittee Signature: /` ,`� Call 503.639.4175 by 7:00 a.m.for the next available inspecti.n date. l 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. 1 Plumbing Permit Application Building Fixtures Oi E I V 1a I ' City of Tigard nRnteeB _ (c /S k,'✓) Permit Mc.. ddrC-e o at 13125 SW Hail Blvd..Tigard,OR 91223 Other Paton : S Phone: 503-634.4171 Fax: 503 9 Plan Review 1960 6 2015 Data/By Inspection Line: 503.639.4175 r,,,;, a3 _� 1 1`' n Internet: www.ti d-or. v ' Not- ed/Meth ga 13o Notified/Method. hi[srvtatioa TYPe �[ "MNG D1 1S101k FEE* SCHEDULE. CREAUL 0 New construction 0 Demolition For special i1formaton use checklist Description I Qty. I Ea. I Total .14Addition/alt r*ioo/reeplacement ❑Other: New I-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY.OF CONSTRUCTION SFR(1)bath _ 312.70 tit and 2-family dwelling 0 Commercial/industrial SFR(2) bath 437.78 SFR(3)bath 500.32 0 Accessory building 0 Multi-family Each additional bath/kitchen 25.02 0 Master _er builder 0 Other: Fire sprinkler( sq ft) Page 2 . .QP.EfFE IIHFFOR.11L4TJON,AND LOCATION She utilities: , Job site address: I 11-1-a $(a (RWWJ krOO 6. LP. Catch Main or area drain 18.76 City/State/ZIP: "ri n Qt(Z,p i OR. ei 7 2 Z3 Drywall,leach line,or trench drain t a.16 hh Footing drain(no.linear ft.: 1 Page 2 Suite/bldglapt.no.: l Prolix ►,./°air: t l C &-o Manufactured home utilities 50.03 Cross street/directions to job sites Manholes 18.76 S 1 .D £L°{-(DL,L,S FEla ' (Z,D - Rain drain connector 18.76 e uo 1470-0 Q or-- Sanitary sewer no linear ft.:_J Page 2 ( (241210 t'n.�U'O . LP_ Storm sewer(no.linear ft.: ) Page 2 h Water service(no.linear ft:_} _ Page 2 Subdivision: -� Lot no.: Fixture or Item: - - Tax map/parcel no.: Bic kflow preventer 3127 Backwater valve 12.51 D.SCRIP rioN of WORK Clothes�e(rcfeeo r_eMoura- - wcraku- sIoKt Dishwasher I 25.02 ,c.e9- '1 G A-GE IdsVU&E(Z/ I GE frtMcEa1 Drinking tountain 25.02 'r.{ I rk +eE2 Ejectors/sump 25.02 1," 0 TENANT Expansion tank 12.51 Name: r l e,/ar0 k;Aijs Fixture/sewer cap 25.02 Address: I ( 4O' 5C i �F) �6 Li Floordedispoorsink/ftub 25.02 J ( Garbage disposal � 25.02 ', ,c' City/State/ZIP: 11 G 1 P r i 2 b i 0 (e?. '1 7 22.-3 Hoae bib 25.02 Phone:( ) Fst ( ) Ice maker p _ 12.51 j;il. t '.©'.A ite4ir ' ' . , `-1` 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name. Medical gas(value:S 1 Page 2 Primer 12.51 Contact name: Roof drain(commercial) 12.51 Address: Sink/basin/lavatory r 25.02 , .)t)C''')" City/State/1 P: Solar units(potable water) I 62.54 , _ Phone:( ) I Fax::( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 - - - Water closet 25.02 Water heater 37.52 Business name: 1Q+ ( J ` +1,4,),)M(5 I Water piping/DWV 56.29 ` ! Address: t1- I a Ili (Rpt�f 7 . Other: 25.02 City/State/ZIP: fl ( A R.D , 0 i=- 1 /LZ3 subtotal ( ,7,...J Phone:( t 2.0-76 0 a Fax:(103 558 -et 35 Minimum permit fee: 572.50 CCB Lie.: S 6,5-3 Plumbing Lk.no.:�-2 57p� Plan review (2556 of permit fee) A - State surcharge(12%of permit fee) 14-"--57-1' Authorized signature: /�_ {�- TOTAL PERMIT FEE 60 Print name: O.fpl.) b Q WIZ... I pate: <v (6 / (-`� This permit application eapira it a permit is oat obtained aritlst _t-ti...., alter it has beta accepted as eompkte. •Fee methodology set by Tn-Coanty Building Industry Service Board. I\Buildii iPetmiuti'LMIJ-PcrmitApp doc I0/01107 440-46I61110/01/COM/WEB)