Permit ., CITY OF TIGARD PLUMBING PERMIT
`• I • COMMUNITY DEVELOPMENT Permit#: PLM2015-00154
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/14/2015
Parcel: 2S102CB01901
Jurisdiction: Tigard
Site address: 13295 SW PACIFIC HWY
Project: Papa Murphy's Subdivision:RTH TIGARDVILLE ADDITION,AMENC Lot: 32
Project Description: Backwater valve.
Contractor: BURFITT PLUMBING INC Owner: WEBER COASTAL BELLS LTD PTNRSHP
6223 NE HASSALO PO BOX 23408
PORTLAND, OR 97213 EUGENE, OR 97402
PHONE: 503-287-1267 PHONE:
FAX: 503-331-3933
FEES
Quantity Description Date Amount
1 ea Backwater Valve 05/14/2015 $12.51
Specifics: 1 12%State Surcharge- 05/14/2015 $8.70
Plumbing
Type of Use COM B0 ea Minimum Fee Adjustment- 05/14/2015 $59.99
Plumbing
Class of Work: OTR
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 O NC by calling 503.232.1987 or 1.800.332.2344.
Issued By: "AlIPI Permittee Signature: �` ;e( 1\1 l/a
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 RECEIVEP______________________________________
Site Utilities
1111 City of Tigard MAY 14 2015 DateBY, 7y � N �o�s/Permi - z /ao%5
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
I Phone: 503.718.2439 Fax: 503.598 ategy Other Permit No.:
Inspection Line: 503.639.4175 rITY(!F f(GARU Date Ready/By: Juris ® See Pa
T I k;A It I)
Internet: www.ti ard Or. ov esdY y' Page 2 for
g 8 r Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑New construction ❑Demolition For special injormalloe 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
❑ 1-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
❑Accessory building ❑Multi-family SFR(3)bath 500.32
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:13295 SW Pacific Highway Catch basin or area drain 18.76
City/State/ZIP:97223 Drywell,leach line,or trench drain 18.76
( Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name:���� / 11 ��Or �' 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: Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve L 12.51 /2,S/
/el__ Clothes washer 25.02
• Backflow valve "�� Dishwasher 25.02`CC�JJ� 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 ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name: Medical gas(value:$ ) Page 2
Contact name: Primer 12.51
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02 _
City/State/ZIP: Solar units(potable water) 62.54
Tub/shower/shower pan 12.51 ` { ° ' I
Phone:( ) Fax::( ) P
E-mail: Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name:Burfitt Plumbing,Inc. Water piping/DWV 56.29 '
Address:6223 NE Hassalo Other: 25.02
City/State/ZIP:Portland,Or.97213 Subtotal
Phone:(503)287-1267 Fax:( ) 71/17 Minimum permit fee: $72.50 72.50
Plan review (25%of permit fee)
CCB Lic.: 1076 7/3 V t.5 Plumbing Lic.no.:26-11 Pe) State surcharge(12%of permit fee) 8.79
Authorized signature: eJ/J fl TOTAL PERMIT FEE - 81.20 -4
Print name: I lit( a Date:5/14/2015 This permit application expires if•permit is not obtained within 180 days
(des after it has been accepted as complete
J "Fee methodology set by Tri-County Building Industry Service Board.
I:\Building 1Permits\PLMU-PermitApp.doe 10/0I/09 440.4616T(10/02/COM/WEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13295 SW PACIFIC HWY, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2015-00154
Inspection Type: Inspector:
399 Plumbing final George Heimos
Result:
PASS - NoCofO
Comments:
1 " A.R.I. model DC-500 serial number AB1051106
Violation Summary:
Inspector Contractor