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Permit (13) CITY OF TIGARD PLUMBING PERMIT lig ■ COMMUNITY DEVELOPMENT Permit#: PLM2016-00501 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/03/2016 Dg Parcel: 25111 DA07000 Jurisdiction: Tigard Site address: 8822 SW BELLFLOWER ST Project: CORRIGAN Subdivision: APPLEWOOD PARK NO.2 Lot: 65 Project Description: Shower pan replacement. Contractor: OWNER Owner: CORRIGAN,VICTORIA IVANOVNA VICTORIA CORRIGAN 8822 SW BELLFLOWER ST 8822 SW BELLFLOWER ST TIGARD, OR 97224 TIGARDS, OR 97224 PHONE: 503-341-0735 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Tub/Shower/Shower Pan 10/03/2016 $12.51 Specifics: 1 12%State Surcharge- 10/03/2016 $8.70 Plumbing Type of Use: SF 60 ea Minimum Fee Adjustment- 10/03/2016 $59.99 Class of Work: ALT Plumbing 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 le rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-00•s ou ay ob, ' a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.805. ' .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. Plumbing Permit Application -1, BuildingAt Fixtures �� ' ` << City of Tigard '''W I h Received ' `, g \ Date/By: I�j Permit No. [(a-'cz jC� 13125 SW Hall Blvd.,Tigard,OR 97223 {. Plan Review / 9/v 1 ■ Phone: 503.718.2439 Fax: 503.598.}QUO\ ,*1,9,:i„) Date/By: Other Permit No.: Inspection Line: 503.639.4175 v �' , Date Ready/By: Juns: T I G A R D Internet: www U azd or ov �7c Is , ' \� y y H See Page 2 for g g 84i >d y' 'vti,N; Notlfied/Method .(�}0 Supplementallnformatton IIINew construction ii olition For special information use checklist Description Qty. I Ea. I Total ®Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) ' ; 1GAT O 7t 0 CONSTRUCTION TION • . . SFR(1)bath 312.70 Pa 1 and 2-family dwelling SFR(2)bath 437.78 ❑Commercial/industrial SFR(3)bath 500.32 ❑Accessory building ❑Multi-family Each additional bath/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 »•; � ** AI '` TI.4l x y Site utilities: Job site address: 8.8_9_2_ 5 ill 13.lL F eALe 2 T Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: -r-i 6-- {L 0 i 6 iFt. 6 -7 22. 'L Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name: (tel_,,. r' � Manufactured home utilities 50.03 Cross street/directions to job site: `� u 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 CrO A1 C t3F WORK Backwater valve 12.51 . ., ., „ ' Clothes washer 25.02 ga Pr---/4-e-e--, 5 I &., Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 tank,► '.,off'" ''�� .'' 0 'T)� �ii��" ,;• Expansion an 12.51 Fixture/sewer cap 25.02 Name: i// C_7 e 2..">7- L' F'12.2 1 S-79-..../ Floor drain/floor sink/hub 25.02 Address: S D___Z 5 &C..,J e L -.t!�L,,,,,,_ S,7 Garbage disposal 25.02 City/State/ZIP: T/ O / v _ 'YC7 2 2_ 474 Hose bib 25.02 Phone:("pp 3 y/-0.7 3 S' Fax:( ) Ice maker 12.51 ' � Interceptor/grease trap 25.02 1 .: I'C.Y i� + NTACT 1' l f!I Business name: Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax: :( ) Tub/shower/shower pan l 12.51 /64 ,,51 Urinal 25.02 E-mail: :tet coNTRAcr©R '-',g4,,,,'41.%,';, • Water closet 25.02 .,...,k.,. - Water heater 37.52 Business name: WaterPg/ 1p m DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal /02, Minimum permit fee: $72.50 -7d,.S--0 Phone: ) Fax:( ) Plan review (25%of permit fee) CCB Lic.: Plumbing Lic.no.: State surcharge(12%of permit fee) (.7„ Authorized signature: C 3 TOTAL PERMIT FEE re/ 1 % /1//40This permit application expires if a permit is not obtained withinl80 days QPrint name: Date: ater it has been accepted as complete.G *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Pennits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)