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Permit (55) ih CITY OF TIGARD t PLUMBING PERMIT /I, Permit#: PLM2016-00537 �~`- COMMUNITY DEVELOPMENT � �� 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/26/2016 t �"� Parcel: 2S114BA01200 Jurisdiction: Tigard Site address: 16145 SW GRIMSON CT Project: MONROE Subdivision: PICKS LANDING NO.2 Lot: 127 Project Description: (1)clothes washer,(1)sink,and(1)shower for a 578 sq.ft.addition. 10/31/16:REPRINTED permit to add(1)water closet._11/10/2016:ADD(1)laundry tray. Contractor: BC PLUMBING INC Owner: MONROE, CONNIE LEE PO BOX 1026 16145 SW GRIMSON CT SILVERTON, OR 97381 TIGARD, OR 97224 PHONE: 503-845-4993 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Clothes Washer 10/26/2016 $25.02 Specifics: 1 ea Sink 10/26/2016 $25.02 1 ea Tub/Shower/Shower Pan 10/26/2016 $12.51 Type of Use: SF 1 12%State Surcharge- 10/26/2016 $8.70 Class of Work: ALT Plumbing Type of Const: 10 ea Minimum Fee Adjustment- 10/26/2016 $9.95 Plumbing Occupancy Grp: 1 ea Water Closet 10/31/2016 $25.02 Stories: 0 12%State Surcharge- 10/31/2016 $3.00 Plumbing 45 Misc Other Fee 10/31/2016 $45.00 1 ea Laundry Tray 11/10/2016 $25.02 0 12%State Surcharge- 11/10/2016 $8.40 Plumbing 45 Misc Other Fee 11/10/2016 $45.00 Total $232.64 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 • NC by calling 503.232.1987 or 1.800.332.2344. _ -7 Issued By: � Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspectio -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. 1PCITY OF TIGARD PLUMBING PERMIT 2 COMMUNITY DEVELOPMENTPermit#: PLM2016 00537 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 ifitsiorn Date Issued: 10/26/2016 T[ a� Parcel: 2S114BA01200 Jurisdiction: Tigard Site address: 16145 SW GRIMSON CT Project: MONROE Subdivision: PICK'S LANDING NO.2 Lot: 127 Project Description: (1)clothes washer,(1)sink,and(1)shower for a 578 sq.ft.addition. 10/31/16:REPRINTED permit to add(1)water closet. Contractor: BC PLUMBING INC Owner: MONROE, CONNIE LEE PO BOX 1026 16145 SW GRIMSON CT SILVERTON, OR 97381 TIGARD, OR 97224 PHONE: 503-845-4993 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Clothes Washer 10/26/2016 $25.02 Specifics: 1 ea Sink 10/26/2016 $25.02 1 ea Tub/Shower/Shower Pan 10/26/2016 $12.51 Type of Use: SF 1 12%State Surcharge- 10/26/2016 $8.70 Class of Work: ALT Plumbing Type of Const: 10 ea Minimum Fee Adjustment- 10/26/2016 $9.95 Plumbing Occupancy Grp: 1 ea Water Closet 10/31/2016 $25.02 Stories: 0 12%State Surcharge- 10/31/2016 $3.00 Plumbing 45 Misc Other Fee 10/31/2016 $45.00 Total $154.22 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 503.232.19: or 1.800.332. . Issued By: ,/- _",,. r..,,r,„Le.zo..._ Permi ee i e: 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 ty g, Received Iii 1C3I25 SW Hall B ;Tigard OR Pate/lan BY /O //6 permit No: / 'l0�(X 4(. J5 3 r7 Phone: 503.718.2439 Fart 503.59 en3y- Other Permit No.: TI GAR D tnspecxion"Lilxe: 503.639.47 75 GG 1Y\C'.11 Date Ready/By: lurk. 0 See Page 2 for Internet www tigard-0r gov /R n("A Notified/Method. /,,T.,(4., Ssppkmental Information r "t t e r - r Y ';'''','''"',61i.'""';';‘,'714 "� 14 ▪,it" ..'', l� 9'�'+ O�V4`�lAI� ,�rI���`��,' � �r ° , E�i ,� 1� +�".:SGHP+tJiZLE �e; �.. 0 New construction 0 'an�` $$O For s ecial i cans ion use checklist riK Addition/alteration/replacement onlalteration/rGpiacemeni ©q' ��1`���� Descnption �� Qty. l Ea. I Total a - � 14R'1 Di R ® !# 1 f l 1.m l-2-family dwellings(includes 100:1L for utility connection) �▪ � •, r � �i ''''''':,'''' '''',';"•'' �(1)b � 322.70 ... :. ,,.ami,,. .., _ . ,,,.,.� ,, ,�, ,m,. .: ,., S sill i {{1-and 2-family dwelling ❑Commervcia mndushial .` SFR(2)bath 437.78 SFR(3)bath 500.32 IMulti-family Accessory building 0 ' 111 1 • . i Each additional bath/kitchen 25.02 [=I Master builder 0 Other f Fire sprinkler C-sq.ft) Page 2 '$4,P*: tO,a l Ol A1ID b . Olt ..--,.;,','`'';'''14siteutlllties: Job site address: I((LJ r G Catch basin ar area drain 18.76 City/State/ZIP -r,,3„41. of X17 2 2 m► leach line,or trench drain 18.76 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name: 41\ S 4- +.___. !\'ltrI rzrkManufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18:76' Sanitary sewer(no_linear ft::_) Page 2 Storm sewer(no.linear ft.:...._.) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: p,c.jc5 ,,nd,„� No i. Fixture Lot.no.: 127xture or:item: Tax map/parcel no.: Backflow preventer 31.27 P =l?E$C liackwatervalve 1251 �,, Clothes wa5har .I 25.02 6 )/31 / / (p i r4q' /} Ge1 �L,- i - � ��, ""� I. G C�", � � Dishwasher 25.112. Drinking fountain 25.02 Ejectors/sump 25.02 PR RT) OWNER ' A 't Expansion tank 12:51 1 Fixture/sewer cap 25.02 Name: Ca A\v\l e_ N�oAVO r- i---._-___._- Ftoor drain/floor sink/hub 25.02 Address: (6 t N5 60,,r4sc A ci 5w Garbage disposal 25.02 city/StateiZIP: "T,.y`.. Lf or. e1'12z.3 Hose bib 25.02 Phone:(So,3) ,S`%''( so 4'j Fax:( ) Ice maker 1251 ;i PP,i TC . T T . a Q.1 i:lC'7`1',ERg( .( ;F Interceptor/grease trap 25.02 Business name: CC �+ Medical gas(value:$ ) Page 2 J� Cx,44,v<1«1,, ti.-C.- Primer I251 I Contact name: 66' LH Address: Roof drain(commercial) 12.51 v)c b.X: 2r c 9(1 Sink/basin/lavatory k 25.02 95(/,,l,City/State/ZIP: /ctr'T d C9 A_ T1307 .Solar units(potable water) 62.54 Phone:(5.03) QJ/ /S' 7'I Fax::( ) Tub/shower/shower psi 1 12.51 /,4.5j E-mail: Urinal 25.02 101.--;0, k'(.`' g;at 'y( r ., ° water cel CO c s4eG+(/..e1;1//if 25.02 PZj.cl-- 37.52 Business name:'B•C Pi LJ..M:3i r15 4 C Water piping/DWV 7 5629 Address; T.O O. )C. 10.Ot, �� Other: _ 25.02 City/State/ZIP �' ; i V/e..1.--4"/DY") , Ole-- -1'-3 t Subtotal Cp� „5.3 Phone:( 3) i if5--_499-3 Fax:(57:3 ( A i i minimum permit fee: $72.50 70).5-0" - Plan review(25%ofpermitfee) CCB Lic_: 101 .{ 7 lid' Plumbing Lie.no.: , 1 :-' P E� Authorized si : '7(1tl jf 7 State surcharge(inc.of peisnit fee) 8 771)J , TOTAL PERMIT PEE y i 4-E) I Print name. (_ ` _` ` Q",.... Dam:•t "'2'.(- Q This permit.application expires its permit is net obtained within ISO days , Wafter it bas been accepter]as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1:1&a'diegTermitstPLAillPermitAppdoc 10/01/09.. 440.4616T(10/02/COMWEB) I