13375 SW HOWARD DRIVE-1 W
ti
(!a
2
0
1E
m
v
0
1
13375 SW HOWARD DR
CITYOF TIGARD _ PLUtIBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2003-00303
",3125 SW Hall Blvd., Tigard, OR 97223 (5 503) 639-4171 DATE ISSUED: 6/26103
SITE ADDRESS 13375 SW HOWARD DR PARCEL: 2S103CA-00600
SUBDIVISION: W00F)CREST ZONING: R-4.5
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALJ GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF= WASHING MACK: BACKFLOW PREVNTR.S:
OCCUPANCY GRP: FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES _ LAUNDRY TRAYS: SF RAIN DRAINS:
SII:KS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 1
TUB/SHOV `RS: SEWER LINE: 30 ft
WATER CLOSETS: WATER LINE. ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Septic tank to be removed or pumped and filled and inspected. Reverse plumbing
_ _FEES
Owner: Uescriptlon Date Amount
MAY, WILLIAM A - `
13375 SW HOWARD DRIVE I j'LUMBJ Permit Fee 6126103 $117.50
TIGARD, OR 97223 80/0AX]8" State Tax 6/26!03 $9.40
Total $126.90
Phone
Contractor:
MCKEE PLUMBING
PO BOX 801
CANBY,OR 97013 REr'IIRED INSPECTION:'
Phone : 503-266-7982 Misc. Inspection
Final Inspection
Reg #: 1 It 116965
PLM 3-340PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all ether applicable laws. All work will be done in accordance with approved
plans. This permit wi!! expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Issued By _ rr._12,-L�,+ _ .� jr',�i Permc�
Permittee SignaturQ
Call (503) 639=4175 by 7-M P.M. for an inspection needed the next business day
i
Building Fixtures `>U,) &-0 0 D-OT)
Plumbing Permit Application '
Date received ,Z(e�U Permit nojtf'I 0?3-ooh
Cit of Tigard City g Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd,Tigard,OR 97223
City q/77gurJ Phone: (503) 639-4171 Project/appl.no.: Expire date:
Fax: (503) 598-1960 Date issued: By: Receipt no.:
Land use approval Case file no.: Payment type:
'OF PERMIT
Ll 1 r.. 2 family dwelling or accessory 0 Commercial/industrial Li Multi-family U Tenant improvement
U New construction U Addition/alteration/replacement U Food service U Other:
1-Jon sITE INFORMATION1
Description Qty. f'ee(ea.) Total
Job address: %� ) (<_i ( t l j - —
Bldg. no.; Suite no,: Nen 1-and 2-family dwellings only:
(Includes 100 ft.for encu utility connection)
Tax map/tax lot/account no.: SFR(1)bath _
Lot: Block: Subdivision: SFR(2)bath
Project name: SFR(3)bath
City/county: .'1 Q I ZIP: Each additional bath/kitchen
Description and location of work on premises: Site utilities:
Catch basin/area drain
Est.date ofcompletion/inspection Drywells/leach line/trench drain
1 t Footingdrain(no.lin.ft.)
PLUMBING CManufactured home utilities
Business name: 1 kyE L LL 4L// 1 L I L L L01 Mann les
Address: 42
0 V`Cl I Rain drain connector
City: t y ,.. State 't ZIP: 7 Sanitary sewer(no.lin.ft.) u t
Phone: Fax- Email: Storm sewer(no.lin.1l.)
CCB no.: / - r Plumb.bus.reg.no: ��4 �/^ Water service no. lin. f).
City/metro lie.no.: ; Fixture or item:
Contractor's representative signature:' _ Back tion valve _
Back now preventer
Print name: ' ( Date: -h Backwater valve
CONTACT ► _Basins/lavatory
Name: L Clothes washer
Address: -- Dishwasher
Drinking fountain(s) _
City: State.: ZIP: Ejectors
/sump
i
one: I lVax: F.-mail: Expansion tank
Fixture/sewer ca
Name(print): r Floor drains/floor sinks/hu
Mailing address: Garbage disposal
Hose bibb _
City:
State: ZIP Ice maker i
Phone: Fax: C-mail• Interceptor/grease trap
Owner installation/residential maintenance only: The actual installation Primer(s)
will be made by me or the maintenance and repair made by my regular Roof drain(commerci—al—
employee on the property 1 own as per ORS Chapter 447• Sink(s),basin(s),lays(s) _
Owner's si nature:_____--.Date: Sump
RN 124 10Tubs/shower/shower pan _
Urinal
Name. Water closet _
Address: Water heater
City: State: ZIP: Oth
Phone: Fex: E-mail: r Total
Not all junsdictitms accept credit cards,please call jurisdiction for more information. Minimum FCB...............
N
otice: This permit application Plan review(at_ %) S —
U vin U Mastercard expires if a permit is not obtained
Credit cud number within 180 days after it has been State surcharge(8%)....S _ �- J•��
spires
TOTAL........................S
l
Name of cardholder at shown on creditaccepted as complete. c
e�11 card "
— - IL
Cardholder sttinature -- Amount 1164616 t MI
PLUMBING PERMIT FEES:
_ PRICE TOTAL New 1 and 2-family dwellings only:
FIXTURES (individual) __ QTY ea AMOUNT (Includes all plumbing fixtures in PRICE TOTAL
Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT
Lavatory 16.60 for each utility connection)_
One 1 bath _ $249.20 _
Tub or Tub/Shower Comb. 16.60 Two 2)bath _ $350.00
Shower Only 16.60 Three(3)bath $399.00
Water Closet 16.60 SUBTOTAL
Urinal 16.60 8%STATE_SURCHARGE
Dishwasher 16.60 PLAN REVIEW 25$u OF SUBTOTAL
Garbage Disposal 16.60 TOTAL
Laundry Tray 16.60
Washing Machine 16.60
Floor Drain/Floor Sink 2" 16,60
PLEASE COMPLETE:
3 16.60
4" 16.60
Water Healer O conversion O like kind 16.60 Quantity b _Work Performed_
Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/
permit. Capped
MFG Home New Water Service 46.40 Sink
MFG Home New San/Storm Sewer 46.40 Lavatory _
Tub or Tub/Shower
Hose Bibs 16.60 Combination
Roof Drains 16.60 Shower Only
Drinking Fountain 16.60 Water Closet
Other Fixtures(Specify) 16.60 Urinal
Dishwasher
Garbage Disposal _
-'
Laundry Room Tray
Washing Machine
Floor Drain/Sink: 2"
Sewer-1 st 100' 1 55.00 - 3"
Sewer-each additional 100' 46.40 4"
Water Service-1st 100' 55.00 Water Heater _
Water Service-each additional 200' 46.40 Other Fixtures
S eci
Storm&Rain Drain-1 st 100' 55.00
Storm 6 Rain Drain-each additional 100' 46.40
Commercial Back Flow Prevention Device 46.40
Residential Backflow Prevention Device' 27.55 _
Catch Basin 16.60
Inspection of Existing Plumbing or Specially 62.50
Requested Inspections perthr COMMENTS REGARDING ABOVE:
Rain Drain,single family dwelling 65.25 _
Grease Traps - 16.60 -
QUANTITY TOTAL
Isometric or riser diagram is required if
Quantity Total is >9
*SUBTOTAL
8%STATE SURCHARGE
"PLAN REVIEW 25%OF SUBTOTAL
Requirt 1 only if fixture qty total is>9
TOTAL
"Minimum permit fee is$72 50+8%state surcharge,except Residential Backflow
Preventinn Device,which Is$36 25+6%stale surcharge
"All Now Commercial Buildings require 2 sets of plans with Isometric or riser
diagram for plan review.
1:\dsts\farms\plrn-fees.doc 12/26/01