Permit (37) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2017-00340
Date Issued: 08/23/2017
ff,GAR 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S102BCO2600
Jurisdiction: Tigard
Site address: 12875 SW WATKINS AVE
Project: SKARBEK Subdivision: NORTH TIGARDVILLE ADDITION Lot: 25
Project Description: (1)new sink,(1)water closet and(1)dishwasher for kitchen remodel.
Contractor: CORNELIU MORARIU PLUMBING Owner: SKARBEK, STEPHEN&SUSAN
5235 SW 153RD AVE 12875 SW WATKINS AVE
BEAVERTON, OR 97007 TIGARD, OR 97223
PHONE: 503-317-9659 PHONE:
FAX: 503-646-0941
FEES
Quantity Description Date Amount
1 ea Dishwasher 08/23/2017 $25.02
Specifics: 1 ea Sink 08/23/2017 $25.02
1 ea Water Closet 08/23/2017 $25.02
Type of Use: SF 1 12%State Surcharge- 08/23/2017 $9.01
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $84.07
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the -rles
or direct questions to OUNC by calling 503.232.1987 or 1.800.
12‘,
Issued By: e Signature: /� v
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of e project.
Approved plans are required on the job site at the time of each inspection.
RECFVF11
Plumbing Permit Application AUG 2 3 2017
Building FixturesOR 0111(4 t'A 41'1
CITY Of- ilt3A.1.-
city of Tigard
'1111 ii.-- 13125 SW Han Blvd.,Ward.OR 1;31"
LD NG Ilao Itc,act,
7Permiti.,
?1417._-
Phone3`d.0
2430 Fax- 503.5914 1460 i Other fount No ........
insPection Line 503,63(44175 i$ste rtr24,0,, 1 IOW 1 fa See Page 2 for
" Internet wwet.ttgartitot4tw NottfiedlAttit6d. ' S•••Itirtenfo1 Information
,. ' --- -• - , - : ,
TYPE OF WORK FEE*SCHEDULE ' - •- -
t ! lerverial information MSC Cherkibt
J New corm-Renton , 0 minamen E., , Total
RI Ad.111rtalte:ratiaw'repia,-eMCIlt .1 0 Other: •I i. Nos 1-2410011%dwellings I tochttie,1.40 ft for melt 44114)-;e4444.5:tiont,
CATEGORY OF CONSTRUCTION t SFR I I!15$05
$ SFR#2)balg 432.f$
and 2family dwelling (jConitnerinalAndustral -.
......_ _ ...„__ " qizit 0)bieh 5011.32
0 Aczeixr:...building U Mubbfainily -__
4 - - --....- _____i ; It.h.4.1.adrinimkil bliltlatrItsm , 25,02 I
, ,.
0 Master butkiet ti Other
I 1 ro,crrinkteri
JOB SITE INFORMATION AND LOCATION 1-
I i
-
.
Job site addrosy /a 9.s, 5‘.4..) wkrk,iivs _Aug 1 = Catch ba,nt m alea drain
— .. .... a,_
..— -, $ ..._ysval,irAdll 401C.AA It VrICIt&Sin I X.Pd
Cor`Stt. •7114
OA'111 :5N - ,1172`,---aq- • -,- -; It FeIiT;idrai440,_
P.tge 2
'5uile:h14'ail''''''' P`°'ect ramc; ; Ftrimutf4e1414,-d iixttWe
cro -- -,; ------------1 - -- --:--- --- --------1----
mt strectVirectiow,to job stk.,: a..,44 t...4Cir Manholet, it.t 76
Ram dram et-moo:tin
_ . .,
-
sewer inii Itrunr ft I Page 2
. —
Storm gewer km.fintmr 11.: ) : Page 2
Sui-Aivision. I Los no.: L Fqture rtr item:
- phenr 1 acflow nit, 0 27 T
Tax map/parcel tin Bk
' 1 1--
- — - ------" - 4 1315kwatti valw I 12 CI i
OF:SCRIPT/ON OF WORK _.________
-- — _ I Ck.ths",W3,-.1wr :4#' 1,,, 25 42 ar,74 -
NeLo 544214.--., 1--"T=69..4_,6-777 ew Ii4=40)4.0.V*P ! a-ryi,t.....,b, a ,i -,
/_... '11'7-' , ...!6) ....
i.A irchep_ Reim& 00eaLP45.11wAsheit-1 i 6,-;:k ,, ..,;., - ---- : 25 02
-t
irAcr ..._...... . CoppecZoit,$., .1 L1-*".:—.-35' 2O2
$2 51
1 ._._ PROPER:TY OWNER 1 0 TENANT 1 ri"..,i",A.r.'nk
-r- --i-
i-Nattle; s-to. 6 aiti seA le ke, i , 1 Wilt C,:iewCt t ap
4 i
_ — --; - 4 t ric.-oi&ail',thArr sinklu.lb 1 25 02
LA kR11-es:._/.. ; _ 5,40 4.4,47.1c...:LA4
,...._ ..........._____ _ 1 t,,,c 11.12e kINtt-Nal ---i- -4-
25 St2 ..
'
t-
l City/State:ZIP:7-2w /„ ate_467A)77:7,01-e, i 2:;.02 II
, _
I Phone:t ) ! Fax:( ) 1 I..,e maker1 12 51
... .... _____
ty iourAn --- ------17 14.-CONTACT masoN :1,ra4:1ill.1.7 ram:.trap
Vieditdi gat 4 value:S_____# I
• Business own: i, _ ....
g,r7,__, _ -. 1 p,,,iki
Sink.battin•1404attry ;
• _ Pariges_21
t7 25 02 j 020;C0.4.--
City/State,ZIP; Pay744 Ad) a • Si at n1nt
-4 ,-, .. : 1
11011C:4 )6-63—33‘,43 i Iii':.( ) I 1 Tub-Flower,,Turtt er gin
2502
V-
----t i Watt;ihret ' 1 -1
C
O
N
T
R
A
CTO
R
t-- .
3 i 51
Rutttness Mille. CO at4Et...i ( MO A i Likt{NI bit(G it "V • ' - --,
Address: 572 ,:b k.X.," i S'bf • AvE . i Oher'
i ---------41
Cityltit4triZIP; E" AN(r.:-.....-2,-r-X:+/Li ( pia ?70t07 ;
_ ,__. ___
_ '
rh°ne:(563) - "6 i 1 - i6*-5q : i--i54 5v-5) -C,4 6 -094/ 1
Nimunum pernitt tee: 572 50
I OCR 1.w. 1 ki40 toi 40 , ;.., Plumbing l.te.no.- ,61;4619-17.rr t Plait woe 4..5. 0,pcnnit ICC)
, Slate*dIrdlid ge(12%of Nwittit tee) 97-00 4•- ,
Authorized mpature. „....••?;),1.9 .,____ 3 32-' ' , .. -
. ' .2 c----- 49 L 101 Al.PERM VI l•FP, „forsr„,„1,1
-,--— , _. _ , ...
rPtint name, co i..?....i-ce Li t.,i MO P.A.ie.it4 j Date.AtiCtil 17 j lids permit application exodus if a permit is not obtainctl oldtin ISO days glio7
L. .„.._ .,,c,It gas been accepted as complete.
*Ice trwliwt,togy set ny ina-"oarity ituilditto Industry Set•i...e Board.
1 lutifdar:: cro,-,is fq MUd'conItApd do: In:II fr., 4-Vo-4,1,1f;k,0?COM WI)1,