Permit (32) 111 CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2017-00363
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/07/2017
f Parcel: 2S 101 CA00400
Jurisdiction: Tigard
Site address: 7924 SW HUNZIKER RD
Project: MERITAGE FIVE Subdivision: 2007-064 PARTITION PLAT Lot: 1
Project Description: (1)Manhole and 100 ft.of sanitary sewer to reconnect to sewer lateral.
Contractor: RAYBORN'S PLUMBING INC Owner: MERITAGE FIVE LLC
PO BOX 69 FHA&ASSOC
19990 SW CIPOLE RD 155 B AVE#222
TUALATIN, OR 97062 LAKE OSWEGO, OR 97034
PHONE: 503-692-4139 PHONE:
FAX: 503-691-2328
FEES
Quantity Description Date Amount
2 ea Manholes 09/07/2017 $37.52
Specifics: 100 If Sanitary Sewer 09/07/2017 $62.54
1 12%State Surcharge- 09/07/2017 $12.01
Type of Use: COM Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $112.07
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 rules
or direct questions to OUNC by calling 503.232.1987 or 120.0..332.2344.
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available ins. io• 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 Applica ill,'t. j � 1 ,
Building Fixtures ►o►z or►�ici: tsl Oyl.N
SEP 0 6 2017 Received Permit ,_
City of Tigard >u�y: i G7/7 r A4,400-0036-3�
el 13125 SW Hall Blvd.,Tigard,ORA12146, Plan Review
II S � ; y(- ��(„��,�� Other Permit No.:
Phone: 503.718.2439 Fax: 503. (1 6Nh ,/ lot Date/By:
P t.J L ''` 1 t�V i�/N�� Ready/By: loris: H See Pae 2 for
Inspection Line 503.639 4175' Date g
1 f t O Internet www tigazd or gov Nohfied/Method Supplemental Information
� iA __ For special information ase checklist
New construction ❑Demolition Description Qty. Ea. ( Total
❑Addition/alteration/replacement ❑Other New 1-2-family dwellings(includes 100 ft.for each utility connection)
.-- v� .,...,-4.7.:-r. -,;.;-;,--'7,7,..:� t' SFR(1)bath 312.70
SFR(2)bath 437.78
❑ 1-and 2-family dwelling 0 Commercial/industrial 500.32
SFR(3)bath
0 Accessory building
0 Multi-family Each additional bath/Icitchen 25.02
Other + , Cwv_ Fires er. s ft.) Page 2
❑Master builder U i ( -� $ prinkl ( 4
-x _ f n 's' `,�`' ...7� 43 j•,;(7 -4-_;:.$'. Site utilities:
Catch basin or area drain 18.76
Job site address: ?q vi $,.-,1 -Au,.Z j to(‘-r- Qii Drywell,leach line,or trench drain 18.76
City/State/ZIP: r(�)lrA p 9 .4-2,2-3. Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name: Pa-
Manufactured home utilities 50.03
Cross street/directions to job site: Manholes Z 18.76 37
- Rain drain connector 18.76
1.1t tiet Zi ktr R.el? A./etl( ST
Sanitary sewer(no.linear ft.: +o`)) f Page 2 2:5:.Y
Storm sewer(no.linear ft.:,_) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: I Lot no.: Fixture or item:
Backflow preventer 31.27
Tax map/parcel no.: S ICI ( CA t0 N by 12.51
�� Backwater valve
m 25.02
!€X 647 's. -# }.vl ��` `� &.�. C b" �� $`'' .'�=3 Clothes washer
`i)--e-.4......:”..n Cc/.Iv.. 2 S-C..,tst/' (c. -l-t 1--o Dishwasher 25.02
ft c.,0c-J+ M")..-1
Drinking fountain 25.02
Ejectors/sump 25.02
1..f''''' '‘'-'1''''''• --
. 12.51
4,.; 'gExpansion tank� t< k, z� � . ,� Fixture/sewer cap6 y3. ,3 f R.r., ..i ' = 25.02
Name: rt }C �� c,) t-L Floor drain/floor sink/hub 25.02
Address: 513 At j�,✓t/tl G �j ".f c_ 2.Z Garbage disposal 25.02
City/State/ZIP: (-.A pte_.- 05w e'.--c. p(Z al
7 J �S' Hose bib 25.02
Phone (�3 ) SID"(20 Fax ( ) Ice maker 12.51
. 1- N 25.02
Fi _.. ❑ C- Medi al ga atrap Pa e 2
Medical gas(value:$ ) g
Business name: 2A�! ) ? _.�1,«,I%ei✓tr Primer 12.51
Contact name:440 it 5 i 4 4 L J c"itLa 0..✓ Roof drain(commercial) 12.51
Address: (6j/qQ II., c i O'L.-` Sink/basin/lavatory 25.02
Solar units(potable water) 62.54
City/State/ZIP: '"FVC es4 Li,/ ( a a2 ?0 't Tub/shower/shower pan 12.51
Phone:(S b 3 ) cal.- zfl 3`1' Fax::(s-o3 ) (091 '2 3 Z 25.02
Urinal
E-mail: 4 '.4 A X15 ,(,3J.2.4s Co"" 25.02
Water closet
CONTRACTOR Water heater 37.52
Business name: Y310_4
J 6W - `9�,t j,r.(3+n/4--- Water piping/DW V 56.29
Address: ( A 9k 0 5+.-� C:Qd L C LI Other: 25.02
Subtotal /00.06
City/State/ZIP: -CUA 4p T t,i v fZ q 70 6 it - Minimum permit fee: $72.50
Phone:(S0 3 ) C A 2-- Kl 3/ Fax:(5'03 ) (Ai' 1-3 26 Plan review (25%of permit fee)
Plumbing Lic.no.: 3 t(-1(o 663
CCB Lic.: EilicZ- State surcharge(12%of permit fee) 2 v it
Authorized signature: TOTAL PERMIT FEE (Z`�=
This permit application expires if a permit is not obtained within 180 days
Print name:��nj [�f�t �;,.�/ Date:StAtjj alt)i 7 atter it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
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