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Permit CITY OF TIGARD PLUMBING PERMIT . '£> COMMUNITY DEVELOPMENT Permit#: PLM2017-00357 Date Issued: 09/07/2017 TE CIARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S 101 C B00200 Jurisdiction: Tigard Site address: 8200 SW HUNZIKER RD Project: SMITH GERIG WESTERN PROPERTIES Subdivision: None Lot: None Project Description: (1)Manhole and 100 ft.of sanitary sewer to reconnect to sewer lateral. Contractor: RAYBORN'S PLUMBING INC Owner: SMITH GERIG WESTERN PROPERTIES L PO BOX 69 PO BOX 930 19990 SW CIPOLE RD WILSONVILLE, OR 97070 TUALATIN, OR 97062 PHONE: 503-692-4139 PHONE. FAX: 503-691-2328 FEES Quantity Description Date Amount 100 If Sanitary Sewer 09/07/2017 $62.54 Specifics: 1 12%State Surcharge- 09/07/2017 $12.01 Plumbing Type of Use: COM 1 ea Manholes 09/07/2017 $18.76 Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $93.31 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 o•tain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available ins• iorrdate. This permit card shall be kept in a conspicuous place on the job site u it completion of the project. Approved plans are required on the job site at the time of each inspection. f: Plumbing Permit Application Building Fixtures G F) 1.08 oil 1(11 loyl.l City Of Tigard Received E P 0 6 2017 DateBy: �/6.//2 / PermitNo.:t//4.�;o/9,-6,635-7 Ill13125 SW Hall Blvd.,Tigard,OR 9722 Plan Review ((( r I Phone: 503.718.2439 Fax: 503.5 1 y 1 Date/BY: Other Permit No.: Inspection Line: 503.639.4175 i OF `°I t. Date Read/B .oris: ® See Pae 2 for r 1(„v l t n Internet: www.tigard-or.gov 9 U I L.�.1 N G (.)Iv i s i a ( y y: g Notified/Method: i/% S�u�p-plementalInformation For special information use checklist (�New construction ❑Demolition Description I Qty. I Ea. 1 Total ❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) '-,-1 --:4..---- ---z." r_.- ,`ta, SFR(1)bath 312.70 ❑ 1-and 2-family dwelling Elm Comercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder F.4 Other:,J+'ti i.4 i G Fire sprinkler(_sq.ft.) Page 2 --smik" e � a4* . t,,.q " a-'- a v #z v i"' v , s t i e t , 6g. 1 C>' `,- ,1` Site utilities. ,..,,,,,til,,,, ,'..*,1_, . 4 a .v .4 x :,t...... �., _ x 4- � v, .,eCatch basin or area drain 18.76 Job site address: 6?p� S- r-(JAj-,t itec( e,9 - Drywell,leach line,or trench drain 18.76 City/State/ZIP: --t-p 6.q(L 0, Q%2..i-3 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name: SSI/771 Gc fl 7+'wr s irk‘ Manufactured home utilities 50.03 Cross street/directions to job site: //Iverlff rS Manholes / 18.76 j 7,i'-' ,1�el 2`�U /.dc,li Rain drain connector 18.76 1 C� Sanitary sewer(no.linear ft.:t Jv ) 1 Page 2 J 5_2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: ZS lc"C 3002_00 Backflow preventer 31.27 t* P �� e -,t Backwater valve 12.51 ' „7 i ._,. .: _.� .�.= ...._ .-, .. �" *. , Clothes washer 25.02 (2 e t.o,y,e ee ev.t, (.,4vs.I +-i. r_'4-7 On - Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ,. a .,, ...,y ., -..:..5'a,,. ''s`p„ *s a �1 t'mak.'ti x .. +,- Expansion tank .12.51 J• ® c 1-t 1r ,, �, P Name: xture/sewer cap 25.02 Si,Si ;f G e-- q i,Je' cl�i„ Q,�r t`e- LG C Floor drain/floor sink/hub 25.02 Address: `PO a)c lv1 3 D Garbage disposal 25.02 City/State/ZIP: W t( �N J ((e f 09_ 1/O'4 0 Hose bib. 25.02 Phone:(s03 ) 638 Ceti 00 Fax ( ) Ice maker 12.51 v, _ APPLICAN1 . .. © CONT T k°N Interceptor/grease trap 25.02 Business name: Medical gas(value:$ ) Page 2 �py i30(L s' ?Lo 6(/f Gr Primer 12.51 Contact name: -R A 1,1j 14,A L.)`,it S o/r Roof drain(commercial) 12.51 Address: ( 4 Cr e(0 5,t G i eo L Sink/basin/lavatory 25.02 City/State/ZIP: +,Ja�C'Ei✓i (470(Q1 Solar units(potable water) 62.54 � r (7(Z Phone:(13 3 ) (o S y- 4(351 Fax::(S-,3 ) (oq( - 23 `Z 9 Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 's"" i k7 ""�41' Covin . -. � � _- _ Water closet 25.02 CONTRACTOR ' Water heater 37.52 Business name: prk,il3 i0�✓J 5 l?W vv131./✓(r Water piping/DW V 56.29 Address: Other: 25.02 1ri490 5,x.1 C-�PL� CCc.O City/State/ZIP: --r J L.AT(�t b 1Q 970 6 1.... Subtotal $(''� Phone:(S-43) (,g 2- Lf t 3 9 Fax:(s03 ) cog( - 2_3 2 a Minimum permit fee: $72.50 .. c L Plumbing Lic.no.:3c(_ l66 IPS review (12%of permit fee) CCB Lie.: S-? 7 State surcharge(12/o of permit fee) 9 Authorized signature: TOTAL PERMIT FEE `T/64 Print name: Date: This permit application expires if a permit is not obtained within 180 days 4/15 AI L. /t.StvV 3(4t�(rot) after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 440-4616T(10/02/COM/WEBI