Permit R ,l CITY OF TIGARD PLUMBING PERMIT
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COMMUNITY DEVELOPMENT Permit #: PLM2010 -00049
1 Date Issued: 02/17/2010
T f CARD; 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S104BA04700
Jurisdiction: Tigard
Site address: 13884 SW MARCIA DR
Subdivision: CASTLE HILL NO. 2 Lot: 80
Project: Sutherland
Project Description: Install new shower pan and shower valve.
Owner: FEES
SUTHERLAND, KEVIN M & SANDRA L Quantity Description Date Amount
13884 SW MARCIA DR
TIGARD, OR 97223 1 ea Tub /Shower /Shower Pan 02/17/2010 $12.51
PHONE: 1 12% State Surcharge - 02/17/2010 $8.70
Plumbing
60 ea Minimum Fee Adjustment - 02/17/2010 $59.99
Contractor: Plumbing
CLEARWATER PLUMBING LLC
11755 SE HOLGATE
PORTLAND, OR 97266
PHONE: 503 - 935 -0918
FAX: 503- 761 -2143
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Total $81.20
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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued B : Permittee Signatur • .^ , Na .—
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
Feb 16 10 02:09p Clearwater Plumbing Llc 503 761 2143 p.1
t ' fir ''
Plumbing Permit Applicati l t EIVED
Building Fixturestr°" 1 OK � I <i, T FEB 16 l0]d yin e �4 .,. F Rece ;� , �:.'= City of Tig ard y� � _ � :
11114 q Date r� Q�t�t7 J
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13125 SW Hall Blvd., Tigard, OR y OF TIGARD P lan Revtew voh i. ,
C t Phone: 503.639.4171 Fax: 50 Other Pertnit No. . „
Inspection Line: 503.639.4175 �� iNG DIVISION Re ,
T I G 1�R C Date Date, ltead : Iaris: la See Page 2 fur
nu►ar4. Internet: www.tigard -or.gov Notified/Method: Supplemental Information r' •
TYPE OF WORK FEE* SCHEDULE
Ow,/ t
❑ New construction ❑ Demolition For special information usecheckJs4
Descriition Qty. Ea.
Additionialtcration/ lacement ❑ Other: A
reP New 1-2-family dwellings (includes 100 fl. for each utility Conn iGt,
~ CATEGORY OF CONSTRUCTION SFR (1) bath 312.70 < ^�,
m 1- and 2- family dwelling El Commercial /industrial SFR (2) bath 437.78 `': 1,
-- --- - ____- __.� I SFR (3) bath 500.32
❑ Accessory building ❑ Multi - family - - - --
Each additional badvkitchen 25.02 III k.ti t
Master builder ['Other: �nr
❑ ❑ Oth Fire sprinkler ( sq. tt.) Page 2
B oa ^
JOB SITE INFORMATION AND LOCATION Site utilities:
ob lln site ad ss ! 3 c3g) ` w � )
Catch basin or area drain 18.7b )� l e
Dryw'ell, leach line, or trench drain t8 76
City/State/ZIP: -r; 5" - ` k
y �trZ ! 72 3
Footin d rain (no. linear ft.: ) Page 2�Z$
Suite/bldgJapt. no.: l Project name: .Sv t r. / 4 y Manufactured home utilities 50.03 ,
4 { tf:
Cross street/directions to job site: Manholes 1 8.76 -,
s Li) liv` v 5 f ` 7- Rain drain connector 18.76 .i " '
/ll qk'
Sanitary sewer (no_ linear ft: ) Page 2 , 17 , A,„ w
Storm sewer (no. linear f.: ) Page 2 ^. ks' aver
__ Water service (no. linear ft.: ) Page 2 ar '.(
h a
Subdivision: Lot no.: Fixture or item: I: 1 it. , ",,'
Bacltflow preventcr 31.27 . »
Tax map /parcel no.: "
Backwater valve 12.51
DESCRIPTION OF WORK • i�rt* ' `'
Clothes washer 25.02 - '4' :•'
/yrt_.J 51N-C, t..,.-, e_ p / Dishwasher 25.02 1 l, ;'•,;. fxr -p1
.w ,,
/it c. _C, h e ,„ n, ,- L.1 4i. V C.-
Ejectors/sump fountain 25.02 11i,,t
jectors /sum 25,02 i. '• '
J P t ;.ro " i
Expansion tank 12.51
El PROPERTY OWNER ❑ TENANT p'
Fixture /sewer cap 25.02 pI
Name: ;:.,.'
Floor drainifloorsink/hub 25.02 �r '.
Address: te i t
__.___ Garbage disposal 25.02 4: tit'
City' /StateiZIP: Hose bib r ■ 25.02 t y
Phone: ( ) ' Fax: ( ) lee maker J 12.51 jr.d 1e '
1 ,, ,,
gr APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02 t
(( Medical gas (value: $ ) Page 2 .zy e • s , t
Business name: C ecrL Gc7rq 1 � / > , r by/ fs ` I. G 4 °j)
Primer 12 .51 t ti?g
Contact name: . i4- -�-- te r ,y^ ��
( C r f C9 �Y , Roof drain (commercial) 12.51 t�
Address: / 75 r $ ,`_ _
f J G C. �y / Sink /basin(Iavatory 25.02 - ;
City /State /ZIP: i • ?,. : ,,,, '7 n t!
C1 `C 7 Sr b Solar units (potable water) _ 62.54 r /I° trist
Phone: L573 ?3 5 - C7 7 f 8 Fax:: 3) 7 ( - -,H3 Tub /shower /shower pan 12.51 Ell T �
Urinal 1
E -mail: 25.02
.
t � # '`'
- Water closet 25.02 I`, !t? ?•:
CONTRACTOR
Water heater MI 37.52 III t 4;„'
Business name: /G lL W i rC/ Z_ 1 I j 0,., f �t / t f ! , i
_ Water piping/DW V 56.24 Mill:,...
Address: //76 c ,s4 /� - 7 c Other: 25.02 + y ,
City /State/ZIP: j' b 7 Ga Subtotal � y a
Minimum permit fee: $72.50 �. "
Phone: 3) �'� e 7 7/ Fax: ) �� / /Z�y� Plan review (25 % of permit fee) ��
CCI3 Lie.: / O 73 C.7 ri ID Plumbing Lie. no.:/-* j �/ (12% Slate surcharge (12/0 of permit fee) g • 7 p e,
Authorized signature � l 11 TOTAL PERMIT FEE qt • as
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This permit application eapir J a permit 6.7) t obtained nithin I: 7" "'' ?}
Print nam �/ e' DateZ /G ,i alter it has beep aece led orn Nee.
'Fee methodology set by TO- County Building Tndustry Service Bo i
.
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