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Permit CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit #: PLM2009 -00344 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/03/2009 Parcel: 2S114BA13700 Jurisdiction: Tigard Site address: 16280 SW COPPER CREEK DR Subdivision: COPPER CREEK NO. 4 Lot: 102 Project: Larkins Project Description: Replace shower valve. Owner: FEES LARKINS, JANIS L & SHARON A Quantity Description Date Amount 16280 SW COPPER CREEK DR TIGARD, OR 97224 1 ea Tub /Shower /Shower Pan 12/03/2009 $12.51 PHONE: 503 684 -9509 1 12% State Surcharge - 12/03/2009 $8.70 Plumbing 60 ea Minimum Fee Adjustment - 12/03/2009 $59.99 Contractor: Plumbing OHe kwt16• Y PO /Soy 17o4 ROR-T-6AN9, OR 07220 C- Lild t11MAj D Q PHONE: 503 - 789 -3948 4 70/6 FAX: 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 No ' ation - - -r. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules or dir- questions to 0 • • - 'n• 03.246.6699 or 1.800.332.2344. • Iss ed By: I I , I Permittee Si • • , ffjW ■ Call 503.639.4175 by 7:00 a.m. for an inspection that b. ess 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. j. . .12- 03 -'09 09:40 FROM -nw permit 13609452091 T -937 P002/003 F -016 • P um inq Permit A pplication Building P xtures DEC 03 2 0 0 - , r _'l'/ 1I t I Q .44*4 . ` , ,- V :ti p F s,� � City of Ti CITY OF TIGA ° e 0 � : i 1 . 13125 SW Null Blvd., Tigard, OR 472 - L �" ` , J D ji, x , Phone; 503.639.4 171 P,so3.s4R, ILDING DIVIS Qnra" '°e" ' Inspection I ,ihe: 503.639.4I7s T fhha Pama P6°.: `` r ) Intbtn Otto IInternet: wt4w.tigatd.(rr.gav 7Nic !I1 fiec 9.I.2 to `� — .•.. - _. MaiRc41,100,01, v smut tri+noAoa TYPE OF WORK FEY,,' SCHEDULE © New traction 0 lkalwtginn Per vnuelforr Q AdditielvallcreuoN►e�axlnen l � � - eA ten r WM 'fob.! - . - 0 Wen New 1. yf„s d+„eWa includes 100 R fm each util(ty canncclioltl CATEGORY OF CONISTKUC7YON &PR(1)bath MI 312.70 El - and 2.rsmuy dwelling 0 Ccantrt SFR (2) bath 437.7.4 © Accessory building • ulti•femlty 500,32 MIN _ 1 l cr builds Q (?11ar: zSA2 JOB arm INFORMATION AND LOCATION � Job site addf s: 16280 sw Copper Creek Dr. Caleb buts or aria drain 18.76 Min CtiYlSI 'Z1P: r r . 7223 - Drywall, knob Ifos, or trench drain Wu/bldg./4n. no.: Neoprene: Posxictg drain too. Ilne2r fl [:rasa street/directions ro job sl{I MandPactined lima utilities 50,03 MARTIN ST n r111111= Rain drain oannoctm 18.76 Senbety see& (no. 'kW h.: Page 2 8101111 swig (no. Ilttear R: -,....) Subdivision: Water servloc (no. linear fl.: ,, - _) Lot 110.7 I.. . t Tax mop/parcel no.; '� $acktiaw ,.... von 31.27 UESCRWTTON Ole WORK Backwater valve - 12.51 ' LACE PRESSURE BALANCE SHO ► Clothes was 25.02 NMI D1 hwlslwc MI 25.02 - Drinking Wain um 25.02 - f ___ gteutorn/aulnp 25,02 PROPERTY AICVNYJI ] TENANT F+�anslon Name: Jan Lafc&'ns Fix(ardrn+hw Addttiss: Neer ttrtlbtl0oor 25.02 =A 4S City/State/ZIP; LIP Garbage dinxtsal 25.02 • - • • }1o6c bib 111.1 r'<t ( )503-684-9509 race: ( ) 25'02 lcetnsker r✓ APPLICANT ,/ com - Aar Pe:ItiiON lnwrOcptpolrusctrap - 25 02 MEM 91164nta /1 : 4 " :NORTHWEST PERMIT INC medical go(talue:8 ) 111111M � C�a ttannc: CYNDAL h1ILLHOLLIN AA(tlt Roof drain (carntrlen:ial) 12.51 5 L F RD maims Memory CSIy/ POINT ROBERS, WA98281 25,02 tiiulm wilts (potabto water) 111111 x.54 IMO Phone: ( 3160- 945 2787 ) lla ( ) -- -' Tub/showertsnowor pnn f m. 11: I _ 2542 IIII CONTRACTOR 25.02 2 -inom flaw: CRISMAN PLUMBING Ceiu OM ESYSTEMS " " ' r 37.52 Water V Address; 14811 NE AIRPORT WAY lhhor 5r;.24 Mil City/Sltttazi p: _ . C — 25.02 G ► ' 7230 Eobtetal Phone: ( 5Y)3- 789 -3948 Q r� Pax: ( ) tab 51Q ._ p ► Minimum prang fcc: 572.50 ■ C C B Lie.: 183060 Plumbing Lie. no.: PB - 366 /METRO 052454 Plan review (25% of permit rite) -47 Authorizre signature Stab Iutchargc (1296 ofparmit 11:e) I>WI TOTAL P 3!U IT FEE [gem . y D afe j 1 ...y i A w k moil speekstlen frph pea* b cog abet/ ae amble 1Ie seta J .Mr a res hose aseuetd te acuple . • P 0 C mot0000taay wrt 4 y•ni•Cawty Bundler~ Indortry Service Hoard. I.10uiSeineccsiftvu - fiam'Mppdoc Iuwro'G) 444I6( 1t✓a2 "AINAN) '12- 03 —'09 09:40 FROM —nw permit 13609452091 T -937 P001/003 F -016 Northwest Perpt Inc / /` vvvwww Cii � - 6 ,i� ' 13 Cult-Road RECEIVED ED Point itobcrts WA 98281 360- 945 -2787• 360 -945 -2091: DEC 0 3 2009 thcs OF TIGARD BUILDING DIVISION To: City of Tigard Fax: 503 -598 -1960 Attn: Building Division F rom: Naida Khan Date: December 2, 2009 Re: Pages: 3 CC: © : Urgent ❑ For Review ❑ Please Comment 0 Please Reply 0 Please Recycle ri 174: Whprr. it May Concern: ' :P1ease process the attached permit application. I am also sending a PaY :Olent Authorization Form. • Please fax a copy of the issued permit t• 360- 945 -2091; the homeowner was hoping to schedule inspection very soon to. ay or tomorrow). If you have any questions about this application please contact Naida at 360- 945 -2787 or by email at Naida@nwpermit.com Thank you for your assistance!