Permit -¢ h
CITY OF TIGARD
PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2009 -00201
T 1 G ARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 07/24/2009
Parcel: 2S103DA04900
Jurisdiction: Tigard
Site address: 13365 SW WATKINS AVE
Subdivision: Lot: 0
Project: Murfinsimmons
Project Description: Replace 100 feet of water service.
Owner: FEES
MURFINSIMMONS, MATTHEW T & Quantity Description Date Amount
MICAHLE, 13365 SW WATKINS
TIGARD, OR 97223 100 If Water Service 07/24/2009 $55.00
1 12% State Surcharge - 07/24/2009 $8.70
PHONE: Plumbing
18 ea Minimum Fee Adjustment - 07/24/2009 $17.50
Contractor: Plumbing
RELIANT PLUMBING & MECHANICAL
11575 SW PACIFIC HWY STE 219
TIGARD, OR 97223
PHONE: 503 - 246 -1201
FAX: 503- 246 -1205
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: \ L C ` A,N Permittee Signature:
X
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
��;.07l24/2009 14 :16 477 PAGE 01/02
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��� �t Application bin Perm r .X7 ^ _
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a Phone; 503 ? Fax SQ ,5:' ^l�
In6pectiQn Line; 503.639.41 7$ Date/By: Other Permit No.:
f f t 1 f 17` Date Ready /ay:
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: d•or,gov JUL 2 4 2009 4 �>n�� for
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T'YPE'Cri?:: WO e
pPtc inform dan
❑ New construction 1 I! C . m tf • ,
l'L�t3 "'SCHEO .
---� For special in1ormau WE nn cRaCkhsr
A <Idit�on /allerali0n/tcplecem D 0 q r f C�� " Description J Qty, 1 Can. I Total
1 r _, New 1- 2 family dwellings (Includes 100 ft, for each utility connection)
. CATEPORY.'OP CCNSTRUCTTON i ', ...
' 5F'R(1)hath 329.00
1 -and 2- family dwollinp, ❑ Commgrcl s(/;nduStrlal S1'!Z (2) bath 422.00
❑ Accessoryssory bu Ieling T ❑ Multi - family SFR (3) bade 515.00
Each additional bath/kitchen 90.00
0 Master builder ❑ Other:
• . JOB SITE INFORMATION AND LOCATION Aire sprinkler (q _ sq. 0,) aysq• n,
Job site address: 1&. C, _ SIIn males `�., Y1Jr , Caroh basin or ar ea drain 1 6.00
City /State /Z1P : 1-t r"4 1 .^ -. - ' --
t �J r� _ Drywall, ]each lint, or trench drain 15.00
140'inefc
Suitu/bldg.lapt, no.: project nnme: Footing Drain (each rritnt ) 44.00
Cross s teat /dircctionc to job Sitc; ✓h� Mmtufactured tome utilities IOOAO
Manholes 15,00
_ lion drain cormccmr 15.00
Sanitary sewer (o;tch 100 ft.): # of ft, 44.00
Subdivision: Lot nn.;
Septic Connection 31.00
Tax mnp/pnrcB( no / 00-4_,_...-- Storm *ewer (each 100 ft.): 1! of ft, _
44.00
DE5CRIPTION OF WORK' Water service (each 100 R.); it of R. I 4
Fixture or Item
Absofption Valve -_ 15.00 j
l3uckflow prcventoc' 15.00
Brrckwatar valve 15.00
Clothes washer 15.00
'PROPERTY OWNER. 0 TENANT Dishwasher . 15.00
Name Name Drinking fountain 15.00
Address:
15,00
1 - 7 --- --------
Expansion tank - -"
City /Stntc /ZIP: 15,00
Fixture/sewer cap 13.00
•
^ __�� Phone: (` )
Pax:
( ) Floor drain/floor sink/hub 15,00
liel APPLICANT:. • i''CONT'A , T. PERSON ..: Garbaie dispoant ""
15.00 0
Ausinesa ntmcc Hose bib
Contact name: ('-� n° H [ - Hydroponic piping System
1 , 7 cJu. _ 15.00
A_ ddnss: 5 Ice maker 15.00
�5 1 "°"�.4�� + (P- lq _ btterccptot / - trap - . 15.00
City(State/71P: _
_ Mc . .. -. pus (vahre; ,R ) Val, ` Phone: t 5 Fax: : (61:53) 4� to Primer (s) � By V
_ 1 5.00
E- tnnil; �rd r Q�1 } ^ - Reeled tial Re-pipe; 3600 sq,n /less 90,00W
CONTRACTOR � -- tiesidcntlat Re -pipe; 3401 spat} /morn 135.00
Business nnme: I -- . Roof drain (Commerc 15.00
-
Address: er�tQn'� �1tA �JrZ1• 1 AtCn',1 To, 9ink/ba.:iN)nvntery
1 t 5 1 _ 15.00
�� c [ F t L , B rats' - e It hishower /slrowcr pen 13.00
City /State /7_IP: ^ i( r n 1Z ^
( a !
, Urinal
Phone:; (5+�a) r7I 7 � ~ r� Water closet
"` Is.nt _
Q . ! 15 Fax: �'� fCo' 106 15.00
CCI3 tic,; t�l,,C/ i Lic, no._ ► • L Waterheatm 15.00 W �
'- .y mar Mfr }�
C ache,:
(, 1
Authorized si nature: - 1
- s Y C r 00 al
�trit name: // ` Minimum permit fee .„,_,S69;00----22,00
4 �ta� Date; 1 'j4 pi 1 Planreview(65 %of permit fee) ,g
Thlx permit appIteati0n expires if a permit Is not n ruined within 180 days after it has been
accepted as enmptste. * Fee methodology set by Tn -Cnon-y Building Industry Service ",tote surcharge ot'pcetniz fee) 70 TOTTAL AL PERMIT Fp „E 81. 2v
440,--7r6-7--. (101117