Permit - CITY I PLUMBING PERMIT
y+
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 - 00045
T1 ,1?,; 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/7/2008
PARCEL: 2S 111 AD -03800
SITE ADDRESS: 08950 SW PINEBROOK CT ZONING: R -4.5
SUBDIVISION: PINEBROOK TERRACE LOT: 035 JURISDICTION: TIG
PROJECT: HALL
Project Description: installing new water lines to lavatories, water closet and tub
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 0 URINALS: GREASE TRAPS:
LAVATORIES: 2 OTHER FIXTURES:
TUB /SHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
ROBERT & L HALL
8950 SW PINEBROOK CT Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 2/7/2008 $72.50
[TAX] 12% State Surch 2/7/2008 $8.70
Phone :. 503- 788 -6947 Total $81.20
Contractor:
JACK CORMAN PLUMBING INC
7483 SE JOHNSON CREEK BLVD
PORTLAND, OR 97206 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 788 -6947
FAX 503- 788 -6949
Reg #: LIC 88311
PLM 3 -198PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: is m Permittee Signature: S7 7 C�Y�piri
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.
FROM :JACK CORMAN PLUMB ING,INC. FAX NO. :5037886949 Feb. 06 2008 05:29PM P2
•
Pi Im in I'erntit A Heat! ECEN `- 1 , F , :.
b.. 5'4 ,kg : ,. l. :s tl '' h ; 4 Ili Ili i l I '. I l l \ I - "t .,;-[%e 'Ft
�, City Oi Tigard ` U 0 R y i. , - -: �; ( : ; ' ,
1 13125 SW Hall blvd. Tigard OR 97223 EB Darel/13 . / 6 t/.
R F Penal( Nn : �L f � c t��
"� Phone: 503.639,4171 Fax: 503.59N.1960 ' it7R�® >�+ Review O(�C�
- Y if,". Line: 501 639 4175 O��Y ®� bat : Other permit Nn,
, . w, <: Internet www. -ar ov O �V0 Dee R /B MrC .� • -- CO - q 9
A 't;'.''" S M — g OON 0 Notified/Method: brier Rim Page 2 lbr
TYPE OF WORK elemental Information
w FEE" tSCHEDULE
0 New construction 0 Demolition For eclalln ormaden use checklist
1. Addition/alteration /replacement Desari.tion t' allitiMMEEMI
Other:
New 1. 2. dw family eldtyp (includes 100 Ile for cash utility
^'rtt�e. {;`.:, :..
'.�1' °r., �,• ; �. � � CATEGORY SF
OF CONSTRUCTION ocmrrectirnr )
R (1) bath Ill
350. 249.20 00
1- and 2 - flunily dwelling _— ❑ Commerc al/industrial SFR (2) bath
0 Accessory building
_
0 Multi family SFR (3) bath NM 399.00 NM
❑ Master builder ❑ Other:
Each additional bath/kitchut MI
_ 45.00
JOH SITE INFORMATION AND LOCATION Fire sprinkler ( sq.
Job site address: II) Page 2
� ,� � � .'
Cat utilities Catch basin or Wren drain 16,60 M.
City /Statc/ZIP: l Au' /' Drywcll, leach lint. or trench drain 16,60
Suite/bldg./apt. no.:' Project name: Footing drain (no. linear tl,: _) Page 2
—
Cross atreet/directions to job site: Manufactured home utilities 110
Manholes 16.60
Rain drain connector 16.60
-- Sanitary sewer (no. linear 11.: ) Page 2
_ Stlnm sewer (no, linear It.: ) Page 2
Subdivision: Lot no.. Water service (nn. linear R,: )
Tax ap /parcel no.: Fixture or item
Wr
• `T Absorption valve ■ 16.60
1.1Ek.CRIP'1'ION OF WORK Backflow preventcr Page 2
...AtA) — A,E Backwater valve 16,60 MIN
',Virg .14.• � . Clothes washer 16,60 M
Tut � Dishwasher 16,60
v, Drinking fountain 16.60
fr ERTY OWNER ❑TENANT
Ejectors /sump 16.60 MI
Name: / ce?" 24- . _ Expansion tank 16.60 —
Address: 9 o ,s. (.try P -4 /zio al" Pixture /sewer cop 16.60
City/State/ZIP: 72_6 40.1.,r, c ! ' z 0 0."4 5" 7 7Z
Floor drain /(long sink /hub 16.60
Phone: (Sol) 62,y..cr i Fax: ( ) c3arbage disposal 16.60
0 APPLI ANT 0 CONTACT PERSON Hose bib
NEM
Business name:
ice maker ry 16.60
Interceptor /grease trap .1111 16.60
Contact SIM
name: Medical gas (value: $ ) Page 2
Address: — Primer 16. 60
City/State/ZIP: Roof chain (commercial) 16.60 Mill
Phone; Sink/basin/lavatory ILO 16.60 k - ( ) Fax::( )
Tub /shower /shower pan ■' 16.60 E -mail: ill ., , -- . Urinal 10,.60
If ' ^ "' CONTRACTOR "-
Water (Ansel ( 16.60 111 40
Staining name: ) / * 1J I, 1* I Water heater - — 16.60
Addrusa: Mg I a ' , /1 ✓� IL; Other:
- �
�., CI ICU 1 � ., Snhtotal
City/State/ZIP:
Minimum pennit fee: $72.50
Phone: (903) - t • , , 0 L"1 Fax: 633 ) 1 ' ! - ■ j Residential baoktlow minimum •rmit fee: $36.25 12-
CCB Lin.: C6 "�, - .41"- . . Plumbing Lie. no.; '7 ,/ r . Plan review (25% of permit fee)
Authorized signature; 40 0 �: State sunshine (12% of permit fee) g ,"lo
I' nth TOTAL. PERMIT FEE 7 , 2_0
Prirri name: LC Dale: .- ( . T permit application expires if a permit is not obtained wMhtn
um days after It has been accepted as complete,
"Fee methodology sot by Tri- County Building Industry Service Board,
t:sonnet,00.met.eurr „ionmao, esn.Rm° 44at616r om2cuM/wrtn)