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Permit CITY OF TIGARD PLUMBING PERMIT • COMMUNITY DEVELOPMENT Permit #: PLM2011 -00194 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/21/2011 Parcel: 2S114AA00200 Jurisdiction: Tigard Site address: 16285 SW 85TH AVE 103 Project: Happy Camper Subdivision: DURHAM HALL BUSINESS PARK Lot: Project Description: Replacing an existing sink and adding water supply for steamer oven. Contractor: THE PLUMBERS INC. Owner: WH SHIPMAN LIMITED 15808 SW UPPER BOONES FERRY RD BY NORRIS & STEVENS INC LAKE OSWEGO, OR 97035 621 SW MORRISON STE 800 PORTLAND, OR 97205 PHONE: 503 - 519 -6644 PHONE: FAX: 503 - 684 -1202 FEES Quantity Description Date Amount 1 ea Sink 06/21/2011 $25.02 Specifics: 25 Misc Other Fee 06/21/2011 $25.02 1 12% State Surcharge - 06/21/2011 $8.70 Type of Use: COM Plumbing Class of Work: ALT 22 ea Minimum Fee Adjustment - 06/21/2011 $22.46 Plumbing 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 -0090. You may obtain a copy of the rules or direct • . - on • OUNC by calling 503.232.1987 or 1.800.332.2344. Issue. By: 1 , Permittee Sig, . � ;LI • Call 503.639.4175 by 7:00 a.m. for the next available inspection date. 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. Jun 17 2011 10:10AM The Plumbers Inc. 5034894540 p.1 Plumbing Permit Applicatio Building Fixtures ECElVE Ful t ?1' IA( , i ci: ONI.1 City of Tigard Received may 17 // Pe rmit No.:. AP L no-// d0 l 9 • 13125 SW Hall Blvd, Tigard, OR 97223 Plan 17 2011 Phone: 503, 7182439 Fax: 503.598. 1960 Plan Review Other Permit No (- Date/By: I t ` i, L Inspection Line: 503.639.4175 CITY OF TIGARD DateReady/Sy: kris' B See Page 2 for Internet www.tigard-or.gov Notified/Method: Su cmental information c �; s, ",: 11t' ti' as g x r -1{ grlt' r ;ta �r.{ its 3'� , ' ,,8e` � ' - is :Im ! ?" i� er t 7 � t + .. 'i, -ta. lJr .fi' ■ '� l & tip . § � S t S t }�, i i Y � t 1 1 l e mn t ,7 ,, , ,. .�i d i t i � ' tom � � = ,a n� a ct s � r a " ... i� �. 3 l : `�' }tll� ! t • � . �" i vsa � w ti t t � J ❑ New construction ❑ Demolition For special information use checklist Description I Qty. I Ea. , Total ® Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) hste '12 � , 314 - 44 ,lx'' � . ssi , Ai `' ... i,, x ` SFR (1) bath 312.70 PYirtir Il i H �. aili la#.' 3ta.;3t ��t� • ❑ 1- and 2- family dwelling ® Commercial/industrial SFR (2) bath 437.78 SFR (3) bath 500.32 ❑ Accessory building ❑ Multi - family Each additional bathllcitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 3 r b 7a ° P i i ss i `' � 177.,,,...,: t Site utilities: : :2x2a lioliereLR;r2.- ca. V ,a • alt. ti . -+, �D�D Catch basin or area drain 18.76 Job site address: S t.1) . s ,�• Drywell, leach line, or trench drain 18.76 City /State/ZIP Oa.- Q 1 � ' -34- , Footing drain (no. linear ft.: ) Page 2 Suite/bldg./apt. no.: j (3', I I Project name: 0 a -if' /, v Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer (no. linear ft.: ) Page 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.: QS. / //A ft'00?0° Backflow preventer 31.27 Mir r ; , Tun S D. ;. ti+ F . °'" s Backwater valve 12.51 - �irrP x5 1 t , X � � � t � I � n? ti �t : - , wit Clothes washer 25.02 IF r !yr ;%1A, I ' ¢ti `''L' Dishwasher 25.02 UU Drinking fountain 25.02 Ejectors/sump 25.02 , Yltitci iB?igli -.fit 4t 4 °tl k' ... ; �,: . _ ' e ' ,A TisWoa r, )�: � J " ) ` i ° J . `i € t, . ,r , , ,Iz Expansion tank 12.51 f Fixture /sewer cap 25.02 Name: f A` ( t t IOU. �� Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone; j) 0$r,„lc%57 11 ( f Fax ( ) Ice maker 12.51 r 1 . uy ,,brit ml ,f`of "€ r tt t� w a7PZ • tk a f � a l =- ire �« ,.0' i . ' i lia . ,: 3' Interceptor /grease trap 25.02 Business name- r ut y „ ,y-g , .� `_ Medical gas (value: S ) Page 2 Yom' . Primer 12.51 Contact name: .Le iieR.p.4... a1 S Roof drain (commercial) 12.51 Address: j r- ) q . �W IPi��' [� � ( > Sinkiasin/lavatory t 25.02 City/State/ZIP: �c...J d7 ©('Z- et7O Solar units (potable water) 62.54 Phone: (3) 94 (0(e t I Fax: : ( (a 0 j X03- Tub/shower /shower pan 12.51 E-mail: 3 cx tD--L -; j 41"-( �� l u 0.--1-1,44 ( h1C,/ 1/t Urinal 25.02 • t_ "� ld1 �..?in"" -1P9.' i ^i `vlds 1 :'ar - o-� - .� WWater - C1OSet 25.0 i t c , 1 .41 . tl. _ . ;`, 4 ' • .. i� ' � aii�iii " 1," Cra •, , :..,, •• ..,:: - ` Water heater 37.52 Business name: ( " Lx. L- _i_jNc...- Water piping/DWV 56.29 Address: is-loci /I 5 et11 Vp,frte ,-f ecy -a..3 l c(1/) Other. dive") ti4 4 k 25.02 City /State/ZIP: ( ...dc e, } � c,,,-)e (2._ 45 i _ 0 I r Subtotal Minimum permit fee: $ 72.50 Phone: ( (� Fax (�1J Co �tE? CCB Lic.: 17 7 D ...., (4 Plumbing Lic. no.. C344--7 Plan review (25% of permit fee) State surcharge (12% of permit fee) Authorized signature TOTAL PERMIT FEE . - + r l / This permit application expires if a permit is not obtained within 180 days Print name: P Date. f �Q after it has been accepted as complete. f 'Tee methodology set by Tri- County Building Industry Service Board. 1\ euiiding \Permits\PLMU- PermitApp. 10(01109 44O.4e16•(70102COM/WEB)