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Permit " CITY OF TIGARD ; PLUMBING PERMIT ' �'� COMMUNITY DEVELOPMENT 7 / Permit #: PLM2011 -00213 � a Date Issued: 07/08/2011 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 _ • Parcel: 2S102AB01001 • Jurisdiction: Tigard Site address: 11950 SW LINCOLN AVE 1 Project: Monroe Square Subdivision: Lot: Project Description: Replace water service lines to all 7 buildings in this complex. 7/20/11, reprinted to add 100' of sanitary sewer line. Contractor: MP PLUMBING CO Owner: SERFS, JOEL L TRUST PO BOX 393 1440 SW TAYLOR ST CLACKAMAS, OR 97015 PORTLAND, OR 97205 PHONE: 503 - 655 -9161 PHONE: FAX: 503 - 655 -1726 FEES Quantity Description Date Amount 400 .1f. Water Service 07/08/2011 $175.10 Specifics: 1 12% State Surcharge - 07/08/2011 $21.01 Plumbing Type of Use: MF 100 If Sewer Service 07/20/2011 $62.54 Class of Work: ALT 0 12% State Surcharge - 07/20/2011 $7.51 Plumbing Type of Const: Occupancy Grp: Stories: Total $266.16 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 Notificat'. • - ter. 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 • - stions to OU , by c. *rig 503.232.1987 or 1.800.332.2344. Issued :y: // Permittee Signature ,'' 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. CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit #: PLM2011 -00213 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/08/2011 Parcel: 2S102AB01001 Jurisdiction: Tigard Site address: 11950 SW LINCOLN AVE 1 Project: Monroe Square Subdivision: Lot: Project Description: Replace water service lines to all 7 buildings in this complex. Contractor: MP PLUMBING CO Owner: SERES, JOEL L TRUST PO BOX 393 1440 SW TAYLOR ST CLACKAMAS, OR 97015 PORTLAND, OR 97205 PHONE: 503 - 655 -9161 PHONE: FAX: 503 - 655 -1726 FEES Quantity Description Date Amount 400 If Water Service 07/08/2011 $175.10 Specifics: 1 12% State Surcharge - 07/08/2011 $21.01 Plumbing Type of Use: MF Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $196.11 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Not enter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or dire questions to O . • al ' 503.232.1987 or 1.800.332.2344. Issue By: / PermitteeS'gnature: , �� Call 503.639.4175 by 7:00 a.m. for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Plumbing Permit Application 08) Site Utilities . ti 011 1 O la „i i I( I l 'NI 0 \ 1 1' City of Tigard 0t ! Permit No.: Dl �24i/_o0� /3 13 125 SW Hall Blvd, Tigard, OR 97223 \V1" x eview F' Phone: 501718,2439 Fax: 503.598.1960 J ,e\ 1 . y: Other Permit No.: • 1 t f •,,I I - inspection Line: 503,'39.4175 0� � \S I . Date Ready /By: Are 10 See cage 2 for Internet: www.tigard or.gnv ` G Notified/Method: SupplcmeuU1latorma$ern l. x- t• .. ...... . .i, "rr. r, .r rr,,v rv, r( 1 � AV .l .w •rw. � y. . e ,..a.::..... u.. � ...�� ���� ,: ., .. � . L ... 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S l 1 "..n :tlR V:u rJ r Ai r...... , r- ,..r .rr,. tree. � bt , , r}, i," w�6, Fold�l+ �l�ztnrxn ?�u:fr,x,,.utitsl,l>;sw +v „al f �. .d,t .r�r,k+r.,Cr..�tvr"M %� r „r�''raR� .. ",e +!'�edd� . :...:........:: v,.< 1r, ta: vr, a����M�i�� �arY�. rttiN�.IJrhJ�i.�r!�d�(:�i�la1�, ❑ New construction ❑ Demolition FOP Special /njormat'lo►r use checklist Dcscristion • , Ea, Total 7 Addition/alteration /replacement ❑ Other: New 1 - 2 - famil dwellln • (includes 100 ft, for each utility connection) N MrS.,. I:'.' I ll' I. r: l"._. ��.:+_ �„ �::.,: ��:: y::,. � :i�:ii'i1(i)iNR ..YSY�:)I lib: il lt I f. �: Li::( i�.`;').' r. YJ' 1' I.^.:: 1 A P . l' 1' ",.:T.1.� 'Y R'tt'll� d'7 AIr:'Y: ..i . : 0. ,: ... _ , 1 }r b �; a ctA IS II as :g �g {v SFR (1) bath „` " � drhlh4 3 l � rr , ih 312.70 ' ��:; � :... ". t" ., ,.4.., � .,., , , ...r +I . ,, r .....u�..�h.Mti1.,�.t. rat,; l r. � l„ ��, �: ri ,.! ? ° „rn'� + tr�fl���I 0 l- and 2- family dwelling 0 Commercial/industrial SFR (2) bath 437.78 SFR (3) bath 500.32 0 AceeSSOry building I'l Multi - family Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: ft.) 2 . .. 5...,, r s p . . ...... .. r .. . .., , . .,. " ry! �C. ",r ∎ 1 A t r t,' x r ¢ � r..:�,eerrd,a,,,,., „ ��'., A, ,,.,e.,.. _. .,. ., :: i ;:.3a .R' A tPSI d' err i4iiiT�P .r : d.,.r - - m'•r,;•, t ;.. ,, . 1..5 : ::..:.. . ::::.. .. , , wl`r ■„'i�.Y.. ..lt. '.^�} Ill :Il;',.:l,r�^r1xR, Y, p „ ';;,•r:'.( ta;v 4.?, Z',4»,r r.. , ,,, ' 1,AY'. :,:pia vW:0;{h w40 ;' ^ „ n " ' .1. ; :,;r);:�t� fj�ta Site utilities: Job site address: 1 �� T L ,.., ‘rires Catch basin or area drain t g.76 � 1 � Drywell, leach line, or trench drain 18.76 City /State/ZIP: 1 /j 1 p�a 3 Footing drain (no. linear ft.: ) Page 2 Suite/bldg./apt. no.: Project name: , j NI 0..' _ E , t` -0i Manufactured home utilities 50.03 Cross street/directions to job site: 0 Manholes 1836 Rain drain connector 18.76 • Sanitary sewer (no. linear ft.: _ ) Page 2 Storm sewer (no, linear ft.: ) Page 2 Water service (no, linear R.: ESL) Page 2 1 r-/ [a Subdivision: Lot no.: IC/ Fixture or item: Tax map/parcel Backflow preventer no.: reverter 31.27 . . " f M ::::,' ::.:: ..::::::. ::. - - . . ,,.,1 , .' 7., xe :., ^, ::.:.: v,': ... ... 1 1 r !,,',1',. ... c. n: , rr ....,.., -.' . i s::! ' i: ::: ; : :. - : ::: a : :. :.' r - r: :: ...... � ) .. , ,iB MY{�. ''.' , };,Ix . ts ... '' a. ... ,1. r x ll.. x! ::. 7 .... > ?. o gio Backwater valve 12.51 r x" 1 l I (+,.' "+4.' , i� r . d } '! . + 1. ,, , ;: io . ,,a82N!� "YNI u ,r., " ,:.r la. "b %ry ?t Lt h.�:,rr� .. , ..„,. r. mf�n! rwartox ^ �rar"4FItq� % %k �d1l'f��c� ;J .. .4 � Clvthea washer 25.02 r 1LU ft, \i (1W+' L,LCtk B 1 Dishwasher ME 25.02 1 /. .& G 2 to 1 lI. in ae t A ilAElt A 14 Drinking fountain 25.02 Ejectors /sump 25.02 , r .. ....... nti &riA964 +'9 YYp- fw}tI8 (�'{ ^y VV(, ��{{ M ry, �r 'f .r i 1f�4,'. +�1�15 f N . � �V Yd1 n 1, � ' 0 :eu i cif % d p % r r ,rv i Expansion tank 12.51 +firlf, :'^ , 11 , ....5.. r , .,, , , r.r rvrd„r r.vYv�,il�iv t�vlk',�krldi� ,11rFifxN.r.kY. .1¢ �;tl ? .lNx.11�j{' -}hi 7 5 + ll ni, a.: Name: Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25,02 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25,02 Phone: ( ) Fax: ( ) Ice maker 12.51 I. x..,- ., ..: . .. ........ ... r . ,,. „;,.. „ . d J . ,, ,.. 1 dud . 1 m. ,, t , x - ... ... .:a . z .. , ". ,. Y 1" I '. ,l , ' . ��. w��.�.�„ . n rr,li ,, . .. .. �:. .n(H; ...r V �'�'1lMf' ` " ',i' � t r /• .<r :...., ii,.�i v.l. „ i ,�� Y.ii. ,: • ; ' ^ ' a yy�� tt ,3 f ( 1 ` 4St.,p v � .,x r 1 .. . '' : . : + ' 4 d, or, rrld!r4r+n4V It l i .` C , l ' , r r S r l, ; }4 a , ! !i 25 1; 0 .. ,.. - ... r, l k,r r, . riddta, IIMfWty +'nLe,dlldi"'NxNR, vdf 1 .d:4C!f:M Business name: Medical gas (value: $ _ ) Page 2 Contact. name: Primer 12.51 Roof dram (commercial) 12.51 Address: Sink/begin /lavatory 25,02 City/State/ZIP: Solar units (potable water) 62. 54 Phone: ( ) Fax: : ( ) Tub /shower /shower pan 12.51 E -mail Urinal 25.02 .... ,,.,,r „r ;q11 rm ,x.nr " xv .",:::;:.. x .....r: ".�::. r,-: r .'. .m r r;r' r N :'a g{ � ,+ ' ^;,v ,,, �rx.l: , 4.., yY.�C,x w�A .riD: ' . r 'IS 11 " :1r kl.h Sri '� � � � r � � � "I � •4 : I; l?!a' I ::d + yy Y % ^, t� 1ti( u,7�p q u Water C OsC1 25.02 .,,,.� „�.�� r i n +ti .h: ,. /�. 1. r':r:: ,,�;.:, u� ;.• : . yt n ( �� %'n ��r S,{k��;"Si �'c �„ r i;:;;:sr,tl :� . .........:...:.'-:'::':.: a: rl ! n rrrt,;' I r, tSl :iat7adt %11,��lr�a(���xl�� >r�, p!21:�%� ,::arl:��• a ,�vn ,.'�.,. ! . :... .x.... .. . .y i IJnM!.A " A �fY }V � � Water heater J7 ���� . &.b II VMIIIIIIIIIMIII Water piping/I)WV 56.29 MI Address: Q ? 39 Other: 25.02 City /State/ZIP: ,, J _I SILO 0 G'> Subtotal Mire Phone: ( S)? j ) , ss - • ,, Fax; (sj)b) (p S- f ■;67 Minimum permit fee: $72.50 Plan review (25% of permit fee) 11<1C +1 CCB Lie.. cIDC) , Plumbing; Cie, no.: - i i }`�� State surcharge (12% of permit fee) a , 0,2 Authorized signature: TOTAL PERMIT FEE - ,Z�Z -A iziffizz.► I C J This permit application expires if a permit Is not obtained within 180 dayl /, ♦ • Date: �� after It has been accepted as complete. ` i t p If *Pee methodology set by Tri- County Building Industry Service Board. ( ( • I-1Ra;I4;e -01∎I M.MU- Pery.l App • ticu 10101 /00 440- 41.1GT(t0102)COM /WP.t) Z d 6S 146Z60E8 ' 317 : LL '1S /Etr : L L L LOZ 2. 1Ar (I1H1) 6u I Tun Id dH WONJd Plumbing Permit Application, - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Su t ' ression S stems: . r .. .... r,. .•,,:.•,..•, „•fi,,,,x ^, •.,w.,,lY.,,X..,.. .. ',.,,, „E•:.��..,,�.,.,.n -'4 ';RYIr TS1.{� ” "3G: �r ', r, �r'Zi ��•, T ,rr.rrn'''' ,e r�, r n. z,m ,norm. ,, n 4 1'r V�I'UI:R..r'... , 5.... V. L d �� ... ...... .. r . ....... ..:... .. .,. >.. ..... .. �.,,,..,. . 'rr ,,:r �.,r. { ,�,,. .,µ - . .., „•rs ; t . � . ^,,1lQrtSl.S"lq .,�?p'tRM,. r ,�• „�. ` .,^?S M1! r rr +v ry . ,,. r, ,,u, . r � : ' e.. ,1 r t q 1 z '• •r'( ta , t ! r eA'! �A ,nh 1. � i 'N:,: „,•v.a, r. r,,,,;,, ,e.u, r,Aari„2ilAi7b�.1 x t, ?77r PYr'! G r' 4 t � (: / 1 t • 4�Y Y' , ' , jc ; ,R r ("• .1'6�?'in� +irp„ ^ " v, w ar f ! 4•nld � 2 !6 n � � g 1< � kl qr m ^ni n��rinr, •.'r lAl? : Ui . n, rl�Rd1 %..f.,�,4,,.,tl.✓��..U, , 1 'CiLH..��a,,.o25,�id� &',��Yc7: .,,'f,A�fr,F2,re5tr, ,Pw,u,u«" ?n„ ,,, �I. d. Kr;: G, h^ omwr. �, �n-.: z” iw:^ a. � Y•/ aYG„ Ai �, i$, w; �Sn.+» ld, �v���rv).,•,, HV. r.^ NJN4� lrvvkfA' �u�r ..A.ti71~•mr•)v,e(.;�Su,..,c,1.? Footing drain • 1 100' 111111111=1111111 0 to 2,000 $121.90 Footing drain - each additional 100' 37,52 _ 2,001 to 3,600 3169.69 3,601 to 7,200 5233.20 Sewer - let 100' 05VI 7,201 and _ n ter 5327.54 Sewer - each additional 100' 37,52 Era Water Service - 1st 100' 62.54 _ Medical Gas S stems: Water Service - each additional 100' 37,52 i rm „• ': { ''t; {¢ i3s� " S } ^ , �t", ' , r, � r,^) :i s m;A "t1?!K {iiihG ? R "rcr "( { ?l "GNb a;,nrr {' w'w p ms;. ; rn > C 1 , ? ?;',•sic "mn: ;§ { 1 Y ' «rrtn:' : C iyl>r { � m5 0 1 '4 r v;,.Y,l U.,^N N 1��4J vafi ;;;70'. Storm & Rain Drain - 1st 100' 62.54 $1.00 to $5 000.00 Minimum fee $72.50 Storm & Rain Drain • each additional 100' 37,52 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for ;ra.; : : e'.j :, „r : :rt :.,x.c;,a •::.r::,r:,:c;.,;:rrs,: r;,,.r. : : :,;,rac;, :, :,;ae;c,rar, :M1,rara „rrx " „rr °a; err. : :r: ;.x-2,.4; rrr....r :.r :.rxaaa :7r : :,x rcza :.. :'n :�^r - rr n additional � } ' dlh y each addt510 or fraction thereof, to 0 , 00 p ...:.. ,. , .. and .. �; :? ,. ",... +,.,, , r r �., , � >; :rr� eed includin_ $10.00. Inspection of existing plumbing or for $10,001.00 to $25,000.00 $145.50 for the first $1(1,000.00 and $1.54 far which no fee is specifically indicated 00.00/hr ■ each additional $100 ^00 or fraction thereof, to minimumch. :e— 1/2 hour andincludin: $25,000.00. Inspections outside ofnormal business - 90.001hr - $25,001.00 to 550,000,00 $379.50 for the first $25,000.00 and $1,45 for hours minimum char: C — 2 hours each additional $100.00 or fraction thereof, to keinapeotion Fees MI 90.00/hr and includin_ $50 000.00. Additional plan review for revisions 90.00/hr - $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for minimum c _e — 1/2 hour each additional 5100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping, adding or replacing fixtures? If "yes”, please indicate work performed by fixture. Failure to accuratel re ort fixtures could result in increased sewer fees * . "N •• • y�•• M1V nN r�v� , lY yr M1r'H „•Y ,vP:r „ • •pv r •r „ y y ., r ., : •,• •,• , . � �., n „�, . H , �vn� v .,,rv• „ „•.,� ... ,,,., ���„�,�.��•.,., •.. •, � ., , r. hr„ a�cr. ^. r .,rr n'rn�a n Yr4t1' n y, v ,l<c5,p;�d N y ; ,� r. err. n !r�)'� 7+ x )rRy +rara” .Y vvp r • .R. , rn'r. ( r ,r .,.y.� a y.. vY'.�rrtf %� .R mv. >�� 'tk! •. q.r•�» >�lr h 1eS+d„' � M 4 45 +rvr � `rt, :'S`�a„'��`v ^ ?;%;i : +• � t','.;: Y 7••%� :�rwrr'r � „�. •+ � : �. J uz+ i tYM 4r51th z d yaU a t v4�p���' (( "•11�,,?u �gtirr /U r l + h +'.� ll Y���r 't ,�¢lr ,� yr yy n 4 ]�'P Zq��',Gv>E�'G (' ' :, Ik � l ,t i d � l k + yyv.. r 4 (r a rY �t«, >r >n ll',Gou ut iS�ly: a : :r.�rr,l , z Y M ` �t � fd (”' : , �4 9 � nvS,rr n; il�,,,�) e ,.;,, r. ,,. J,,,, .0 ^,.,M , Y r Yyz . , i . r Yr / k�'v ,(d Pf' � �.Y'I' 7 �r i• ' tr t tr 'h '� 7y d �' r z ^ nsC +S4 i Plan review is required for any of the following, h.. , . ,, ” r r. . ; t.;, • . ti. lox , 'i�Ff 9ka �o- W.r� A aY; zp��y „., .r Y "SyJro?,;t X41 Please Chock all that apply. Ba tis• /Font pp _ Y Bath - Tub/Shower = == ❑ Any new wmmercial building with water service 2” and - lacurni /Whirl, • ,1 - -- greater, except systems designed and stamped by licensed Car Wash - Each Stall - -- engineer, - Drive Thru New exterior plumbing site utilities for any complex structure Cus• idor/Watcr ' .irator as defined in OAR918- 780 -0040. Dishwasher - Commercial — ❑ Medical gas and vacuum systems for health care facilities. - Domestic - -- ❑ Any multipurpose fire sprinkler system. Drinkin_ Fountain - -- ❑ Any complex structure as defined in OAR918. 780.0040. Floor Drain/sink - 2” - -- Submit 2 sets of plans with any of the above. Car Wash Drain -- • n .iXx.,, PSN, h81.us • „ , r , • Garbage - Domestic -nnn -fiord 111111111111111 s III Isometric or riser diagram is required for new buildings Disposal - Domestic -food related - -- that meet the a ualifications above. -Commercial-food related - -- - industrial -food related I Ice Mach,/Refri:, Drains - -- Oil s_•'• , tor Gas Station Comments regarding fixture work: Rec. vehicle Dum • Station Shower -Gang - -- -Stall Sink/Lav - Non -food related - Bradley . - Commercial- food related - -- -Service = �= Swieninin Pool Filler Washer - Clothes *Note: If the fixture work under this permit results in an Water Extmctor - == increase of sewer EDUs, a sewer permit will be issued and Willer Closet • Toilet - -- fees assessed for the sewer increase must he paid before the Urinal plumbing permit can be issued. Other Fixtures: - -_ http: / /www.tigard- or.gov/ city _hall /dcpartmcnts/cd /docs/PLM L1- PermitAp�9.doc E d 6S1176Z60E6' °N /Zb:LL'1S /E17:1L LLOZ L 'Ulf (fHl) 6u!gwnld dH HOdd FROM MP Plumbing (THU) JUL 7 2011 11: 44/ST. 11: 43/No.8309284180 P 1 0 3 ti .A N 't 1 0 '/U-1 I \ II 1 •... N ---, - . i 7 .. cs„ N ., ,.,„.„ . ". li . .„ x,„,_..._d,.. . --. s, r.4 . i. , , , ...,„ 1 ,_. i ,, „, „, . it____.. . : ,.._.1 i ..____ ___, ., N. ,,, „.„ ,, .. 1 1 '4 7 / i y j 1 ., r ., 1 % - ? �� '%'111\ __- • • 1 N. E j I __ )_ 'Y - --... �' �. . t ! 1 >, ________ . . 1: .., . i ,,,$) „._ .:: 1 _ ... . . c,. • __. ... .s, ._. ze ,,,,., , _ ..... .... _ ,z... __ __ _ v7. _z , . il . ..._. _.. ,i___t....., ,A .., . (./2 c. c.....„ c,..), 0 . w ,.. P LX) f _ • nl ti p L. r / �J -0 4- 0 . 4. . ' • s, S 4- lb FROM MP Plumbing (WED) JUL 20 2011 17: 08/ST. 17: 07/No.8808284204 P 2 Plumbing Permit Applicati W\ I, Site Utilities t� ,1., 0 ..4 "° e3 I OR t11r1 l( I:: I tit (1 \1 1 City W Hall Y iga� J U L 2 0 2 011 Dal 7 Ao ! 7' Normit No.; i /,./�. �/ / 13125 SW H1vd.,'figard,OR 97223 Yi .,.,. -..._. .._._..... , ....,_..,... _-....__.- ,....... .1.11NqqJf`.. _ .1 .._..... Phone; 503.718,2439 Fax; 503,59$.1 i �$ �� �� ® Plan Review Da B : Other Permit No.; • 1 s Inspection Line: 503.639.4175 !� Dot R°xd /B haie, 2 for - Internet: www.tigard or.gov ! J!w �!� � � r i` t ' � r� Notified /Method: Supplemented Information :: : ... .r. •�,,, .v� ,n i . '; ly '2 �.', r' '. ',k,';':.;.'''',:!:''; .,�.•, , ... � `, ;', . " ' �; a5-;' ��.� . ,L, ',1';iIr •. ti, r,,, .' 1;. ' 5 -' , ,.i rr.r•. � ♦ „�.���. ' {,;+ '.,.. ,. .. '� ' '. ': r. ,,.� � <I�, .1, ^ . '.. \:.: r�lr.�:;'J' .J�' ., 5- 1 / : 1'. a ,��,.,. i�l:�I' ,.:.. .,. ,.r .......:..... .r. r E�QP' tpIRlC /;y'ir. 'i,: ',.rt`i1F'EE; . .. .,� , ... .r,.. � �� .,. .o.... .... � "� .�. .. r.,.... �..,,.. .� .... .... .. ... .r ......,.... ..... - ,. '. 5- 'I. �r':..i :'�� !1 �':,., .. :i / /.' New construction For kit orrn use CJrerklisL ❑ 0 l)cscription Qty. I Fa. T otal El Addition /alteration/replacement ❑ Other: New I. 2 family dwellings (includes 100 ft. for each utility connection) . ,. .„ ( in;�.d'i I , r { w % - 'r' 1; 'ti; � (;A�`EGORY�,OF,; CU�$I�TIC7�Q1�1 „ "�', c t. ; ,,, > : >�> C 0';r SFR (I) bath 312.76 0 I - and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 437.78 SFR (3) bath 500,32 ❑ Accessory building ® Multi - family F act additional bath/kitchen 25.02 • ❑ Master builder © Other: Fire sprinkler (___- sq. ft.) " Page 2 ) ;,. i 1; : V VY„ cgIV.' 4PcIr '"AI W,t 9c,i .,, , i : ,i, J , : , t t {.' site uflLt e. Catch basin or area drain 18,76 Job site address: 11950 SW LINCOLN ST _ - - Drywell, leech line, or trench drain 18.76 City /State/ZIP: TIGARD, OR 97224 - - - - -- - - ' ' Footing drain (no. linear ft.: ___, Page 2 Suite/bldg. /apt. no.: 1 Project name; 2693 MONROE SQUARE Manufactured home utilities " tilities 50.03 Cross StreetAlireCliOns to job site: Manholes 18.76 Rain drain eonneetor 18.76 Sanitary sewer (no. linear ft.; _) 100 Page 2 62.54 .- . . Storm sewer (no. linear ft.: Page 2 Water service (no. linear ft.: Page 2 Subdivision: Lot no.; Fixture ar Item: - Tax map /parcel no.: Backflow pm 31 ..'5-r:.: t ve , � T�I9CiR�'FIO�1'' °i' r a HIV' r , . ' ........,.�.. � ,:..., ... 5-t .5-, .P:1 :rnr.... u .m .. ., „•a!r - - '- - - Clothes washer 25.02 LESS THAN 100' SANITARY SEWER PLEASE ADD TO EXISTING PERMIT Dishwasher _ 25,02 I' L �s2011 -00213 Drinking fountain 25,02 Ejectors /sump 25,02 ...." ., .. : � 'i5-.. (^!� :,::. ,'PRQPERlY• OWNEJt;';/; :i i;� ;t'. ?..NAN'1".;r) -1i t i ? " . ; .... Expansion tank 12.51 Name: Fixture/sewer cap 25.02 _._ ..: __ - Floor do:an/foor sink/hub 25.02 Atldre88: _ - _ Garbage disposal 25.02 City/ State/ZIP: - ._ Hose bib 25.02 _ Phone: ( ) Fax: ( ) Ice maker 12.51 ,,- ,,'^ ,' ;:'':;:' .',. i.pN ", lnt tor/ a trap ..,.,., °,,..:. z. ,�,��,A�!I,ICl►T� »r,�c ,;a�:i�`:s; „{� �, ��.OI!1'�'�RGI,. ��:'j:u� ;i: cp greras p .02 Business name; MP PLUMBING CO Medical gas (value: $ ) - Page 2 ____ .. Primer 12.51 Contact name: CINDY CRIVELLONE - -- . - . Roof drain (commercial) 12.51 Address: PO BOX 393 Sink/basin/lavatory 25.01 City/State/ZIP! CLACKAMAS, OR 97015 Solar units (potable water) 62.54 Phone: (503) 655.9161 Fax: : (503) 655-1726 Tub /shower /shower pan 12.51 E -mail: CINDYC @MPPLUMBINC.COM Urinal 25.02 ; -,,, ,. , 4 .. ....... ...:.. , „ ,...:: ,.,,,, ,; �;+ 'i''4 t ��!� i a'y ?;,c.d;, � t i'i "1•, ' .. i ' fa : , , ,1 ),COkITELAC� OR ._ . , , { ,; 5- y f 0., Water heater 37.52 Business name: MP PLUMBING.COM . --- Water piping/DWV 56.29 Address: PO BOX 393 Other: 25.02 ' City/ State/ZIP: CLACKAMAS, OR 97015 Subtotal Phone: (503) 655 -9161 Fax: (503) 655 -1726 Co 2 " ,' - Plan review (25% of permit fee) - CCB Lic.: 5002 Plumbing Lie, no.: 3 State surcharge (12% of - Authorized sigtlaturc: rg permit fee) ''7 __ ._ __ - .. _ ,_ . . . TOTAL PERMIT 1 '70. S' Print name; CINDY CRIVELLONE Date: 7/20 /11 This permit application expires If a permit is not obtained within 180 days alter it has been accepted as c nipkte. "Fee methodology em by Tri- Cuunly Building Industry Service Bunn1. 1:1BuiidinalPennitdFLMU -P iniitApp.doc 10/01/09 440 4616T(1Wo2/COMtWEB)