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Permit
CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit #: PLM2009 -00197 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/22/2009 Parcel: 2S104CD10700 Jurisdiction: Tigard Site address: 13835 SW HILLSHIRE DR Subdivision: Lot: 0 Project: Cook Project Description: Install water heater Owner: FEES COOK, THOMAS L & LINDA G Quantity Description Date Amount 13835 SW HILLSHIRE DE TIGARD, OR 97223 1 ea Water Heater 07/22/2009 $16.60 1 12% State Surcharge - 07/22/2009 $8.70 PHONE: Plumbing 56 ea Minimum Fee Adjustment - 07/22/2009 $55.90 Plumbing Contractor: COLUMBIA CONTRACTING SERVICES INC 38197 SE HUDSON SANDY, OR 97055 PHONE: 503 - 225 -0774 FAX: 503 - 668 -3701 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: � Permittee Signature: p 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. Ju 21 09 08:31a p.1 ., 11• 17/ 2000 11:Z4 1 X1.13 1la1116U OLLY OF 11GA W VII VV:1 PllimbinE Permit A licalio 1 r. , < : t . { N.,.... 13125 r sw Tigard. OR 9T223 it II 212 K-� - P e�it�ro.: ?a...4 Z - o o (?y Thom: 503.639.4171 Paic 503598.1460 Review MarPeaviLNo: • In Line 503.639.4175 p� TIGARD -12" CITY raiz lid :t �r„et a„rw tigattd or�DV _ i , i _ t® FNe A n Supplemental tifw_ ln <, �..• ; • i; :[ - • • -4-- • . -.7 '1 1 % . 11 i' - ':i:tK n`417' . � .� -f�•� •:r.: ;.. • .•� ;,- +.r:. „'r '•rC - + -,`' : ' =. "�1 - 'ci' . 0;f'r `• % - r v : .-� ._.u " • . y5 - ' El trmtian El Demolition For 7aQtSQfluae � 1)gainbao Qty. Ea. Total Additiunlalteratiai/rcplacemcrrt 0 Other. New1-2-eauoly dwellings (includes 100 fl_ for each utility connection) ;ti,; "_+- Y- y. �'ri - ; •' :. s i .`. i v i.� . : : _ � .•.i� •. k-': - ' SFit (1) bed 24920 N'. - and 2-smay dwelling 0 Commercial/industrial SFR (2) bath 350.00 - 0 Accessory Molding 0 Multi- fanttly SFR (3) bath 399.00 Each ❑ Master builder Each asdditimml bai1Jkisdaoa 45.00 - Other ','S `=9, F "11*. . 1 ' iiirliP.. y - . , • y .. e _ Fite sprrahlQ (---- aq. 9 .) 2 i } Site 1#hti, Job site addtc s: / :S 135 ) 1 L/4, ,1 Coda basin or m a drain 16.60 ^ C+ty/StatefAP: / - 4"1 � Uryv+cll, halo has, or trench dram 16.60 Suite/b1d /apt. um: jest nom: C' r90 /� � Footing drab) (no. linear fl : _� Pam 2 , • Cross street/directions to job Site: Matanfaanred 6anaeutilities 110.00 Manholes 16.60 Rain dra cornoetor 16.60 • Sanitary sewer (so. linear B.: ,___) page 2 • Sloan sewer (no. Racer it: J Paget Subdivision: , Lot no.: Wet= =vise (um linear 0.: ) Page stoat or• ices Tax inaplpa reel no.: Gov R � '� 3"i • • y °° fir ' :..>...: ;�,� ■.: calve 16.60 Badcftowpreventa pnEA2 - Backwater vale 16.60 I Clothe washy /6,60 Dishwasher 16.60 °a : - = i:y ` , T'- , •3 .. , � iA7Pt --.•:::•-:- _ _ Drinking fountain 16.60 Name: / Ejo+�ra/suntp 16.60 f� /i !kC/I� .�4Dt Expnasioa revere 16.60 Address: ` 16.60 City/StaustJLIP: Floor dmin/floor sink/hub 16.60 Phone: ( ) 'c'-Q.e - },rs I Fax: ( ) Garbage disposal 16.60 �;$- 4 {ma .,, - Business name' Ice maker 18.60 Contact name 1r�0�g' trap 1660 Address; Medical gas (vain S ) Pago2 Primer 16.60 CitylStatelZlp Rorifdreia ( . T Phone: ( ) J 16.60 Fir : { ) `Stiak/bssiff/iaratory 16.60 E-mail: J i Tub/shower/shower pan 16.60 t. =-: . f : • V ' - !.. : • ;Z-.: ` : - • _ Urinal 16.60 ----4-4.-; :' R Water dose: 1660 F Business "Me: - z /u ,e2.- /A- G •.5 C /2L�- Z WaRtaeahr 16.60 Address: ,_. �/ 9. 7 $ ,l-lie •l ei scaN <ac / otiur IIIIIIIII City/State/ZIP: __S;`4.1/',.-4 C,...,_ C' � ?vS6 - Subtotal Phone: ( aZ25 © 77 Fax: ( ) 7,) • Mamma permit fee: 572.50 CGB Lie: Residential bactflow minimum • ••1 fee: 536.25 //` r 3 . �z� i I Plumbing Lim no 3 Plan review (25% ofpetmic fee) Authorized sigaature� e _ ` � J t c- - c.__.._ -� / State / 7 // Tots per®it app ado expimq if at permk b otrpiaed; t+E,:aeaawoma 18Q dam atler k tree bee, acoepEdi as compl not ete• tw�doc 06'2£406 eaa.�sas�ua yv,�t act I 'd - County Beading ladusa y Service Board.