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Permit CITY OF TIGARD PLUMBING PERMIT B COMMUNITY DEVELOPMENT Permit #: PLM2011 -00352 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/10/2012 Parcel: 2S101AB00100 Jurisdiction: TIGARD Site address: 12017 SW 70TH AVE Project: Dr. Sepehri Subdivision: Lot: Project Description: Setting of plumbing fixtures on previously installed underslab piping. Contractor: EXCELLENCE PLUMBING LLC Owner: RED ROCK BUSINESS ASSOCIATES LLC 7520 SW 140TH AVE 23077 SW NEWLAND RD BEAVERTON, OR 97008 WILSONVILLE, OR 97070 PHONE: 503 - 643 -3459 PHONE: FAX: 503 - 643 -2815 FEES Quantity Description Date Amount 1 ea Backflow Preventer 04 /10/2012 $31.27 Specifics: 1 ea Clothes Washer 04 /10/2012 $25.02 1 ea Dishwasher 04 /10/2012 $25.02 Type of Use: COM 1 ea Expansion Tank 04/10/2012 $12.51 Class of Work: ALT 1 ea Floor Drain/Floor Sink/Hub 04 /10/2012 $25.02 Type of Const: 1 ea Sink 04 /10/2012 $25.02 Occupancy Grp: 9 ea Lavatories 04 /10/2012 $225.18 Stories: 2 ea Water Closet 04 /10/2012 $50.04 1 ea Water Heater 04/10 /2012 $37.52 1 12% State Surcharge - 04/10/2012 $54.79 Plumbing Total $511.39 Required Items and Reports (Conditions) • This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or direct • - • - - • OUNC by calling 503.232.1987 or 1.800.332.2344. Issued • y: / �� Permittee Signature: i• • se . Call 503.639.4175 by 7:00 a.m. for the next available Inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. 11/28/2011 17:26 FAX r Z001/001 , Nov 28 1105:29p Craft Master 5032921177 p.1 Plumbing Permit Anglican's Building Fixtures 1- cEp , i ,, f , ,,, , , 1 11 4 _ City 7igard,oR 1r9 V 2 9 2011 � lI7 ' ! �xo.: o ho / /--ee�53 L ri - :503.718 39 Floc 501598.1960 PlIO ' _ ore�rt lea :oweRoll /�/ 1 411'5 CITY OFTIGA;�D Nainse :o d,a,, / S ■ s.. s www.tigard-or.gov � : , r , ::a. � �! ... . W 6tr�ti.a i TYPE of , 1 •� O New construction 0 Demolition . . far s1�rd�llrt ❑ Addition /alteestioetl4ieplaoemeat ❑ Other: oeiO on OW. Ea 1 Total Nsw 1-2 -aroty dwemap (includes 1 & for oath utility connection) CATEGORY OF CONSTRUCT/ON • SFA (1) bob _ 312.70 ❑ 1- and 2.family dwelling Site WA a) 437.7$ , 0 Accessory building 0 Multi•fssnibr gy(3) bath 50032 ❑ Mir builder 0 Other: _ Endo additional 2502 Fos aphides. (_ sq. R) Page 2 JOB SITE CYPORMATIm4 AND LOCATION , Sits awes: Job site oddrase 12. on 5103 7 o 'W' AV•C, . Catch both) or oes drain 1t76 (S y /8tnto1 1P: 17, 4 ' v i e Osyw�l. lends boron Wendt drain 18.76 2 Suite/bldg./as&no.: I Project nor= 5 - PeJ'1rl De , M wedborn iaerrR:�.,� P50 �� hsar�ared borne Wain 50.03 Cross street /direotioosto Job site: _bQr ,,, c,,,AL, 4 5) - .1 manholes 18.76 Rena drab. w arocior 18.76 r 9tasltary sews nee/also. 10- liner ft.: �_) . Page 2 Slone ne(xo. linear ft:__) Page 2 Wiler service (no. linear l: ___,) Page 2 Subdivision: I LAt no.: 1F1 veer Woe - Tax ntap/pereel no.: Ale! 1g(3 6Q! er7 fiackflow presenter 11 y - 31.27 3/.27 10ESCRIPflON OF WORK va i 1251 �rwr+e�/ -.r Mika washer 1 25.02 �g, - e-W rA.4 -4 -5 ��r 1 2302 ,95.(73.. Drinking ter 2102 _ Eledowisinap 25.02 ®'raoPElrrY OWN I • 0 =coif Expeosiontank 1 1231 tA.51 Name: r. P{.01,4 ,q .517461r1. Pixdrldlxrrareap 23.02 Address: - Flax drain/floor siArAutb 02 / 25.02 ,2 5,o9.- disPNBI 25.02 City/State/ZIP: Y _ floe bib 25.02 Phone: ( ) Pan: ( ) lee mailer 1231 Oi 0 CONTACT PERSON s trap 25.02 Business maw: C..r - a.. ' p ie -- o, Or a h Medical Bas (value: f ) Pie 2 � � " ="1 i Pr1mQ 1231 COn>bce ommc: i, / / Roof drain (commercial) (commercial) 12.51 Address: (0.441% $ 6 ••• Nl S,nkil esinllwldory 0 2502 .25 / oho City/State/ZIP: Pi= r +4 0...e # © iz_ a 7 a. Z S Sold units (potable weer) 62.54 Phone: (so;) C r? 7 - I Fax:: (r 292 -U'77 nrvthower/nbower pan 12.51 Urinal 21.02 E-mail: G fjet 4:/ . 11/4.)G t Water chews 2- 25.02 $Q. og Weer hearer 1 3732 , ?7." ., Dcsiness 11x1ne: • / 4' ,.a a i Address: 772 0 .SW / I ' WOW r b. _ X02 a /staearar� vP, - , l �n /��' 9 7 erJ _ salrtoa, � 5( r - . ' ( 5i) b413� -3 ‘.1 max: ( 69. -2,8/5 Minimum p m$ &a: $12-51) - . COI Uc : 175`1/ 7 ! NJ t3 Plumbing Lie.. no.: Pt= review (1396 of pemdc �C) Styeambargo(1296ofomo&fee) cei•79 Authorized signature: / 7 I /y TOTAL PERMIT FETs Print name: ,fig /4i F r en / 0 oatC / - ZS /1 Thin I"°" apti° U lus a . r' a d ' vtlM. 180 ds,. / 'Fa• methede%op sal by 1►:Caegr 11fiidiag tnclusby &nice Boma tmuaalpitainiorimu•Paerurpane see I D 440.4e1eTIIW/LC0>.Uw0a,