Permit CITY OF TIGARD PLUMBING PERMIT
117 COMMUNITY DEVELOPMENT Permit #: PLM2012 -00096
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/27/2012
Parcel: 2S103AD02100
Jurisdiction: Tigard
Site address: 10950 SW PATHFINDER WAY
Project: Leach Subdivision: PATHFINDER Lot: 12
Project Description: Directional boring in of approximately 60' of water service from meter to house.
Contractor: ALL IN ONE PLUMBING INC Owner: LEACH, TOM ALLEN SR & HYE SIN
16321 SE HILLSIDE LN 10950 SW PATHFINDER WAY
MILWAUKIE, OR 97267 TIGARD, OR 97223
PHONE: 503 - 620 -6068
HONE: 503 - 344 -4705
FAX: 503 - 208 -2059
FEES
Quantity Description Date Amount
60 If Water Service 04/27/2012 $62.54
Specifics: 1 12% State Surcharge - 04/27/2012 $8.70
Plumbing
Type of Use: SF 10 ea Minimum Fee Adjustment - 04/27/2012 $9.96
Plumbing
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 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued B Permittee Signature: F
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.
RECEIVED
APR 2 6 2012
CITY OF TIGARD
BUILDING DIVISION
Plumbing Permit Application
Site Utilities Rik urFIr : I E o''1,1 - -
II City of Tigard = / ' _ �_ j • - ° 'LN 0!. 0■ . i
13125 SW Hall Blvd., Tigard, OR 97223 Paso Review
Phone: 503.718.2439 Fax 503.598.1000 gat. Other Penult No.:
T 1 - -- Lit? Inspection Line: 503.639.4175 Date R /lt , rad. I n See Page 2 far
Internet www.tiganior -pgov ,y (,�, NoLifedMkghed: . , Sopplemeetal tnformauon
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1 , h . - .-(, w•r i� ,' ,41� � 1Es•, SCflED `)1.E i:. t - r
❑ New construction ❑ Demolition
For special Wormaafnn,ese ebrranse
Description 1 Qty- 1 Ea 1 Total
j if.Additioniallerationireplacement ❑ Other: New 1.2- family dwellings (includes 100 ft. for each utility connection)
{ :;s t . .- : I f 4A Qg` dt~ii5tt(a btj' r p r., SFR 31270 1
0..1- and 2- family dwelling ❑ Commerciabindusuial SFR (2) 437.78
SFR (3) bath 500.32
❑ Acecaso,y building ❑ Multi- family Each additional bathAcitchen 25.02
❑ Master builder ❑ Other Fire sprinkler (_ sq. R.) Page 2
: I`'} j`.1.'• � SE$B of Pb *OX- GNU .W? }.00K : E y w` - j `" :z Site at6Idm:
Job site address: ! 09 r5 0 P .Q..ot e,,-' Woe Coach basin or am Groin 18.76
1 Drywall, leach tine, or trench drain 18.76
City/State/ZIP: Ti r�LZSr t t1 `r- Footing drain (no. linear ft.: _ ) ( Page 2
Suite/bldg./apt no.: 1 Project name: Manufactured home utilities 50.03
Cross street/directions to job site Manholes 18.76
Rain drain cotmeclor 18.76
Sanitary sewer (no. linear R: _ ) Page 2
Storm sewer (no. linear ft.: _J Page 2
Weter service (no. linear ft.: J0) Page 2 ( x '2.6
Subdivision: l Lot no.: Flare or Item:
Tax map/parcel no.: 13ackflow presenter 31.27
'° ,. a _ wv Backwater valve 12.51
, r n 1 (+ ° • ,. ' . ^. r , C I ace, ,,,,,b, 25.02
0l gr9,1 ]� O net, WO Ps/ Dishwasher 25.02
$9,1/. CA. M� �,� - 41 - t 40.'5'4. Drinking fountain 25.02
Ejectors/smnp 25.02
i
�, �,Pltt�'�R3„!" - DEC <� ', h * T�. _�,r 'tf 't~E';rKtwt; ` , / a � Exparasiontank 12.51
Name - 1 w LeD„cali Fi)dute/sc+vercop 25.02
, r �� Floor dmin/floor sink/hub 25.02
Address: / S:,) Pr. .' I t ie:"r` Garbage disposal 25.02
City/State/ZIP: ^( ot Cl Hose bib 25.02
Phone: (103) (-) 0 t: , 0 6 a Fax: ( ) la maker 12.51
f r��ry' AP ,; c' L r . i15Att'4 iiigi}\ - is ]oaapter /grease trap 25.02
Business name: M ) In t r/ :,,w h, Lq Medical gas (value: E _) P 12. 2
1 0.0.9+
Prima 12.51
Contact name: J ,4jd,.‘n Roof drain (commercial) 12.51
Address: /WIZ LSE /i0`116,Ve_ L siaadsiaafavatot 25.02
Caty/State/ZIP: 4a1 um, )6 97 67 Solar units (potable water) 6234 a
1 Phone: (50 3 3 y y- N70 5 Fax: (Si3) Z D Z 0 S! Tub/shower/shower pan 12.51
1 �,� 1 - !- [,
Urinal 25.02
/41 /ci.vr)o flc. iq e red- W aterc t oset 25.02
:'4.1;'• ' v r { PtTRXi:I'oRv;- . - .... - 4 Water haw 37.52
J a .
Business name: 44 t ,1r f 4 G Pi ( j � ^,y I Water pipiag/DW V 56.29
Acidness: ... I ( . Other: 25.02 • • ity/State2TP: /v1,16(0., ' i (A Subtotal (
�`t'I l phone: qv; ) - 39 Li -t/ � Far c ce 3)�� - z0s9 ,j Minimum permit fee: 572.50 72.50
A,' ' CCB Lie.: ) . 0 - y i 4 / Plumbi c uc. no.: PQ S3 • ( ,"4 Plan hang .g.-70 (25:0 of permit fee) �-
�� �= SatesurCharge(1r4of permit fee) .7o
Authorized signature: ei-1 TOTAL PERMIT FEE _ )_
Print name: tj . R .r • Date: /I it, / T at
rhr. permit app es if a as complete wuhioTa� na
after t� .
'Fee mew seer by Tri-Camay Budding lndumy Service Board.
a oal PetdesW iO- Pambgpp.As iaolp9 440- 4eI611I0/07/COM/w®)
OP:6 gtotian /P e in Z e6ud 0961 (COS) L.:aGA :el 690L 1809) le :mod asom e :won j
From: Justin West Fax: +1 (503) 208 -7059 To: Fax: +1 (503) 598-1960 Page 1 of 3 4/28/2012 9:44
FAX
Date: 4/26/2012
Pages including cover sheet: 13
To: From: Justin West
All in One Plumbing, Inc
16321 SE Hillside Ln
Portland
OR 97267
Phone Phone +1 (503) 828 -9896
Fax Number +1 (503) 598 -1960 Fax Number +1 (503) 208 -7059
NOTE: