Permit � t CITY OF TIGARD PLUMBING PERMIT
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- � 7 1 1 •.- COMMUNITY DEVELOPMENT Permit #: PLM2012 -00100
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/02/2012
Parcel: 2S112CB06100
Jurisdiction: Tigard
Site address: 15412 SW 82ND PL
Project: Stutevoss Subdivision: ASHFORD OAKS NO.2 Lot: 75
Project Description: Relocate hose bib and add (1) outdoor sink.
Contractor: VENNE PLUMBING LLC Owner: STUTEVOSS, CAROLINE ZONA
17678 SW GALEWOOD DR 15412 SW 82ND PL
SHERWOOD, OR 97140 TIGARD, OR 97224
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PHONE: 503 - 624 -9309 PHONE:
FAX: 503 - 684 -0940
FEES
Quantity Description Date Amount
1 ea Hose Bib 05/02/2012 $25.02
Specifics: 1 ea Sink 05/02/2012 $25.02
1 12% State Surcharge - 05/02/2012 $8.70
Type of Use: SF Plumbing
Class of Work: OTR 22 ea Minimum Fee Adjustment - 05/02/2012 $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 questions to OUNC by calling 503.232.1987 or 1.800.332.2344. ' / _ /
Issued By: Permittee Signature: ON 6V�G /C , t d . / /
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.
Apr 30 12 12:49p Venne Plumbing 503 694 0940 p.1
Plumbin Permit A . licatio ECEI !1 B ED
Building Fixtures APR 3 0 2012 I (11t ()I l k I. I til ON I.\
Received ��. P ermit N o. : ��20 // 1V� •
City of Tigard Datd : 0 r ®®
13125 SW Hall Blvd., Tigard, OR 9 722 N 0� TI Plan R Other Permit NorL�sja�f /,? X400 S
CI Phone: 503.7182439 Fax: 503.598.1 D ateB y .
Inspection Line: 503.639.4175 BUILDING DIVISIO Date ReadyBy: flel ®Page m z for ' ! i - n R D I www.dgard- or.gov No fie/Method: Supplemental lnformadan
TYPE OF WORK FEE SCHEDULE
For special lnfornwllon use checklist
❑ New construction ❑Demolition Description I Qty. I Ea. I Total
® Addition/alteration/replacement ❑ Other. New 1- 2- family dwelli i. (includes 100 R for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 312.70 437.78
❑ Commercial/industrial SFR (2) bath
® 1 -and 2- family dwelling SFR (3) bath 50032
❑ Accessory building ❑ Multi- family Each additional bath/kitchen 25.02
❑Master builder ❑ Other. Fire sprinkler (__ sq. ft) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Catch basin or area drain 18.76
Job site address: 15412 SW 82 Place Drywell, leach line, or trench drain 18.76
City/State/ZIP: Tigard, OR Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt no.: I Project name: Stutevoss 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 L0t no.: Fixture or item:
Backflow preventer 31.27
Tax map/parcel no.: Backwater valve 12.51
DESCRIPTION OF WORK Clothes washer 25.02
Relocating hose bib and adding outdoor sink Dishwasher 25.02
Drinking fountain 25.02
Ejectors/suntp 25.02
® PROPERTY OWNER r 0 TENANT Expansion tank 12.51
Fixture/sewer cap
Name: Stutevoss Floor drain/floor sink/hub 25.02
Address: 15412 SW 82 Place Garbage disposal 25.02
City /State/ZIP: Tigard, OR Hose bib 1 25.02 25.02
Phone: ( ) 3 Fax: ( ) Ice maker 12.51 ® APPLICANT
a❑ CONTACT PERSON Interceptor /grease trap 25.02
Page 2
Medical gas (value: $ ! ) Pa g
Business name: Venue Plumbing, LLC
Primer 12.51
Contact name: Ryan Venue Roof drain (commercial) 12.51
Address: 17678 SW Galewood Sink/basin/lavatory 1 25.02 25.02
City/State/ZIP: Sherwood, OR 97140 Solar units (potable water) 62.54
Phone: (503) 6249309 I Fax: : ( ) 503 684-0940 Tub/shower /shower pan 12.51
Urinal 25.02
E -mail: ryan@veuneplumbing.eom Water closet 25.02
CONTRACTOR Water heater 37.52
Business name: Venue Plumbing, LLC Water piping/DWV 56.29
Address: 17678 SW Galewood Other. 25.02
Subtotal
City/State/LIP: Sherwood, or 97140
- Minimum permit fee: $72.50 72.50
Phone: (503) 6249309 Pl (503)
Lie. 0940 /'Li 7 C ` W
Plan review (25% of permit fee)
CCB Lic.: 192494 r Plumbing c. no. 96Pe State surcharge (12% of permit fee)
Authorized sigma e: p, ! s e 7//1 TOTAL PERMIT FEE 81.20 /
Date: 04/30/121 ! �I
This penult appficadoo expires if a permit is not obtained within 180 days I/
I Print name: Lindsay cone after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.