Permit n CITY OF TIGARD PLUMBING PERMIT
s COMMUNITY DEVELOPMENT Permit #: PLM2012 -00179
T L G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/27/2012
Parcel: 1 S133AD12500
Jurisdiction: Tigard
Site address: 11334 SW SUMMER LAKE DR
Project: Rager Subdivision: SUMMER LAKE Lot: 6
Project Description: Replace (1) tub, (1) shower and (2) lays.
Contractor: METRO PLUMBING CO Owner: RAGER, MIKE L & CAROL J
PO BOX 873 11334 SW SUMMER LAKE DR
NEWBERG, OR 97132 TIGARD, OR 97223
PHONE: 503 - 538 -4094 PHONE: 503-686-0230
FAX: 503 - 538 -4094
FEES
Quantity Description Date Amount
2 ea Lavatories 06/27/2012 $50.04
Specifics: 2 ea Tub /Shower /Shower Pan 06/27/2012 $25.02
1 12% State Surcharge 06/27/2012 $9.01
Type of Use: SF Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $84.07
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 qu o-QUNC by calling 503.232.1987 or 1.800.332.2344.
•
Issued y: Permittee Signature: c:52eL
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.
06/24/2012 20:08 538 -4977 BSENECAUT tatri },j 6 01
Plumbing Permit AnplicatioRECEIVED J4 / ` • u b
Building Futures alac aaI a 0 a a .i 1a.1 ,
City of Tigard J 2 4 :Q,� "No.: 'a/Am-60177
13312255 SW3, Hall Blvd., Tigard, 503 OF T1QARD Review ppm Permit No..
Ph: Inspection Line: 503.639.4175 A UILDING DIVISION line asodyBy: - ® get Fagg 2 for
Internet: www.tigard- or.8ov �d I l s cat Woman=
TYPE OF WORK FEE* SCHEDULE
❑ New construction 0 Demolition
For special W B"t we cllaaArt:Pr
y Description ) Qty. I Ea I Total
® Addition/alteration/replacement ❑ Other: New 1- 2- funnily dwell (included 100 R for each utility connection)
CATEGORY OF CONSTRUC'T'ION SFR (1) ball 312.70
SFit (2,) bath 437,78
® 1- and 2- family dwelling ❑ Commercial/industrial _
SFR (3) bath 50032
❑ Accessory building ❑ Multi-family additional bath/kitchen 25.02
0 Master builder ❑ Other • Fire sprinkler (_ sq. it ) Page 2
JOB SITE INFORMATION AND LOCATION Site ntW : -
Catch basal or area drain 18.76
Job site address: 11334 SW 3atmmelrlake Dr Drywel, leach line, or trench drab" 18.76
City /Statc/ZlP: Tigard, OR 97223 Footing dram (no. linear ft.: _,__) Page 2
Suite/bldg./apt. no.: Project name °�; F a
_ea Manufactured home utilities 50.03
Cross street/directions to job site: Springwood 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: Lot no.: Fixture or item:
Backflow proves 31.27
Tau map/parcel net.:
Backwater valve 12.51
DESCRIPTION OF WORK Clothes washer 25.02
Replace tub, shower, & 2 lave Dishwasher 25.02
Drinking founts 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER ❑ TENANT Expansion tome 12.51
^,. /� Fixwrdsewer cap 25.02
Name: Mike Rigger • co U� Floor drainIfIoor sink /hub 25.02
Address: 11334 SW Summerlake Dr Garbage disposal 25.02
City/State/ZIP: Tigard, OR 97223 Hose bib 25.02
Phone: (503)686 -0230 Fax: ( ) Ice maker 12.51
® APPLICANT ❑ CONTACT PERSON ink /8° trap 25.02 I,
Business name: Metro Plumbing Co Medical gas (value: S ) Page 2
. Primer 12.51
Contact name: Brad Senecaut Roof drain (enennercial) 12.51
Address: PO Box 873 Sink/bask/lavatory 2 25.02 50.04
City /State/ZIP: Newberg, OR 97132 Solar units (potable water) 62.54
Phone: (503) 538 -4094 Fax: : (503) 538 -4094 Tub/shower /shower pen _ 2 1251 25.02
_ - Urinal 25.02
E -mail: metroplbeco®aoLeom •
Water closet 25.02
CONTRACTOR Wad beater 37.52
Business name: Metro Plumbing Co ✓ water pipin8/DW V 1 56.29
Address: PO Box 873 Other. 25.02
City /State/ZIP: Newberg, OR 97I32 Subtotal 75.06
Phone: (503) 538.4094 Fax: (503) 538 -4094 Minimum permit fee: $72.50 .
Plan review (25% of permit foe)
CB tan.: 101261 ; �' rrtnbiag Lie. no.: 36.63YB 11 t oI
_ State =charge 02% of permit leer) 94117 y •
Authorized signature: -• ,c. . . _ TOTAL PERMIT FEE J14430_ 01
Print name: Brad Seneesut Date: 6-25-12 R "' it ap�cidea expires t • permit b not obtained within IBe days 64
alter It has bees accepted as complete.
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