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Permit
CITY OF TIGARD PLUMBING PERMIT s COMMUNITY DEVELOPMENT Permit A: PLM2012 -00251 T WARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/29/2012 Parcel: 2S109AB06900 Jurisdiction: Tigard Site address: 13114 SW STARVIEW DR Project: Aue Subdivision: FORAN Lot: 11 Project Description: (1) sanitary sewer repair and replace sewer pipe belly Contractor: LOVETT EXCAVATING INC. Owner: AUE, BRENT R PO BOX 86280 13114 SW STARVIEW DR PORTLAND, OR 97286 TIGARD, OR 97224 PHONE: 503 - 504 -2847 PHONE: FAX: 503 - 288 -1630 FEES Quantity Description Date Amount 10 If Sewer Service 08/29/2012 $62.54 Specifics: 1 12% State Surcharge - 08/29/2012 $8.70 Plumbing Type of Use SF 10 ea Minimum Fee Adjustment - 08/29/2012 $9.96 , Plumbing Class of Work: OTR 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: - fA/Wit BLit Permittee Signature: D/ll. A PPue ULi 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. Aug. 29. 2012 11:20AM Lovett Excavat ing No. 1967 P. 1 Plumbing Permit Applicatl ECEIVED Site Utilities AUG 2 9 2012 City g ( FOR OFFICE USE ONLY �l of Tigard Received � d/ / /� sr Permit No, � o ' ' ! a. OD oy � N. 2Di/ r v u 13125 SW Hall Blvd., Tigard, OR 9 nateRlr a te Review Phone; 503.718.2439 Fax: 503.59 . e' TIGAAD D OthcrPomtitNo.: - Inspection Line: 503.639 ING DIVISION Date/By: 1 I a . : n at � t � BUIL rate Beady/By: ru - y: : See Page z for Internet: www.tigard-- o �} �7�. Notified/Method: �} ® Supplemental Information ��.rh'' :-+::_ '-. ig ry J 1'PR. OF WO {1.:. .. M1 _ ^.� +, ~ '.Y .jt_� Y 004. I .Il'." : . ❑ New construction ' ❑ Demolition FO! special Info rnzoflon site checklist. Description I Qty. I Ea. ( Total IN Addition/alteration/replacement ❑ Other: New 1- 2- lbmlly dwellings (includes 100 ft. for each utility connection) • • CA�tEGO)tY OP' CONSTRUCTIONa` ' =; _ v gf; SFR (1) bath 312.70 ® 1- and 2- family dwelling ❑ Colntnercial/industrial SFR (2) bath 437.78 building SFR (3) bath 500.32 ❑ Accessory g ❑ Multi- family Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other; Fire sprinkler ( sq. ft.) Pagc 2 y'y ti •:.. . ' =• 41TE IIVIp iLUATIdh; A NID'LOCATION. Site utilities• Job site address: 13114 SW STARVIEW J)RIVF Catch basin or area drain 18.76 City /State/ZIP: TIGARD/ OREGON/ 97224 Arywell, leach line, or trench drain 18.76 Fooling drain (no. linear ft.: ___,) Page 2 Suite/bldg. /apt. no.; I Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 _ Sanitary sewer (no. linear ft.: El) 1 � Page 2 62.54 Storm sewer (no. linear ft.: ) Page 2 Water service (no. linear ft.: `) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map /parcel no.: Backfow preventer 31.27 : 4 Backwater valve 12.51 ' Clothes washer 25.02 REPAIR AND REPLACE SEWER PIPE BELLY _Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 . • Q.•PROPERTY 'OWNER ' , l . ❑ TE>v'Ai�x -:.:k4-.f' Expansion tank 1251 Name: Fixture /sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 - City/State/ZIP: I'lase bib 25.02 Phone: ( ) Fax: ( ) Ice maker 12.51 : .. ❑ APPLICANT . ®.CON"TACT PERSON Interceptor /grease trap 25.02 Business name: LOVETT, INC Medical gas (value: $ _) Page 2 Contact name: TOM WOLFS Printer 12.51 Roof drain (commercial) 12.51 Address: P.O. BOX 86280 _ _ Sink/basin/lavatory 25.02 City/State/21P: PORTLAND/ OREGON/ 97286 Solar units (potable water) 62.54 Phone: (503) 383 -2298 I Fax: : (503) 288 - 1630 11lb /shower /shower pan 12.51 E -mail; tort ©lovettservices.com Urinal 25.02 rr y Water closet 25.02 Water heater 37.52 Business name: LOVETT, INC. Water piping/DWV 56.29 Address: P.O. BOX 86280 Other; 25.02 City/State/ZIP: PORTLAND/ OREGON/ 97286 Subtotal Phone: (503) 737 -8523 Fax: (503) 288 -1630 Minimum permit fcc: $72.50 72.50 CCB Lie.: 125507 Plumbing Lic. no.: 26 -773PB Plan review (25% of permit fee) State surcharge (12%ofpermit fee) 8.70 Authorized signature: TOTAL PERMIT FEE 81.20 Print name: PATRICIA SMITH Dale: 088 This permit application expires If a permit Is not obtained tvlthln 180 days after It has been accepted as complete. *Fee methodology act by Tri- County Building Industry Service Board. l:\ Duilding \PennIAPLMU.PeRaitapp.dOC 10/01/09 440-1616T(10,'03icom Q &) CITY OF TIGARD PLUMBING PERMIT s COMMUNITY DEVELOPMENT Permit A: PLM2012 -00251 T WARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/29/2012 Parcel: 2S109AB06900 Jurisdiction: Tigard Site address: 13114 SW STARVIEW DR Project: Aue Subdivision: FORAN Lot: 11 Project Description: (1) sanitary sewer repair and replace sewer pipe belly Contractor: LOVETT EXCAVATING INC. Owner: AUE, BRENT R PO BOX 86280 13114 SW STARVIEW DR PORTLAND, OR 97286 TIGARD, OR 97224 PHONE: 503 - 504 -2847 PHONE: FAX: 503 - 288 -1630 FEES Quantity Description Date Amount 10 If Sewer Service 08/29/2012 $62.54 Specifics: 1 12% State Surcharge - 08/29/2012 $8.70 Plumbing Type of Use SF 10 ea Minimum Fee Adjustment - 08/29/2012 $9.96 , Plumbing Class of Work: OTR 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: - fA/Wit BLit Permittee Signature: D/ll. A PPue ULi 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.