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Permit CITY OF TIGARD PLUMBING PERMIT t. 71 ,--.- ."L COMMUNITY DEVELOPMENT Permit#: PLM2012-00309 � ,N+.� Date Issued: 10/25/2012 'IIGARDj 13125 SW Hall Blvd.,Tigard OR 97223 503.718 2439 Parcel: 1S133DB00700 Jurisdiction: Tigard Site address: 11580 SW SHEFFIELD CIR Project: Naylor Subdivision: BRITTANY SQUARE NO 2 Lot: 31 - Project Description: Replace tub/shower Contractor: RAYBORN'S PLUMBING INC Owner: NAYLOR, STEVEN P&TRACEY L 19990 SW CIPOLE RD 11580 SW SHEFFIELD CIR TUALATIN, OR 97062 TIGARD, OR 97223 PHONE. 503-692-4139 PHONE FAX: 503-691-2328 FEES Quantity Description Date Amount 1 ea Tub/Shower/Shower Pan 10/25/2012 $12.51 Specifics: 1 12%State Surcharge- 10/25/2012 $8.70 Plumbing Type of Use: SF 60 ea Minimum Fee Adjustment- 10/25/2012 $59 99 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 OUNCCbby calling 503 232 1987 or 1.800 332 2344 Issued By: //`; Permittee Signature: 4e)41 G/ e T/O 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. 503 691 2328 Rayborns Plumbing 02:59:59 p.m. 10-24-2012 2/2 Plumbing Permit ApplicationAECEIVE Building Fixtures City of Tigard OCT-2 4 2012 Received Permit Na. • 13125 SW Hall Blvd.,Tigard,OR 97223 Dategy' ley250 )°�a0i�#030 I Phone: 503.639.4171 Fax: 503.598.19t� TIGARQ Plan Review Other Permit No.: p�� t �y{q Date/By: • 1 I t:n 1:I i Inspection Line: 503.639.4175 DV1LoiNG U1 Y IS to Ready/By: 1 6if Sae Page 2 for Internet: www.tigard-or.gov otified/Method: LL1 Sopplementat Information TYPE OF WORK FEES SCHEDULE ❑New construction . Demolition For special information use checklist �,I/ Description I Qty. I- Ea. I Total ,C addition/alteration/replacement ❑Other: New I-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 12-1:;;Id 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 Accessory building Multi-family SFR(3)bath 500.32 ii Accessory Multi-famil Each additional bath/kitchen 25.02 ❑Master builder ❑Other. Fire sprinkler(_sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: r�t e� Catch basin or area drain 18.76 Job site address: �'!7 B� S(,� 5�2.tt r� ��r - Drywell,leach line,or trench drain 18.76 City/State/ZIP: -r;Q © , 4P1)3 int_ Footing drain(no.linear R.:_) Page 2 Suite/bldg./apt.no.: 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.:_) Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: 1 Lot no.: Fixture or Item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 ^' Clothes washer 25.02 KepIact..- 1 �v`\J/ s Lower Dishwasher 25.02 ` Drinking fountain 25.02 Ejectots/sump 25.02 ❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) lee maker 12.51 ❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 I ` Medical gas(value:$_) Page 2 Business name: % �V14 5 P\u X90.4 `�C. 1 Primer 12.51 Contact name: a�e. /�a k r /__ Roof drain(commercial) 12.51 Address: 'J&CW S W 6-t,FICA e. R a. Sink/basin/lavatory 25.02 Cit /State/ZIP: Solar units(potable water) 62.54 Phone:(5'03) 6 c01-413s I Fax::(So3) 6(43 -4[1/ Tub/shower/shower pan / 12.51 E-mail: f %...,..... Urinal 25.02 C(}E Gla/ D yvt5. Water closet 25.02 / CONTRACTOR �j r, ` Water heater 37.52 Business name: �f�` 6��-ic }/thy A 1nL_ Waterpiping/DWV 56.29 Address: 1 ekck`Ct� w e,w,,t i Other. 25.02 City/State/ZIP: /ru ' , C( 062 Subtotal (�3) 6 9.D- y/ '7�/ (j�) �Vf/ Minimum permit fee: $72.50 Phone: 7 _/ 3 / Fax: 7 CCB Lic.: t 7gC3-• PI ' gLic. .. 3U..146 . Plan review (25%of permit fee) a l State surcharge(12%of permit fee) Authorized signature: 1tI,...r-%"! ' TOTAL PERM ITFEE Print name: Date: TAIs permit application expires if a permit is not obtained w1 180 days !.?" eT,r ,.: O`^` /. after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 0 I:'Budding.Permits\PLMU•Pe mnApp doe 10.01.09 440.4616T(10/02/COMWEB) 7 f' v n2 l