Permit •
•
1.1 CITY OF TIGARD PLUMBING PERMIT
` = " COMMUNITY DEVELOPMENT Permit #: PLM2012 -00335
1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/19/2012
I1G . 9.
.:. = Parcel: 2S103ACO3500
Jurisdiction: Tigard
Site address: 12498 SW 114TH TER
Project: Jackola Subdivision: WALNUT GROVE Lot: 4
Project Description: Install soaking tub at existing shower location.
Contractor: MP PLUMBING CO Owner: JACKOLA, ERICA
PO BOX 393 12498 SW 114TH TER
CLACKAMAS, OR 97015 TIGARD, OR 97223
•
PHONE: 503 - 655 -9161 PHONE:
FAX: 503 - 655 -1726
• FEES
Quantity Description Date Amount
1• ea Tub/Shower /Shower Pan 11/19/2012 $12.51
Specifics: 1 12% State Surcharge - 11/19/2012 $8.70
Plumbing
Type of Use: SF 60 ea Minimum Fee Adjustment - 11/19/2012 $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 OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By Permittee Signature:
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.
Plumbing Permit Aaalicati c WED
Building Fixtures �
City of Tigard ;, n V aeca.ed ,C - f V oe3.3
1 5 ? Q 12 R, sy: k /> /42.- 1'armit >�
13125 SW Hall Blvd, Tigard, OR 97223
Phone: 503.718.2439 Fax: SOt !T reF TIGARD Plan
Dai�y: Other Permit No.:
1 1 i Inspection Line: w503.639.417 pDate Ready/By. See Page for
Internet: ww.tigard.or.gov BUILDING DIVISION Notified/ Method: ' ty/ Impplem 2 tafarmeaan
•.,. ... "y .��, „. . xn �.�.,.. .. :�:w - .,c.�::� " r - ,:y..�.¢.+.�:ili':: :u.,.:�: �. ,:.i::�
.
•,.r - tan 'fr.r4i 14 '�"' ..v. .1.t oN , m �a t' ,ii.i �.1 nr. it y� 'l. ',r�.,...
..°.� �'. ..,.n nn`Mi! :,, i'°:.'... A? �5+. � ..T+�t. aha:, :. .. i.: iw�. �' iI�C�' '..iCU+��I;T�!ek.`�la'. %�'1 d.S'ti;:. <��,'cn.,. : :;
r•4n
❑ New construction ❑ Demolition For. spells! infonnirion use checklist
Description I Qty. I Ea. I Total
® Addition/alteration/replacement SFR )
.. .f: ❑ Other: New 1- 2-famlly dwellings (includes 100 ft. for each utility connection)
! ` .. �g,,t. t 74� .1" 46101 . r tY F -� � fir'• R .L ` I bath i 12.70
.s... r'•f , J��.�,..,�.. �. �.�.� �.. ��1 '^ •�!`s:'.�...`1��°� ,°�,�>1i °'ry..(k?:��'.ti' (
® I- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 437.78
❑ Accessory building ❑ Multi - family SFR (3) bath 500.32
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other Fire sprinkler ( sq. ft.) Page 2
t / y ., f a t . ....� Y .,. ,... f� •ti...'N" J
ti ' �; Vi ' i .f.. ,I..e: M0' i• th ��l rrR�l1:::t Sif• "lid"'
Catc
i'. ^: '�� ..�ac? A;. ...i4'7lT .• x�. - .r. .:'��:M ;Ef'i1�4Y4.r.. c•.. v
Job site add" ss: 12498 SW 114"' TERRACE ' basin or situ drain 18.76
Orywell, leach line, or trench drain 18.76
City /StatetZTP: TICARD, OR 97223 Footing drain (no. linear lt.: ) Page 2
Suitc/bldgJapt. no.: I Project name: 53136 JACKOLA 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 sewn (no. linear ft.: Page 2
Water service (no, linear ft.: ) Page 2
Subdivision: I Lot no.: Fixture or item: -
Tuxmap/perm no.: clack flow presenter 31.27
s 4✓ t � e:r r I S 1
M1� p 71'1• '"" P � r hrcy'4F�+ �= 1.,1 y y,�•• Backwater valve 2..
!4 ,►•� iii`+ r'' S�. L�,! �' ��'.' 1 ""�r1�tiJ,� i1�i
�• " ` CbUres vvastter 25.02
INSTALL CUSTOMERS S' SOAKING TUB AT EXISTING SHOWER I)ishwrahxr 25.02
LOCATION Drinking fountain 25.02
Ejectonistm p _25.02
!� W t ,. n.«1�•�ry,.+,'{� i��iy'k�V,' i��jh " �,;` v '.1.;:'..'r' E •'i ion tank 12,51
�1� , iltill`.' �I�`�'1Fih441�ti >�+v� » "�'17ttyh/ .i �
Name: ERIKA JACKOLA Fixmue/sea'er cap 25
Floor drain/floor sink/hub 25.02
Address: Garbage disposal 25.02
City/State/ZIP: hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12.51
31k. � : X , :i , , -• s.�_ c,�� 5 r " � ry��b "{ Interceptor /grease trap _ 25.02
•;. 'ell 1�. .k, +:� � ,•h;,� .,
Business name: MP PLUMBING Medical gas (value a .... ) Page 2
Primer 12.51
Contact name:
Roof drain (ix,mneercial) 12.51
Address: Sink/basin/lavatory 25.02
City /State/ZIP: Solar unit,. (potable wafer) 62.54
Phone: ( ) Fox:. ( ) Tub/shower/shower pan 1 12.51 12.51
E-mail; DONNAT @MPPLUMBINC..COM Urinal 25.02
:�..,.. t�- .,..t:Vrtyr ., .. �`; . 4 .. "/ . �o °r ,: ;.;r.r� <, . ,, � ? .,,•; ,,. Water Cloaca 25.02
45..g :1 j'';�iT ir}.!�it:4 il;..s�•,"•( 1 ?'4 4.. i� *- 4 : "�iti°S i`,7 ":1i 3.04 :4v», f •r i •�,� W ater heater 37.52
Business name: MP PLUMBING CO Water piping/DWV 56.29
• Address: PO BOX 393 Other: 25.02 '
City/State/LIP: CLACKAMAS, OR 97015 Subtotal 12.51
Phone: (503) 655 -9161 Fax: (503) 655 -1726 Minimum permit fox: S72.50 72.50
CCB Lic.: 5002 r a • Plumbing Lic. no.: 3-17PB Plan review (25% of ptr,ttil fox)
/ Stale surdtttrge (12% of permit fee) 8.70
Authorized signature: tiBin i///��/ TOTAL PERMIT FEE: 81.20
r
Print name: DONNA M - TTI IEWS Date: 11/15/12 This permit application expires If • permit is not obtained within 180 days
after it has been accepted as complete.
"Foe methodology set by Tri Cocmty Building Industry Service Board.
I.\ Buitdi ,ueremicsll'LMU- Pa!smAup,duc i(Yailln 44l►4(IM1r(Ie4f)rv&MlwsK)
Z d IscveZ80E6' /IP:B '1S /IP:e Z 10 Sl AON (f)Hl) 6u dN HOdd