Permit r ,� CITY OF TIGARD PLUMBING PERMIT
1 ,,, a COMMUNITY DEVELOPMENT Permit #: PLM2013 -00004
Date Issued: 2013
01/03/
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 01/ 2S109AB10400
Jurisdiction: Tigard
Site address: 13113 SW WILMINGTON LN
Project: Philpott Subdivision: RAVEN RIDGE Lot: 33
Project Description: Install new shower pan.
Contractor: CLEARWATER PLUMBING LLC Owner: PHILPOTT, CLAIRE
11755 SE HOLGATE 13113 SW WILMINGTON LN
PORTLAND, OR 97266 TIGARD, OR 97224
PHONE: 503 - 935 -0918 PHONE:
FAX: 503 - 761 -2143
FEES
Quantity Description Date Amount
1 ea Tub /Shower /Shower Pan 01/03/2013 $12.51
Specifics: 1 12% State Surcharge - 01/03/2013 $8.70
Plumbing
Type of Use: SF 60 ea Minimum Fee Adjustment - 01/03/2013 $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: D� :" / e� j7,/t/
_ 4 ( .4 4 71(.21..____
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.
01/03/2013 11:51AM 50376121443 PAGE 01/02
Plumbing Permit ,A.pplicatidl?FI• EIVED
Site Utilities JAN 0 3 2013•
City of Tigard �
n /� � , VBd / 3 /3 t N y ozi
Perm tot,is �D00Y
:
13125 SW Hall Blvd, Tigard, OR a OFTIGARD Plan Review Other Pt that Flo.:
I Phone: 503318.2439 Fax: 5 1 Date/By:
Inspection Line: 503.639.4175 `�G DIVISION
1 A It 1) Date Rea lutir 1g See rage I fir
ilrtentet: www.tigard-or.gov Notified/Method: 1 Sa _plemestal Ioforoatioa
,. T•Y*R.;:OF'Wf(O . FEE' SC )1J11
❑ New construction ❑ Demolition For special informnwlon checklist:
Description Qtv. I Ea. i Total
Eg Addltiontalterationheplacement ❑ Other New 1.2 dwellings (includes 100 R for each utility connection
• •
.... ... 7 .. . .. C14Et;01if.1' Of ,C.ONBTHiJei'ION . • • ,.... ' !'; `.,; , ,-.. ::. •.':• SFR (1) bath
isi 1- and 2 family dwelling ❑ Commercial /industrial SFR ) bath 43738
-- SFR (3) bath 500.32
❑ Accessory building ❑ Multi - family _SFR
additional bath/kitchen 25.02
❑ Mdstel' builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2
•', = • °a.'..iOla:$h1' INF0RMsenels ATli . tiWCAlWtI Site utilities:
Job site address; 13113 sw wilmington la. Catch basin or area drain 18.76
- Drywell, leach line, or trench drain 18.76
City /State/ZIP: tigard or.. 97224
Footing drain (no. linear ft.: Page 2
Suitt/bldg./apt no.; I Project name: Manufactured home utilities 50.03
Cross street/directions to job site Manholes 18.76
Rain drain connector I 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:
Tax map /parcel no.: Backflow preventet 3127
DE9Cit>[ETTt714.0g; WORK
Backwater valve 12.51
• - Clothes washer 25 -02
new shower pan
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump w 25.02 • IPRO1PEJO R :•,<...- : :i i Expansion tank 12.51 •
Name: P///4/°07-7"---
L /°0T� Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address; _ Garbage disposal 25.02
City /StaIe/Z1P: _ Hose bib 25.02
Phone; ( ) Fax: ( ) Ice maker 12.51
d • APFI:iCANi , '.`CCK'tthr PERSON intercep /grease trap 25 -02
Business name: ClearWater Plumbing Ile. Medical gas (value: S , ) Page 2
- --�-^^ - Primer 12.51
Contact name: gary townsend
-
Roof drain (commercial) 12.51
Address: 11755 se holgate Sink/basin/lavatory 1 25.02
City/State/ZIP: portland or. 97266 Solar units (potable water) 62.54
Phone: (503) 935 0918 Fax: : (503 ) 761 2143 Tub /shower /shower pan 1 12.51
E - mail: Urinal 25.02
Water closet 25.02
-�_ CO ' . . . . . Water heater 37.52
Business name: ClearWater Plumbing llc. Water piping/DWV 56.29 _
Address: 11755 se holgate Other: I 25.02
City /State /ZIP: portland or. Subtotal
one: (503) 935 0918 -V/ y Fax: (503) 761 2143 Minimum permit fee: S72.50 7.Z SO
CCB Lie.: 180730 a / l / / Plumbing l,ic. no.: pb554 J%/ �y
Plan review (25 %of permit fee)
State surcharge (12% of permit fee) f ,10 P Authorized signature: TOTAL PERMIT FEE , to
Print name: gary townsend Date; 1/3/13 This permit application expires if a permit is not obtained within 180 days
after it bus been accepted as complete.
+Fee methodology set by Tri-County Building Industry Service Board.
1: 1BuildieglPumits1P1 ,MU.PemHApp.doe 10/Ot/09 440- 40) oT(}O/02/COM/WID)