Permit CITY OF TIGARD PLUMBING PERMIT
`I COMMUNITY DEVELOPMENT Permit #: PLM2013 -00016
Date Issued: 01/10/2013
T [ GARD: 13125 SW Hall Blvd., Tigard OR 97223 503 718.2439 Parcel: 1 S135DB05600
Jurisdiction: Tigard
Site address: 11400 SW 95TH AVE
Project: Virtue Subdivision: MILLER Lot: 9
Project Description: Water for (1) Dishwasher, (1) garbage disposal, (1) ice maker, (1) sink (2)InstHot/Potfill
Contractor: RELIANT PLUMBING & MECHANICAL Owner: VIRTUE, LISA R
11575 SW PACIFIC HWY SUITE 219 GALINAT, RAYMOND A
TIGARD, OR 97223 11400 SW 95TH AVE
TIGARD, OR 97223
PHONE' 503-246-1201 PHONE: 503 - 883 -3873
FAX: 503 - 246 -1205
FEES
Quantity Description Date Amount
1 ea Dishwasher 01/10/2013 $25 02
Specifics: 1 ea Garbage Disposal 01/10/2013 $25 02
1 ea Ice Maker 01/10/2013 $12 51
Type of Use: SF 1 ea Sink 01/10/2013 $25 02
Class of Work: ALT 50 Misc Other Fee 01/10/2013 $50 04
Type of Const: 1 12% State Surcharge - 01/10/2013 $16 51
Occupancy Grp: Plumbing
Stories:
Total $154 12
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. :y obt. • cop • - - rules
or direct questions to OUNC by calling 503 232 1987 or 1 800.332.2344. - / /
■10111.: LAP I�
Issued By: l I / / n I/) / /1, ',r� Permittee Signature: '�
/ ll�� CC..
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.
Jan, 10. 2013 12:15PM Re1ient Plumbing and Mechanical No. 7035 P. 2
Plumbing Permit ApplieatioR
Site Utilities 1 I{,a�/I�� A c. FOR OFFICE USE ONLY
1.111 City of Tigard JAN 10 2013 Date/By: ( ( / 3 sty Permit No.: Poi 008 - 00.)I40
q 13125 SW Mall Blvd,, Tigard, OR 97223 Flan Review
R Phone; 503.718,2439 Fax: 503.598. Other Permit No.:
V II OF TIGARD Date/13y;
r I i , ,1 R r) hlspection Line: 50 Data Ready/By; / 1B See Page 2 for
Internet: www.tigard- or.gov BUILDING DIVIS IN Notified/Merhod, ra+ge� _ 1 I 0 Sup ' lementet Information
- - 1Ht49t.. '11 "v,:(/ `7�. Cam-__ _ -- -'I i ,t ;Zi0_910111 = --- ----
❑ New construction ❑ Demolition For special Information use checklist
Description I Ow. I Ea. I Total
® Addition/alteralion/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
- - =a _ur:2 ) ;a` I) : -r i ;L'L PPi .Isnl t -- _ ._ SFR( 312.70
1- and 2-family dwelling y g 0 ConimcrciaUindustrial SFR (2) bath 437.78
❑ Accessory building ❑ Multi - family SPR (3) bath 500.32
Each additional bath /kitchen 25.02
❑ Master builder ❑ Other:
- _.. Firs sprinkler (�_ sq. ft.) Page 2
-- ;111) :Ffii Nr.� r �
11:I iTl oJ r/ 2 111 - listc,1:0(') _ _i Site utilities:
Job site address: 11400 SW 95 Ave Catch basin or area drain 18.76
Dryweli, leach line, or trench drain 18.76
City/ State/ZIP: Tigard, OR 97223 Footing drain (no. linear ft.: ) Page 2
Suitc/bldg. /apt- no.: I Project name: Virtue Manufactured home utilities 50.03
Cross street /directions to job she: SW 95'" Ave / SW Orecnburg Rd 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:
Tax map /parcel no.: Backflow pieventer 31.27
- Backwater valve 12.51
:17D! (cia1.it(,) ;i( !o 1
- -�. I Clothes washer 25.02
Water for 6 fixtures Dishwasher 1 25.02 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
��- II,(gJA;liiat(g)` 4`I�I;t 1(6 1�= 41:',0Z0i= - Expansion tank 12.51
Name; Lisa Virtue V Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 11400 SW 951 "Ave Garbage disposal 1 25.02 25.02
City /State/ZIP: Tigard, OR 97223
Hose bib 25.02
Phone: (503)883 -3873 Fax: ( ) Ice maker 1 12.51 12.51
... _.: : - J- 1 1(r ks _ 1 ?RP - Esl y, .1 Interceptor /grease trap 25.02
Business name: Reliant Plumbing & Mechanical, Inc. Medical gas (value: $ ) Page 2
Primer 12.51
Contact name: Andrew Bourke
Roof drain (commercial) 12.51
Address: 11575 SW Pacific Hwy, #219
Sink/basin/lavatory 1 25.02 25.02
City/State /ZIP: Tigard, OR 97223 Solar units (potable water) 62.54
Phone: (503) 246 -1201 Fax: : (503) 246 -1205 Tub/showerlshowerpan 12.51
E -mail: andrew@rellantplumbing.com Urinal 25.02
r Water closet 25.02 • L::..: - • Water heater 37.52
Business name: Reliant Plumbing & Mechanical, Inc. Waterpiping/DWV 56.29
Address; Other: InstHot/Polf& 2 25.02 50.04
City/State /ZIP: Subtotal 137.61
Phone: ( ) Fax ( ) Minimum permit fee: $72.50
CCB Lie.: 169844 , P ' , t ic.� PB117
Plan review (25% of permit Fee)
i .- Statesurcharge(12 %ofpemdt 16.52
Authorized signal A�arg. TOTAL PERMIT FEE 154.13
Print name: Andrew O
�r Thl1 permit application expires If a permit is not obtained within 180 days
urke Date: 01/10/13 after It has been accepted as complete.
*Fee methodology set by Tot -County Building Industry Service Board.
i. muita <ogieermua1PLhril- PcrmlApp.me 10101/09 440- 4616T110/02/COMnvE13) 1 S 1 l
Jan. 10. 2013 12:15PM Relient Plumbing and Mechanical No. 7035 P. 1 • � eziant
PLUMBING & MECHANICAL, INC.
11575 SW Pacific Hwy, Suite 219 Tigard, Oregon 97223 (503) 246 -1201 Office (503) 246 -1205 fax
-
CCB #169844 MBE #4738 WA #RELIAPM928DG
- FAX
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Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11400 SW 95TH AVE, TIGARD, OR, 97223
Residential - Plumbing
399 Plumbing final
03/20/2013 00:00
PLM2013-00016
PASS - No C of O
Violation Summary:
Inspector Contractor