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Permit CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit #: PLM2013 -00035 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/31/2013 Parcel: 1S136DC04400 Jurisdiction: Tigard Site address: 11945 SW 70TH AVE Project: TVF & R Subdivision: FRUITLAND ACRES Lot: 31 Project Description: Repair 200' of water service. Contractor: RELIANT PLUMBING & MECHANICAL Owner: TUALATIN VALLEY FIRE & RESCUE 11575 SW PACIFIC HWY SUITE 219 11945 SW 70TH AVE TIGARD, OR 97223 TIGARD, OR 97223 PHONE: 503 - 246 -1201 PHONE: FAX: 503 - 246 -1205 FEES Quantity Description Date Amount 200 If Water Service 01/31/2013 $100.06 Specifics: 1 12% State Surcharge - 01/31/2013 $12.01 Plumbing Type of Use: COM Class of Work: OTR Type of Const: Occupancy Grp: Stories: Total $112.07 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: Onr 1.9- 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. 31. 2013 10:44AM Relient Plumbing and Mechanical No. 7151 P. 2 Plumbing Permit Application Site Utilities Fon 01/11(1: IiSP: ()NIA' JAN 3 1 2013 Received of Tigard Date/By: /3j ,, 41474-- PermitNoA e? 0/ 0 002. E v 13125 SW Hall Blvd., Tigard, OR 97223 rr ITY OF TIG ' ' I Plan Rev/Dy: ie v Phone: 503.718.2439 Fax: 503.598.1 60' Other Permit No.: ,�!p l TIC R r Inspection io li no: 503 UILDING DIVES! I � Idle Re ady /By: 7>,r' BI See Page 2 far Internet: www.tigard- or,gov Notified/Method: ' • Supplemental information - =_ - - ❑ Now construction 0 Demolition For special information nse checklist. Description I Qty. 1 Ea. I Total ® Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) -- e- 1 47P , 53!1;?!eio 7r(e1} ∎fV ;1 -. SFR(1)bath 312.70 ❑ 1- and 2-family dwelling ® Commercial/industrial SFR (2) bath 437.78 • SFR (3) bath 500.32 ❑ Accessory building ❑ Multi-family Each additional bath/kitchen 25.02 ❑ Master builder 0 Other: Fire sprinkler ( sq. ft.) Paget -- - - Je) 36T Il l:1 - 61∎1 r.b 10AdYL1 .8f0):I Site utilities: to Catch basin or area drain 18.76 Job site address: 11945 SW 70 Ave City/State/ZIP: Tigard, OR 97223 Drywall, leach line, or trench drain 18.76 Footing drain (no. linear ft.: ) Page 2 Suite/bldg.apt. no.: - I Project name: TVFR Manufactured home utilities 50.03 Cross street/directions to job sie: SW 70 Ave / SW Dartmouth St 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.: j 2 Page 2 100.06 Subdivision: Lot no.: Fixture or Item: Tax map/parcel no.: Backflow preventer 31.27 - ..__...... _... ...._,......._:.. ... ...:. .:........._ :........._.._.............. Backwater valve 12.51 someg ....7.•.•717217=112...„ ad Clothes washer 25.02 Emergency repair /replacement to water service line Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump I I 25.02 ;!..; dt!Li):]_f:9d'Fr. ? /:lAIt = - - -- :.__ itkl, , r : Expansion tank 12.51 Name: Tualatin Valley Fire & Rescue Fixture/s ewer cap 25.02 Address: 11945 3W 70 Ave Floor drain/floor sink/hub 25.02 Garbage disposal 25.02 City /State /ZIP: Tigard, OR 97223 Hose bib 25.02 Phone: (503)209 -7312 pax: ( ) 1ce'nurker 12.51 4r7a]7�LlfE ?l, - f7 = iiijalii7:xr1EI.;)1iK(t)4 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/lavatoly 25.02 City/State/ZIP: Tigard, OR 97223 Solar units (potable water) 62.54 Phone: (503) 246 -1201 I Fax: : (503) 246 -1205 Tub /shower /shower pan 12.51 E- mail: andrew©rellantplumbing.com Urinal 25.02 - Water closet 25.02 Water _- .,.,.:�..:;_.... --- _ .......... ...,.., ................ ...... Wat heater 37.52 Business name: Reliant Plumbing & Mechanical, Inc. " War r i p p ug/bW'V 56.29 Address: Other: 25.02 C' /State/Z1P: Subtotal 100.06 hone: ( ) Fax: ( ) Minimum permit fee: $72.50 Plan review (25% of permit fee) CCB Lie.: 169844 Plumbing Lic. no.: P)3117 State surcharge (12% of permit fee) 12.01 Authorized signature: miLQ p TOTAL PERMIT FRE 112.07 '"--- Print name: Suzanne Postllla Date: 01/31/13 I This permit application expires If a permit is not obleined within 180 days after It has been accepted as complete. *Fee methodology set by 'Fri-County Building industry Service Bourd. 1:1fuilding1Permn2\PLMU- PermiiApp•dee 10/01/09 440.46 I6T(10/02/COM/WEB) Jan. 31. 2013 10:44AM Rel ient Plumbing and Mechanical No. 7151 P. 1 • � eiiant 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 #RELUAPM928DG FAX • To' & ' / 7 as From: 't ' h e-- (�n � lul�g Cover). . Phone: (6CO).598 .--/960 Date: ! /3 Re' `pi /J . a?" ." /Y 1.'. • v/ 1! • �Y /.J.Qh/:,i.r.. ry C•Cr. .. . } , . .. ..< • figq5 SW 70 • • • • •