Permit •
�, CITY OF TIGARD PLUMBING PERMIT
�1 a • COMMUNITY DEVELOPMENT Permit #: PLM2013 -00038 •
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/04/2013
Parcel: 2S 104C D02300
Jurisdiction: Tigard
Site address: 13698 SW HILLSHIRE DR
Project: Ping Subdivision: HILLSHIRE ESTATES Lot: 23
Project Description: (2) backwater valve: (1) clothes washer; (1) dishwasher and (1) sink
Contractor: MARXMEN PLUMBING & CONSTRUCTION INC Owner: PING, VANLOEUN
9665 SW 163RD AVE 13698 SW HILLSHIRE DR
BEAVERTON, OR 97007 TIGARD, OR 97223
PHONE: 503 - 579 -2200 PHONE: 503-560-6596
FAX:
FEES
Quantity Description Date Amount
2 ea Backwater Valve 02/04/2013 $25.02
Specifics: 1 ea Clothes Washer 02/04/2013 $25.02
1 ea Dishwasher 02/04/2013 $25.02
Type of Use: SF 1 12% State Surcharge - 02/04/2013 $12.01
Class of Work: ALT Plumbing
Type of Const: 1 ea Sink 02/04/2013 $25.02
Occupancy Grp:
Stories:
Total $112.09
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..2 or 1.800.332.2344.
Issued By: `�d'�.Q.GCJt Permittee Signature: Al D r[. ( � 1 /i C
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.
04/04 2013 06:21 5035792201 MARXMEN #2313 P.002/002
Plumbing Permit Application RECEIVE 1
1,
Building Fixtures r-,,R O► ! R ►: ► S!: (�N►.,
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City of Tigard F F B 4 1013 1 R 9-I y 13 W Pconit No.: P4t•( 9I 3 - vcZ.)-
13125 SW Hall Blvd Tigard, OR 97223
InanReimve
Phone: 503.718.2/139 Fax 503.598.1 TYOFTIGARD • > : other Permit No.:
n ; ; Inspection Line: 503.639.4175 Date Ready/1ty: El See Po 2 rot
(ntemct: www.tigard-or.gov BUILDING DIVISIO �: tkomiesseutal tnformauan
4 .i,:. ham' bT: 7 . Yd A ± : 4 1 V , T.: ";v ' f , F`�C^Y`v,iiaTr. ` .t. - z. ','• 3 ,y
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� � ��as .ik:1�z�•. ,4"4: Y'r•7!,- x,:+,��. G` -� I AH � '�), :k1 %: . T�l . a; :• , _ \'??i' cY.�.�lrE Tiktw ` ,:.. •e.. •04?� :•�uT.. f`
❑ New construction ❑ Demolition . ,;. Foe special information use cheeldiht
® Addition /altcration/replaocmcnt El Other: Qty. � Ea_ t'utat
New 1- 2-family dw (includes 100 tl for each utility connection)
' i ,v .,n me ,,y -. •d.+:rl�a+Y+l. "f Y , �' '7.Z �•r27: r..s0 :N,Int
:A t .y • ' , 2:' , ).' 're;w� J-4 SFR(1)bath 31270
sx
0 1- 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
r. r - ._ n .. c `43 "S- �,' �e'ta�� -•;7i nyi 1'IiE sprinkler sq. 1l) I Page 2
•
+e' n Av , '�? .
)'- `._: .. = 1 . -.' , .s 4 f:F?: p r.'�-• , : sit e thni cs:
Job site address: 13698 SW Billshire Dr. Catch basin our mra drain 18.76
City/State/Z1P: Tigard Dmvell, leach line, or trench drain 18.76
Footing drain (no. linear ft_: ) Page 2
Suite/bldgJapt no.: I Project name: Pin ' Manufactured home utilities 50.03
Cross street/directions to job site: Manholes I 1 &76
Rain drain connector 18.76
Sanitary sewer (no. linear ft: Page 2
Storm sewer (no. no= ft: ) Page 2
Water service (no. linear S: ) Page 2
Subdi vision: ILL,ot no.: - Fixtm a or item:
Tax map/parccl no.: Back pteventer 31.27
y4... Ry� ,
L.�l�A''s-tr! :n k,:t77 4-47 - A . ; „ ."4 •t'". Backwater 2 12.51 25.02
. r y iii . . `; ,s l?o& .,.,sr,' - :: 0 - v s-' ,.",V. r..ed%V.'t Clod= washer 1 25.02 25.02
ir of unlicensed work Dishwasher I 25.02 25.02
'Down stairs automatic washer rough -in
Drinking fountain 25.02
down stairs kitchen sink Ejectors/sump 25.02
Wt - r y •,.,- :::w4S 4.,. ..- .'"r, F Expansion taok I 12.51
Name: Vanloeun Ping Fixture /sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 13698 SW Hillshire Dr.
Garbage disposal 25.02
City/Stater tigard 97223 Hose bib 25.021' • -`
Phone: ( ) Fax:( ) lee maker 12.51
'" r s z" 1'::'c " fit',`:x '�`"`*- 1.77 -1(7 , .; ;-wfc I tor/
f .7 x t' M>.,.� • ,- Y . '• ^ s, - ". , u- n: P 1' stse trap 25:02
• - : 0a :.Win.: 1" Z li: i Ji` a! x. 3 ti_: ri. a ! ri imaa
Bu name: Maramen Plumbing and Construction Inc. gas (value $ ) Page 2
Primer 12.51
Contact name: Mark Snethen
Roof drain (commercial) 12.51
Addtets: 9665 sw 163 Ave Sink/basin/lavatory 25.02 25.02
_
City/StsterLIP: Beaverton 97007 Solar units (potable water) 62.54
Phone: (503 -) 579 -2200 I Fax: : (503 -) 579 -2201 Tub/shower/shower pan 12.51
E-mail: m_cm9ramen@gma3.com Urinal 25.02
"�., 70M X , ,M g r , ; •( �5'�oi' ^L'' "�. � Warr closet 25.02
7 ,a• jr + v r, a f t21∎• • WON healer 3752
t1' r? , ;Kin`�a� - ' ..v •.,? ° - ;1: -'• : s� 'cic'%}`.i.K1�,$'�w,'v��'��l�w
Business name: same Water pipineDW V 5629
5 -'
Address: Other. 25.02
City/State/7.1P: Subtotal
Phone: ( ) Fax: ) Minimum permit fix: $72.50 100.08
CCBtic.:1024,32 $1 P1 »».,i Lie - 161PS Plan review (2S%of permit fax)
State surcharge (12% of permit fee) 12.00
Authorized signature: r ,' TOTAL PERMIT FEE 112.08
I Ibie Psneir 2Pitheilinu *spurs ire perm* a oorobtaiaed within 180 days
Print name: Mark Suethen Date: 2-4-13 after h has ban accepted as complete
'Fee metbodoloty sct by TA-County Building Indsauy Service Board.
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