Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2013 -00191
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/18/2013
Parcel: 2S 111 CC08800
Jurisdiction: Tigard
Site address: 10110 SW SUMMERFIELD DR
Project: Callahan Subdivision: SUMMERFIELD NO.2 Lot: 115
Project Description: Install (1) clothes washer and (1) laundry sink.
Contractor: MP PLUMBING CO Owner: CALLAHAN, CATHY
PO BOX 393 10110 SW SUMMERFIELD DR
CLACKAMAS, OR 97015 TIGARD, OR 97224
PHONE: 503 - 655 -9161 PHONE:
FAX: 503 - 655 -1726
FEES
Quantity Description Date Amount
1 ea Clothes Washer 06/18/2013 $25.02
Specifics: 1 ea Laundry Tray 06/18/2013 • $25.02
1 12% State Surcharge - 06/18/2013 $8.70
Type of Use: SF Plumbing
Class of Work: ALT 22 ea Minimum Fee Adjustment - 06/18/2013 $22.46
Plumbing
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: c / �`� ` G �i�� � Permittee Signature: O � �� /_ G /e 9- _ /
G Call 503.639.4175 by 7:00 a.m. for the next available inspection date. , V
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.
•
FROM MP Plumbing (HON) JUN 17 2013 10: 15/ST.10: 14/No.8308284728 P 2
Plumbing Permit Application DECEIVED
Building Fixtures 1 ��:� FUR OFFF It 1•: 1 ` O\I.1
City of Tigard JUN 17 2013 Date/By �� , - ' i f Perr No.: / 2 4/3 DD/
„{ 13125 SW Hall Blvd., Tigard, OR 97223 p v n Review
lea ' Phone: 503 718.2439 Fax: 503.598.1 0FTIGAR r)atcitly: Other Permit No.:
1 1 t I, I .
Inspection Line: 503.639.4175 D ate Read . 1 See Page 2 for
Internet: www.tigard-or.gov BUIL DING DNISIO NotifiedlMethod: B I ® 0 S , lemental Information
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❑ New construction CI Demolition For special lnfornwadon use ciYecklisi
DmeriEliurr Lgy. J Ea. } Total
® Addition/alteration/replacement ❑ Other: New 1 2 dwellings gir (includes 100 ft. fur each utility cuimexaiurr)
1
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ci i i` � " ,1' � �} r n W "k > �' ,,:3ras ` ,a i r 1 r1 X 31?I4 7 31: " t.' eli? il. z, ii..1k!!1 SFR(1) I 312.70
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® I - and 2 - family dwelling El Commercial/industrial SFR (2) bath 437.78
SFR (3) bath 500.32
❑ Accessor building ❑ Multi- family
Each additional bath/kitchat 25.02 •
❑ Master builder ❑ Other Fire spunkier (_ sq. ft.) I Page 2
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`""'Yn q.'1 :1,f �1 r r iN'A , 11 C t re c.' " plat {lt+,Ilr11Stit+� d73 ti �11ll lla'FI
.r;$iA gthAf. *.vr ,. . ,..- : rf {, it * k;y 1 1' tJ;,.�..,,,.i. site utilities!
Job site address: 10110 SUMMERFIELD DR Catch basin or area drain 18.76
ihywell, leach line, or trench drain 18.76
City /State/ZIP: TIGARD, OR 97224
Footing drain (no. linear ft.: ) Page 2
Suite/bldg./apt. no I Project name: S3368 CALLAHAN Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 1 8.76
Sanitary sewer (no. linear ft.: ) Page 2
- -- Storm sewer (no, linear ft.: ) Page 2
Water service (no. linear ft.:) Page 2
Subdivision: I Lot no.: Fixture or Item:
Tax map /parcel no.: Baekftuw prevenlrr • 31.27
f ,, ; u, ,, rs ,qI, r. r i ,> n 1 + , a7wr ream j is 3 r t r BaBackwater' valve 12.51
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:.J�,i. �ti - -x� era, yr�k9a 1s uti. ,,:I , rs.,raa . 1, I _ . �' Clothes washer I 25.02 25.02
ROUGH IN LAUNDRY TRAY AND AUTO WASHER
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
" 7e,` ;v m� �mrCry c k' as tilg, r.∎ r r i r t . Expansion tank 12,51
*- 1 h � r - r , fi ., r Fl Nry ri, ? l fir + i , y 1 1111, ttlfi 111 H
d. + �.�r�'�.(14w,wi..,lUF11" �iui "Ihr +rdtrv", -C+>W �7r.- �.1��°,.1'r ,,.- il.�fk�8i >r vG��iE9 �i14.r�7�!4f18V 1Pt'W1�t7r... �,�rt�i.Arh
Name: CATHY CALLAHAN Fixturc/scwercap 25.02
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
1 ii '. I tjl t } � : ITI en alt! p gla, 14 $ F 'su [i y i , . ,u, 4 + i ; ; F `
,r }I ; , i � Ti I t ega xi`f r�� rs'I .P-V4r 7 � "1 1 f 1 :' interceptor /grease trap 25.02
Business name: MP PLUMBING CO Medical gas (value: $ _ ) Page 2
Primer 12,51
Contact name: CINDY CRIVELLONE
Roof drain (commercial) 12.51
Address: PO BOX 393 Sink/basin/lavatory 1 25.02 25.02
City/State/ZIP: CLACKAMAS, OR 97015 Solar units (potable water) 62.54
Phone: (503) 655 -9161 I Fax: : ( 503) 655 -1726 Tub/shower /shower pan 12.51
E -mail: CINDYCOMPPLUMBING.COM Urinal 25.02
u i ,� 1 gr y
1 `)i .u"' l� c% v .rt dr ,,,v i 9 { g s_i r r 11, r; �r�ii Water closet 25.02
.n z... ... r.. r r . ..... .. +t;:L.exm . E. :,_> .y.. n b .4., r7.ti,. <4:zal.,M: S�-Iac . J l 1, Water heater 37.52
Business name: MP PLUMBING CO waterpiping/DWV - 56.29
Address: PO BOX 393 Other: 25.02
City / State/ZIP: CLACKAMAS, OR 97015 Subtotal 50.04
Phone: (503) 655 -9161 Fax: (503) 655 -1726 Minimum permit fee: $72.50 72.5
V Plan review (25% of permit fee)
CCB Lic.: 5002 Plumbing Lic. no.: 3 - 17PB
Slate surcharge (12% of permit tee) 8.70
Authorized signatwcL- I() rAL Ptumrt' FEE 81.20
Print name: CINDY CRIVELLONE Date: 6/17/13 This permit ap expires If a permit Is not obtained wttaln iao days
after It boa been accepted ere complete.
'Fee methodology set by i'ri•Counly Building Industry Service Board
1: utuildlntverwiu\PLMU- eermnapp .due 10101/09 440.4616'r(InmVCOnt)WEB)