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Permit CITY OF TIGARD PLUMBING PERMIT S COMMUNITY DEVELOPMENT Permit #: PLM2013 00245 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/18/2013 Parcel: 2S 111 CC 17700 Jurisdiction: Tigard Site address: 10340 SW HIGHLAND DR Project: Opoka Subdivision: SUMMERFIELD NO.4 Lot: 228 Project Description: Repipe house, supply lines only. Contractor: ADVANCED PLUMBING LLC Owner. OPOKA, ROBERT T & JANET M PO BOX 593 10340 SW HIGHLAND DR PORTLAND, OR 97207 -0598 TIGARD, OR 97224 PHONE: 503 -241 -4945 PHONE: 503 684 -8473 FAX: 360- 571 -4188 FEES Quantity Description Date Amount 1 ea Water Piping /DWV 07/18/2013 $56.29 Specifics: 1 12% State Surcharge - 07/18/2013 $8.70 Plumbing Type of Use SF 16 ea Minimum Fee Adjustment - 07/18/2013 $16.21 Class of Work: ALT 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 N. ' . on - • -r. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or dir- questions to OU .. by call'. • 503.232.1987 or 1.800.332.2344. Issr4ed By: I • Permittee Signature: ' i 4 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. Plumbing Permit Applic `itfl . .. . Site Utilities FOR ° . _ • l I USI, .ON ^l.Y City of Tigard JUL 18 2013 Received N i I Permit etmt o.: ,y' III NI 1 3125 SW Hall Blvd., Tigard, OR 97223 Date/By: 7 / g" / 3 1 LJ' q )f -CN 2 �S Plan Review Other Permit No.: s Phone: 503.718.2439 Fax: 503fS TIGARD Date/By: Line: 503.639.4175 v Date Read B ru ®See Pa e 2 for T IGA Z D. Ready /By: g Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method: Supplemental Information TYPE OF WORK FEE' SCHEDULE ' ❑ Ne construction 0 Demolition For special information use checklist Description I Qty. I Ea. I Total Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 312.70 I- 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 ❑ Other: Fire sprinkler ( sq. ft.) Page 2 . JOB SITE INFORMATION 'AND LOCATION - . Site utilities: Job site address: I7 / 03 i J Y ' © St AJ 14 1 MIti ) 1v b Dr Catch basin or area drain 18.76 Drywell, leach line, or trench drain 18.76 City/State /ZIP: I I s w r 3 /)2 7 2 2 Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: Project name: nplrr� kA Manufactured home utilities 50.03 Cross street/directions to job site: f ' ) 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: I Lot no.: Fixture or item: Tax map /parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Re ?UV n i t') -1 r c Ur w itl4 P.1 ti A � , k Dishwasher 25.02 --(6 r It Vi) Drinking fountain 25.02 �� Ejectors/sump 25.02 Ly PROPERTY OWNER � I ❑ TENANT Expansion tank 12.51 ame: f 9 3 / 0 C A I' i 1^ l t ,` ,fig /) Fixture /sewer cap 25.02 j" J H /'11V 1 '\ ¢Yj Floor drain/floor sink/hub 25.02 Address: b 4_ Sim ©4Q ' \ Garbage disposal 25.02 City/State/ZIP: T ' rd ��..,, ©]e 11727-Li Hose bib 25.02 Phone: (S01 4 L - iJ 1 1 7 Fax: ( ) Ice maker 12.51 ❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02 Business name: Medical gas (value: $ ) Page 2 Contact name: SeT'.--- ADVANCED PLUMBING LLC Primer 12.51 r.O. BOX 503 Roof drain (commercial) 12.51 Address: PORTLAND, OR 97207 WWADVANCEDPLUMBING.NEf Sink /basin/lavatory 25.02 W City /State /ZIP: /� 1 J Solar units (potable water) 62.54 Phone: ($0 7 I r 47 Fax: /' S 7/ - 9 /V% _ Tub/shower/shower pan 12.51 E -mail: it Urinal 25.02 Water closet 25.02 ' CONTRACTOR ' Water heater 37.52 Business name: ADVANCED PLUMBING LLC II'.V. IiUX 553 Water piping/DWV / 56.29 5621 Address: PORTLAND, OR 97207 Other: 25.02 City/ State /ZIP: WWW.ADVANCEDPLUMBING.NET Subtotal 56 a 7 Phone: (503) Z L ( 4./11s- Fax: s 7/ 4` /e9 Minimum permit fee: $72.50 72. 5° CCB Lic.: , i Plumbing Lic. no.: 36 7 Plan review (25% of permit fee) v State surcharge (12% of permit fee) 5 Authorized signature: L -; TOTAL P ERMIT FEE ir.,I / / L �. ` ., 81. Print name: j MI Cl/ / / , S1 f.'r Date: 7- t17 - / This permit application expires if a permit is not obtained within 180 days f after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. I:\Building\Permits\PLMU- PermitApp.doc 10/01/09 440-4616T(10 /02JCOM/WEB)