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Permit (48) p CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit#: PLM2016-00050 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/03/2016 Parcel: 2S110DB90982 Jurisdiction: Tigard Site address: 15435 SW 114TH CT 98 Project: Cook Subdivision:FAINS AT SUMMERFIELD CONDO-PH/ Lot: 98 Project Description: Remodel master bath and main bath:(2)lays,(1)tub/shower,(1)shower pan&(2)water closets. Contractor: ACKERMAN PLUMBING Owner: COOK, PAIGE JANES REVOCABLE TRUS 7493 SE OVERLAND ST STE A 15435 SW 114TH CT UNIT 98 MILWAUKIE, OR 97222 TIGARD, OR 97224 PHONE: 503-698-2211 PHONE: 913-488-6703 FAX: FEES Quantity Description Date Amount 2 ea Lavatories 02/03/2016 $50.04 Specifics: 2 ea Tub/Shower/Shower Pan 02/03/2016 $25.02 2 ea Water Closet 02/03/2016 $50.04 Type of Use: SFA 1 12%State Surcharge- 02/03/2016 $15.01 Class of Work: ALT Plumbing Type of Const: Occupancy Grp: Stories: Total $140.11 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 OUNC by calling 503.232.1987 or 1.800.332.2344. Is ued By: Permittee Signature: L V 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. i Plumbing Permit Applijk �' 1 Building Fixtures City of Tigard Received q e f Date/By: �' •7 �y,�j Permit No.:P[,K'0 r(Q't � ■ 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax g Date/ By: Other Permit No.: y� p Inspection Line: 503.639.4 7 01' �i t;�Kl) Date Ready/By: Ju is: 0 See Page 2 for Internet: www.tigard-or Notified/Method: Supplemental Information ZYPY r .r ❑Demolition FEE' SCHEDULE New construction i For special In ormairon use checklist ®Addition/alteration/replacement ❑Other: Description I Qty. I Ea. I Total CATEGORY OF CONSTRUCTION New I-2-family dwellings(includes 100 ft.for each utility connection) ® 1-and 2-family dwelling ❑Commercial/industrial SFR(1)bath 312.70 SFR(2)bath 437.78 ElAccessory building ❑Multi-family SFR(3)bath 500.32 ❑Master builder ❑Other: Each additional bath/kitchen 25.02 JOB SITE INFORMATION AND LOCATION Fire sprinkler(_sq.ft.) Page 2 Job site address:15435 Sw 114th Ct Site utilities: Catch basin or area drain 18.76 City/State/ZIP:Tigard,Or. 97223 Drywell,leach line,or trench drain 18.76 Suite/bldg./apt.no.:Unit Project name: Footing drain(no.linear ft.: Page 2 Cross street/directions to job site:Summerfield and Sw 114th Ct Manufactured home utilities 50.03 Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: Page 2 Storm sewer(no.linear ft.:__j Page 2 Subdivision:Fountains @ Summerfield Lot no.: Water service(no.linear ft.:_) Page 2 Tax map/parcel no.: Fixture or item: DESCRIPTION OF WORK Backflow preventer 31.27 Backwater valve 12.51 Clothes washer 25.02 Remodel master and main bathroom Dishwasher 25.02 Drinking fountain 25.02 PROPERTY OWNER ❑ TENANT Ejectors/sump 25.02 Name:Paige J Cook Revocanle Trust Expansion tank 12.51 Fixturelsewer cap 25.02 Address:15435 Sw 114th Ct Floor drain/floor sink/hub 25.02 City/State(ZIP:Tigard,Or.97223 Garbage disposal 25.02 Phone:(913)488-6703 Fax:( ) Hose bib 25.02 © APPLICANT I ❑ CONTACT PERSON Ice maker 12.51 Business name: S�-RAl kg:n (' C-04 ' n Interceptor/grease trap 25.02 Medical gas(value:$ ) Page 2 Contact name: M O f r� Primer 12.51 Address: l 0'3 ((P %orfzvg 1Mi L. A G Roof drain(commercial) 12.51 City/StateIZIP: t,�gS (- In 2 Sink/basin/lavatory 2 25.02 50.04 Phone:(j03) S/Cf `Sq(P 3 Fax;;( ) Solar units(potable water) 62.54 E-mail: (- Tub/shower/shower pan 2 12.51 25.02 YYn �r r U CONTRACTOR rinal 25.02Water closet 2 25.02 50.04 Business name: G 45-on L �i eS v 1 Com. S Water heater 37.52 Address:71491 S F_ 0%)e-Y lc,. S tt- _ Water piping/DWV 56.29 City/State/ZIP: ► woj,,1�i �Q 3- Other: 25.02 Phone:�(� ) -� Fax; (J ) $ - `066 Subtotal 125.10 Minimum permit fee: $72.50 CCBLic.: 3 �j� Pl bing Lic.no.: q; Plan review (25%of permit fee) Authorized signature: State surcharge(12%of permit fee) / O Print name: f o r�� Dater-)_- TOTAL PERMIT FEE I:lBuildinglPvmitstPLMU-PamitApp.doc 10/01/09 440-4616T(1QWtC0M/WEB)