Loading...
Permit (105) CITY OF TIGARD PLUMBING PERMIT 114 COMMUNITY DEVELOPMENT Permit#: PLM2016-00083 T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/22/2016 Parcel: 2S103AC08600 Jurisdiction: Tigard Site address: 12880 SW FONNER POND PL Project: EQUITY TRUST CO Subdivision: ON FONNER POND Lot: 4 Project Description: Replacing 25 ft.of sanitary sewer. Contractor: T C EXCAVATING INC Owner: EQUITY TRUST CO CUSTODIAN PO BOX 2471 FBO JONES, STANLEY IRA ESTACADA, OR 97023 3027 NW 160TH CT BEAVERTON, OR 97006 PHONE: 503-407-0503 PHONE: FAX: FEES Quantity Description Date Amount 25 If Sanitary Sewer 02/22/2016 $62.54 Specifics: 1 12%State Surcharge- 02/22/2016 $8.70 Plumbing Type of Use: SF 10 ea Minimum Fee Adjustment- 02/22/2016 $9.96 Plumbing Class of Work: ALT 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: e i tee-Signature: Call 503.639.4175 by 7:00 a.m.for the next available ins ction 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 Application Site Utilities ��� I (112 O I I I( I. ► .1 ()NI 1 Received City of Tigard �G�. Date/By: / /i& - PermitNo.:1114 lo 13125 SW Hall Blvd.,Tigard,OR 972plea Reew L V��V O I Phone: 503.718.2439 Fax: 503.598.1 60 QQ ��16 DateBy: Other Permit No.: I i t n It l) Inspection Line: 503.639.4175 l� -D `' 1 s.t ed/Method: : 1 ® See Page l for Internet: www.tigard-or.gov Oc Al.;,..11-1.,.. f�C ed/Met ..../.5 Supplemental tuformatiou TYPE QF wclxlc tiIQ� `�% nO".StitatiLE F ❑New construction ❑p For special information use checklist Description Qty. I Ea. I Total Addition/alteration/replacement 0 Other: PNew 1- -famt1 y dwellings(includes 100 ft.for each uti li connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 Pi ❑Accessory buildingSFR(3)bath 500.32 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: u) iD fine" 1 Poyid (>1 Catch basin or area drain 18.76 Job site address: 1�8 (� 5 City/State/ZIP: Drywell,leach line,or trench drain 18.76 1 y t"r Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:25) / Page 2 62-jz( 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 -R.-efkc E'- 25 Ct. DE 5`t rLt � C5.-t'.l- -T- Dishwasher 25.02 0/I . r©g-P� r Drinking fountain 25.02 't 7 Ejectors/sump 25.02 0 PROPERTY OWNER 1 0 TENANT Expansion tank 12.51 Fixture/sewer cap 25.02 Name: 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 Fir APPLICANT0 CONTACT PERSON Interceptor/grease trap 25.02 Business name:TL 4,U� Medical gas(value:$ ) Page 2 ab.6.,,\. (� c.- Primer 12.51 Contact name: (C Roof drain(commercial) 12.51 Address: P, 0 eoy. a t.( '7 I Sink/basin/lavatory 25.02 City/State/ZIP: 5i.0..�C ©(Z- 9 70 Solar units(potable water) 62.54 Phone:(5t 3) 6,-401,_ 5,S( ( Fax::( ) Tub/shower/shower pan 12.51 E-mail: .- QOCC t J,v�y�, e 6,„,,,,,,,,,I r C p, Urinal 25.02 . CONTRACTOR Water closet 25.02 Water heater 37.52 Business name: `TC tYCk_ (I4, w-)C Water in WV 56.29 J P.tPg� Address: p.p p x_ .,Ct 7 f Other. 25.02 City/State/ZIP: E ,c, ,(-Az/JS (2A 7 a a Subtotal (4/Jt/ Phone:(53 J) 6-it 1 _'I (c„5- Fax:( ) Minimum permit fee: $72.50 714. ,5D CCB Lic.: `sp 5/a'�- Plumbing Lic.no.: ?"6 1'3 Plan review (25%of permit fee) State surcharge(12%of permit fee) ?x1), � Authorized signature: - -- 7/1TOTAL PERMIT FEE `1x0 Print name: j etS�".._ tLJ it, 5 Date:y'L b.14 fr This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\PLMU-PermitApp.doe 10/01/09 440-4616T(l0/02/COM/WEB)