Permit Support Document CITY OF TIGARD PLUMBING PERMIT
• COMMUNITY DEVELOPMENT
Permit#: PLM2020-00213
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TIGARD13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 5/22/2020
f iLLllSff�!!! Parcel: 2S103BC03200
FiLAl tf'7+7 6,j. Jurisdiction: Tigard
Site address: 12270 SW ALBERTA ST
Project: Gilchrist-pink house Subdivision: CANOGA PARK Lot: 6
Project Description: hall bath.mstr bath remodel. 6/30/20:REPRINTED permit to include(1)kitchen sink.
Contractor: VENNE PLUMBING LLC Owner: GILCHRIST
15145 SW DIVISION ST 12270 SW ALBERTA ST
SHERWOOD, OR 97140 TIGARD, OR 97223
PHONE: 503-624-9309 PHONE:
FAX: 503-684-0940
FEES
Quantity Description Date Amount
2 ea Lavatories 05/22/2020 $50.04
Specifics: 2 ea Tub/Shower/Shower Pan 05/22/2020 $25.02
2 ea Water Closet 05/22/2020 $50.04
Type of Use: SF 1 12%State Surcharge- 05/22/2020 $15.01
Class of Work: ALT Plumbing
Type of Const: 0 12%State Surcharge- 07/13/2020 $3.00
Plumbing
Occupancy Grp: ea Sink 07/13/2020 $25.02
Stories:
Total $168.13
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 1.80 4.
Issued By: / ittee Signature:
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.
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Plumbing Permit Appliat 3 , !9
BuildingFixtures i tilt (11 t I( 1 1 NItt'.Ia
JUnf 8 2020Rec�
City of Tigard M TtrvM
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III13125 SW Hall Blvd.,Tigard,OR 9722 1 ---------
■ Phone: 503.7182439 i' 503.598.1 X•I� ' J 1:1211rtview later Penme No
lnspedion Line: 503.634.419.5--- rate Read e6 new 0 Sae► 2 tor
1 It,Ai U Intend www li anlor 1101 NoIf,OcVMCtlkbd lot larumattee
e_
ix Ft tit 31-01t.. 3 , s i ad
❑New construction ❑Demolition F'ars{rr f i.Vin stadan toe cher_/iet
x� ....._... -_ 13c&enpnon 1 Oty..T Ea. �._ Total
j,1rAddttlon'altcration rip la anent J 0 Other New 1-2datnlly dweMags(includes 100 ft,for each utility cwam..nrant
IAlitOR�.......—_ ._....__ g�3
1 Y OF CONS 4gucrioN T �Si( SFR(13 bolo _ 3T2..70 i
I-and 2-faintly dwelling �., SFR(2)bath _ 437.78 ..� —`
r ❑Commerciavuniustrial
LJ Accessory building El Multi-family
SFR(3)bath v .�500,32
Eadt additional baUthitchen • 25,02
D Muster builder El Other Fire sprinkles( sq.ft,) Page 2
v ._ Site aunties:
Job site address: \`) 27tee Cu) .. -�"Ti Catch basin or arco drain 18.76
DlyCity/State/ZIP: "'�'� &`js,go O` f"�-1•'' Footing
tl4 railean(no.l or trench lama age 2
t � "1 C..!-' Fauting drain(tm,linear ff.:_) Page 2
Suite/bldg./apt.no.: Project name:
Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain o nnector _ 18.76
Sanitary sewer(no.linear(1__) Page 2
Storm sewer(no.linear it:_) Page 2
Water service(no.linear ft.:•,__) Page 2
Subdivision: ,.Lot no.: Fixture or item:
Tax map parcel no.: Backflowprevcntcr 3127
�_._ ._ .. Baekwaier valve 12.51
DF 5C RIPTT()\ OF WORK
Clothes washer 25.02
PC ►-(\ G ' TUYtE: --10 �lC tS'TVL)(-1 47eleMI'1 Dishwasher ' 25.02
) 1 , l /( fit.— /jLW pr Dr
, , - inking fountain 25.02
L M ( �
// Ejectors/sump 25.02
t-g " t'q 'ff 0' •'1•Er t 'i ",'. Expa°siontank 12.51
?soma,. Fixture/sewer cap 25.02
Floor draineftaor sink/hub 23.02
Address. Garbage disposal 25.02
City/State/ZIY Hose bib 25.02
Phone:t I Fax'( ) Ice maker 12.51
(] APPLICANT 0 CONTACT PERSON """ tntercePnor/graze trap 25.02
�.�..--- - --- Medical gas(value:$_) Page 2
Business earn:
- Primer 12.51
C60tact°°II1C' Roof drain(commercial) 12.51
Address: Sink/basin/lavatory / 25.02 ZS t72,4,
City/StaterZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shover/shower pan 12.51
_. Urinal 25.02
E-mail:
} ) sg s+.r z .ter m Water chisel 25.02
i ;.1;is,: 1 . » Water heater 3752
Business name '
{{1,, (� �)F,� Water piping/D V 5629
Address: tl�� e CW 1J,V tc �j W� + Other: 25.02
City/State/21P: 4kPe LIMO") i Ci J Iii0 Subtotal
Phone:( ) Fax:( ) Minimum permit fee: $72.50
I'ye� Plan review (25%of permit fee)
CCB Lie.: ��Z Plumbing Lie.no.: State surcharge(12%ofpermit fee)
Authorized signal
TOTAL PERMIT FEE
Print name: L ( .. f, * 41j - Date: r. )/>;'y�� This permit application expires if permit N oo1 obtained within lab days
7 t `l.11. �i [wi+t' after it has been accepted as toogrkte.
*Fee methodology set by Id-County Holding industry Service host&
Ia9u(dnsanm srPLMU-Youm, de tael.4$ 440.4616T(I0918C)MIWFa)