Permit Support Document CITY OF TIGARD PLUMBING PERMIT
IN COMMUNITY DEVELOPMENT Permit#: PLM2020-00135
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 7 Z7 Date Issued: 3/31/2020
TIGARD 9 Parcel: 2S102CB06801
Jurisdiction: Tigard
Site address: 10475 SW PARK ST
Project: ABM Remodel Subdivision: 1992-092 PARTITION PLAT Lot: 1
Project Description: ROUGH IN ONLY for master bath,hall bath and kitchen remodel. 7/27/20: REPRINTED permit to change
contractor to owner installation.
Contractor: OWNER Owner: J&E HOME SOLUTIONS LLC
13301 SW 128TH PL
TIGARD,OR 97223
PHONE: PHONE:
FAX:
FEES
Quantity Description Date Amount
ea Clothes Washer 03/31/2020 $25.02
Specifics: 1 ea Hose Bib 03/31/2020 $25.02
1 ea Ice Maker 03/31/2020 $12.51
Type of Use: SF 4 ea Sink 03/31/2020 $100.08
Class of Work: ALT 2 ea Tub/Shower/Shower Pan 03/31/2020 $25.02
Type of Const: 2 ea Water Closet 03/31/2020 $50.04
Occupancy Grp: 1 ea Water Heater 03/31/2020 $37.52
Stories: 1 12%State Surcharge- 03/31/2020 S33.03
Plumbing
90 Investigation Fee 05/13/2020 $90.00
11 Investigation Plumbing 12% 05/13/2020 $10.80
State Surcharge
45 Misc Administration Fee 07/24/2020 $45.00
Total $454.04
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: ) f.03 Permittee 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.
Plumbing Permit AppliC C E I V E D
Building Fixtures JUL 16 2020
C' Of TigardReca.sd Permit No 13tts 5W Hall l _Ti(OtM,Qc�i��T2y3OF TIGARD ��B 7� '��U JT� - !M `
Phone: 303.718.2434 Fax:)5bQJ4 G DIVISION Plan Other Porno`a
Inspection Line: 503.639.4175 Data R .;^gr.: Jana ®See Pave 2 far
Internet: www.flgsed-or.gov T'wrl(Md'\tethad. 7 Supplme neat lnfamation
TYPE OF WORK FEE' SCHEDULE
Q New construction Demolition special information use chrekiid.
.te r I Description i Org. I Ea I Total
❑Additiomfalterati0Nreplacement IS3 rfir:•Ti..(3 k. rh,„.A."t} New t-2-family dwellings(includes 100 R.for each utility connection)
��/ CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
yQ 1-and 2-family dwellingSFR(2)bath A37.78
f 0 Conner(alrndusv ai
SFR(3)bed( 5W.32
Q Accessory building 0 Multi-family Each additional bath/kitchen 25.02
0 Master builder 0 Other: Fire sprinkler( sd.R) Page 2 •
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: r't:-' 75 Lc, 1- •-e. .)E Catch basin or area drain 18.76
/ Drywell.leach line,or trench drain 18.76 •
City/State/ZIP: )s "it�,i..ex . ` 4'1 r'�+) Footing drain(no.linear ft.:_) Page'_
Suite/bldg./apt.no.: I Project name: Manufactured home utilities 50.03
Cross strtxUdirectiors to jab site: ( .i-IC(' t'1.. Manholes 18.76
Rain drain connector 18.76 1
Sanitary sewer(no.linear fl.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: I Lot no.: Fhtare orItem
Tax map parcel no.: 13atkftow preventer 31.27
Backwater wive 12.51
DESCRIPTION OF WORK
) t Clothes washer 25.02
c+L 7e Lrii/1'Cf,.,.z4*✓r V e5:1,^S4-tA') ;PL:,/14i'{-• Dishwasher 23.02
f- ••t+`xL r,., - 4 a Cv+w Pic.4C tl^t'4b"• lf?vMLr.5 5 Drinking fountain 25.02
Ejectorsisump 25.02
,PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
same: r1-, L. 6.4 f; L, Fixture-sewer cap 25.02
Floor drain/floor sinkthub 25.02
Address: f I, ,J r cw l-r i- f(,
Garbage disposal 25.02
City/State/ZIP: ii, LT2 Y7Z 3
�l ".y ix..r .. Hose bib 23.02
Phone:(S.:_i) ?f Y, 7t r-i Fax:(h. ) Ice maker 12.51
APPLICANT 'a CONTACT PERSON Intcrceplougrease trap 25.02
) f t Modica]gas(value:S_) Pane 2
Badness name: -7 i E ?clap."C SX V o L.7 i Primer 12.51
Contact name: rf-t-t ( C[e'�. Roof drain(commercial) 12.51
n
Address'. 1't,),�! Sti, 1-�..a'( PL 5ink'baainlxwatory 25.02
City/Slate/ZIP: 'rt . w,.,.(. &re Lf711 3. Solar units(potable water) 62.54
Phone:( i j) '..y r. 7 J/L{ Fax::( ) Tub showersbower pan 12.51
a
E-mail:' nfcl tit"$Erf{u•✓(4. 5;u(l1:-tu^7 S. ['C;, :^1. Urinal 25.02
Water closet 25.02
CONTRACTOR Water heater 37.52
Business name: C3(,v,/jj E2 Waterpiping/DWV il 56.29
Address: Other 1 25.02
City/State/ZIP: Subtotal
Phone:( ) Fax:( ) Minimum permit fix. 572.50
CCB Lie.: Plumbing Lie.no.. Plan review(25%ofpermit fee)
Authorized signature: State surcharge(12%of permit fee)
..460........
TOTAL PERMff FEE
Print name: Er..L -..:'C \ Date:"j-f>..2,...LLi Thin permit applientlaiexppiro if.*prem,dit is not mined within ISO days
•Ere/mthodoIogy so b.:Tn.Courtt)Bonding Iniratry Semitic Board.
I" $Para+++O hOU-Pemiwyplur Mil 01 4Is.rdl6Tllme2itOMMEBI