Permit q CITY OF TIGARD PLUMBING PERMIT
7 COMMUNITY DEVELOPMENT Permit#: PLM2020-00305
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 8/4/2020
Parcel: 1 S 134AA01100
Jurisdiction: Tigard
Site address: 11348 SW IRONWOOD LOOP
Project: Nelson Subdivision: ENGLEWOOD Lot: 18
Project Description: Replace gas water heater.
Contractor: OWNER Owner: NELSON,JENNI
11348 SW IRONWOOD LOOP
TIGARD, OR 97223
PHONE: PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Water Heater 08/04/2020 $37.52
Specifics: 1 12%State Surcharge- 08/04/2020 $8.70
Plumbing
Type of Use: SF 35 ea Minimum Fee Adjustment- 08/04/2020 $34.98
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 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: Permittee Signature: /
1 if 47 p/j,l
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 Application
Building Fixtures RECEIVE* FOR OFFICE USE ONLY
Received
Cityof Tigard Permit N p
II � 13125 SW Hall Blvd.,Tigard,OR 97223 JUL 2 8 2020 Date/By: ��y � -CQ(� 7-(-ti d2C420"Oa.105
6 Plan Review
Phone: 503.718.2439 Fax: 503.598 19 n DateBy. Other Permit No.:
TIGARD Inspection Line: 503.639.4175 CITY O'�F±TIGARD ate Read/B inns
�IJI`DING D y y: ® Seeman l information
Internet: www.tigard-or.gov iVIS10 1Jotified/Methud: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑New construction ❑Demolition For special information use checklist
Description I Qty. I Ea. I Total
Idition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
�
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
1-and 2-family dwelling ID Commercial/industrial SFR(2)bath 437.78
_
SFR(3)bath 500.32
O Accessory building 0 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: 11348 S�J ' Wood r�P Catch basin or area drain 18.76
DrT9 d D�- 97aa3 Footill,ng
drain
ore trench drain 18.76e
City/State/ZIP:
�7 Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name: ///1/5�/ Manufactured home utilities 50.03
Cross street/directions to job site: , Y 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
Backwater valve 12.51
DESCRIPTION OF WORK
/ �q�q� /1 Wale('
/ /� / Clothes washer 25.02
icephea aas W I fihIA Dishwasher 25.02
J Drinking fountain 25.02
Ejectors/sump 25.02
PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Name: ')/. AidJ1,1`� Fixture/sewer cap 25.02
� 3e (1 W 1i'dri t(4aod � Floor ge disposaor sink/hub 25.02
Address:
Garbagedisposal 25.02
City/State/ZIP: g 7eRe 23 Hose bib 25.02
Phone:( 7/ ) 53 v9 2-3 Fax:( ) Ice maker 12.51
0 APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name: Medical gas(value:S ) Page 2
Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax: :( ) Tub/shower/shower pan 12.51
Urinal 25.02
E-mail: Jr_VA-Ait",/r5 CIA/Lh( v-.c,r (. cc,w,
Water closet 25.02
TEuic ove O
S LNC TOR
Water heater f 37.52
ON / 37
Business name: L11V/1ir-Ar" Water piping/DWV 56.29
Address: Other: 25.02
City/State/ZIP: Subtotal 3 7.s-
A
Phone:( ) Fax:( ) Minimum permit fee: $72.50 7,2,-s
CCB Lie.: Plumbing Lic.no.: Plan review (25%of permit fee)
State surcharge(12%of permit fee) /V
Authorized signature: "I .t....., TOTAL PERMIT FEE j �r'�
J M rf/ "
Print name: //Q y1 / / �rl/l Date: /�7/a0 This permit application expires if a permit is not obtained withi 180 days
("G�j t J l v. - after it has been accepted as complete.
°Fee methodology set by Tri-County Building Industry Service Board.
I 1Building\Permits\PLMU-PermitAppdoc 10/01/09 440-4616T(10/02/COMIWEB)