Permit 14CITY OF TIGARD PLUMBING PERMIT
V COMMUNITY DEVELOPMENT Permit#: PLM2020-00334
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 8/24/2020
Parcel: 2S111 DA04500
Jurisdiction: Tigard
Site address: 8752 SW LODI LN
Project: Ergenekan Subdivision: APPLEWOOD PARK NO.2 Lot: 40
Project Description: Install 180'trench drain around back yard.
Contractor: 1 OREGON LANDSCAPE MAINTENANCE&IRRIGATI Owner: ERGENEKAN, NECMI E & HAYLEE FRAN
PO BOX 754 8752 SW LODI LN
SHERWOOD, OR 97140 TIGARD, OR 97224
PHONE: 503-969-8653 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Drywell,Leach Line or Trench 08/24/2020 $18.76
Specifics: Drain
1 12%State Surcharge- 08/24/2020 $8.70
Plumbing
Type of Use: SF 54 ea Minimum Fee Adjustment- 08/24/2020 S53.74
Class of Work: OTR 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: ;/ Permutes Signature: , j
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.
p Plumbing Permit Applies ' , ' . ( l--
Site Utilities " ct �
eon orlICI 1'S1:: ONLY
Ci Of HJBI Tigard 10 I Received O.Z 7%2-Q �o Permit 710P C^ I ZQ20-00 J s/
13125 SW Hall Blvd.,Tigard,OR 97223 n UG Plana Rev
II Phone: 503.718.2439 Fax: 503,598.19E 24 Review
Z�20 Date/By: Other Permit No
Tl� RD Inspection Line: 503.639.4175 CITY
OF
Internet: www.tigard-or gav 1 r-+---, Date Ready/By: Juns: See Page 2 for
Ilah lIL, Notified/Method: Supplemental Information
TYPE OF WORK}111
I"N^:. ?s
FEE* SCHEDULE
❑New construction ❑Demolition For special information use checklist.
Description t
❑Ad ' on/alteration/replacement ❑Other: Qty. Ea. Tolal
__. New I-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR.(1)bath 312.70
1-and 2-family dwelling ❑CommerciaVindustrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Lire spunkier( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION /� Site utilities:.
Job site address. �"' "--'.2-
.r , 1.diJ �O . } L/i Vitt
y Catch basin or area drain 18.76
City/State/ZIP: 1 9ra1 Drvwell,leach line,or trench dram ' (}I 18.76
� o.
-- + Footing:drain(no.linear ft.; ) Page.2.
Suite/bldg./apt.no.: Project name: 22--?--Lir y Manufactured home utilities 50_03
Cross street/directions to jobsite: 'J,,4/j� p f�� Mardtoles 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
DESCRIPTION OF WORK Backwater valve 12.51
//1 -sty �j ,, Clothes washer 25.02
y- �t��,l �v8 r I "i " �-f IA Dishwasher 25.02
'V (X j (,(,:��4 Drinking fountain 25.02
V V Ejeemrsfsump 25.02
1,1ROPERTY OWNER ❑. TENANT Expansion tank 12.51
Name: {j'J �-{�/"�,'(J Fixture/sewer cap 25.42
`� J `�" �� ��n Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP:,.
Hose bib 25.02
Phone:( ) Fax:( ) lee maker r 12.51
fa APPLICANT ? i ❑ ONTACT PERSON Interceptor/grease trap 25.02
�A � �„l � / (� r
Business name: (( t W V \ t if„AiV'� W ' Medical gas(value:$ ) Page 2
Contact name: .��1YY[ Mt
�"' /t/I'� Primer 12.51
Address: ((+ ) G Roof drain(commercial) ,51
l i.idil� Sink/basin/lavatoryis 25.02
City/State/ZIP.
Solar units(potable water) 62.54
Phone: 1 , I '-1 Fax.: i b. `161 Tub/shower/shower pan 1241
E-mail: / r la
1 i4 I t Urinal. 25.02
, / CONTR CTOR rl Water closet 25,02
-- Watertjieater 37.52
Business name: I (�
I J Water piping/DWV 56.29
• Address: ( ���(I ` COI Other:
`3\i p I OI t 25.02
City/State/ZIP:
�l� ` ���/'/// Y U} Subtotal
Phone:( / VVV //JJ�� Fax:( ) Minimum permit fee: $72.50 7,2„sd
CCB Lic.: L C /)} Plumbing Lic.no.: Plan review (25%of permit fee)
r i State acharge(12/s of permit fee) P,7r)
Authorized signature: r,. G ( 5 TOTAL PERMIT FEE 7'/, 20
Print name: ?mum')/,/� r Data. ��� u permit application expires ifs permit is not obtained within 180 days
• • Ag after it has been accepted as complete.
1 Fee methodology set by Tri-County Building Industry Service Board.
I lnviidingeornitslPLMU-PemmitAppdoc 10/01/09 .140.4615T(I0102/COMAVE11)