Permit Support Document CITY OF TIGARD PLUMBING PERMIT
°'! ' COMMUNITY DEVELOPMENT Permit#: PLM2020-00340
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 0
Q Date Issued: 9/3/2020
2
a Parcel: 2S103DA05700
Jurisdiction: Tigard
Site address: 10634 SW COOK LN
Project: Sholes Subdivision: FANTASY HILL Lot: 11
Project Description: To get inspection for work done w/o permit for bathroom conversion.09/29/20;Reprinted to add contractor
Contractor: PIPELINE PLUMBING Owner: SHOLES, LANCE M& KRISTIN A
333 S STATE ST SUITE V-108 106334 SW COOK LN
LAKE OSWEGO, OR 97034 TIGARD, OR 97223
PHONE: 503-624-1906 PHONE:
FAX: 503-624-1926
FEES
Quantity Description Date Amount
1 ea Sink 09/03/2020 $25.02
Specifics: 1 ea Lavatories 09/03/2020 $25.02
1 ea Water Closet 09/03/2020 $25.02
Type of Use: SF 1 12%State Surcharge- 09/03/2020 $9.01
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total 584.07
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 r 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 50 .2 2.1987 or 1.800.332.2344. TJ�/�/J
Issued By: Permittee Signature: �/JgaL'��� v!"
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. ��/'
This ermit 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 Application
Building Fixtures AECE1VED FOR OFFICE USE ONLY _�)City of Tigard S E P 2 9 2020 Receivedch. Pennit No��/yt D`Gfle
pril
•■ 13125 SW Hall Blvd..Tigard.OR 97223 Date By.
1/0
Plan Review
Phone: 503.718.2439 Fax: 503.598.I y if TIGARD Other Permit No
Date B
TIGARD Inspection Line: 503.639.4175 BUILDING DIVISION D qy /B odv: ,ris
See Page for www.tigard-or.ttov -a• t: -h : Supplemental
• Information
TYPE OF WORK a i FEE* SCHEDULE
O New construction ❑Demolition /�►i� For special irjurnrutial use checklist{{{rr,���, / FY�Y Description I Qty. ( Ea. I Total
1 Addition/alteration/replacement 0 Other: New I-2-family dwellings(includes 100 ft.for each utility connection)
` CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
lit I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
0 Accessory y buildingSFR(31 bath 500.32
0Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 1666 ` s'6_, &Z�e L..7 . Catch basin or area drain 18.76
l�j nr Dr'well,leach line,or trench drain 18.76
City/State/ZIP: l
/'�'^, y�J62}2 • q� � Footing drain(no.linear ft.:_l Page 2
Suite/bldg./apt.no.: '-J I Project name: Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
U: 4'n§ f�l tQ , Rain drain connector 18.76
Lt�.LiC{ ®I ` 'vv Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
/� Water service(no.linear ft.:_) Page 2
Subdivision: ��y rL 1. L V. .1Lot no.: Fixture or item:
Tax map/parcel no.: Backflmv preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
tit Ejectors/sloop 25.02
PROPERTY OWNER J I 0 TENANT Expansion tank 12.51
None:4e • ryl '' 1� l f Fixture/sewer cap 25.02
Address: ,e f•3,/tf JS� P/��✓v Jill (� Floor drain/floor sink/hub 25.02
l7 ( (/�I� Garbage disposal 25.02
City/State/ZIP: L oT, q-2a �� Hose bib 25.02
Phone:. 27 L (Cj/ 1�>/, Fac( I Ice maker 12.51
0 APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name. l,.rr�s h'f2.e..5�a v6r,,e"Le Cirri?„ Medical gas(value:$_) Page 2
Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory ' 25.02 c25,0
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shover pan ' 12.51 la,6/
E-mail: Urinal 25.02
Water closet 1 25.02 as
CONTRACTOR
Water heater 37.52
Business name: T. S r,e l L)re7 J/n Water I in WV 56.29
Address: Ji s viol) Other: 25.02
City/State/ZIP: C Q f . .d) _ q.90- y- Subtotal
�3 / v�/._ 10 yti , "`'''��l Minimum permit fee: $72.50
Phone: (pef`C V Fax:( )
Plan review (25%of permit fee)
CCB Lic.: 1 swz40 Plumbing -c.no.: 4-75.1)47
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE O7
Printnam-. /Isefri J Date: 9/014/915 This permit application thasbeefaccpteti not
mplete.dwithin ISOdays
f afterys it has been uuny uil as complete.
'Fee methodology set by Tri-County Building Industry Service Board.
I'.auildint.nmits:PL\IGPermitApp doc 100109 440.46I6T110.02 CO5LwE8)
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September 18,2020
Job Site: Bill To:
Residential Property Lance/Kris Sholes
10634 SW Cook Ln.
Tigard,OR.
Inspection of the master bathroom plumbing:
Fixtures:
1-toilet/2-sinks/1-jacuzzi tub/1-tile shower
Drainage: ABS
Water lines: Pex(crimp)
Area's of inspection: all visible piping in the bathroom/crawl space
Evaluation:
All Fixtures are in proper working order. Hot water is located on the left side of all
fixtures. Shower valve is temperature and pressure balanced. The jacuzzi pump is
accessible though the lavatory cabinet (access panel removalable). The drainage through
the master bathroom crawl space is properly graded and supported. All fixtures are
properly strapped and the use of wye branch fitting are present.
All pex piping is properly strapped against the insulation and sized to provide proper flow
to all fixtures.
No leaks were found throughout the crawl space or in the finish space of the bathroom.
All plumbing was completed in a workman like manner. I don't for see any problems
with the existing system.
Sincerely,
Journeyman Plumber #JP6789
Perry Garrison
nun p•polneplumigg.net ph.503.624.1906 fax 503.624.1926 pipet:neplun.t ng«t,-4nt er.cern
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