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Permit CITY OF TIGARD PLUMBING PERMIT 111 COMMUNITY DEVELOPMENT ra f Permit#: PLM2021 00137 Z� . Date Issued: 4/8/2021 IF G A P:D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S 104AB 13500 Jurisdiction: Tigard Site address: 12403 SW 134TH AVE Project: Nguyen Subdivision: MORNING HILL NO.7 Lot: 163 Project Description: Adding bathroom and kitchen to new addition. NO FINAL INSP UNTIL WATER METER UPSIZED. NOT APPROVED FOR ADU. 6/3/2021: REPRINT to correct plumbing fixture count per approved water meter worksheet from UB.8/4/21:REPRINT to add one bar skink(HV). Contractor: OWNER Owner: NGUYEN, KIEN TRUONG-NGUYEN, KIM NGUYEN,ANDREW 552 N WHITE RD SAN JOSE, CA 95127 PHONE PHONE: FAX: FEES Quantity Description Date Amount ea Sink 04/07/2021 $25.02 Specifics: 1 ea Tub/Shower/Shower Pan 04/07/2021 $12.51 1 ea Water Piping/DWV 04/07/2021 $56.29 Type of Use: SF 1 ea Water Closet 04/07/2021 $25.02 Class of Work: ALT 1 12%State Surcharge 04/07/2021 $14.26 Type of Const: Plumbing Occupancy Grp: 1 ea Dishwasher 07/28/2021 $25.02 Stories: 1 ea Sink 07/28/2021 $25.02 1 ea Lavatories 07/28/2021 $25.02 0 12%State Surcharge- 07/28/2021 $9.01 Plumbing Total $217.17 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 Issued By: H 7 VavvDe/Wege Permittee Signature: Owl lt Cr✓ l Qn pp 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 Applica#io> E EIVED Building Fixtures JUN 0 9 2021 • 1312513 of Hall B a.,Tigard,OR 97223a;tT'l OF TIGAR� Dersy: 4� 145CZ.1 AP Permit Not)t ft-i-2.r� 2,J-DO 3`7 li r Phone: 503.7182439 Fax 503.59819T(®INGDIVISIOr Plan Renew Other Permit No.: Inspection Line: 503.639.4175 Dat Re t!6. Date ReadyBy: kris PI See Page 2 for Internet: www.tigardor.gov Notificd/Mcthod: Sup plemental Information TYPE OF WORK FEE* SCHEDULE ❑New construction 0 Demolition For special information use checklist Description I Qty. I Ea. I Total tAddition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 0-1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-familySFR(3)bath 500.32 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: J 21 y-.. ,L. 1-I� l C- , Catch basin or area drain 18.76 "�`� L'1 Drywell,leach line,or trench drain 18.76 City/State/ZIP: t t ,1 1 Cj .2 Gt '-2-Z 3 �"'�. Footing drain(no.linear ft.: ) Page 2 Suite/bldgJapt no.: \ ) Project name: r1 c'j' ,,, )u' _o,n 24,7 Manufactured home utilities 50.03 Cross street/directions to job site: : I 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 DESCRIPTION OF WORK Backwater valve 12.51 ut IG t� � Clothes washer 25.02 r -- S2'•5� al b,taup 4 P Dishwasher 1 25.02 + -x 1t.Tir` pomPreiG) () -' 1 1--. Drinking fountain 25.02 i,,_I'-1 'k°) ZI'.,- 1j Ejectors/sump 25.02 14 PROPERTY OWNER ) 0 TENANT Expansion tank 12.51 �) Fixture/sewer cap 25.02 Name: k1 M VA-NJ JV?6'U., GA Floor drain/floor sink/hub 25.02 Address: 1 a t r_D 2, 'W L) v � Garbage disposal 25.02 City/State/ZIP: Tit �1 �L/ i 7 '' Hose bib 25.02 Phone:(l f fjg) 7 8 T 6"1-1 ,I t Fax:( ) lce maker 12.51 ] APPLICANT `T 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: \ [l ,,lam AC V LU1\7� Medical gas(value:$ ) Page 2 t�Y` ��> Primer 12.51 Contact name: Roof drain(commercial)1j 12.51 Address: Smk/basin/laJatory 11j..,. 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan 12.51 Urinal 25.02 E-mail: CONTRACTOR Water closet 25.02 Water heater 37.52 Business name: /,44.1 z. Water piping/DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal Phone:( ) Fax:( ) Minimum permit fee: $72.50 Plan review (25%of permit fee) CCB Lic.: Plumbing Lic.no.: State surcharge(12%of pennit fee) Authorized signature: TOTAL p TOTAL PERMIT FEE iy,.e?- Print name: i�) f v ��}}}��� lk• NDate: 'S t I This permit apptieation expires if a permit is not obtained within ISO days fafter it has been accepted as complete. "Fee methodology set by Tri-County Building Industry Service Boanl. 1:1tuild6. Permils\PLMU-PermitApp.doc 1010I/09 440-4616r(IONIK;OM/wEa) x Dianna Ornelas From: #Building Permit Technicians Sent: Thursday, June 3, 2021 2:21 PM To: Vy Bui Cc: Harmony Decor;Julie Drinkwater; UB Online; David Young /0 , - /Z/ '-QC)/ ?7 Subject: RE: Request to complete 2021 Water Meter Fixture Unit Worksheet - 12403 SW 134th Ave Attachments: PLM2021-00137.pdf Hello Vy, At the request of the building inspector, we have added the plumbing fixtures that were missing on your permit, which now matches all fixtures you submitted to UB on the water meter fixture worksheet. The balance due is$84.07 (see attached invoice). The additional fees can be paid online at https://aca- prod.accela.com/TIGARD/Welcome.aspx by searching for the permit record number PLM2021-00137 under the Building tab. These fees must be paid before another inspection can be scheduled on this permit. Once the fees are paid, please email the permit technicians at TigardBuildingPermits@tigard-or.gov so that a revised permit can be issued and work can resume. Thank you. Dianna L. Ornelas Building Division Services Supervisor City of Tigard I Community Development 13125 SW Hall Blvd I Tigard, OR 97223 503-718-2430 Direct 1503-718-2439 Permits From: UB Online<UBOnlinepay@tigard-or.gov> Sent:Tuesday,June 1, 2021 5:48 PM To:Vy Bui<vybui@harmonydecor.org> Cc: Harmony Decor<project@harmonydecor.org>;Julie Drinkwater<JulieD@tigard-or.gov>; #Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Subject: RE: Request to complete 2021 Water Meter Fixture Unit Wroksheet Attached is the corrected and signed form. The remodel will require a meter size upgrade. Kind Regards, Jill (she/her/hers) 1 CITY OF TIGARD 6/3/2021 Ill 13125 SW Hall Blvd.,Tigard OR 97223 4:05:40PM 503.639.4171 TIGARD Activity Listing Case #: PLM2021-00137 Project Name: Nguyen Site Address: 12403 SW 134TH AVE www, w DATE DONE C E DESCR "i N_SP DONE BY Notes 315 Post/beam plumbing 04/12/2021 PART David Young Add lay to permit, no lay on current permit as shown on approved plans. Sink on permit located at different area of addition. Add dishwasher to permit, DW on plans not on plumbing permit. Fixtures to be added by plumbing rough in inspection. CaseActivityShortForm.rpt Page 1 of 1 Water Meter Fixture Unit Worksheet for Additions/Remodels/ADUs Please complete the following information: Customer Name: KIET4 oeui-E1sa Service Address: Street/Suite#: 1E4O3 SO 1 14% -1ASJE City: Mei641,D State: OR., Zip: t3 ] Phone Number: 94.-944 Email: eLt Ml dL Or CS I Please till in the number of each fixture you currently have. Please fill in the number of fixtures you propose to add. Multiply the quantity by the point value to arrive at the current Multiply the quantity by the point value to arrive at total. the proposed total. Fixture Unit Current Point Current Proposed Point Proposed Quantity Value Total Addition Value Total Bar sink x 1 = i x 1 = -1.— Bidet x I = x 1 Clothes washer A x 4 = A. x 4 = Dishwasher { x 1.5 = ti,5 { x 1.5 = S S Hose bib It x 2.5 = 2.5 x 2,5 = Hose bib,each t x 1 = t x I = Kitchen sink I x 1.5 = t,5 x 1.5 = Laundry sink x 1.5 = x 1.5 = Lavatory 3 x I = 3I.. x I = i, Water closet, 1.6 GPF 3 x 2.5 = ^1.5 L x 2.5 = Z Fj Bathtub/whirlpool x 4 = x 4 = Shower stall x 2 = >L x 2 = Z.. Bath/shower combo j x 4 — $ p x 4 = Current Points: 29 _ Proposed Increase: _ 13. is Current Points+Proposed Increase= _ 37_ =New Total Points =Required Meter Size .3/4 Meter Sizes: 1 to 30 points=5/8" 30.5 to 37 points=%" 37.5 and over points= 1" o New Meter Size Needed for New Total Points: 3/4 Cost: $ $13 page 1) Corrected Current Meter Size per Utility Billing: 5/8�, Cost: S $94 ee page 1) Meter Rates New Meter Size Cost minus Current Meter Size Cost= $ 4$4,059.00 Effective (This is Your Cost to Increase Meter Size Due to Additional Fixture Units) Jan 1, 2021 FOR OFFICE USE ONLY Current Meter Size Confirmed with UB J Bentley - mtr will require size increase 5/27/21 Signature of UB Representative Date _ w 1:/Building/Forms/WaterMeters_070119 Adddocx Page 2 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT ' Water Meter Fixture Unit Worksheet T I G.A R D For Additions /Remodels /ADUs 13125 SW Hall Blvd. • Tigard, Oregon 97223 •503.718.2439• www.tigard-nr.gov LOCATION: City of Tigard—City Hall WATER METER SALES: Utility Billing 13) Appointment Only: 503-718-2460 13125 SW Hall Blvd. vlonda) —Thursday. 9 a.m. to Noon Tigard,OR 97223 METER: SIZE: FEE: Pricing,effective 7/1/2019 5/ $9,406.00 Fee includes: 3/4" $13,425.00 water system development charge, 1" $24,645.00 water meter,and 1-1/2" $72,969.00 meter installation fee. 2" $118,163.00 DETERMINING METER SIZE FOR RESIDENTIAL CUSTOMERS City of Tigard Water Service Area.uses the American Water Works Association Manual and the Oregon Plumbing Specialty Code to determine the size of meter needed to adequately serve buildings. Due to the variety of home sizes built in the Tigard area,we count the fixture units of all homes to determine the appropriate meter size. Use the worksheet on Page 2 to calculate the current number of fixture units compared to the proposed increased number of fixture units,which will determine whether an increased meter size will be required. Submit this signed worksheet with your building or plumbing permit application submittal. DOCUMENTATION Once you are ready to purchase the new meter, please provide the following items to the Utility Billing counter: • Completed water meter fixture unit worksheet for additions, remodels,ADUs,etc. (on back page). • Copy of building or plumbing permit application date-stamped by building division. • Copy of issued building or plumbing permit. Your fixture count will be verified and your request will be processed upon receipt of these documents. No exceptions. INSTALLATION TIME Once the upgraded meter size has been purchased,please contact Public Works for installation.Their number is 503-718-2591. Most meters are installed within 10-14 business days. liBuilding/Forms/WaterMeters_070119 Add.doot Page 1 Property Owner Statement RECEIVE® Regarding Construction Responsibilities �� - 9 Z°Z, Oregon Law requires residential construction permit applicants who are not license it eTIG' Construction Contractors Board to sign the following statement before a building p 1ii$ MSK issued. (ORS 701.325(2)) This statement is required for residential building,electrical,mechanical,and plumbing permits. Licensed architect and engineer applicants,exempt from licensing under ORS 701.010(7), need not submit this statement.This statement will be filed with the permit. Please check the appropriate box: r1I own, reside in, or will reside in the completed structure and my general contractor is: Name CCB# Expiration Date I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. or I,V I will be performing work on property I own, a residence that I reside in, or a residence that I will ' reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. Print Name of Permit Applicant IQ/kV Signature of Permit Applicant Date 1fc24 Permit#: --._'LM 22 2 i(_ co 1) .� .. Address: �Zy 3 �q „t '1► 41r2( 0 It 41)1L3 I*tetr.A7'.4..1'fi, :!!! P Issued by: __\_\ 1_11Date: L\`'"i\Zit 1.1 1 This Copy for Permit Offices is/stfWli.MMai%llsfiru MfnNilff�!/fli/r/Fe.1Fii/1}/i fulilu!tuiNnF. rri.✓,r./fi i'.N.zhYYx /IFT,F�pN! iNasAlleu Nifui!!i i nuhtd trNlsrNNiHI/ fE/Fila/!t rlirNNr rwsra+rcfAei iNiKlui/i NAf// i/HutNle4/rfl:i. Dianna Ornelas From: #Building Permit Technicians Sent: Thursday,June 3, 2021 2:21 PM To: Vy Bui Cc: Harmony Decor;Julie Drinkwater; UB Online; David Young Subject: RE: Request to complete 2021 Water Meter Fixture Unit Worksheet - 12403 SW 134th Ave Attachments: PLM2021-00137.pdf Hello Vy, At the request of the building inspector, we have added the plumbing fixtures that were missing on your permit, which now matches all fixtures you submitted to UB on the water meter fixture worksheet. The balance due is$84.07 (see attached invoice). The additional fees can be paid online at https://aca- prod.accela.com/TIGARD/Welcome.aspx by searching for the permit record number PLM2021-00137 under the Building tab. These fees must be paid before another inspection can be scheduled on this permit. Once the fees are paid, please email the permit technicians at TigardBuildingPermits@tigard-or.gov so that a revised permit can be issued and work can resume. Thank you. t t,'f'21 A/ /6 E72_/1 1 i �"7y.4 i L 7'_Z1 /'!. l ''' Dianna L. Ornelas Building Division Services Supervisor City of Tigard I Community Development 13125 SW Hall Blvd I Tigard, OR 97223 503-718-2430 Direct 1503-718-2439 Permits From: UB Online <UBOnlinepay@tigard-or.gov> Sent:Tuesday,June 1, 2021 5:48 PM To:Vy Bui<vybui@harmonydecor.org> Cc: Harmony Decor<project@harmonydecor.org>;Julie Drinkwater<JulieD@tigard-or.gov>;#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Subject: RE: Request to complete 2021 Water Meter Fixture Unit Wroksheet Attached is the corrected and signed form.The remodel will require a meter size upgrade. Kind Regards, Jill (she/her/hers) 1 A WI Jill ,i-o oCANEEPoo. -* City of Tigard-UtifityBilling Senior Accounting Asst (888)826-7211 Payments (503)718-2460 UB Main jittbititegard-or.gov (503)718-2494 13125 SW Hall Blvd. -z :. . Tigard, OR 97223 From:Vy Bui <vybui@harmonydecor.org> Sent:Tuesday,June 1, 2021 5:02 PM To: UB Online<UBOnlinepay@tigard-or.gov> Cc: Harmony Decor<project@harmonydecor.org>;Julie Drinkwater<JulieD@tigard-or.gov> Subject: Fwd: Request to complete 2021 Water Meter Fixture Unit Wroksheet organization and we are unable to Warning!This message was sent from outside your orga ' verify the sender. Hello, Thank you for the notice. Please see the attached 2021 Water Meter Fixture Unit Worksheet for the address 12403 SW 134th Ave and let me know if you have any questions. Thank you. Best regards, Forwarded message From: Harmony Decor<project@harmonydecor.org> Date: Tue,Jun 1, 2021 at 9:56 AM Subject: Fwd: Request to complete 2021 Water Meter Fixture Unit Wroksheet To: Vy Bui<vybui@harmonydecor.org> Harmony Decor 522 NW 23rd Ave, Suite E, Portland, OR 97210, USA US&INTL Business +1-503-943-9744 I Nestor Ngo Vietnam Business +84-935305488 I Thao Duong Website-Facebook-Instagram Forwarded message From:Julie Drinkwater<JulieD@tigard-or.gov> Date: Tue,Jun 1, 2021 at 9:37 AM Subject: Request to complete 2021 Water Meter Fixture Unit Wroksheet To:project@harmonydecor.org<project@harmonydecor.org> Cc:Jill Bentley<JILLB@tigard-or.gov> Hello Kien 2 +/lfNil!ivf/ rI//i//!N 1 iFJiF/!N Ne:J ilNti/[E!J p ✓ 1lJti/tr- !H 1/e r iifAF�/+tJ N of lffiiilJn/1�r✓f!-f/!#ifs i/d/�'pNl.!Y/+l1Mli/{.{/,t. ,,�j,.✓. + Y /v/fFrx UL�/F1/'/ Y luui J.rda f'V<r.+ �ururrev u.ruiiFaiRR..ei is+.r... The water meter fixture unit worksheet that was submitted to the utility billing department, for 12403 SW 134th, is dated 2019. Please complete the attached 2021 worksheet, and resubmit it to the utility billing department at uboniinepay@tigard-or.gov. It will then be approved and a copy will then be forwarded to you and to the building department. You may contact the utility billing department, at 503-718-2460, with any questions that you may have regarding the worksheet. Thank you and please let us know if you have any questions. Julie Drinkwater Permit Technician Assistant City of Tigard I Building Department 13125 SW Hall Blvd Tigard, OR 97223 503-718-2804 DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained by the City of Tigard in compliance with the Oregon Administrative Rules "City General Records Retention Schedule." Vy Bull Interior Designer Harmony Decor 522 NW 23rd Ave, Suite E, Portland, OR 97210 US & INTL Business +1-503-943-9744 I Nestor Ngo Vietnam Business +84-935305488 ( Thao Duong 3 https://www.harmonydecor.orq/ https://www.facebook.com/harmonydecor.orq/ } A M 4 /uia-O)-I l z `/ S w 13 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT II al Water Meter Fixture Unit Worksheet TIGARD For Additions /Remodels /ADUs RECEIVED 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-oiJgOv 3 2021 CITY OF TIG®BD WILDING DIVISION LOCATION: City of Tigard—City Hall WATER METER SALES: Utility Billing By Appointment Only: 503-718-2460 13125 SW Hall Blvd. Tigard, OR 97223 METER: SIZE: FEE: Pricing effective 01/01/2021 5/8" $9,495.00 Fee includes: 3/4" $13,554.00 water system development charge, 1" $24,886.00 water meter, and 1-1/2" $73,689.00 meter installation fee. 2" $119,333.00 DETERMINING METER SIZE FOR RESIDENTIAL CUSTOMERS City of Tigard Water Service Area uses the American Water Works Association Manual and the Oregon Plumbing Specialty Code to determine the size of meter needed to adequately serve buildings. Due to the variety of home sizes built in the Tigard area, we count the fixture units of all homes to determine the appropriate meter size. Use the worksheet on Page 2 to calculate the current number of fixture units compared to the proposed increased number of fixture units, which will determine whether an increased meter size will be required. Submit this signed worksheet with your building or plumbing permit application submittal. DOCUMENTATION Once you are ready to purchase the new meter, please provide the following items to the Utility Billing counter: • Completed water meter fixture unit worksheet for additions, remodels, ADUs, etc. (on back page). •. Copy of building or plumbing permit application date-stamped by building division. • Copy of issued building or plumbing permit. Your fixture count will be verified and your request will be processed upon receipt of these documents. No exceptions. INSTALLATION TIME Once the upgraded meter size has been purchased, please contact Public Works for installation. Their number is 503-718-2591. Most meters are installed within 10-14 business days. l:/building/Forms/WaterMeters_070120_Add.docx Page 1 Water Meter Fixture Unit Worksheet for Additions/Remodels/ADUs Please complete the following information: Customer Name: Kien Nguyen Service Address: Street/Suite#: 12403 SW 134th Ave City:Tigard State: OR Zip: 97223 Phone Number: 503-943-9744 Email: Project©harmonydecor.org Please fill in the number of each fixture you currently have. Please fill in the number of fixtures you propose to add. Multiply the quantity by the point value to arrive at the current Multiply the quantity by the point value to arrive at total. the proposed total. Fixture Unit Current Point Current Proposed Point Proposed Quantity Value Total Addition Value Total Bar sink x 1 = 1 x 1 = 1 Bidet x l = x 1 = Clothes washer 1 x 4 = 4 x 4 = Dishwasher 1 x 1.5 = 1.5 1 x 1.5 = 1.5 1"Outside Water Spigot x 2.5 = x 2.5 = Water Spigot,each add'l x 1 = x l = Kitchen sink 1 x 1.5 = 1.5 1 x 1.5 = 1.5 Laundry sink x 1.5 = x 1.5 = Lavatory(bathroom sink) 3 x 1 = 3 1 x 1 = 1 Water closet,1.6 GPF(toihet) 3 x 2.5 = 7.5 1 x 2.5 = 2.5 Bathtub/whirlpool x 4 = x 4 = Shower stall x 2 = 1 x 2 = 2 Bath/shower combo 2 x 4 = 8.0 x 4 = Current Points: 25.5 Proposed Increase: 9.5 Current Points+Proposed Increase= 35 =New Total Points =Required Meter Size 3/4" Meter Sizes: 1 to 30 points=5/8" 30.5 to 37 points='/d" 37.5 and over points= 1" New Meter Size Needed for New Total Points: 3/4" Cost: $ $13,554.00 (see page 1) Current Meter Size per Utility Billing: 5/8" Cost: salamis( $9,495.00 (see page I) New Meter Size Cost minus Current Meter Size Cost= $Xmas$4,059.00 (This is Your Cost to Increase Meter Size Due to Additional Fixture Units) ************************************************************************************* FOR OFFICE USE ONLY Current Meter Size Confirmed with UB J Bentley (mtr required to be upsized) 6/1/21 Signature of UB Representative Date I:/Building/Forms/WaterMeters_070120 Add.dOCX Page 2 CITY OF TIGARD PLUMBING PERMIT I ' COMMUNITY DEVELOPMENT Permit#: PLM2021-00137 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 4/8/2021 TIGARD 9 Parcel: 2S104AB13500 Jurisdiction: Tigard Site address: 12403 SW 134TH AVE Project: Nguyen Subdivision: MORNING HILL NO.7 Lot: 163 Project Description: Adding bathroom to addition:toilet,sink,shower Contractor: OWNER Owner: NGUYEN, KIEN TRUONG-NGUYEN, KIM NGUYEN,ANDREW 552 N WHITE RD SAN JOSE, CA 95127 PHONE: PHONE: FAX: • FEES Quantity Description Date Amount 1 ea Sink 04/07/2021 $25.02 Specifics: 1 ea Tub/Shower/Shower Pan 04/07/2021 $12.51 1 ea Water Piping/DWV 04/07/2021 $56.29 Type of Use: SF 1 ea Water Closet 04/07/2021 $25.02 Class of Work: ALT 1 12%State Surcharge- 04/07/2021 $14.26 Type of Const: Plumbing Occupancy Grp: Stories: Total $133.10 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: Nattyva,tvDe,Weve Permittee Signature: OvvAppUca.tio-vt Call 503.639.4175 by 7:00 a.m.for the next available inspection date. f f 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. Plumbin:;Permit Apnlicati E C E l V E - 3(29/2i Building Fixtures 6MR 9 2021 City of Tigard Rey.D1{- 0 L 2o2 i Permit No.: PLNl202/-0D iJ7 i • 13125 SW Hall Blvd.,Tigard,OR 97223ITY OF TIGARD D c/By: a Phone: 503718 439 Fax: 593s91Dt ING DIVISION : Other%mitNo.MS f20J20-e0 / t !LAMInspection Line: St73.639.4175 Date Ready/By: Z Internet: www.tigard-orgovPage Notified/Method: 't`� 0 See Sapptesen4l Information TYPE OF WORK FEE* SCHEDULE ❑New construction 0 Demolition Fee special ufjommaton use checklist iddition/ttlteratioNreplacement ❑Other: - Description I Qty. 1 Ea. I Total New 1-2-family dwellings(includes 100 ft for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 (J]1-and 2-family dwelling 0 Commercial/industrial SFR(2) 437.78 .Accessory building 0 Multi-family SFR(3)bath 500.32 ❑Master builder Earle additional bath/kitchen 25.02 0 Other Fire sprinkler( sq.ft) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 17s_it)- S I t}7ln Catch basin or area drain 18.76 City/State/ZIP: 1 l �,/ ,7 `j�/ �� K Diywe 1 leach line,or trench drain 18.76 Suite/bl T� t ern i 3 Footing drain(no.linear ft.:_) Page 2 tiglapt no.: , Project name: hi) STZO it)--0-0 zt;9 Manufactured home utilities 50.03 Cross street/directions to job site: fry Manholes 18.76 kK>1\v1lt\ +i 7yl Rain drain connector 18.76 Sanitary sewer(no.linear ft:_J 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 pp �,..�,�j f� DESCRIPTION OF WORK Backwater valve 12.51 it Gt 54� 1�C� fir^ k '�J Clothesishw washer 25.02 -r- L / �.0 Dishwasher 25.02 I O i (- 1 nnc U1{„ t I}_`-� '-'wr� Drinking fountain 25.02 C)�J ff (�� (I G. t 2.) IL - Ejectors/sump 25.02 PROPERTY OWNER! 0 TENANT Expansion tank 12.51 Name: K t 61J VAJ\i N C-V G� Fixture/sewer cap 25.02 Address: iL Floor drain/floor sink/hub 25.02 l a Lt o $4,I 13 l ')'4'1 Mil' Garbage disposal 25.02 City/State/ZIP: t i M.l C R. 0 7 2 3 Hose bib 25.02 Phone:(tf.{)�) 7 i . -6 s f ) ! Fax:( ) Ice maker 12.51 1K APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: Medical gas(value:$_) Page 2 Contact name:` M y p- �c„(y - I Primer 12.51 I v 1 L� v Address: l.6t 6 �_1 Roof drain(commercial) } 12.51 `� ( i�t' Sink/basin/lavatory 25.02 7h'-✓2,- City/State/ZIP: ?3-6l-{ t j e Solar units(potable water) 62.54 Phone:(51.)) ' t C1 `34 e. I Fax::( ) Tub/showed/shower pan I 12.51 ' Z.'S-) E-mail: Urinal 25.02 CONTRACTOR Water closet ) 25.02 . 7-+Z Business name: Water heater 37.52 Waterpiping/DWV / 56.29 5-1.,.Z Address: b\>`-)k‘ t' 2--' J Other: 25.02 City/State/ZIP: Subtotal tte. kLi Minimum permit fee: $72.50 Phone:( ) Fax( ) Plan review (25%of permit fee) CCB Lic.: Plumbing Liz.no.: Authorized signature: State surcharge(12%of permit fee) /x f 24 TOTAL PERMIT FEE r7f, /o Print name: t�l Vs) UAM N t.A,/c. 1 Date: ^� )/I�I The permit application been accepted not obtained within lax days 7 �v o`f/ J accepted complete. "Fee methodology set by TriCoonty Building Industry Service Board. 1:113uwldiaglPam2sPLM11-permitppp.mc 10/01/09 44O.4616(1a02/COM/WEB)