Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2021-00152
and OR 97223 503.718.2439
13125 SW Hall Blvd.,Ti Date Issued: 4/13/2021
TIGARD9
Parcel: 2S102CA00400
Jurisdiction: Tigard
Site address: 9750 SW FREWING ST
Project: EGGERT Subdivision: FREWING'S ORCHARD TRACTS Lot: 18
Project Description: 40 ft.of sanitary sewer to connect existing dwelling to sewer. Septic tank to be pumped and filled.
Contractor: SEWER RENEWAL SPECIALISTS LLC Owner: EGGERT, JULIA L
PO BOX 230147 9750 SW FREWING ST
TIGARD, OR 97281 PORTLAND, OR 97223
PHONE: 971-803-2042 PHONE:
FAX:
FEES
Quantity Description Date Amount
40 If Sanitary Sewer 04/13/2021 $62.54
Specifics: 1 12%State Surcharge- 04/13/2021 $8.70
Plumbing
Type of Use: SF 10 ea Minimum Fee Adjustment- 04/13/2021 $9.96
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:
Holy va.w De,We.t;le 0YvAppL%Cat60-vt
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 Z'_ , 5/21
Building Fixtures RECEIVED FOR OFFICE USE ONLY'
Received
City of Tigard Permit No.: /1
II U 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: �J//j/a( r �jja�-�f�(ra
fl pp Plan Review
E Phone: 503.718.2439 Fax: 503.598.1980R c 2C2� Date/By: Other PermitNo.: (��g6�,J lga.
Inspection Line: 503.639.4175 :;IWOFTIGARD ✓ r 1
TIGARD i Date Ready/By: 7u-: H See Page2for
Internet: www.tigard-or.gov 2T'n Noted Method: Supplemental Information
TYPE OF w LUIN(,DIVISION FEE* SCHEDULE
0 New construction 0 Demolition For special infornmtion use checklist
Description I Qty. I Ea. I Total
.vddition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
�� CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
13"1-and 2-family dwelling ElCommercial/industrial SFR(2)bath 437.78
0 Accessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/Idtchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
' Job site address: 97s75 5iv ix/2 J'h'ee f Catch basin or area drain 18.76
t Drywell,leach line,or trench drain 18.76
City/State/ZIP: r15 Oiq9
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt no.: 1 Project name: s
� (,. Manufactured home utilities 50.03
Cross street/directions to job site: 9'9to a-,,,, ,Jy()Lan Manholes 18.76
Rain drain connector 18.76
r'N Fee--Je-r' flitl",tlxt 4rtne de Y `7/t/al 6 p5 Sanitary sewer(no.linear ft.: ) j Page 2 (j�
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: qI'(UIh5 � �
CC -frrry"c Lot no.: Fixture or item:
Tax map/parcel no.: 2 512G! ,A,_ ®p q..Ctf) Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
�� *�C - t_JA /dn r Clotheshwwasher 25.02
,�p pJ � � rye. ` Clf Dishwasher 25.02
A v tel.)I )t� , Drinking fountain 25.02
55 Ejectors/sump 25.02
I3"PROPERTY OWNER ❑ TENANT Expansion tank 12.51
Name: 0j,/,a �yiii Fixture/sewer capFl 25.02
Address: 915 /1 w? /" s," Garbage
drain/floore sink/hub 25.02
7 Garbage disposal 25.02
City/State/ZIP: ff( 07 Z Hose bib 25.02
Phone:( 3) CI _/ 9'7 Fax:( ) Ice maker 12.51
0 APPLICANT yca-CONTACT PERSON Interceptor/grease trap 25.02
Business name: P„re,n n ie r- of/y�'n-7, ' 6�2, y" Medical gas(value:$_) Page 2
"Y"'�•C`�1{ 1 Primer 12.51
Contact name: ,�(0 f/ Q
( 1 t '" yew-
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( gib6c,-rb Fax: :( ) Tub/shower/shower pan 12.51
E-mail: Pax�fel 1. (' Q a0%, Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: Sawa- QQ yyt/t J/(Q ' )O /t L Q Water piping/DWV 56.29
Address: 1TJ " f 44 "� f�_` Other: 25.02
City/State/ZIP: fri b. y7Z g/ Subtotal Got
Phone:(q71 ) 1p1{-Z Fax:( ) Minimum permit fee: $72.50 -Ns-5--G
Cat Lie.: 2.2Y 33 Plumbing Lic.no.: /9/5�-3Cf�1 Plan review (25%of permit fee)
State surcharge(12%of permit fee) 7 a
Authorized signature: 0244
"/J a(� TOTAL PERMIT FEE et et
. 9e l. 51 rice( This permit application expires if a permit is not obtained within 180 days
Print name: W1(� 9jj Lt Date: 1 P after it has been accepted as complete.
l;/J "Fee methodology set by Tri-County Building Industry Service Board.
1:1BuildinglPermits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)