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Permit CITY OF TIGARD PLUMBING PERMIT 1111 • COMMUNITY DEVELOPMENT Permit#: PLM2021-00165 and OR 97223 503.718.2439 13125 SW Hall Blvd.,Ti Date Issued: 5/13/2021 TIGARD9 Parcel: 2S 114AC01100 Jurisdiction: Tigard Site address: 9118 SW WAVERLY DR Project: Engen Subdivision: WAVERLY ESTATES Lot: 44 Project Description: Replacing sink,garbage disposal,dishwasher drains and supplies Contractor: OWNER Owner: ENGEN, MATTHEW P&JESSICA L 9118 SW WAVERLY DR TIGARD, OR 97224 PHONE: PHONE: FAX: FEES Quantity Description Date Amount ea Dishwasher 05/10/2021 $25.02 Specifics: 1 ea Garbage Disposal 05/10/2021 $25.02 1 ea Sink 05/10/2021 $25.02 Type of Use: SF 1 12%State Surcharge- 05/10/2021 $9.01 Class of Work: ALT Plumbing Type of Const: Occupancy Grp: Stories: Total $84.07 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 clone 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: Holly yam,ve,wage Permittee Signature: Ow,Appli. ati-o- rt 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. Plumbinu Permit Application 13-el 01 Building Fixtures RECEIVED �^7� AAnn Received ",/ Permit No.:p 20 4- o l6j City of Tigard Date/By:6-"'T �� II 13125 SW Hall Blvd.,Tigard,OR 97223 a{7 �1 9 ZQ�I f II �jj r. 1 t7 Plan Review is Phone: 503.718.2439 Fax: 503.598.19 Date/By: Other Permit No.: TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By:�I,[ /7n� ltpay , S See Page 2 for Internet: www.tigard-or.gov �f� Notified Metho L1/ 1 ' Supplemental Information TYPE OF W ILIJIN©CIVISION CAU e ,, ,. FEE" SCHEDULE ❑New construction ❑Demolition For special information use checklist Description I Qty. I Ea. 1 Total ®Addition/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 ❑ Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building ❑Multi-family Each additional bath/kitchen 25.02 ❑Master builder ['Other: Fire sprinkler(_sq.ft.) Pagc 2 JOB SITE INFORMATION AND LOCATION Site utilities: I I g Sw lr• 4.4�2Ly 2 Catch basin or area drain 18.76 l Job site address: Drywell,leach line,or trench drain 18.76 City/State/ZIP: T 1 c 0.2( 0 2 9 r)22M Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name: Manufactured home utilities 50.03 Cross street/directionsn to job site: Manholes 18.76 St,1 `2r I^Vi_: 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: Backflow preventer 31.27 Tax map/parcel no.: Backwater valve 12.51 DESCRIPTION OF WORK 25.02 h• Clothes washer R(sQ -p,c (,- 5u4I4I CIni3PGlS LJ,SQOSIA. - I Dishwasher 1 25.02 25.0'1.. IL)IS 1.4WAS(A-ia. 'b#2.( tr$S f s(> So1'r"OS1 I Drinking fountain 25.02 Ejectors/sump 25.02 J PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Fixture/sewer cap 25.02 Name: 0 pepr ,n(G L r.l Floor drain/floor sink/hub 25.02 Address: c11fa Sw WAue2Ly r)2 Garbage disposal 1 25.02 '14, 02 City/State/ZIP: -4.7 G!ez_r- C)!Z g7'1.2-6I Hose bib 25.02 Phone:(50*) 3 i 1 3% (p Fax:( ) Ice maker 12.51 ® APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Medical gas(value:$ ) Page 2 Business name: Primer 12.51 Contact name: Sips Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 1 25.02 25.01 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan 12.51 Urinal 25.02 E-mail: m enaG� YZSY (�f� Water closet 25.02 �l CONTRACTOR Water heater 37.52 Business name: typc Water piping/DW V 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal Minimum permit fee: $72.50 ri 5 0(p Phone:( ) `� '411 ( ) Plan review (25%of permit fee) l ' , h(0 CCB Lie.: Plumbing Lic.no.: 9 /► State surcharge(12%of permit fee) ,,00 y� Authorized signature: / TOTAL PERMIT FEE 10 2.8 2.�i Date: I This permit application expires if a permit is not obtained within 180 days Print name: /J‘(�T" E..A G a. Li 1 i st2:1 after it has been accepted as complete. °Fee methodology set by Tri-County Building Industry Service Board. h\Bnilding'PermitslPLMU-PermitAPp.doc I0i01/09 440-4616T(10/02/COM/WEB)