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Permit
CITY OF TIGARD PLUMBING PERMIT 14 • . COMMUNITY DEVELOPMENT Permit#: PLM2021-00240 Date Issued: 6/9/2021 T f C;A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S108DB03300 Jurisdiction: Tigard Site address: 15156 SW SEINE DR Project: Parrish-Addition Subdivision: POLYGON AT BULL MOUNTAIN Lot: 31 Project Description: No meter upsize needed.Adding a Bath(Sh,Lay,Toilet)Bar Sink,Water heater&Dog Wash Station(Sh Pan& Valve) &Sewer Ejector Pump.REPRINT 7/26/21 -NV Contractor: CUSTOM PLUMBING &CONSTRUCTION LLC Owner: JULIER, MICHAEL A&DANIELLE E PO BOX 1051 15156 SW SEINE DR CANBY, OR 97013 TIGARD, OR 97224 PHONE: 503-266-1212 PHONE: FAX: 503-266-4391 FEES Quantity Description Date Amount 1 ea Sink 06/09/2021 $25.02 Specifics: 1 ea Lavatories 06/09/2021 $25.02 1 ea Water Closet 06/09/2021 $25.02 Type of Use: SF 1 ea Water Heater 06/09/2021 $37.52 Class of Work: ADD 1 12%State Surcharge- 06/09/2021 $13.51 Type of Const: Plumbing Occupancy Grp: 1 ea Ejectors/Sump 06/09/2021 $25.02 Stories: 2 ea Tub/Shower/Shower Pan 06/09/2021 $25.02 0 12%State Surcharge- 06/09/2021 $6.00 Plumbing Total $182.13 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 I 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: U ------------" Permittee Signature: t� i t 1 Len 1 p l i L L '„Th 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 Building Fixtures RECEIVE- r 1 V ,fy� wReaived ry �„ p z�z t -t:6z90 City of Tigard Date'By LD 1-1 `�� Fermi No `1f(1 11111 13125 SW Hall Blvd.,Tigard,OR 97223 z,.,.. Plan Review I Phone: 503.718,2439 Fax: 503.598.1960 i I £, : DiWBy. Other Permit No t i t i,• tc h Inspection Line: 503.b39.4175 Date Ready/By- tun la See Page 2 for Internet: www,tigard-or.gov CITY OF TIGARD Notified/Method: Su!pleiaeatal Information TM OF WORK BUILDING DIVISION rap SCx6DUL6 0 New construction 0 Demolition For special Minn madoa use checklist Description I Qty. I Ea. I Total [A Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utilitvconnection) c*ii'oY OF OONsI'aUC1TON SFR(1)bath 312.70 ® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bash 437.78 Accessory buildingSFR(3)bath 500.32 ❑Accesso 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: lob site address: 1 Gj C� SW l 'Y►f...) �V1✓LJ Catch basin or area drain 18.76 Drywall,leach lane,or trench drain 18.76 City/StatelZlP: 1 f 9 O(L a 72Z3 Footing drain(no.linear ft.:_J Page 2 Suite/bldgJapt.no.: Project name: Manufactured home utilities 50.03 Cross street/directions to job site: 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.: Backtbw preventer 31.27 pcsour ION OF WORK Backwater valve 12.51 Clothes washer 25.02 Dishwasher 25.02 AtO -rt, S yAtIJ CA)f -�^ Drinking fountain }5.02 Ejectors/sump 1 ` 25.02 0 pROPWCYy t�- WAR 1 Q TENANTTENANTExpansion tank 12.51 A . , 11 r Fixture/sewer cap 25.02 Name: d I/(.� ireA,', A_.t ,nit f d. Kn&( 1c) Ntl00f sink/hub 25.02 Address: 1 L f�., f Floor drai(p S tt`) (,5 y‘.(, Dh o Garbage disposal 25.02 City/State/ZIP: f j4(,th QC_ '1141, Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 © Apruc 14T Q CtNITACT UNION Interceptor/grease trap 25.02 , Business name: Medical gas(value:f_) Page 2 Primer 12.51 Contact name: Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) 'tub/shower/shower pan 2 12.51 E-mail: Urinal 25.02 Water closet 25.02 tokIRIA CONTRACTOR W,ater heater 37.52 Business name: Plumbing Rc Construction,LLC Water D tPing/DWV 56.29 Address:PO Boa 1051 Other: 25.02 1 City/State/ZIP:Canby/Oft/97013 Subtotal Phone:(503)266-1212 Fax:(503)266-4391 Minimum permit fee: $72.50 Plan review (25%of permit fee) CCB Lic.: 199591 Plumbing Lic.no.:1336 State surcharge(12%of permit fee) Authorized signature: ,& 1Y7 TOTAL PERMIT FEE I Print name:Linda Sandsnesss,Own r J Io Date: 1.0,ot,2,1 This permit application expires if a permit ts not obtained width ISO days aver it bad been accepted as corn pkte. / `Fee makhodoftev sci M-In-Conroy Building Industry Setvicc Bopcy i\BuildinglPermus,PLMU.Penn App.doc 10)01x09 440-e616T(tOVIKOMWEB) Holly Van De Wege From: UB Online Sent: Monday,July 26, 2021 8:45 AM To: #Building Permit Technicians Subject: RE: Custom Plbg - PLM2021-00240 Follow Up Flag: Follow up Flag Status: Completed Categories: Holly The address of 15156 SW Seine Dr has a one inch meter and will not need to be increased in size. Kind Regards, Jill (she/her/hers) . A WO,,. Jill • itt IOU CANBEggyT j-• City of Tigard-Utility Billing W ` " a Senior Accounting Asst (888)826-7211 Payments cj» (503)718-2460 US Main jbtEktigard-or.gov (503)718-2494 �al= KEG 13125 SW Hall Blvd. k Tigard, OR 97223 From:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Sent:Thursday,July 22, 2021 2:58 PM To: UB Online<UBOnlinepay@tigard-or.gov> Subject: FW: Custom Plbg- PLM2021-00240 Hi Jill, Will this picture (below) work? I've requested the contractor send a PDF or at least a scanned copy but she is pretty unresponsive. Thank you. Holly Van De Wege Program Development Specialist City of Tigard I COMMUNITY DEVELOPMENT 13125 SW Hall Boulevard Tigard,Oregon 97223 www.tigard-or.eov From: Linda Sandsness<linda@customplbg.net> Sent:Thursday,July 22, 2021 2:28 PM To: 'Chris Parrish'<Chris@renewnw.com> 1