Permit CITY OF TIGARD PLUMBING PERMIT
�. COMMUNITY DEVELOPMENT Permit#: PLM2021-00347
Date Issued: 8/24/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S1046A10600
Jurisdiction: Tigard
Site address: 13665 SW LIDEN DR
Project: Luu Subdivision: CASTLE HILL NO.3 Lot: 136
Project Description: adding,toilet,sink,shower and garden faucet at exterior
Contractor: OWNER Owner: LUU &CHAU REVOCABLE TRUST
BY LUU, MARK&
CHAU, TU TRS
13665 SW LIDEN DR
PORTLAND, OR 97223
PHONE PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Hose Bib 08/20/2021 $25.02
Specifics: 1 ea Sink 08/20/2021 $25.02
1 ea Tub/Shower/Shower Pan 08/20/2021 $12.51
Type of Use: SF 1 ea Water Closet 08/20/2021 $25.02
Class of Work: NEW 1 12%State Surcharge- 08/20/2021 $10.51
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $98.08
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: Holly Van/tie/Wage Permittee Signature:
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.
t.
Plumbing Permit Applic €CELvED
Building Fixtures
AUG 16 �021 Received '�/�j')�
City of Tigard Qa 17 20Z( Permit No.:RM�_ 00347
14 . 13125 SW Hall Blvd.,Tigard,OR 9F Plan
Rev
OF TIGARIa Plan Review Other Permit N`t.1SUJ �2,k4
Phone: 503.718.2439 Fax: 503. 9 0 Date/B
t l t,A I t? Inspection Line: 503.639.4175 IUILDING DIVISION Date Ready/By: turfs: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
r, FEE* �>
❑New construction ❑Demolition For special information use checklist;
Description I Qty. I Ea. I EJAddition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
,ri, F,, n.• ' ' SFR 1 bath 312.70
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.) Page 2
INFORMATION ANEtOCATION Site utilities:
Job site address: t 3(OGCj .' 5 L3 L i de-( l J ('_ Catch basin or area drain 18.76
City/State/ZIP: •--j Ick(d Q a- 172.z 2, Doting leach line,or trench drain 18.76
( ` // Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name: Mot k, 1._LA (n 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.: Backflow preventer 31.27
HT•wSt ON t RK Backwater valve 12.51
�� (t.`�nti'O l y► b tofLKJ 1 I� Dishwasher
25.02
t Dishwasher 25.02
r f) fir•k l S�tit(' CTn..1'I Drinking fountain 25.02
A< a c J2.)+eC10 (.. Ejectors/sump 25.02
f"PROPERTY OWNER TENANT Expansion tank 12.51
Name: Mfg- ���. Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02 `
Address: �,� %,.i j...,14 ej t. c ..
Garbage disposal 25.02
City/State/ZIP: '7 eNc t O.g- 01 7z$ Hose bib 25.02 I
Phone:(5"-u', c4 9 s I SI, Fax:( ) Ice maker 12.51
' +E NTACI' Is1ts?? Interceptor/grease trap 25.02
Business name: Medical gas(value:$ ) Page 2
Contact name: KX A+(` `✓ L LL to Primer 12.51
L Roof drain(commercial) 12.51
Address: 13�!b� t-3 1 dM. )' - Sink/basin/lavatory 25.02 I
City/State/ZIP: A.Cc4 t O t. t 7 2 ZS Solar units(potable water) 62.54
Phone:(S-1)5 ram-[,,t 6( - i S fj Fax::( ) Tub/shower/shower pan 12.51 1
Urinal 25.02
E-mail: Vv‘x.%^'c'1,.1 tAVI ‘N.�\ , . (..c Water closet 25.02
.z°• Water heater 37.52
Business name: Water piping/DWV 56.29
Address: Other: 25.02
City/State/ZIP: Subtotal S 7.S 7
Phone:( ) Fax:( ) Minimum permit fee: $72.50
CCB Lic.: Plumbing Lic.no.: Plan review (25%of permit fee)
' � State surcharge(12%of permit fee)
Authorized signature:
===� y��'.✓/e-- L/3 .►�' TOTAL PERMIT FEE 9f.DIg
Print name: /t_4/./ L u (mil Date: WM - i./ This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
"Fee methodology set by Tri-County Building Industry Service Board.
(:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)