Permit CITY OF TIGARD PLUMBING PERMIT
i COMMUNITY DEVELOPMENT Permit#: PLM2021-00362
Date Issued: 8/30/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1 S 133 DC00400
Jurisdiction: Tigard
Site address: 13407 SW ORLIN CT
Project: Donna Park Subdivision: DONNA PARK Lot:
Project Description: Water service for six lots in Donna Park: 13407, 13422, 13449, 13458, 13475,and 13494.
Contractor: ALPHA OMEGA PLUMBING LLC Owner: SCOTTCO BUILDING&DESIGN INC
201 ARDUS DR 11640 SW 135TH AVE
NEWBERG, OR 97132 TIGARD, OR 97223
PHONE: 503-538-7848 PHONE:
FAX:
FEES
Quantity Description Date Amount
500 If Water Service 08/27/2021 $212.62
Specifics: 1 12%State Surcharge- 08/27/2021 $25.51
Plumbing
Type of Use: SF
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $238.13
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
Issued By: ` Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application _ _ L
Site Utilities FOR OFFICE USE ONLY
City of Tigard RECEIVED Received /}
Pate/By: ��{ Permit No LJi/N 11 f_ 64
14
13125 SW Hall Blvd.,Tigard,OR 97223 I��-/ /+9110''
Plan Review
20€t� Other Permu o.
Inspection imle 5039633 41 75 03.598.i;�jQ, 3 [ Date/By: N
I C+rlKD AUb ^ Date Ready/By: `,0/� Iu H7See Paget for
rntemet www.ligat d-or gov NotifiedMlethod SK( Su Irmental Information
�v OF TIGARL,
TYPE OF �5 Or * GfIFD19.F
' IVISi01 "� +� vim; ,.o.m ti
A�New a truction , Far special information use checklist.
5F' l)escn$on G Qty. Ea. I, Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION - SFR(I)bath 312.70
4.4 1-and 2-family dwelling ❑ Commetcialdndustrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ❑Multi-family
------ Each additional bath/kitchen 25.02
❑Master builder E Other Fire sprinkler( sq.ft.) Page 2
,, a
JOB SITE INFORMATION AND I,OCITION Site utilities:
Job site address: \ ` (a4 O (�(,J ` 3)f"h , Carcb:basia or area dtaia 18.76 .
City/State/LIP: `+ a !� 7 3 Drywall,leach line,or trench drain 18.76
"L 2G 3. Footing.drain(no.linear ft.:_) Pagc2
D
Suitebldg./apl.no.: Project name: 0l� ✓1a tP
p-�av'k._ Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.75
Rain drain connector 18.76
Sanitaoy aevrv;Iatr,liaaa.it: ) - Page-2
S*®Pm sewer(ne Betray R.: ). Page 2
Water service(no.linear ft.:5 _ Page 2 Z(Z.do 2."
Subdivision: I2 oy l r1 6t '-
.a u".. Fixture or item: .
Tax map/parcel no: i.tj 7Dc. Backflow preventer- 31.27
...DESCRIPTION OF WORK. Backwater valve 12.5E
' Clothes washer 25.02
0,1 e.'' fL ,' -j("-i,-sit(.L' I i✓1 E'3 Dishwasher 25.02
+'I9rinkingfmrntain 25!02
Ejectors/sump 25.02
"0PROPERTY OWNER 1 ❑ TFNVNT - Expansion tank 12.51
- -- + y - Fixture/sewer cap 25.02
Name: G2 L/c ' Col t
�_ �t /�_77 -� J Floor drain/floor sink/hub 25.02
Address: t? 4b 1 3(hi r�IAv'V1ond- C-t
Garbage disposal 25.02
City/State/ZIP: ''r( al,- c3-1-2Z3 Hose bib 25.02
Phone:( ) 4, i 3 7 i Fax ( ) Ice maker 12.51
l L1 v` W' API" , <,;•, Q CONT.U'r PEILSON Tr trtct'gtorfgrus ImP 25.02
Business Poore: ' Medical gas(valets:$:_) 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/showerishower pan 12.51
E-mail: `Urinal 35:'02
n a
�,, k, r . z ' ' z' a _ „y , f - Water closet 25:02
I
2 >
� z ��s.,-,....�ss�, ��,. a._�. . „�tm.�.�.�. ., .4 �r� ., ...e>� Water heater 37.52
Business name: �1ph0 C)M Qep4
// Au lt7h//1 [� Water piping/DW V 56.29
Address: ZOJ 1 � 4. ya S Pr J Other: 25.02
"I 97/ 6� 9,1/ 3 2 Subtotal
City/State/ZIP: nl����
Phone:7/) 475 08('j.L Fax:( ) Minimum permit fee: $72.50
CCB Lie.: /c/4 C°Ey 09// Ptninbing Lie.na: v' Plan review (25% ofpermttfea)
`''/AA State�surcharge(1 no of pemntfee) �M
Authorizedsrgnal/We:- �/I�a, G P IJ I14 i 7/�r3 TOTAL PERMIT WE j -✓
Print name: �1 ,,,,r GGGGni .. I/Q al I..Date: 6 Z31zi This pern:ef spphcaterit.hasr_-.f. permit.....n..,peered wirh.r•.6R.Q.d_,..
/,' t--iO t j / after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\BuIdlag\PermildNLMO-PermitApp.doe 10/01/09 4404616T(l0/02/COM/WEB)