Permit 'piCITY OF TIGARD PLUMBING PERMIT
ii
t . . COMMUNITY DEVELOPMENT Permit#: PLM2021 00510
Date Issued: 12/21/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439iris .
Parcel: 2S111DB07000
)j- `;ri Jurisdiction: Tigard
Site address: 15400 SW ALDERBROOK DR
Project: BLEM Subdivision: SUMMERFIELD NO.7 Lot: 391
Project Description: 80 ft.of storm sewer,rain drain connectors, low point drain in crawl space,and sump pump.
Contractor: CURTIS HEINTZ EXCAVATING INC Owner: BLEM, ROBERT WILLIAM
PO BOX 1105 BLEM, GEORGENA LEE RIEGEL
SHERWOOD, OR 97140 15440 SW ALDERBROOK DR
TIGARD, OR 97224
PHONE: 503-925-9400 PHONE:
FAX: 503-925-8014
FEES
Quantity Description Date Amount
1 ea Catch Basin or Area Drain 12/20/2021 $18.76
Specifics: 4 ea Rain Drain Connector 12/20/2021 $75.04
80 If Storm Sewer 12/20/2021 $62.54
Type of Use: SF 1 ea Ejectors/Sump 12/20/2021 $25.02
Class of Work: ALT 1 12%State Surcharge 12/20/2021 $21.76
Type of Const: Plumbing
Occupancy Grp: 45 Misc Administration Fee 01/21/2022 $45.00
Stories:
Total $248.12
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:# L'G „r7 Permittee Signature: ' o
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.
CITY OF TIGARD PLUMBING PERMIT
2 COMMUNITY DEVELOPMENT Permit#: PLM2021-00510
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/21/2021
Parcel: 2S 111 DB07000
Jurisdiction: Tigard
Site address: 15440 SW ALDERBROOK DR
Project: BLEM Subdivision: SUMMERFIELD NO.7
Lot: 391
Project Description: 80 ft.of storm sewer, rain drain connectors, low point drain in crawl space,and sump pump.
Contractor: CURTIS HEINTZ EXCAVATING INC Owner: BLEM, ROBERT WILLIAM
PO BOX 1105 BLEM, GEORGENA LEE RIEGEL
SHERWOOD, OR 97140 15440 SW ALDERBROOK DR
TIGARD, OR 97224
PHONE: 503-925-9400 PHONE:
FAX: 503-925-8014
FEES
Quantity Description Date Amount
1 ea Catch Basin or Area Drain 12/20/2021 $18.76
Specifics: 4 ea Rain Drain Connector 12/20/2021 $75.04
80 If Storm Sewer 12/20/2021 $62.54
Type of Use: SF 1 ea Ejectors/Sump 12/20/2021 $25.02
Class of Work: ALT 1 12%State Surcharge- 12/20/2021 $21.76
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $203.12
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
Building Fixtures
City of Tigard I Y eoeivea ]
p9722.PC )ate/By: /�1�/f t Permit No.:�i may,;j y��/`y
13125 SW hall Blvd.,Tigard,OR Ptau Review `"'r w�r�+
• Phone: 503.718.2439 Fax: 503.598.1960 Date/By: /� Other Permit No.:
Inspection Line: 503.639.4175 qq(�qq
y• NA,j -
T I G A R D �1 t G�L Due ReadylBy Jam. 64. See Page 2 for
I Internet. www.tigard-orgov NonfiediNlethod: •Ii ,)I Supplement:d Information
TYPE OF '%ORK 'r ,v •nia-,i ,', FEE* SCHEDULE4
New construction For special in ormation use checklist
❑ ❑Demolition P 1
- Description I Qty. 1 Ea 1 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
Ei 1-and 2-family dwelling IDCommercial/industrial SfR(2)bath 437.78
buildingSIR(3)bath 5C)0.32
❑Accessory ❑Multi-family
- - Each additional bath/kitchen 25.02
❑Master builder ❑Other:
Fire sprinkler( sq.II.) Page 2
.10D SITE'INFOR;NA'I ION AND LOCATION Site utilities:
Job site address: 15440 SW Alderbrook Dr Catch basin or area drain 1 18.76 �� 7G�
Drywell,leach line,or trench drain 18.76
City/State/ZIP: Tigard, OR 97224
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name: /5 ,,y,.y Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76 - c /ti
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear II.: 80) X Page 2 6,#2 .5
Water service(no.linear:1:_) Page 2
Subdivision: -
I IIII., no.: Fixture or item:
Tax map/parcel no.: Baekflow preventer 31.27
DESCRIPTION OF WORK - Backwater valve _ 12.51
Clothes washer 25.02
Rain Drain Connectors, 80 feet for storm/rain drain Dishwasher 25.02
low point drain in the crawlspace, and sump pump Drinking fountain 25.02
Ejectors/sump 1 25.02 1(5-,�cj_
' ❑ PRO!'ER'fy 01'I'1NI,R ❑ `ri:s"NT Expansion tank 12.51
Name: �/ x
Fixture/sewer cap 25.02
f� �4 ��✓ /„(e' " Floor drain/floorsink/hub 25.02
Address: �
Garbage disposal 25.02
City/State/ZIP: Ilose bib 25.02
Phone:( ) <ax:l Ice maker _- _._1 12.51
►3 APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name: Faster
Medical gas(value:$ ) Page 2
Faster Permits _
-- Primer 12.51
Contact name: Dan Williams Roof drain(commercial) 12.51
Address: 2000 SW 1st Ave, Suite 420 Sink/basin/lavatory 25.02
City/State/ZIP: Portland, OR 97201 Solar units(potable water) 62.54
Phone:(503)81 9-7754 Fax::( ) Tub/shower/shower pan 12.51
Urinal 25.02
1Inail dan@fasterpermits.com
CO�T1`RACd'OR Water closet 25.02
Water heater 37.52
11030 ncunw. r /�
��3 l YZ ) water plphtg UW V 10.29
Address: I0 j JLC 1 .CJ / ,} /�1 /O Other: 25.02
/r
City/State/ZIP: ' fit 'ci A y 9/40 Subtotal /fl: ,
�+� �ry f r� / Minimum permit tee $72.50
Phone:(JCi �t J Fax: �Gf !
" j� Plan review (25%of permit fee)
CCD lie q.��,y✓ Plumbing Lie.no.: `1
TT State surcharge(12%of permit tee) ,21 , 76
Authorized signature rl'...p 1'O'T'AL PERMIT FEE
3z13: rA
Print �; �/2/ y� ".,,/ This permit application expires if p permit is not obtained within ISO days
ttattlf: Date: , r/ (j� after it has been accepted as complete.
"Fix methodology set by Tri County Building Industry Service Board.
IABuilding\t'ennin4P1..MU•Perm0 App.doe 10/01/09 440-4616T(10/02/COM/WEn)