Permit Support Document CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT ) Permit#: PLM2022-00047
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 2
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Parcel: 2S103 22
S103AA00900
Jurisdiction: Tigard
Site address: 11000 SW WALNUT ST
Project: KEPHART Subdivision: ECHO HEIGHTS Lot: 6
Project Description: Sewer connection for an existing dwelling.Septic tank to be pumped and filled.
Contractor: LHOTKA CONSTRUCTION LLC Owner: KEPHART, DAVID A&KIMBERLY D
11945 SW KATHERINE ST 11000 SW WALNUT ST
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503-807-7619 PHONE:
FAX:
FEES
Quantity Description Date Amount
100 If Sanitary Sewer 02/17/2022 $62.54
Specifics: 1 12%State Surcharge- 02/17/2022 $8.70
Plumbing
Type of Use: COM 10 ea Minimum Fee Adjustment- 02/17/2022 $9.96
Class of Work: ALT Plumbing
45 Misc Administration Fee 03/01/2022 $45.00
Type of Const:
Occupancy Grp:
Stories:
Total $126.20
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:
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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.