Permit (8) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2023-00234
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 6/26/2023
Parcel: 2S103CB01000
Jurisdiction: Tigard
Site address: 12275 SW JAMES ST
Project: Gwynn Subdivision: WILLAMETTE NO.2 Lot: 9
Project Description: New sewer connection to existing dwelling.
Contractor: SUBCOM EXCAVATION & UTILITIES LLC Owner: GWYNN, SHANE&APRIL
PO BOX 4055 12275 SW JAMES ST
HILLSBORO, OR 2022 TIGARD, OR 97223
PHONE: 503-648-9310 PHONE:
FAX:
FEES
Quantity Description Date Amount
100 if Sanitary Sewer 06/26/2023 $62.54
Specifics: 1 12%State Surcharge- 06/26/2023 $8.70
Plumbing
Type of Use: SF 10 ea Minimum Fee Adjustment- 06/26/2023 $9.96
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
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: r. A LLC3���!n
/
H6 'fl_l2-D
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.