Permit (20) 71 CITY OF TIGARD PLUMBING PERMIT
Permit
_ COMMUNITY DEVELOPMENT #: PLM2023-00390
Date Issued: 9/5/2023
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S136AA09800
Jurisdiction: Tigard
Site address: 10225 SW MCKENNA PL
Project: Riehl Subdivision: VENTURA ESTATES Lot: 20
Project Description: Re-pipe water throughout house.
Contractor: BLACKWELL PLUMBING LLC Owner: RIEHL, JAMES A&JESSICA
9155 SW NORTH DAKOTA ST 10225 SW MCKENNA PL
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503-451-1803 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Water Piping/DWV 09/05/2023 $56.29
Specifics: 1 12%State Surcharge- 09/05/2023 $8.70
Plumbing
Type of Use: SF 16 ea Minimum Fee Adjustment- 09/05/2023 $16.21
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 Cent . hose 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: 1
9.:17,..W.." , 1.1 (.1).(r If,t6/1.44,
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 ApplicatioRECEIVED
�1 V/C
C
Building Fixtures FOR OFFICE USE ONLY
City of Tigard AUG 31 2023 Date/By: 13iIuti3 9 PermitNo.: p1IM lib 23•GYl3gU 1
• 13125 S50 Hall Blvd.,Tigard OR 97223 P�Renew O,G• s Phone: 503.7182439 Fax: 503.598.1 Other Permit No.:
Inspection OF TIGI�RD Da1�'
Inspection Line: 503.639.4175 Datc ReadyBy: -uric ® See Page 2 for
TIGARD Internet: www.tigardor.gov BUILDING DIVISION Nodfied/Method: Supplemental Information
TYPE OF•WORK
FEE* SCHEDULE
For special information use checklist
0 New construction ❑Demolition Description Qty. I Ea. I Total
l'sfAddition/alteration/replacement 0 Other New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
SFR(2)bath 437.78
i"11-and 2-family dwelling 0 Commercial/industrial 500.32
SFR(3)bath
❑Accessory building ❑Multi-family _ Each additional bath/idWhen 25.02
❑Master builder 0 Other Fire sprinkler(_sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Catch basin or area drain 18.76
Job site address: C L r).r7_.pileach line,or trench drain 18.76
L.J Drywall,
City/State/ZIP: 14•-,c! t 3 2 i� Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name: (_"._ ' Manufactured home utilities 50.03
Croossystreet/directions to job site: Manholes 18.76
.76
c,c_2bk aninitarys connector 1Page 2
sewer(no linear ft.: ) B
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.:_ ) Page 2
Subdivision: I Lot no.: Fixture or item:
Backflow preventer 31.27
Tax map/parcel no.: Backwater valve 12.51
DESCRIPTION OF WORK Clothes washer 25.02
9\,u tf r(/ lx)L Dishwasher 25.02
-' "1 Drinking fountain 25.02
Ejectors/sump 25.02
( TENANT Expansion tank 12.51
PROPERTY OWNER ❑
Fixture/sewer cap 25.02
Name:-1 C-� Ck' f y.-x: e-k( --�' Floor drain/floor sink/hub 25.02
Address: )(n_--2. 7L) }LA C key). O- �� Garbage disposal 25.02
City/State/ZIP:�0 [ Cf��2/ Hose bib 25.02
Phone:( ) Fax:( )
Ice maker 12.51
A APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Medical gas(value:$_) Page 2
Business name. ti C L/lt(9(4' floyik 1 / u_ Primer 12.51
Contact name: i'l I 2x Roof drain(commercial) 12.51
Address:CI5 � �r ,}� Sink/basin/lavatory 25.02
City/State/ZIP:
''r~1:1 6,....e.4 9. 2 Solar units(potable water) 62.54
(tom.)
Phone:(t c.d I - I'wi 3 I Fax::( ) Tub/shower/shower pan 12.51
' �f. _�'� Urinal 25.02
E-mail:b1.,,L�i-LAW ii f '�LJ`)if+�t�l: 1 , t Jv�. 25.02
111 `J Water closet
CO OR Water heater 37.52
iii I'Business name. 0. V Waterpi�p)ing�/D�WV .�7
Address:C114 ,t)J�D,c V Otlme>a ' 25.02 25:�Y
City/State/ZIP D' -723 I Subtotal
Minimum permit fee: $72.50 �Z" `
��j ax:( )
Phone:�Y- J 1 �� Fax:_-_ 2,5�� Plan review (25°h of permit See)
CCB Lic.: � Plumbing Lic.no.:c. State surcharge(12%of pemlit fee) X.-.7
Autho' si t tore /� TOTAL PERMIT FEE g 23
prifp��►/pft�{ ^'Ijtj De ! 2..9 Tbis permit appiieadon expires if a permit is not obtained within 110 days
! after it bea b-eo accepted a cImulete.
"Fee methodology set by Tri-Cowry Building Industry Service hoard.
1:IBuildivg\PamRdPT.MU-PenaaApp.doc 10/01/09 440-4616T(10/02/COM/WEn)