Permit n CITY OF TIGARD PLUMBING PERMIT
' 7 2 ' • COMMUNITY DEVELOPMENT Permit #: PLM2011 -00384
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/29/2011
Parcel: 2S 109ACO3200
Jurisdiction: Tigard
Site address: 13361 SW ANGUS CT
Project: ROMMEL Subdivision: WILSON RIDGE Lot: 6
Project Description: Bathroom remodel.
Contractor: ROBERT FOWLER CONSTRUCTION SERVICES Owner: ROMMEL, SCOTT R & !LIANA
18350 NE BALD PEAK RD 13361 SW ANGUS CT
NEWBERG, OR 97132 TIGARD, OR 97224
PHONE: 503 - 550 -5829 PHONE:
FAX:
FEES
Quantity Description Date Amount
2 ea Tub /Shower /Shower Pan 12/29/2011 $25.02
Specifics: 1 12% State Surcharge - 12/29/2011 $8.70
Plumbing
Type of Use: SF 47 ea Minimum Fee Adjustment - 12/29/2011 $47.48
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
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: •ermittee Signature: O /
- ice/ 4
01112. = i
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.
PlumbiniPermit Application �)
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Building Fixtures 06‘N l�t) t - i)hl•u - r l `+1- \r., - Roceival , Permit No.: r I _. 3 City of Tigard � DatdU :
y . w 13125 SW Hall Blvd„ Tigard, OR 97?�2� i "+ w Plan Review
1 Phone: 503.718.2439 Fax; 503.598\060' � O* Date/% other Permit t1o.:
Inspection Line: 503.639.4175 O V ♦ S Date Ready/11y: 1uris • WI See Pale 2 for
'1 I A it t ) /memo , www,tigard- or,gov ��r�� �C Notified/Method; TM, Supplemental Information
TYPE OF WO4AV
FEE' SCHEDULE
• Demolition F or. speelelormofdon use checklist.
I=1 Ncw construction Description I Qtv..1 La. I Total
N Addition/altcrationhcplacemcnt ❑ Other: New 1.2- famlly dwelliuga (includes 100 ft, for each utilily,connection)
CATEGORY OF CONSTRUCTION SFR (l) bath 312.70 • 437.78
SFR (2) bath
0 1- and 2 family dwelling ❑ Commercial /industrial 500.32
SFR (3) bath
❑ Accessory building 0 Multi ihmil Hach additional bath/kitchen 25.02
❑ Master builder ❑ Other; Fire sprinkler (_ s4. R,) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Catch basin or area drain 18.76
job site address: 13361 SW Angus Court . .
Drywell, leach line, or trench drain 18.76
City/State/ZIP; Portland, OR 97224 II hootin drain (no linte R .: Page 2
Suite/bldg./apt. no,; rvy €.'( Manufactured home utilities 50.03
Manholes 18.76
Cross street /directions to job site: Bull mountain road Man 18.76
-' Rain drain connector
Sanitary sewer (no, linear fl.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Water service (no. linear ft.: _ ) Page 2
Subdivision: lot no,; Fixture nr iltin:
Backflvw preventer 31.27
Tax map /parcel no.; Backwater valve 17.51
DESCRIPTION OF WORK
Clothes washer , 1 25.02
Bathroom remodel Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump J 25.02
PROPERTY OWNER ❑ TENANT W
Expansion lank 12.51
Fixture /sewer eap 25.02
Name: Scott & llllana Rommel Floor drain /floor sink /h 25.02
Address: 13361 SW Angus Court Garbage disposal 25.02
- ,_----
City /State/LIP: Portland, OR 97224 Hose bib 25.02
Phone; (503)957 r flX • ( ) ice maker 12.51
- _
® 22. 51
APPLICANT ❑ CONTACT PERSON interceptor /grease trap
- •- Medical gas (value: $ ,) , Page 2
Business name: Wacker Remodel LLC Primer 12.51
Contact name: Scott Wacker Roof drain (commercial) 12.51
Address; 1126 SF 52' Avcrnue Sink/basin/lavatory 25.02
Solar units (potable water) 62.54
City /State /7..IP: Portland, OR 97215 2 12 51
F ax:: (5 03 236 -7497 Tub/shower /shower pan
Phone: (503) 539 -9650 )
Urinal 25.02
E -mail: Scottrg@wackerremodel.eom Water closet 25.02
CONTRACTOR Water heater 37.52
Business name: Robert li awnler Plumbing _Water piping/DW V 56.29 _
her: 25.02
Address: 18350 NE Baldpeak Road O t • Subtotal
City /State /LIP: Newberg, OR 97132 ��
Minimum permit fee: $72 72.50
Phone; (503) 550 -5829 Fax: ( ) Plan review (25% of permit tee) - _
CCB Lie.: 150987 11 NAM Plumbing Lie, no.: Pb-705 • r 1 _ State surcharge (12% of permit fee) : ` �. 7(1.
Authorized signature: / TOTAL P RMl'I' FEE gi .
J/ Ir Th1s permit application expires If n permit is not obtained with n 180 days
Print name: Robe. Fownle after it hat: been accepted as complete.
*Foe methodology at by Tri -County 13,1ilding industry Service hoard.
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