Permit v CITY OF TIGARD PLUMBING PERMIT
2 : COMMUNITY DEVELOPMENT Permit #: PLM2013 00076
Date Issued: 03/11 /2013
TIGARD
I G ARD. 13125 SW Hall Blvd , Tigard OR 97223 503.718 2439 Parcel: 2S111AC00700
Jurisdiction: Tigard
Site address: 14595 SW 91ST AVE
Project: Walters Subdivision: PINEBROOK TERRACE Lot: 5, PLUS
Project Description: (1) 40 linear ft. sanitary sewer, (1) 4" drain in crawl replacement
Contractor: EXCELLENCE PLUMBING LLC Owner: WALTERS, JIMMY C AND
7520 SW 140TH AVE NORMA M
BEAVERTON, OR 97008 14595 SW 91ST AVE
TIGARD, OR 97224
PHONE. 503 - 643 -3459 PHONE
FAX: 503 - 643 -2815
FEES
Quantity Description Date Amount
1 If Sewer Service 03/11/2013 $62 54
Specifics: 1 12% State Surcharge - 03/11/2013 $8 70
Plumbing
Type of Use SF 10 ea Minimum Fee Adjustment - 03/11/2013 $9 96
Plumbing
Class of Work: ALT
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: Permittee Signature: 9 f #PP.0 , / � /1 n,
}tdrcul2e.y C alll l 033.639.4175 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.
03/11/2013 09:55 5036269149 POSTALANNEX PAGE 01/02
Plumbing Permlit licat RECEIVED
Site Utilities 1 ()I TICE I.ISi.: ONL\
City of Tigard MAR :
MAR 1 1 2013 Reeoivcd 1 i 13 s; Permit No.: 'Lw av13 - ?GU /k
3
■ a Phone: 03 7182439 Tigard, 503. 98.19010T 1 IG ARD I , t e/B y Other Permit Nu.:
Inspection Line 503,639.4175 BUILDING DNISIO 1 oars RendyfBy r P m b l lnfnfne.ItOP
Tic ,1 l: D Internet; www.tigard- or.gov Not d/Method:
'' t,tit'�VV t.c - '
•,,r `.. :,. :. •, "• > _. . us
,,checklist
< ' . ';. • : ; icora it onnation
0 Now constructicm 0 Demolition (? escriptign Ea, 1 atnl
Ea AdditioAddition/alteration/replacement ent
❑ Other. New 1- 2- family dwellings (includes 100 it for each utility connection)
312 70
Ca :. SFR (1) bath -
; . .', is #'? ,�s01t �O .G N1 ,' ; . r .... bath 437.78
® 1 - 2- Rnnily dwelling ❑ Commercialdndu.strial SFR (3) bath 500.32
❑ Accessory building El Multi - family
- Each additional hath/kitclrcn 25.02
ID Master builder El Other: Fire sprinkler ( , sq. 11) Page 2
=` ' i1t s `I Iiti kott l .. L& A1:tol f:,.' ' , ` Site ntlndos:
Catch basin or area drain 1 8.76
Job site addrswa:14595 SW 91 st Drywcll, leach line, or trench drain 18,76 „
City/Statc/7.TP:1'ignrd, OR 97224 Footing drain (no. linear R.: ,�) Page 2
- Suite/bldg./apt. no Pr name: Walters Morlutltcturc I home utilities _ 50.03
Cross street/directions 18.76
dircctirnts to job site: 18,76 _
Rain drain connector
-- Sanitary sewer (no. linear ft.: 40) 1 Page 2 62,54
-- Storm sewer (no. linear It: „ ) Page 2
Water service (no. linear ft.: __J Page 2 _
Subdivision: . Lot no.: Fixture or Item:
13ackflow preVcntcr 31.27
Tax map/par-el ne- -. Backwatci valve 12,51
V''' ;'r i^ u' - :• .;p t: t ., o rt3liti . Vl! 1 •-: ; ,„ � ;':- • : ' .. ' : ` �IOthes washer 25.02
R 1 e,d/ ' A' d ' rte - Dishwasher 25.02
c I 25.02
Electors /su
�� 4:44-• C , &p....4.4.- • Drinking fountain Il
L � n1p 25.02
i Expansion tank 12.51
1J;, ?>fiROPE: t owM;'tl:- , ": , T'•1VNA1�'7 .; ,.,':
Fixture /sewer cap 25.02
Name: 'Floor drain /floor sink/hub 25.02
Addr _ . Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone: ( ) Fax• ( ) Ice maker 12.51
Interceptor/grease trap 25.02
Medical gas (value: $ ) • Page 2
Business name: --
12.51
Primer _
Contact name; - Roofdrain (commercial) 12.53
Address: _ Sink/basin/lavatory 25.02
City/Statc/ZTP: Solar units (potable water) 62.54
Phone: ( ) Fax: ' ( ) Tub /shower /shower pan 12.51
25.02
,.
_ Urinal
E-mail: 25.02
.,.. , . Water closet _
tti:, :: •ti,. :'••:•••'
Water ficater 37.52
'[
Business name: Excellence Plumbing, LLC Water piping/t)WV 56.29
Address; 8269 SW Cirrus Dr. Other: 25,02
City/Stote/ZTP: Beaverton, OR _ Subtotal
( )
Phone: (503) 643-3459 Fax: 503 643 -2815 Minimum permit tbe: $72.50 72.50
Plan review (25% of permit fcc)
CC Lie.: 175768 Plumbing Lie. no.: PB344 State surcharge (l2 %of permit fee) 8.70
C'
Authorized signature: G / ,�Q- r TOTAL PCRMiT Ft3F 81,20
•
�� Date: 3-11 -2013 Th7s permit application r _apices it n permit it not obtained within 180 days
Print name: Shelly Eugenio after it has been accepted as complete.
"fee methodology set by Tri- County Building military Service Bbn d.
1;\ Build ingNanniteU'LNnla'cnnitApp.doc IWM/ng 440- 4616T(10/07/COM/ry6A)
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
14595 SW 91ST AVE, TIGARD, OR, 97224
Residential - Plumbing
399 Plumbing final
03/12/2013 10:33
PLM2013-00076
PASS - No C of O
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
14595 SW 91ST AVE, TIGARD, OR, 97224
Residential - Plumbing
310 Crawl drain
03/12/2013 00:00
PLM2013-00076
PASS
Violation Summary:
Inspector Contractor