Permit CITY OF TIGARD ; PLUMBING PERMIT
g COMMUNITY DEVELOPMENT Aa0 Permit#: PLM2014-00316
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/19/2014
TIGARD Parcel: 1S135DB02800
Jurisdiction: Tigard
Site address: 11475 SW 91ST AVE
Project: Nick Milo Subdivision: CHARBEN Lot: 13,DOG
Project Description: Kitchen Remodel. 10/20/14,reprinted to add 75'of water service,(1)hose bib,(1)lay,(1)tub&(1)water closet.
Contractor: POWER PLUMBING CO Owner: SANDBO REVOCABLE TRUST
P O BOX 19418 11475 SW 91ST AVE
PORTLAND, OR 97280 TIGARD, OR 97223
PHONE: 503-244-1900 PHONE:
FAX: 503-244-8825
FEES
Quantity Description Date Amount
75 If Water Service 10/21/2014 $62.54
Specifics: 1 ea Dishwasher 09/19/2014 $25.02
1 ea Hose Bib 10/21/2014 $25.02
Type of Use: SFA 1 ea Sink 09/19/2014 $25.02
Class of Work: ALT 1 ea Lavatories 10/21/2014 $25.02
Type of Const: 1 ea Tub/Shower/Shower Pan 10/21/2014 $12.51
Occupancy Grp: 1 ea Water Closet 10/21/2014 $25.02
Stories: 1 ea Water Heater 09/19/2014 $37.52
1 12%State Surcharge- 10/21/2014 $28.52
Plumbing
Total $266.19
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notif en e . ose rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or dire suestions to OUNC by c• in. a.. 32.1987 or 1.800.332.2344.
I- ued By: ' 4 jf/ ' /, Permittee Si:nature: -`
// '
Call 503.639.4175 by 7:00 a.m.for the next available ins•-ction date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
OCT/20/2014/MON 10:36 AM � � P. 001/001
R�Ct `l`�
Plumbing.Permit Application kett
Building Fixtures OCR FOR OFFICE USE ONL1'
NO
City of Tigard OW O Roceivad 4 At/a ,�.:�' Permit No.: /N'!/t'I7��3/`Q
,`3 4-1010/1‘ Datc/By:
13125 SW 11e11 Blvd.,Tigard,OR .47411'3 ` Plan Review Other Permit Na.:
Phone: 503.7I8.2439 Fax 503 �5�$>))Q y11 Dan -
Inspection Line: 503.639.4175 Sal�"�1` / D�Ready/By; ® See Page 2 for
1IG_11�1) Internet wwwtigard-0rgov Nohfied/Met od _ rT •plcmente
` _ l a -a' %A-.,t .t`, 14 %fi r S f L�O checklist r?Information f j
f For ecia r e'1 lkl , --- _.. 1
''`-- - ' -- !in nrntaGon use
❑New construction W❑I7cmolition Dcscri•lion IIENI Ea. Total
-ITZ Additionlalterationlreplacemeat ❑Other• New 1-2-tamlly dwellings(includes 10011,for each util' connection)
`'I SFR(])bath 31230
JP- - Commercisl/industrral SFR(2)bath _ 437.78
r 1-and 2-family dwelling ❑ SFR(3)bath 11111 500.32
❑Aooessory building ❑Multi-family : • additional b • a • • 25.02
❑Master builder ❑Other: Piro sprinkler sq.ft.) Page 2
. ,,ra a-Pn y e 1•.e l��'trt o1., k Ap>tl6 talUntu l 4 - .`• Site udlltles:
I ._-..., xr�._.._.A-e;.r.. T, rLsk `S'a'`„•lbl. -
•�--���,...� �-•• Catch basin or area drain 18.76
Job site address ' iNi ° 5 t11 '1,A
Drywe11,1each line,or trench drain 18.76
City/State/ZIP: 4 I P '1 3 Footing drain(no.linear R-: ) Page 2
Suite/bldg./apt no: I Project name: /1 „ 'vm 1 m Manufactured home utilities 50.03
crass street/directions to job site: Manholes 18.76
- Rain drain connector 18.76
Sanitary sewer(no_linear ft.: Page 2
_
Storm sewer(no.linear fi.: Page 2
Water service(no_linear ft:"15 ) Page 2 t&•5
Subdivision: ---•, •1-0tno,:�..•-:.-..W- - fixture or-item: . _-.._
- - _..
------ ••- �ac�,dlow pizvcntcr
Tax map/parr2l no Backwater valve 12.51
l a:ic t ); ., • , ,• i,<, r,_ , ;i;:{._- =' Clothes washer 25.02
Mel,_. , tp -eX1•517r2q t1ii1th Dishwasher 25.02
}PL p n 10),1- 0493,16 r Drinking fountain 25.02
1v1 "7 Ejectors/sump 25.02
. f ��rYUt l�{F .nl ..2: 1 a� yS4-�1 jp��v�'�• cwo� lo
Expansion tank 12.5]
- - -
Fixturelsewer cap 25.02
Name: Floor drain/floor sink/hub 25.02
Address: Garbage disposal 25.02
City/StatelZe: _ Hose bib 25.02 L)
Phone;( ) I Fax ( ) Ice maker 12.51
•ti--,.r �••,.;,. �.�.-mot- . •
25.02
} F 2Rij�^�4 , YJ'ls_5r i4G rny" j Y-$1. w C arTd,. rffti-..'5�NA.0 v k`iInterco tor/ in*
Medical gas(value:S ) Page 2
Business name: PS am b!Y d Primer 1,2.51
Contact name: V
/ ,'/(/ 1.6 _ Roof drain(commercial) 12-51
Address: pV I ), 4 I Sink/basin/:vetory 25.02 2S.D 2-
/ • 72 Soler units(potable water)
'hone:(5ZIP: -. BMhower/shower pan 1_ 12.51
Phone:(� )02 - �� Fax::( ) 4/ ��ZS�
Unnai 25.02
Ermai1 Sg(!1'(,2, o%,1 p�,i y�a1 Lt LO, L o �v
{ �.�
,-,E,..--,,r.--T7'. ' r c, n S ilrDk'6i ww--,, r t f 4 Water closet I 25.02
-1-7,-;--,,....::1.;7 , red `v ;n�,t�f3ic;iir1.`----1 :,-,', ,''''' r .,. -�. ,.,"`- `l^`•� 37.52
. ,- ,..:.s .._--.__ Water heater
Business name. 0 i 2:-•t / ., ed /I Gd - / Water piping/DWV 56.29
Address: Lees /1 v / d Li J . ,-C Other. 25.02
City/State/ZIP:
,Z6 Q- ' 2 2- Subtotal w/
Minimum permit*e: 57250 .1-
Phone:(a) ) U- Q Fax:( i.3) ,_,2 1/- ff,K� Plan review (25%of permit fee) r--
CCB I.ia: 5 z3 P bing Lic.no.: -42) p' State surcharge(12%of permit fee) 1 • .0
Authorized signature: J, ,a TOTAL PERMIT FEE p 1,y s,
•G J a ' C This permit application expires If a permit is not obtained within 180 days
Printtlame: r ...1 '-dJ Date:.Al `. . i A . afterithas bean accosted as completes ..
a /
*Fee methodology set by Tri-County Building Industry Service Board.
11HUNdineuerTM LMi1,PemItApp.doc 10!01/09 .
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11475 SW 91ST AVE, TIGARD, OR, 97223
Residential - Plumbing
399 Plumbing final
PASS - No C of O
PLM2014-00316
George Heimos
Violation Summary:
Inspector Contractor