Permit p CITY OF TIGARD PLUMBING PERMIT
�r1 I ' COMMUNITY DEVELOPMENT Permit#: PLM2014-00386
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718,2439 Date Issued: 11/26/2014
Parcel: 2S112CA03400
Jurisdiction: Tigard
Site address: 15270 SW 79TH AVE
Project: Trevor Subdivision: DURHAM ACRES Lot: 30
Project Description: Replace approximately 50'of water service.
Contractor: OWNER Owner: BRETT TREVOR
BRETT TREVOR 15270 SW 79TH AVE
15270 SW 79TH AVE TIGARD,OR 97224
TIGARD,OR 97224
PHONE: 541-350-0383 PHONE: 541-350 0383
FAX:
FEES
Quantity Description Date Amount
50 If Water Service 11/26/2014 $62.54
Specifics: 1 12%State Surcharge- 11/26/2014 $8.70
Plumbing
Type of Use SF 10 ea Minimum Fee Adjustment- 11/26/2014 $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.
Issue By: / Permittee Signature: irm
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 Applicatio x
Utilities i JEIUF
Site U 1J FOR OFFICE I SF oNI.l
City of Tigard NOV 26 2F.F.4 Received // a'� / .f) Permit No.: ,24 -aO 3cYp
Date/By:13125 SW Hall Blvd.,Tigard,OR 9
a Phone: 503.718.2439 Fax: 503.4 1 'IeMu Date/By:Review Other Permit No.:
NI Date/By:
Inspection Line: 503.639.4175 h T I G A R D :j mowt ni lelnl Date Ready/By: tuns: ® See Page 2 for
Internet: www.tigard-orgov
Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑New construction ❑Demolition For special information use checklist
Description 1 Qty. 1 Ea. 1 Total
®Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
® 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ❑Multi-family Each additional bath kitchen 25.02
❑ Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 15270 SW 79th Ave Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name:79th house Manufactured home utilities 50.03
Cross street/directions to job site:Thusrton Ln Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.:50) 1 Page 2 62.54
Subdivision: 1 Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
Backwater valve 12.51
DESCRIPTION OF WORK
Clothes washer 25.02
Replace main water line from meter to house Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER f ❑ TENANT Expansion tank 12.51
Fixture/sewer cap 25.02
Name:Brett Trevor
Floor drain/floor sink/hub 25.02
Address: 15270 SW 79th Ave Garbage disposal 25.02
City/State/ZIP:Tigard,OR 97224 Hose bib 25.02
Phone:(541)350-0383 Fax:( ) Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name:
Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
Urinal 25.02
E-mail:
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: C w f`` l+L Water piping/DWV 56.29
Address: Other: 25.02
City/State/ZIP:
Subtotal 62.54
Phone:( ) Fax:( )
Minimum permit fee: $72.50 72.50
Plan review (25%of permit fee)
CCB Lie.: Plumbing Lic.no.:
State surcharge(12%of permit fee) 8.70
Authorized signature: '/- 21 .y /1'j TOTAL PERMIT FEE 81.20
(( -�V �l 666///��� ����CJ This permit application expires if a permit is not obtained within ISO days
Print name: Date: after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I.\Building\Permits\PLMU-PermitApp.doe 10/01/09 440-4616T(10/02/COM/WF.B)
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
15270 SW 79TH AVE, TIGARD, OR, 97224
Residential - Plumbing
399 Plumbing final
PASS - No C of O
PLM2014-00386
George Heimos
Violation Summary:
Inspector Contractor