Permit CITY OF TIGARD PLUMBING PERMIT
1111 I COMMUNITY DEVELOPMENT Permit#: PLM2014-00390
Date Issued: 12/03/2014
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S111CD04000
Jurisdiction: Tigard
Site address: 9545 SW BRENTWOOD PL
Project: Wenner Subdivision: SUMMERFIELD NO.9 Lot: 529
Project Description: Master bathroom remodel,hall bath remodel,kitchen remodel,move laundry to garage,install water piping for
tankless water heater.
Contractor: ASSURED PLUMBING INC Owner: SHERMA WENNER
PO BOX 230816 9545 SW BRENTWOOD PL
PORTLAND, OR 97281 TIGARD, OR 97224
PHONE: 503-985-9093 PHONE:
FAX: 971-249-3145
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 12/03/2014 $31.27
Specifics: 1 ea Clothes Washer 12/03/2014 $25.02
1 ea Dishwasher 12/03/2014 $25.02
Type of Use: SF 1 ea Ice Maker 12/03/2014 $12.51
Class of Work: ALT 1 ea Sink 12/03/2014 $25.02
Type of Const: 2 ea Lavatories 12/03/2014 $50.04
Occupancy Grp: 2 ea Tub/Shower/Shower Pan 12/03/2014 $25.02
Stories: 2 ea Water Closet 12/03/2014 $50.04
1 ea Water Heater 12/03/2014 $37.52
1 12%State Surcharge- 12/03/2014 $33.78
Plumbing
Total $315.24
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: ( Q \, ( ''/ Permittee Signature: x
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 Applicati
Building Fixtures I ECEIVEh FOR OH I It I. USE ONL1
City of Tigard Received /3/ y ( Permit No.: /> j[��� q0
. Datem : /� r -.+ r
13125 SW Hall Blvd.,Tigard,OR 97�C 3 2 4 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960
Date/By: Other Permit No.:
Inspection Line: 503.639.4175
TIGARD ■
r1( AR ) Date Ready/By: tuns El See
Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
rmation
TYPE O {p G
DIVISION FEE* SCHEDULE
❑New construction ❑Demolition For special information use checklist
Description I Qty. I Ea. I 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
0 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:9454 SW Brentwood place 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/bldgJapt.no.: I Project name:Wenner Manufactured home utilities 50.03
Cross street/directions to job site: 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.: ) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 1 31.27
Backwater valve 12.51
DESCRIPTION OF WORK
Clothes washer 1 25.02
Master bath remodel,hall bath remodel,kitchen remodel,move laundry to garage Dishwasher I 25.02
tankless water heater Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name:Sherma Wenner Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:9545 SW Brentwood Place
Garbage disposal 25.02
City/State/ZIP:Tigard,OR 97224 Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 1 12.51
❑ APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:TL Remodel&Construction Inc Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Tim Labunsky
Roof drain(commercial) 12.51
Address:PO Box 1996 Sink/basin/lavatory 3 25.02
City/State/ZIP:Lake Oswego,OR 97035 Solar units(potable water) 62.54
Phone:(503)984-2783 Fax::( ) Tub/shower/shower pan 2 12.51
E-mail:TLRemodel @yahoo.com Urinal 25.02
Water closet 2 25.02
CONTRACTOR
Water heater 1 37.52
Business name:Assured Plumbing Inc Water piping/DWV 56.29
Address: PO BOX 230816 Other: 25.02 ,
City/State/ZIP:Portland,OR 97281 Subtotal �' 144;
4J
Phone:(503)985-9093 / Fax:( ) Minimum permit fee: $72.50 -�--
1 l r9 Plan review (25%of permit fee) �^
CCB Lic.: l�`/g, 1 Plumbing Lic.no.: hilt) `1.1
�^ � State surcharge(12%of permit fee) 3 .7 cg
Authorized signature: / - TOTAL PERMIT FEE / 15r o'
Print name:Mi uel Dorantes /14 This permit application expires if a permit is not obtained within 180 days
g after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board. 1
1:\Building\Permits\PLMU-PermitApp.doe 10/01/09 440-4616T(10/02/COM/WEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9545 SW BRENTWOOD PL, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Plumbing PLM2014-00390
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
PASS - NoCofO
Comments:
Corrections done.
Violation Summary:
Inspector Contractor
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
9545 SW BRENTWOOD PL, TIGARD, OR, 97224
Residential - Plumbing
399 Plumbing final
FAIL
May 5, 2015 at 3:13:31 PM
PLM2014-00390
David Young
Check slow draining kitchen sink for obstructions. fixture not working properly, at: 310.4
Seal drain pipe penetration thru foundation in garage.
Violation Summary:
Inspector Contractor