Permit CITY OF TIGARD PLUMBING PERMIT
11111 * COMMUNITY DEVELOPMENT Permit#: PLM2015-00013
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/20/2015
Parcel: 2S112CD07300
Jurisdiction: Tigard
Site address: 15838 SW 76TH AVE
Project: Smith Subdivision: 1994-100 PARTITION PLAT Lot: 1
Project Description: Bathroom remodel,(2)lays,(1)tub/shower&(1)toilet.
Contractor: B AYRES PLUMBING&CONTRACTING INC Owner: SMITH, ROBERT W&JUDITH C TRUST
PO BOX 149 15838 SW 76TH AVE
CANBY, OR 97013 TIGARD, OR 97224
PHONE: 503-266-5955 PHONE:
FAX: 503-266-5957
FEES
Quantity Description Date Amount
2 ea Lavatories 01/20/2015 $50.04
Specifics: 1 ea Tub/Shower/Shower Pan 01/20/2015 $12.51
1 ea Water Closet 01/20/2015 $25.02
Type of Use: SF 1 12%State Surcharge- 01/20/2015 $10.51
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $98.08
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 questie s o OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued :y: j Permittee Signature.
•
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.
01/20/2015 09:52 5032665955 TRISTA PAGE 02/02
Plurbin Permit A lication EIVED
Building Fixtures FOR 01-I,1(•I( l SL ()NIA
City of Tigard 2 0 2015 Received e/ : / ale �-, Permitxo.: 0�jy�Ol�_ X13
IN- • 13125 SW Hall Blvd.,Tigard,OR 9 Plan Review
Phone: 503.718.2439 Fax: 5 I Y 9 DateDate/By: Other Permit No.:
Inspection Line: 503.639,4175 L ur TIGARD Date Ready/By: runs 81 See Page 2 for
TIc,ARD
lntemet: www.tigard-0rgovBUILDING DIVISION rlwiScdRctelhod supptemantaltafurm:tiva
a r i!,tt. , tttlitn+laa itt � Lptgli dN,ITrttfltP.m:e rho f,n;ta�'iiaJtatlpW _ lfar� :4!11i?∎∎ni l oAilil:,tx ±V.'t Ei ntP�t r r S4 Hliii4 7 •rtn{ ._ iiiiiflllj.lima hnt€Ift1;ig
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'�^� ,4T'I:�t �_�n ,., Ik)n��rn,.CI1u�d7�l�TrF. {, WF.�: 5.,:."�,-„■ ,�., � rvll'1l, ,v ,z. _... 1r � .• -
-F Ott n �,.,. ..
❑New construction ❑Demolition
Fur spedaf lntbrm on use checklist.
Description ,I Qly. I Ea, I Total
®Addition/alteration/replacement ❑Other. New I-2-family dwellings(includes 100 ft.for each utility connection)•a ",•r i t 1aG LaaIIao-ccf!.:4�1A t:n,nn un.mu'p 4.''' 9' 'rtre teI''''. G a t] M II7�II- 1„ t t t 1 i:Itllt ,6
SFR(1)bath 312.70
i, Io t ,i,r 1i�(1f1d t, i;a i it rr 6tliihAatrg, .n t n.>rtl i ttl t,II-^L lla ' .
, ® I-and 2-family dwelling SFR(2)bath 437.78
y g ❑Comrnercial/industrial
~
SFR(3)bath 500.32
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler(^sq.ft.) Page 2
tiu I E r ! -hy t l I1 a #IIII ! II„F I: Site utilities:
...,..,,, -a:,.,„ :-,- r< ' c..m-.z:`:,:�,r..«,:Wit:; amr: t..._:..._.........:: ,••. --
Job site address:15838 SW 76th Ave. Catch basin or area drain rain 18.76
--•--•-- Dry-well.leach line,or trench drain 18.76
Cityy/State/Z1P:Tigard,OR 97224
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt-no.: Project name: ON I f1-4' Manufactured home utilities 50.03
Cross street/directions to job site: Manholes _ 18.76
Rain drain connector 18.76 I
Sanitary sewer(no.linear ft.: ) Page 2 I
Storm sewer(no,linear ft,: ) Page 2
Water service(no.linear ft. _) Page 2
Subdivision: j Lot no.: fixture or item:
Tax trap/parcel no.: Iiackflow preventer 31.27-
t
t d {,I i i!t , i p Backwater valve 12.51
,Iii,..... iii 91 VIII � ti11 e ,5�/�},� i t3 !.l it i.v...1,11: 1 �i! 1.'.
Clothes washer - 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
I..ata„ tl t J iii i.� a ng �' 1 } " 1 Vtl Bv , ;+ Ex usion tank i251
Name: Fixture/sewer cap 25.02
------ Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02 City/State/ZIP: Hose bib 25,02
Phone:( ) Fax ( ) Ice maker 12.51
liti }' i t- ? 1 �mClpf . lfll1lL7I�il'-='( w,L.iu lil;rl: &t i 'i!.:'.P, Interceptor/grease trap 5-•
., Ilel,v,�i ,�5��,,.-...,,,,,1R,i,., -�IJF'idl 'f't. t I ., -•
Business name Medical gas(value$_) Page 2
Primer 12.51
Contact name:Trista Ayres -
--,- Roof drain(commercial) 12 51
Address: Sink/basin/lavatory 2 25.02 50.04
v
City/State/ZIP: Solar units(potable water) 62.54
-
Phone:(503)266-5955 I Fax: :(503)266-5957 Tub/shower/shower pan 1 12,51 12.51
E-mail:ayresplumbing®gmail eom
Urinal 25.02
IN:m.t.i�a Lauu Cam mT t nt41: r, i tip.;,Iii!ivti c=:.lrri::Q.:4u, rAili V.Je�kk�� ifii. Water closet 1 25.02 25.02
2,tli ltittili,iitllEltintrtiiMiit�: '..r i' 'AliN to Pf1I>ZERI iiVili niiNiinnini!Zi}8ifl� 1R Jii∎1, Water heater 37.52
Business name:B.Ayres Plumbing Water piping/DWV 56.29
Address:PO Box149 Other: 25.02
City/State/ZIP:Canby,OR 97013 Subtotal 87.57
Phone:(503)266-5955 Fax:(503)266-5957 Minimum permit fee: $72.50
CCB Lie.:173825 Plumbing Lie.no.:PB301 Plan review (2 5%of permit fee)
State surcharge(12%of permit fee) 10.51
Authorized signature; S,,,,,......0 TOTAL PERMIT FEE 98.0%
Print name:Trista Ayres Datc: 1/20/2015 This permit appttcytion etpires if a permit is not obtained within 180 clays ,
after •it bas been accepted as complete. V'
*Fee methodology set by Tri-County Building Industry Service Board...
I:\Building\Pcrmite\PLMt1-PcrmiiAeo.doc 10/01/09 440-461OT(10/07/COM/WED)
01/20/2015 09:52 5032665955 TRISTA PAGE 01/02
E.1471,4,
Plumbing &
Contracting, Inc
'RESIDIN11AL•COMM.Nl'U
Rellabie Pi You
Can T•64-It FAX COVER
OFFICE: 503-266-5955
FAX: 503-266-5957
TO: DEBBY—CITY OF TIGARD
503-598-1960
1 OF 2 PAGES INCLUDING COVER
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
15838 SW 76TH AVE, TIGARD, OR, 97224
Residential - Plumbing
399 Plumbing final
PASS - No C of O
PLM2015-00013
George Heimos
Violation Summary:
Inspector Contractor