Permit q CITY OF TIGARD PLUMBING PERMIT
Ill * COMMUNITY DEVELOPMENT Permit#: PLM2015 00020
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/21/2015
Parcel: 2S103CD06800
Jurisdiction: Tigard
Site address: 11655 SW FAIRVIEW LN
Project: DAVIS Subdivision: TERRACE TRAILS Lot: 28
Project Description: Replacing water piping throughout house.
Contractor: SARKINEN PLUMBING Owner: DAVIS, RANDI RENEE
34911 NE 127TH AVE. FOWLER, MARCUS RICHARD
LA CENTER,WA 98675 11655 SW FAIRVIEW LN
TIGARD, OR 97223
PHONE: 360-882-2034 PHONE:
FAX: 360-263-7644
FEES
Quantity Description Date Amount
1 ea Water Piping/DVW 01/21/2015 $56.29
Specifics: 1 12%State Surcharge- 01/21/2015 $8.70
Plumbing
Type of Use: SF 16 ea Minimum Fee Adjustment- 01/21/2015 $16.21
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 folio• the r -s adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-009'. .0 ma obtain a •py of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: "(7 Permittee Signature:
--
j„„0" r •
Call 503.639.4175 by 7:00 a.m.for the next available inspectio d. e.
This permit card shall be kept in a conspicuous place on the job site until co pleb.n of he project.
Approved plans are required on the job site at the time of each inspectio .
Plumbing Permit Application �I
Building Fixtures CCI rAI FOR OFFICE USE ONLY
City of Tigard Received
`J g Date/By: I �l l T- - Pennil N" rl�,2j�ES'-t��
13125 SW Hall Blvd.,Tigard,OR 97223 A 1 2015 Plan Review
Phone: 503.718.2439 Fax: 503.598.196(�AN N it Date/By: Other Permit No
T 1�,,\is a Inspection Line: 503.639.4175 " l iV pav Date Ready/By: lure ® See Page 2 for
Internet: www.tigard-or.gov ��11 l ����10 Notified/Method: c„ Supplemental Information
TYPE OF Wc�GV FEE* SCHEDULE
0 N7 construction ❑ emolition For special information use checklist.
Description 1 Qty. ( 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
land 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: /lip S 5 SW SFR;4 v,`„ .
Catch basin or area drain 18.76
City/State/ZIP: / Drywell,leach line,or trench drain 18.76
"5' " t "1 , q 2Z 3 Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name: 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 31.27
DESCRIPTION OF WORK Backwater valve 12.51
FeI ( Clothes washer 25.02
he�' ttvtvl wC- ��12 ■rcls 1�tSrto(P_ O4 4Q1/ . Dishwasher 25.02
J Drinking fountain 25.02
Ejectors/sump 25.02
L2 I ROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name: •Zr~.,i: i /'1OVICG 5 Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: I I i0 SS Sys Fa'I.V e44/ Ln_ Garbage disposal 25.02
City/State/ZIP: fl Oe. I7113 em.11 Hose bib 25.02
Phone:(5O3 ) ZO " 9-1444 timie. low( 3 ) 781- /1Z-$ Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
.r
Medical gas(value:$ ) Page 2 name: ,/ "r Pi /I�` Primer 12.51
Contact name: J e S S,,,,, e,e f t,S H
Roof drain(commercial) 12.51
Address: 9 56,z NE -7z.. ithr, Sink/basin/lavatory 25.02
City/State/ZIP: V um. 9P 5 Solar units(potable water) 62.54
Phone:(30 ) 112. Zd3,/ I Fax::(34D ) calz. c'374, Tub/shower/shower pan 12.51
E-mail: .+ a „,,,, Ww.Qr . Lcy..t Urinal 25.02
D.5 a P '� Water closet 25.02
CONTRACTOR
c / Ova. Water heater 37.52
Business name: tfh�n /`vim i,..51
Water 1 in DWV 56.29 c /
P P 6
Address: 75-07._ Air -7Z "'° /4e. Other: 25.02
City/State/ZIP: 1/04,e..„., t ,A l4 Lc Subtotal 5-4,
Phone:( ) � ) Minimum permit fee: $72.50 _Sp
340 1 i.Z yd;s( Fax:( 06 ti Z 0 3 lie Plan review (25%of permit fee) ��
CCB Lic.: "7 0 U SZ Plumbing Lic.no.: P8 115-
State surcharge(12%of permit fee) 4"--70
Authorized signature: -TrI/17 TOTAL PERMIT FEE 4/,
�' /Z This permit application expires if a permit is not obtained within 180 days
Print name: t V S 4 t n� Date: l V J� after it has been accepted as complete.
•1 *Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp doe 10/01/09 440-4616T(10/02/COM/WEB)
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
11655 SW FAIRVIEW LN, TIGARD, OR, 97223
Residential - Plumbing
399 Plumbing final
PASS - No C of O
January 26, 2015 at 9:47:28
AM
PLM2015-00020
David Young
All visible piping replaced appears to meet code.
Violation Summary:
Inspector Contractor