Permit CITY OF TIGARD PLUMBING PERMIT
11111 $ COMMUNITY DEVELOPMENT Permit#: PLM2015-00125
T GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/27/2015
I
Parcel: 1S 135DC01800
Jurisdiction: Tigard
Site address: 11895 SW LINCOLN AVE
Project: Noyes Subdivision: TIGARDVILLE PARK Lot: 9
Project Description: Repair/replace 5'of sanitary sewer line.
Contractor: ENVIRONMENTAL WORKS Owner: NOYES, BONNIE J
2634 SE STEELE ST 11895 SW LINCOLN AVE
PORTLAND, OR 97202 TIGARD, OR 97223
PHONE: 503-719-6715 PHONE:
FAX: 503-972-1866
FEES
Quantity Description Date Amount
5 If Sanitary Sewer 04/27/2015 $62.54
Specifics: 1 12%State Surcharge- 04/27/2015 $8.70
Plumbing
Type of Use SF 10 ea Minimum Fee Adjustment- 04/27/2015 $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 N. . • --nter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or di ct questions to O C • ailing 503.232.1987 or 1.800.332.2344.
Is- ed By: Permittee Signature:
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Call 503.639.4175 by 7:00 a.m.for the next available insp• tion 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.
To: City of Tigard Page 2 of 2 2015-04-27 19:40:19(GMT) 15039721866 From Matthew Lowrance
plumbing Permit Application.
Building Fixtures RtCEIVEll FOR 01414 1, I '4 tr■I
City of Tard
1312S V kialligd.....Tigard,OR 97223
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Phone: 50171.8.2.439 FaK.! 59?Or-12601 2.015
Inspection Line7 511.3.639.-1175 I.5
Internet NIF'...'s ..:Fre,--.•r F2•■, 'I Received
[ Date 11%: 4/,61.7- 11101111 Penoll. No.: P/310/10/5,zyll,9 S'-' .
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`,.•r i-, .1 P,■,i ....... Other PerrniCtiV.,.
lurA 0 See Pipe 2 ftt,
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Supplement:0 knfifilyinkm
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r;=:23':>f:?:-.:',:i:=:Z:::.;:,.::::',, ,:,%&1:;`.::-.., •- , i't PI. 01 'A I2 I;I.i. , lift:* SC El Frill.E
. ' For special7;17;renation use r.heehlivt.
0 Nei construction 13, ;.„.E Der,,L,t,,,,,
1 ' ? Dcwrirsnon : Qty. i Ea : loud
, ill A ddition!alteratioareplacement ] 0 Other New 1-2-family dwellings i ndjde IIXI 11 for each unlit).enrineettrao
CA 11,..t.;01i.1 OF CONS TRUCTION 4=tri-`,At,:":t;,:;:t.';';':f;:.;,::-,;,",:,et.:::''.:''' SFR(11 ba•mi 312.7,.0 1 i
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SFR 121 bath 437.78 ;
1 Egj 1-and 2-lamily dwelling 3 commeretattirtdwa,,:o _...:__ ..._...i .
I SFR(31 bath I 500.32
0 Accessory building 1 0 Multi-famil). I
,- ---i F.acb additional hatftlitchen 25.02
-
0 hlaster builticr a other:
1 Fire sprinkler( sq-0-i , Page 2 i
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JOB SITE INI ORNIATION 8ND LOCATION '1 Site utilities: i
--
: I Catch basin or area drain i la
k.:iLidiess:11895 sy‘ t 'Inca in 4.4.e r -,......= •;D -----1
-1 1 ry v.elt.leach tine.or trench drain .1 DI 76
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(ityiState,LIP:Tigard , ,,------
,. 1 Footing drain mu linear 11. / i Page 2
Siiitelt14.1.apt.no Project name: ,
MallaidUrdli horrie utilities t 1 50.03 1
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Cross wort/directions to job.site: Manholes 18_76 ME
Rain drain connector I 111.7n
Sarni:1r% ,,ewrr(no linear tt:fs.) i Page.2 62.54
----
Storm%ewer i no linear ft: I
Page 2
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i 1 1 %valor%.e.r%ice i Ito linear It- 1 age.'1 _.__ .._1...._
1 Subdivision: 1 ot no.: r Fixture or item:
---1 ..Blicillow.preventer _ __
31.27 1
I.:I\,tnni nan2c1 no
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-- liaekwater calve 1151 i
I DEStRIP1 ION of Ni DRK
L - - C.lotliks v,asSor 25.02
Dishwashec 2.5021
Sewer spot repair on property(trenching) Drinking fountain 25.02
..v....-.., .---+......... , i
' Eficctors.,smp 2502
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E2 ['ROPER-TN OWNER ' 'I.- E i t:s.t,N.- I F sparmion tank 12.51 ._
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FLIinfrefSeWei cap 25.02
Name: -
s: Floor drain in
illoor skihub , , 25.02
Addrea
- Garbage divosai I 25.02
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' City/State/ZIP: Hose bib, 25.1)2
, _ ..._ . .....
Phone:t 1 Fax ( ) • lee maker H
':::0*****tglii.Egi:::-:igiltat~07":,117.A. jlirerse'ePratigivst UV 25.03
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, Medical gas(value':S ) 1 PEW 2
Rosiness name: 1
1 Primer 12.51
Contact name: .1"?--1 6-V' . C4S‘Ple--c-. 1 It„ioi,,
t aralll(commercial) 1 12.51 —1
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Address: Sinklbasinilaratory 1 21 ir2 I
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ciLtStatei'ZIP: Solar units(potable water) i 62.54
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Phone:(505) n 7 , V 5-
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i Fax::1 }
Tott-'showerishower pan
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1.-mail: .
-0****C 7.7137g:P ....MM:F.M.We.;4;10::•:-;.:':'.::.''..i -Water 25.02
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1 ftusiness name.Unvironmental Works Win;-er pipingtDWV 1 ' .50.29
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Address;2634 SF Steele St i Ott--- --r. 2502
City:State/1P:Pord 1 and/OR/97202 Sutootat
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MaInnttat permit ter- $72 30 7250
t‘hcate:(,50.1)/19-6711'...... -------,........:_ t Fax:(5031 972-1866 .... . .
--1, Plan review(25%of pemit feel ! • .
CCI3 lie.:185781 ■ Plumbing 1 ie.no.:
41
State surcharge(12%of feel t
Authorized signature: --0""110111111111 A.,. 1 . TOTAL PERIOD 11:./._
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Print name: Ryan Meyer ' i Date:04124/2015
1 —1
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Them permit Aptikration et pirm WI)permit 6 Wit tibial neci*Rhin 1S0 days
after it hes berm accepted as complete.
'le ineriaidAttiv.set to Iii-Conat): stry Service Board
:,Fiuj,:::i0,eriniact,LNiti,PerrmAiiceo. 11'0 i•-•::=, -1-a,4■16T4i0,02T9W67451
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To City of Tigard Page 1 of 2 2015-04-27 19:40:19(GMT) 15039721866 From: Matthew Lowrance
FAX COVER SHEET
TO City of Tigard
COMPANY Plumbing Permit
FAX NUMBER 15035981960
FROM Matthew Lowrance
DATE 2015-04-27 19:40:00 GMT
RE Plumbing permit
COVER MESSAGE
Please process the attached. Thank you!
VVVVVV MET ROFAX COM
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
11895 SW LINCOLN AVE, TIGARD, OR, 97223
Residential - Plumbing
399 Plumbing final
PASS - No C of O
PLM2015-00125
George Heimos
Replaced 5' of cast iron sewer, installed 4" 3034.
Ryan@eworksnw.com
Violation Summary:
Inspector Contractor