Permit n CITY OF TIGARD PLUMBING PERMIT
111111 ,
' COMMUNITY DEVELOPMENT ` Permit#: PLM2015-00233
T WARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/22/2015
Parcel: 1 S135DB01600
Jurisdiction: Tigard
Site address: 11560 SW 91ST AVE
Project: RAMIREZ Subdivision: CHARBEN Lot: 4
Project Description: 1 BATH INTERIOR HOT/COLD WATER ONLY REPIPE-WATER HEATER WILL NOT BE INCLUDED
JOSE RAMIREZ.7/27/15,reprinted to add(1)clothes washer&(2)hose bibs.
Contractor: JACK HOWK PLUMBING/RESCUE ROOTER Owner: RAMIREZ, JOSE C/MARIA
PO BOX 2830 11560 SW 91ST
CLACKAMAS, OR 97015 TIGARD, OR 97223
PHONE: 503-850-3100 PHONE: 503-443-4464
FAX: 503-491-2932
FEES
Quantity Description Date Amount
1 ea Clothes Washer 07/27/2015 $25.02
Specifics: 2 ea Hose Bib 07/27/2015 $50.04
1 ea Water Piping/DWV 07/22/2015 $56.29
Type of Use: SF 1 12%State Surcharge- 07/27/2015 $15.76
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $147.11
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. enter. 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 • t questions to •-NC by calling 503.232.1987 or 1.800.332.2344.
Is ed By: 9 Permittee
Call 503.639.4175 by 7:00 a.m.for the next available ins•.ction date. Q _
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.
503-491-2932 ARS 01:34:34 p.m. 07-27-2015 1 !1
RECEIVES ..... _.
Plumbing Permit Application
Building Fixtures JUL 2 7T 2015 FOR OFFICE USE ONLY
III City of Tigard 'ITX�7223j 1GARD �- M -
- n 13125 SW Hall Blvd., r a tai {
Phone. 503.639.4171 J fl 9BIVISION [ILj #) ►h Oih 7 R
71 G A RD Inspection Line: 503.4 Date Ready/By Iwis ®See Page 2 for
Internet: www.tigard-or.gov Notified/Method Supplemental Information
TYPE OF\V• 2K FEE* SCHED `> ..
❑New construction ❑Demolition For special information use checklist.
Description I Qty. F EEL I Total
Addition/alteration/replacement ❑Other: New I-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION ,; SIR(1)bath 312.70
41-end 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
-
❑Accessory building ❑Multi-family SFR(3)bath 500.32.
Each additional bath/kitchen 25.02
❑Master builder ❑Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION Qiyl) L JCATION Site utilities:
Job site address: !J Catch basin or area drain 18.76
City/State/ZIP: / 3 Drywell,leach line,or trench drain 18.76
Suite/bldg./apt.no.: Project name: 774 Footing drain(no.linear R.:_� Page 2
Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no. L _ . , Page 2
Storm sewer(no. Alf:0,11:1 P/WY
Water service(no.linear ft.:_) Page 2
Subdivision: , Lot no.: Fixture or item:
Tax map/parcel no.: Backtow preventer 31.27
j z Backwater valve 12.51 DESCRIPTIO QE,W RI, ;r ?.3 4
Aip ` I ca c�n l J' ?
Clothes washer 25.02 �D�
U V/� l �[�� W^tt Dishwasher 25.02
/ & 61% Drinking fountain 25.02
Ejectors/sump 25.02
PROPERTY OWNER ❑ TENANT `s - Expansion tank 12.51
Name: Jo Fixture/sewer cap 25.02
Address: .. f'' ' ' Garbage drain/floor isink/huh 25.02
City/State/ZIP: �L✓7,,49%] / Garbage disposal 25.02
�CfLYTF T 1 4....- Hose bib --'1*- 25.02
Phone:( ) - if / F3 I liew ) Ice maker
12.51
°,APPL1CAl'-r - t�ft131�( A PERSO,
su Nt 14,-:�Ic-t; '('.�I'- ,,.. •'tj # Interceptor/grease trap 25.02
Business name:ARS dba JACK HOWK/RESCUE ROOTER Medical gas(value:S�) Page 2
Contact name:JOYCE DENNIS
Primer 12.51
Roof drain(commercial) 12.51
Address:P.O.BOX 2830
Sink/basin/lavatory 25.02
City/State/ZIP:CLACKAMAS,OR 97015 Solar units(potable water) 62.54
Phone:(503)850-3100 Fax::(503)491-2932 Tub/shower/shower pan 12.51
E-mail:JDENNIS @ARS,COM Urinal 25.02
Water closet 25.02 t- t „
Water heater 37.52
Business name:ARS dba JACK HOWK/RESCUE ROOTER Water piping/DWV 56.29
Address:P.O.BOX 2830 Other: 25.02
City/State/ZIP:CLACKAMAS,OR 97015 Subtotal
Phone:(503)850-3100 Fax:(503)491-2932 Minimum permit fee: $72.50
CCB Lic.:127325 ^ tubing Lic.no.:34-168PB
Plan review (25%ofpermit fee) '
{ State surcharge(12%of permit fee)
Authorized signature:
l/�� TOTAL PERMIT F: n
Print name:JOYCE DENNIS DatOT j/11 This permit application expires it'll permit is not obtained" Tait 1 - -
JJJ�����' 'v�l /i:•
after it has been accepted as complete.
s •Fee methodology set by Tri•County Building Industry.. a
- __PL ! i •_ . .. ' "4'�-r Y ��
IU3uildingiPcrmitslPLhlU Pee itAppd T1(71tII/ifQ•` 440.46 16T(10/OIICOAf1 VEB)� L
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
11560 SW 91ST AVE, TIGARD, OR, 97223
Residential - Plumbing
399 Plumbing final
PASS - No C of O
PLM2015-00233
David Young
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
11560 SW 91ST AVE, TIGARD, OR, 97223
Residential - Plumbing
399 Plumbing final
FAIL
PLM2015-00233
George Heimos
1. Electrical grounding required when replacing metal water piping with plastic. (Minor
Label not allowed) 604.8
2. Add to existing permit:1- clothes washer, 2- hose bibbs
4. Recall inspection, when completed
Install meter box and ok to backfill
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
11560 SW 91ST AVE, TIGARD, OR, 97223
Residential - Plumbing
399 Plumbing final
FAIL
PLM2015-00233
George Heimos
Electrical permit for grounding. ELC2015-00607, please provide final electrical approval.
All else ok
Violation Summary:
Inspector Contractor