Permit (32) CITY OF TIGARD PLUMBING PERMIT
1 . - COMMUNITY DEVELOPMENT Permit#: PLM2016 00286
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/09/2016
TIGARD Parcel: 2S110BD06300
Jurisdiction: Tigard
Site address: 11959 SW ASPEN RIDGE DR
Project: Tse Subdivision: ASPEN RIDGE Lot: 30
Project Description: Cap(1)bidet in crawl space.
Contractor: VENNE PLUMBING LLC Owner: TSE, TENNY P&GEORGIANA S
15145 SW DIVISION ST 11959 SW ASPEN RIDGE DR
SHERWOOD, OR 97140 TIGARD, OR 97224
PHONE: 503-624-9309 PHONE:
FAX: 503-684-0940
FEES
Quantity Description Date Amount
1 ea Fixture/Sewer Cap 06/09/2016 $25.02
Specifics: 1 12%State Surcharge- 06/09/2016 $8.70
Plumbing
Type of Use: SF 47 ea Minimum Fee Adjustment- 06/09/2016 $47.48
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 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: „A::147 Permittee Signature: 6'4/�nfl fn9- 7O /
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. v
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 Application
fluilding Fisterres •
RECEIV0
Cky of Tigant
il
I 3125 SW flan Bbid,Tigard,OR 97223
Phone: 503.71112439 Fat: 503.541140 1 2016
Inspection Line: 503,639.4175 Other Permit No..
Axis Eti See Page 2 for
Internet:
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0 New cortexection 111 Demolition Far special infornsadart sae drecklist.
Description I Qty. [ Ea. I Total,
)44/tdditioni"rplaccurent 0(Aber: New i-2-finurly ihreelairt(indutka 100ft.for emit utility conneetis )
A 1-and 2.4araily dwelling 0 CommercialAndustrial SFR(2)bath 437.78
SFR(3)bath 50032
0 Accessory building 0 Multi-family
Each additional bathikitchim 25.02
0 Master builder 0()the:: Fire sprinkler( sq.R.
Page 2
.102 strz rawftAntxc.toil Sae ulintles:
Job
5'1 SW f\ a Catch basin or area dealt 18.76
s-e,site aikkess: 1141S pz-n 9 t Pr
Drywelt,leach line,or trench drain 1&76
City/Stahl/ZIP: j te,)a rd or, 9 11_24
' Footing drain(no.linear ft.: ) Page 2
SuitethigJapt.no.: Project name: -putn 1 1. , Matmfactured home utilities 50.03
---
Cross iirrectalinxiioas to job site: Manholes 18.76
Rain drain connector 1876
Sanitary sewer(no.linear IL:____) Page 2
Storm sewer(no.linear ft.: ) Page 2
_ _ _ Water service(m.linear ft.: ) Page 2
Subdivision: Lno: Fixture or item: -
_
Backflow;reverter 31.27
Tax map/parcel no.:
WoBackwater valve 12_51
ElitaliCIII10110fti 011.' w
C Clothes washer 25.02
C42 6 iCtz:t itn Cra1r11 S P(ACl,- ' Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
U pitizifiam, iiiiiira l' -0,. :13 Iiitr- „,,' , ,.. --,::::, EaPtmsian tank 12.51
Fixturcisesver cap i 25.02 ZS.Di
Name:
Floor drain/floor sink/hub 25.02
Address:
- Garbage disposal 25,02
City/Stare/ZIP:
THose bib 25.02
Phone:( ) Fax:( ) lee maker 12.51
7 ''.- 5/Amorist ' ' . - -- ti,(intl.-Act nidissirt . : tmercePtadgitasc IT4P 25.02
Medical gas(value:$ ) Page 2
Business ramie: \I E-,WNE 91At,1 1
Primer 12.51
Contact mute: 1..-(VNLk%a>1._V Cr1t11,- ______.
Roof drain(commercial) 12.51
Address: 1'N,'-'15. 5vkl ..D,k‘v i,Sto'n Sk 8 ink/basintlaratory 25.02
City/StaterZIP: ‘,,,a,A,,t,ue c el i 6(... et 1 1,i 0 , Solar units(potable water) 62.54
Phone:(5o3 ) (D211-130/ Fax::( 503)fitil-0414D Tuhlshower/shower pall 12.51
Urinal 25.02
E-mail:
25,02
Water heater 37.52
Business name: 9K(1,E
Water piping/DWV 56.29
Address: ()dux: 25.02
City/StateZIP: Subtotal
Slinimuni permit fire: $72.50 '-/2,,ri-.*.)
Phone: _( ) Fax:( )
Plan review (25%of permit fee)
Cal 1..ic.: /?2, 9(Fq Plumbing I,ic.no.: P/5 FS-V. ,
State surcharge(12%of permit fee) C? .1Q
Authoriard signature: TOTAL PERMff FEE'it el 1 ,2,I)
..._.
Print name: 1......: ,-,A .4 \I e....r)(1,1L Date: 0 to/ t/ 1 l., This pryer*aratioss aspires if a permit is as*obtained within 1St day,
alter wit ins bees sayeated as complek.
*Fee methodology set by Tri-County Building indusay Service Bond
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