Permit CITY OF TIGARD PLUMBING PERMIT
111 ' COMMUNITY DEVELOPMENT Permit#: PLM2016-00331
T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/28/2016
Parcel: 2S115AA07800
Jurisdiction: Tigard
Site address: 10544 SW TITAN LN
Project: Belair Subdivision: BERKLEY ESTATES Lot: 10
Project Description: Cap existing shower stall,Convert existing tub to shower stall,resize tub drain.
Contractor: WESTERN PLUMBING Owner: BELAIR, GREG C&NANCY H
9460 SW TIGARD AVE SUITE 101 10544 SW TITAN LN
TIGARD, OR 97223 TIGARD, OR 97224
PHONE: 503-639-5296 PHONE: 503-620-0716
FAX: 503-684-9015
FEES
Quantity Description Date Amount
ea Fixture/Sewer Cap 06/28/2016 $25.02
Specifics: 1 ea Tub/Shower/Shower Pan 06/28/2016 $12.51
1 12%State Surcharge- 06/28/2016 $8.70
Type of Use: SF Plumbing
Class of Work: ALT 35 ea Minimum Fee Adjustment- 06/28/2016 $34.97
Plumbing
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 que tionsjo OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued Permittee Signature: ) �1
Call 503.639.4175 by 7:00 a.m.for the next available inspection'date. ✓r
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 `,f,
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Building Fixtures `' ,; , �-..
City of Tigard `,.8 ` Received %,�� 1/, Permit No.: p a u1I 0033/
■ 13125 SW Hall Blvd.,Tigard,OR 97223 ��
Date/By: (Q (C�
IN
a^� ra Plan Review■ Phone: 503.718.2439 Fax: 503.598.196Q0;k a Date/By:
� Other PermitNo.:
Inspection Line: 503.639.4175 U
TIL Rn ,* h �: Date Read B Jnris: H See
Page
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Internet: www.tigard-or.gov :IA Notified/Method Supplemental Info
rmation
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0 New construction nlhtion For special information use checklist.
Description Qty. 1 Ea. 1 Total
CI Additio alteration//ielllacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
11,0 t. 4� rs a "t R SFR(1)bath 312.70
®1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-familySFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( ,sq.ft.) Page 2
A '3 s, 6 s r z+ Site utilities:
a a.4 , 1MisiYsk,u0.,.:F r. Y .. r X. . .0.z, .u. . H.M..: -a �gP.;$
Job site address:10544 sw titan Ln Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97224 Drywell,leach line,or trench drain 18.76
Footing dram(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: 1 Project name: Manufactured home utilities 50.03
Cross street/directions to job site:SW 108th off of Durham Rd 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
i ' s i "' ` ` it , dBackwater valve 12.51
e: S .. , .4. ._w.a 0, aO .. t
Clothes washer 25.02
Remove existing stall shower,cap water supply&drain
Dishwasher 25.02
Convert existing stand alone tub to stall shower with Kerdi pan&Membrane Drinking fountain 25.02
Resize tub drain from 1.5"to 2"(work done by western plumbing) Ejectors/sump 25.02
r3 r 19 q: -a; :re v� `:., ; „ a ' I .* ,a a ` Expansion tank 12.51
���',✓ e..d,o. :I. .�.�, NS wk�.,,.$.,.���;...>sv�s-.�`.''�K�..,ar, . a, .r a��..L� -�� �. , 5,..,k. . �e�..a.i �ati /
Name:Greg Belair Fixture/sewer cap C�,(toWf 2) i 25.02
Floor drain/floor sink/hub 25.02
Address:10544 SW Titan Lane
Garbage disposal 25.02
City/State/ZIP:Tigard,OR 97224 Hose bib 25.02
Phone:(503)620-0716
, [Fax:( ) Ice maker 12.51
1; ye G is 1 1 ,4� ,OJ5 InterC or/�easetraP 25.02
Business name: k Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Greg Belair
Roof drain(commercial) 12.51
Address:10544 SW Titan Lane Sink/basin/lavatory 25.02
City/State/ZIP:Tigard,OR 97224 Solar units(potable water) 62.54
Phone:(503)708-2812 cell Fax::(503) Tub/shower/shower pan 1 12.51 12.51
E-mail:gcbelair@msn.com Urinal 25.02
c ' ' I � t � p Water closet 25.02o
:t41... evaVM ,. a.MRSVOCAt.t, ',A4 4.4.4,V P-„,.Z5 n2,b..g*:*H+.�.-'i4 ,. „"knt Water heater 37.52
Business name:Western Plumbing Water piping/DWV 56.29 9
Address:9460 sw Tigard Ave Suite 101 Other: 25.02
City/State/ZIP:Tigard OR 97223 Subtotal 68.80
Phone:(503)639-5296 Fax:(503)684-9015 Minimum permit fee: $72.50 72.50
CCB Lic.:2439 Plumbing Lic.no.: Plan review (25%of permit fee)
(� • State surcharge(12%of permit fee) 8.70
Authorized signature: ` ,, moi\"�.L,. TOTAL PERMIT FEE 81.20
Print name:Greg Belair \1 Date:6/28/16 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Pennits\PLMU-PennitApp.doc 10/01/09 440-4616f(10/02/COM/WEB)