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Permit (200) CITY OF TIGARD PLUMBING PERMIT nil COMMUNITY DEVELOPMENT Permit#: PLM2017 00282 Date Issued: 07/17/2017 GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S104CB00400 Jurisdiction: Tigard Site address: 13421 SW ASCENSION DR Project: Merckling Subdivision: HILLSHIRE WOODS Lot: 20 Project Description: Remodel of master and guest baths. Replacing(4)lays,(3)tub/showers&(2)water closets. Replacing entire water supply for both bathrooms. Contractor: EMPIRE PLUMBING LLC Owner: MERCKLING JOINT TRUST 19572 SW TREEHOUSE LN 13421 SW ASCENSION DR BEAVERTON, OR 97007 TIGARD, OR 97223 PHONE: PHONE: 971-506-6354 FAX: FEES Quantity Description Date Amount 4 ea Lavatories 07/17/2017 $100.08 Specifics: 3 ea Tub/Shower/Shower Pan 07/17/2017 $37.53 2 ea Water Closet 07/17/2017 $50.04 Type of Use: SF 1 12%State Surcharge- 07/17/2017 $22.52 Class of Work: ALT Plumbing Type of Const: Occupancy Grp: Stories: Total $210.17 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 exp e if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law require ou to follow the rules adopted by the Oregon Utility Not - ter. Those rules are set forth in OAR 952-001-0010 through OAR 95 •11-11190. You may obtain a copy of the rules or dir-- questions to 0 C r :.Iling 503.232.1987 or 1.800.332.2344. lss ed By: 0 —4 Permittee Signature: v Call 503.639.4175 by 7:00 a.m.for the next available inspection 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. PLl--1a417 A $a. "TOpcpG Plumbing Permit Application 7�f7�17 � 1.-., Washington County v,\VW.co.washington.or.us Inspections 503-846-3699h. 155 N.IC Ave,Suite 35042 Phone:503-846-3470 Email:1::;;bidg(a,co.washineton.or.us Hillsboro,OR 97124 Fax: 503-846-3993 akm& Project# Permit f ,-- TYPE TYPE OF WORK FEE* SCHEDULE 0 New construction 0 Demolition For special information use checklist. Description I Qty. I Es. I Total IA Addition/alteration/replacement 0Other= New 1-2 family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 369.75 411-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 474.75 ❑Accessory building 0 Multi-family SFR(3)bath 577.75 Each additional bath/kitchen 102.00 ❑Master builder 0 Other: Fire sprinkler(# sq.ft) By Sq.ft. JOB SITE INFORMATIO AND LOCATION /�Liz e Site utilities Job site address: �' �l Catch basin or area drain 16.75 City/State/ZlP: --7---7,....,cy-U('L // .o CZ q4 ? Drywell,leach line,or trench drain , 16.75 Suite/bldgJapt.no.: I Project name: M e.eik,,J(o Footing Drain(each 100'increment) 49.50 Manufactured home utilities 112.50 Cross street/directions to job site: G Manholes 16.75 / `fq �1p 1� e ,r Rain drain connector 16.75 ce,s 54 v.)t. B`( , Sanitary sewer(each 100 ft.):#of fk 49.50 Subdivision: Lot no.: Storm sewer(each 100 ft.):#of ft. 49.50 Tax map/parcel no.: Water service(each 100 ft.):#of ft. 49.50 DESCRIPTION OF WORK F -{-- Fixture or item /� a V 11�f c -jai( f4S��51 1 L Absorption Valve 16.75 11---e--"N••-.0...? tY(..e.„( Backflow preventor 16.75 Backwater valve 16.75 Clothes washer 16.75 0 PROPERTY OWNER i 0 TENANT Dishwasher 16.75 Drinking fountain 16.75 Name: Ejectors/sump 16.75 Address: Expansion tank 16.75 City/State/ZIP: Fixture/sewer cap 16.75 Phone:( ) Fax:( ) Floor drain/floor sink/hub 16.75 0 APPUCANT ['INTACT PERSON Garbage disposal 16.75 t Hose bib 16.75 Business name: -�v C-l. i ey - �` Hydroponic piping system 16.75 Contact name: N l c.k 1,4 i c-&. Ice maker 16.75 t Address: �� 4-C-- Interceptor/grease trap 16.75 City/State/ZIP: `- f c £9_L L) Medical^ gas(value:$ ) By Value Phone:(j , Fax::( ) to '- 16.75 4 • ,'den s, pi!,- MIi . t,A;s ,i 107.00 E-mail: t\i/)/\D 1 (O �wt ' t I .(.© "L_ - N j Residential Re-pipe:3601 sq-ft/more 161.00 CO CTOR f / Roof drain(Commercial) 16.75 Business name: / U c.e C Sink/basin/lavatory � (QQ,OS /0 Address: / SIA --1412. C/�!� Tub/shower/shower pan ' � 17.53 J City/State/ZIP: J )�liiP w i 9 �, Urinal 16.75 , �+ j� Water closet �C. 5? 't Phone:g7f) Sr lD 6 3 _s,!�j Fax.( ) 16.75 ii Water heater CCB lit.: t 9 7 2,..11 r Lic.no.: /P3 �7 Other: Authorized signature: - Subtotal 1 g7.4,5- Minimum permit fee Siete Print name: GE/2 A /C/C(/ Date: ' /6. 20 _ $ This permit application expires if a permit is not obtained within 180 days ter it has been State surcharge(12%of permit fee) $ 74,52. accepted as complete. *Fee methodology set by Tri-County Building Industry Service TOTAL PERMIT FEE $5J ,/'7 Board. S:\FORMSUuly 2013 forms/Plumbing Permit Form rev 06-13.doc City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13421 SW ASCENSION DR, TIGARD, OR, 97223 October 18, 2017 at 2:09:31 PM Record Type: Record ID: Residential - Plumbing PLM2017-00282 Inspection Type: Inspector: 399 Plumbing final Aaron Cillo-Gobel Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor