Permit iipfi . CITY OF TIGARD PLUMBING PERMIT
tC . COMMUNITY DEVELOPMENT Permit#: PLM2017-00323
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/08/2017
Parcel: 1 S 134DA06300
Jurisdiction: Tigard
Site address: 10747 SW NORTH DAKOTA ST
Project: Whitney Subdivision: 1991-107 PARTITION PLAT Lot: 3
Project Description: Replace 300 sq.ft.water service.
Contractor: LOVETT INC Owner: WHITNEY, JACK C&HEATHER A
PO BOX 86280 10747 SW NORTH DAKOTA ST
PORTLAND, OR 97286 TIGARD, OR 97223
PHONE: 503-737-8423 PHONE:
FAX: 503-288-1630
FEES
Quantity Description Date Amount
300 If Water Service 08/08/2017 $137.58
Specifics: 1 12%State Surcharge- 08/08/2017 $16.51
Plumbing
Type of Use: SF
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $154.09
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 Notif - .•- 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 direc •uestions to •. C by calli • 503.232.1987 or 1.800.332.2344.
Issu=d By:
i
ii, ( Permittee Signat e: , j
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.
Aug. 4. 2017 3:44PM Lovett Excavating No. 4857 P. 2
PlumbinE Permit Application
Building Fixtures liECEIVED FOk O1'1ICL LJSL ONL,
City of Tigard Received /. /"w
p 7 2 017 pare/By' , ` 7 / Permit No. Ziff
: 13125 SW Hall Blvd.,Tigard,OR 97 (� Plan Review
Phone: 503.118.2439 Fax: 503.59 . 60 Date/By: Other Permit No.:
Inspection Line: 50.3.639.4175TI .AiIil /4 .. , ,w• :: lris; H See Page 2 for www tlgard orgov .( NuefiAyBhy : Supplemental Information rmation
5 .: -u .:. gc I711 ;4 w7°lr V1I " r9 N. k ',2,17;77-,::::::,
,ArrZ Ii r i :�C� 1Yit i„ .„,,nn,FC
,vN m. .
❑New construction ❑Demolition For special information use checklist
Description Qty. La. Total
74 Addition/alteration/replacement ❑OtherNcw I-2-family dwellings(includes 100 ft.for each utility connection)
7 -.i- al:tt` ".9y�L'y ,..cM 1;t,°tlit7;L 0 1�aerl'6:,)ry a41 ql ll.11kt}f 1 MJ,:::::-.;';.,:t‘;c ; sw SFR(I)bath 312.70
I 1-and 2-family dwelling 1:1Commercial/industrial i SFR(2)bath 437,78
Accessorybuilding - SFR(3)bath 500,32
❑ ❑Multi-family
El Master builder Each additional bath/kitchen 25,02
❑Other
p ?" bA iA V; :IN+ �. �' < T""`"':P'7"W^++� , fire sprinkler( sq.ft.) Page 2
d,µ.4:,-. �� 1 "4'0 {y'�.�l �M^."j i l9 al r 1Y1, ti0��� ��n"bhJI.il1h 1F1t 1�''i d-✓0'? tit'°-,:;1 Site utilities:
Job site address; 1c0-7470\1, -If Catch basin Or area drain 18.76
�� TV led 74 Drywall,leach line,ortrenoh drain 18,76
City/State/Zll': : r_i tCa e- 11
Footing drain(nolinear ft.:_) Page 2
Suite/bldg,/apt,no.; Project name; Lo1+.i TN t Manufactured home utilities 50.03
Cross street/directions to job site: _Manholes 18.76
_-',-) /cc ' Rain drain connector 18.76
Ss
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no,linear ft.:_) Page 2
Water service(no.linear ft.: ( Page 2 1 37,57
7 57
Subdivision: Lot no.: Facture or item: +
Tax map/parcel no.: Backflow preventer V 31.27
a"M,t,H., wt:w'tkm.,**ry>' m a 4z:.„w' Aofa ' P 0,11 J' °i,,i rp triG1 2 ', Backwater vaYe
12.51
-
// }�� Clothes washer 25.02
....4-1.-1P(Gem . '�' Dishwasher 25,02
f _Drinking fountain 25.02
Ejectors/sump 2$.02
x '�9El
ir �
<'1"41,1 3gr )v� o'15:41r`tiM 9a'6 " Mq
t ti4.,40,4,:r'
'`va' ,:r' p 'ap-1-4 rt,i.^' ,+t. M z: Expansion tank 12.51
Name: Pixture/scwer cap 25.02
Address: Floor drain/floor sink/hub 25.02
City/State/ZIP: Garbage disposal 25.02
Hose bib 25.02
Phone:( ) Fax;( ) Ice maker 12.51
: ,,,i tt ww o ,Cber � ,< • s„,, 4 E.,,d, T, ?a Interceptor/grease ease trap
25.02
Business name; / a v-_pe- Medical gas(value:$ ) 1'12, 2
rr�` an Primer
Contact name: ea . ,� a=1,0. keit_. 12,51
Roof drain(commercial) 12,51
Address:
8GoSink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:(,coN S5( - Si 0 Fax::( ) Tub/shower/shower pan 12.51
in
- ail: .i.►.ff dtL--, 1. sl✓-4_ T T. i ✓t Gt$ C+ Urinal 25.02
A' Water closet _ 25.02
' " Water heater 37.52
Business name; V"L-�-�- Water piping/DWV `
Address: P P llro 5629
04i., Other. 25.02
- City/State/ZIP: e, -1.- fp., pI f 4 c7.) Sabtotal
Phone: 7 r& 4/. .:,3 Fax;( N) Minimum permit fisc: $72.50
CCB Lie.: _
f o 'lumbing Lic.no.: • y Plan review (25%of permit fee)
`' Stare surcharge(12%of permit fee) )(0. �/
Authorized signatorI
�"� _ 7�� _ TOTAL PERMIT FEE / ' aq
/
Print name: i t]C/� f P� ff! Date4 / / /I This permit application expires if a permit is not obtained within a d s 1
i. after It bas been accepted as complete.
epee methodology set by Tri-County Building Industry Service Board.
I:1BuildinglPermir\PLM[J-PermuApp.doe ID/01/09 440-46161(10102/COM/WLn)
Aug. 4. 2017 3:44P Lovett Excavat i ng No. 4857 P. 1
City of Tigard
13125 SW Hall Blvd
Fax: 503-598-1960
8/4/17
Permit app,please process ASAP! Send us link for credit card payment.
Thank you!
Linda M Pin
Service Department Administrator
Lovett, Inc. &Lovett Restoration& Waterproofing
PO Box 55580
Portland, OR 97238
Linda.p@lovettservices.com
Office: 503-737-8423
Fax: 503-288-1630
LOVETT, Inc.&Lovett Restoration&Waterproofing
P.O. Box 55580 I Portland,OR 97238
Office:503-737-8423
Fax:503-288-1630
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10747 SW NORTH DAKOTA ST, TIGARD, OR,
97223
Record Type: Record ID:
Residential - Plumbing PLM2017-00323
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor