Permit (202) CITY OF TIGARD PLUMBING PERMIT
111
■ COMMUNITY DEVELOPMENT Permit#: PLM2018-00345
Date Issued: 07/16/2018
T 1 c;A lz.['t 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S114BB15600
Jurisdiction: Tigard
Site address: 16052 SW 103RD AVE
Project: Condon Subdivision: RIVERVIEW ESTATES Lot: 2
Project Description: Backflow preventer for landscape irrigation.
Contractor: OWNER Owner: CONDON, JOSH
JOSH CONDON 16052 SW 103RD AVE
16052 SW 103 TIGARD, OR 97224
TIGARD, OR 97224
PHONE: 503-422-3160 PHONE: 503-422-3160
FAX:
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 07/16/2018 $31.27
Specifics: 1 12%State Surcharge- 07/16/2018 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment- 07/16/2018 $41.23
Plumbing
Class of Work: OTR
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: / Permittee Signature: ILjj1,t/
Call 603.639.4175 by 7:00 a.m.for the next available i •ection date.
This permit card shall be kept in a conspicuous place on the job site it completion of the project.
Approved plans are required on the job site at the time ach inspection.
Plumbing Permit Application
C•4_ rT.iliWe, c> -». '; FOR OFFICE USE ONLY
City of Tigard RDate/Bed 7 / /
13125 SW Hall Blvd.,Tigard,OR 97223 JUL 1 2018 y ( � ! ermtt )U`g O��`��
IN = g Plan Review /+
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.:
T I G A K D Inspection Line: 503.639.4175 C Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov Pl lsl 1. Notified/Method: Supplemental Information
N TYPE OF WORK ` FEHEDULE ;.max
❑New construction 0 Demolition For special information use checklist
Description Qty. Ea. Total
®Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
vx.
.1'CATEGORY,OF"CONSTRUCTIOI' ' 9 ''` SFR(1)bath 312.70
® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
0 Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
.,JOB SITE INFORMATION iAND LOCATION ,,;:,,..',.:7' Site utilities:
Job site address:16052 SW 103rd Ave Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name:Condon Irrigation System Manufactured home utilities 50.03
Cross street/directions to job site:Closest Cross street is Durham and 103rd Manholes 18.76
Avenue,2 houses in to the south of Durham on the est side of 103r1 Ave. 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:Riverwood Estates 1 Lot no.: Fixture or item:
Tax map/parcel no.:2S114BB15600 Backflow preventer 1 31.27 31.27
" Backwater valve 12.51
DESCRIPTIONA OF WORX''e'
Clothes washer 25.02
Adding a Backflow Preventor or a new irrigation system Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
:, ® PROPERTY OWNER , I TENANT 3 Expansion tank 12.51
Name:Josh Condon Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:16052 SW 103rd Ave
Garbage disposal 25.02
City/State/ZIP:Tigard OR,97224 Hose bib 25.02
Phone:(503)422-3160 Fax:(NA) Ice maker 12.51
' Interceptor/grease 25.02
® APPIICAN'I' : ' _ >a,CONTACT PERSON - trap
Business name:NA Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Josh Condon
Roof drain(commercial) 12.51
Address: 16052 SW 103rd Ave Sink/basin/lavatory 25.02
City/State/ZIP:Tigard OR,97224 Solar units(potable water) 62.54
Phone:(503)422-3160 Fax::(NA) Tub/shower/shower pan 12.51
E-mail:condonj@hswc.com Urinal 25.02
�, Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:NA Water piping/DWV 56.29
Address:NA Other: 25.02
City/State/ZIP:NA Subtotal 31.27
Phone:(NA) Fax:(NA) Minimum permit fee: $72.50 72.50
Plan review (25%of permit fee) 18.13
CCB Lic.:NA Plumbing Lic.no.:NAI lt(�
State surcharge(12%of permit fee) 8.7
Authorized signature: � TOTAL PERMIT FEE 99.33
Print name:Josh Cond nDate:07/16/2018 This permit application expires if a permit is not obtained within 180 days
i� after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)