Permit CITY OF TIGARD• PLUMBING PERMIT
III�1 COMMUNITY DEVELOPMENT Permit#: PLM2018-00454
13125 SW Hall Blvd.,Tigard OR 97223 503/18.2439 Date Issued: 10/03/2018
T"t C A T.n 9 Parcel: 2S111CD04700
Jurisdiction: Tigard
Site address: 15980 SW BRENTWOOD CT
Project: MCCAULEY Subdivision: SUMMERFIELD NO.9 Lot: 506
Project Description: (2)sinks,(1)tub/shower,(1)water closet,and(1)water heater for addition over existing garage.
Contractor: JAM PLUMBING Owner: MCCAULEY, DEE M
3439 NE SANDY BLVD#610 PARKER, RICHARD W
PORTLAND, OR 97232 %CLOSE, HELEN, LIFE ESTATE
15980 SW BRENTWOOD CT
TIGARD, OR 97224
PHONE: 503-490-5541 PHONE:
FAX:
FEES
Quantity Description Date Amount
2 ea Sink 10/03/2018 $50.04
Specifics: 1 ea Tub/Shower/Shower Pan 10/03/2018 $12.51
1 ea Water Closet 10/03/2018 $25.02
Type of Use: SF 1 ea Water Heater 10/03/2018 $37.52
Class of Work: ALT 1 12%State Surcharge- 10/03/2018 $15.01
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $140.10
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 thefrf- adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You rliay • ain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or,..''.332.2344.
Issued By: Permittee •ature: / I,
� . _ _ //
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.
Plumbing Permit Application
Building Fixtures " EG /�
i .
City of Tigard i *Review-. i s/3Received • /i Y Permit
too: ,LAV12)l i t�
Phone:
S 0 Nall Blvd,9 riFax: 50 97223.1IJ C ` ` 2018 Ptaa /y
�. Phone: 503.7182439 Fax 503398.1960 p,�gy. Other Perch No.:/ii LTi,20 i -ali'1 Z
Inspection Line: 503.639.4175 y'ny- � j ss dd �b�e Rady�By: anis: ®See Page 2 for ✓
Internet:vrww.tigard tr.gov V l 1 V i 4ie i a2latifiedJhfsriod: Supplemental Information
wiIL-D'\iG_1 1V6e it)N
❑New construction 0 Demolition For special laionsiadote are aMeka,
gAddition/akeration/replacenient 0O
DesNewcription r1i ) (tl � Ea. I Total
i-2-family for dwellings(includes 100 .for each uW' connection)
CATEGORY OF CO/IS3'1RUCTION' SFR(I)bath 312.70
❑I-and 2-family dwelling 0 Commercialrmduslrial SFR(2)bath 437.78
0 Accessory building 0 Mufti-family $ (3)bath 500.32
Each additional bath/kitchen 25.02
❑Master budder 0 Other: Fire sprinkler(+,_sq.ti) Page 2
l� 9TFIDI AND LOCA Ole math=
Kr j Catch bas area drain 18.76
Job site address: /V•y�
Li.
City/State/ZIP: � Dryweti,leach line,w trench drain 18.76 1
/ Footing drain(no.linear ft:__)
Page 2 1
Suite/tddgiapx no.: project nMne: ,/)1 C(44 41 r Manufactured dome utilities 50.03
Cross street/directions to job site: / Manholes 18.76
Rain drain tor _ 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page2
t Water service(no.linear fl.:_.__) Page 2
Subdivision: L Lot no.: Fixture or item:
Tax parcel no.: Backflow preventer 31.27
MISCREPTION OP Backwater valve 12.51
t V144 (t( 09/2
v 7p. f.!!. Dish warder 25.02
{rte illi ri 7�U`/� Dishwasher 23.02
40 Drinking fountain 25.02
Ejecroresuriq+ 25.02
0 PROPERTY OWNER • 1 13 litpioT ; Expansion lenk 1231 3
s
Name: '! �'j + Fixture/sewer cap 25.02
FGFlowdnrinJOoor sink/hub 25.02
Address: ✓ ,a frier sj
/-a f"
Garbage disposal 25.02
City/State/ZIP: hose bar 25.02
Phone:( ) I Fax:( ) Ice maker 12.51
APPLICANT
0.60 TACr._PSRSON•, : Interceptor/grease tap 25.02
Business name: ��i �,/j� Medical gas(value:S_) Page 2
Contras amne:111 i "'' r/S ( Primer 12.51
Roof dram(commercial) 1231
Address: Sink/basihiavany 25.02
City/Stale/ZIP: ,) Solar units(potable wary) 62.54
Phone:503 1,02--l/ 3 1' 3 Fax::( ) Tub/Sim pan ' 1231 J, S-/
E-mail: Ural 25.02
Water closet 25.02 d-S-C,),
)) waw heater , 3732 3'7-7�.-
Business name:( , irj?1 u ill`>' II
4yk' Water piping/DWV 56.29
Address: . 'i Ae ili �/ C� L. 1 U
Other: 25.02
City/State/ZIP: I)1,i(C vt G,( Cy- G1-7 Z 3 2- Subtotal,j#2...57(;)i
Phone:( G, 4410 S .!;-(4(. Fax ( )
Minimum permit fee: $72.50
��} Peen review(25%ofpermit fix)
CCB Lie.: U 2_`7 77� Iumbing Lic.no.:17..,1? T� /15-'� Statcsurrharge(1296ofpamitha) l ./1
Authorized signature �l �i ti
v -�--- TOTAL PERMIT FEE I'i),it)
Print name:.
LA
This permit appli atiao enp&nif a permit tsaoe obtained with ISO days
� )(. �..C/ � G b c G1 l Z � �(� � ! �r� attewil las ben aeoedled m aompkee.
*Fee methodology set by Tri- County Buddiag ladasay Service Bawd.
t .doe m101/09 44n.6e6TQemO2CEM Wna)
5
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
15980 SW BRENTWOOD CT, TIGARD,
OR, 97224
Record Type: Record ID:
Residential - Plumbing PLM2018-00454
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor