Permit (174) CITY OF TIGARD PLUMBING PERMIT
N I COMMUNITY DEVELOPMENT Permit#: PLM2019-00086
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/06/2019
T t C A I:[: 9 Parcel: 2S102DB01900
Jurisdiction: Tigard
Site address: 13245 SW BURNHAM CT
Project: LEWIS Subdivision: BURNHAM PARK Lot: 13,PT 8
Project Description: Replacing(1)hose bib,(1)ice maker,(1)sink,(1)lavatory,(1)tub,and(1)water closet for kitchen and bathroom
remodel.
Contractor: NADEANS CUSTOM PLUMBING Owner: LEWIS, EVAN W&KAREN E
19376 LELAND RD 13245 SW BURNHAM CT
OREGON CITY, OR 97045 TIGARD, OR 97223
PHONE: 503-869-0416 PHONE:
FAX: 503-650-6078
FEES
Quantity Description Date Amount
1 ea Hose Bib 03/06/2019 $25.02
Specifics: 1 ea Ice Maker 03/06/2019 $12.51
1 ea Sink 03/06/2019 $25.02
Type of Use: SF 1 ea Lavatories 03/06/2019 $25.02
Class of Work: ALT 1 ea Tub/Shower/Shower Pan 03/06/2019 $12.51
Type of Const: 1 ea Water Closet 03/06/2019 $25.02
Occupancy Grp: 1 12%State Surcharge- 03/06/2019 $15.01
Stories: Plumbing
Total $140.11
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503. 32.1987 or 1.800.332.2344.
Issued By:7/‘ *</i/
/ r •ermittee Signature: aier7
l./
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application
Building Fixtures iot ()FR( I 1 SI: Oy1.1
City of Tigard Received
13125 SW Hall Blvd.,Tigard,OR 97223 Date/By:
Plan Revew /y G
)�(j
,� Phone: 503.718.2439 Fax: 503.598.1960 ` �(foy Date/By:
Inspection Line: 503.639.4175
TIGARD
Date Ready/By: Juris la See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
r .r
WORK- - - - '.FEE*-`SCIIEDICLE
❑-New construction
❑Demolition For special information use checklist
Description I Qty. I Ea. I Total
®Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OP CONSTRUCTION SFR(1)bath 312.70
® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler(_sq.ft.) Page 2
jo$SITE.INFORMATION AND LOCATION Site utilities:
Job site address:13245 SW Burnham Ct. Catch basin or area drain 18.76
City/State/ZIP:Tigard Oregon 97223-6027 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name: Manufactured home utilities 50.03
Cross street/directions to job site: 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: Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPUON;OP.WORK
Backwater valve 12.51
Clothes washer 25.02
AP Dishwasher 25.02
Drinking fountain 25.02
,1 -a � J�/tom 7,e- Ejectors/sump 25.02
r/
? O 'ERTy OWNER Expansion tank 12.51
Name:McWiliams Residence Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 1 25.02
Phone:( ) Z. Fax:( ) Ice maker I 12.51
ri APPLICAN ❑,CONTACT,PCOs Interceptor/grease trap 25.02
Business name:NaDean's Custom Plumbing Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Dean Rothe
Roof drain(commercial) 12.51
Address:19376 Leland Road Sink/basin/lavatory A 25.02
City/State/ZIP:Oregon City,Or.97045 Solar units(potable water) 62.54
Phone:(503)869-0416 Fax::(503)650-6078 Tub/shower/shower pan 1 12.51
E-mail:nadean101@comcast.net Urinal 25.02
Water closet / 25.02
s CONTRACTORWater heater 37.52
Business name: j?I) ,._ Water piping/DWV 56.29
Address: c_5&.•3. `l'o gs Other: 25.02
City/State/ZIP:7 calf i- Subtotal
/ � Minimum permit fee: $72.50
Phone:( ) Fax:( ) ,141,1)p 7l l l,I(/
CCB Lic.:173767 Plumbing Lic.no.:74813:11rPlan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name:2) ///1-/ Ko THE Date:3/1/19 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\Perrnits\PLMU-PermitApp.doc 10/01/09 4404616T(10/02/COM/WEB)
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
13245 SW BURNHAM CT, TIGARD, OR, 97223 July 8, 2019 at 11 :14:32 AM
Record Type: Record ID:
Residential - Plumbing PLM2019-00086
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Corrections completed.
Violation Summary:
Inspector Contractor