Permit (186) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2019-00099
T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/13/2019
Parcel: 1 S135CD08100
Jurisdiction: Tigard
Site address: 9734 SW LONDON CT
Project: BERO Subdivision: LONDON SQUARE NO.2 Lot: 33
Project Description: (1)sink and(1)tub/shower for remodel.
Contractor: KENNEDY PLUMBING Owner: BERO, LORRAINE P
13985 SW FARMINGTON RD 9734 SW LONDON CT
BEAVERTON, OR 97005 TIGARD, OR 97223
PHONE: 503-643-5535 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Sink 03/13/2019 $25.02
Specifics: 1 ea Tub/Shower/Shower Pan 03/13/2019 $12.51
1 12%State Surcharge- 03/13/2019 $8.70
Type of Use: SF Plumbing
Class of Work: ALT 35 ea Minimum Fee Adjustment- 03/13/2019 $34.97
Type of Const: Plumbing
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 wor is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to fol. the rules adopted by th regon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. may obtain y of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
� 1
Issued By: Permittee Signature: ��►�
JI1.►-
Call 503.639.4175 by 7:00 a.m.for the next available insp date.
This permit card shall be kept in a conspicuous place on the job site until completion • e project.
Approved plans are required on the job site at the time of each inspectio
Plumbing Permit Application
Building Fixtures FOR OFFICE I. ONLY
City ofSW Tigard C E I VE� Eiew
REate/ / /1 PermitNo.:]3125 Hall Blvd.,Tigard,OR 97223 / � ^' Gz._ Phone: 503.718.2439 Fax: 503.598.1960 n D
MAR O Date/By: Other Permit No.:
TI C A R D Inspection Line: 503 639 4175 1 3 2�1J Date Read/By:
Internet: www.tigard-or.gov N UJ ® See Page 2 for
n ottfied/Method J r"6 Supplemental Information
CI O,i t
�❑New construction :,�_...,��..= _ . Demolition��� ��j�� � �� � Fors special information f �
0p f n use checklist
Description Qty. Ea. Total
®Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
�K
ti, -; 4TU� lC�l �r sem,,' , 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
0 Master builder Each additional bath/kitchen 25.02
❑Other
Fire sprinkler( sq.ft.) Page 2
, K ! C�1 / � � , , Site •utilities
Job site address:9734 SW London Ct Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97123 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name:
8,,,....,„
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: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
;" Backwater valve1 2.51
,�-1-,, A Clothes was 25.02
✓"`c7 U '�c" ��� )( � Dishwasher 25.02
Drinking fountain 25.02
' vs', e ���, F ,M-'4",;',5-:,,vy / ''''''''''em--- l Ejectors/sumpn
25 02
,7; �w,,,t ,., , g " �N,a Expansion tank 12.51
Name:Lorraine Bero Fixture/sewer cap 25.02
Address:9734 SW London Ct Floor drain floor sink/hub 25.02
Garbage disposal 25.02
City/State/ZIP:Tigard,OR 97123 Hose bib 25.02
Phone:( )408-799-1381 Fax:( ) Ice maker
� „� � 12.51
s ..... ,e. " Interceptor/grease trap 25.02
.ate�,..�_. , ...,.r � _>�' � l�` � ,_��y`
Business name:Kennedy Plumbing Medical gas(value:$ ) Page 2
Contact name:Joel Dirickson
Primer 12.51
Roof drain(commercial) 12.51
Address: 13985 SW Farmington Rd Sink/basin/lavatory 1 25.02 25.02
City/State/ZIP:Beaverton,OR 97005 Solar units(potable water) 62.54
Phone:( )503-643-5535 Fax::( ) Tub/shower/shower pan 1 12.51 12.51
E-mail:jdirickson@kennedyplumbing.com Urinal 25.02
.=, O1 „�?..G.: sou ;;°,.,,;rr..,>,a '
Water closet 25.02
Water heater 37.52
Business name:Kennedy Plumbing
Water piping/DW V 56.29
Address:13985 SW Farmington Rd Other: 25.02
City/State/ZIP:Beaverton,OR 97005 Subtotal
Phone:( )503-643-5535 Fax:( ) Minimum permit fee: $72.50 72.50
CCB Lie.:10967 Plumbing Lic.no.:34-42PB Plan review (25%of permit fee)
State surcharge(12%of permit fee) 8.70
Authorized signature: iii .- TOTAL PERMIT FEE 81.20
This permit application expires if a permit is not obtained within 180 days
Print name:Joel Dirickso Date:3-12-19
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMO-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9734 SW LONDON CT, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Plumbing PLM2019-00099
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor