Permit (158) CITY OF TIGARDPLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2019-00166
7-I( ;A i;,F) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/24/2019
Parcel: 2S112CB15500
Jurisdiction: Tigard
Site address: 8439 SW NORFOLK CT
Project: Anderson Residence Subdivision: HAMPTON COURT Lot: 4
Project Description: Regrade 95 ft of sanitary sewer line as needed to maintain the connection.
Contractor: SYGNET SOLTIONS LLC Owner: ANDERSON, STEVEN J&
PO BOX 2508 ELIZABETH M
GRESHAM, OR 97030 8439 SW NORFOLK CT
TIGARD, OR 97224
PHONE: 503-882-2104 PHONE:
FAX:
FEES
Quantity Description Date Amount
95 If Sanitary Sewer 04/24/2019 $62.54
Specifics: 1 12%State Surcharge- 04/24/2019 $8.70
Plumbing
Type of Use: SF 10 ea Minimum Fee Adjustment- 04/24/2019 $9.96
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 calling 503. • .1987 or 1.800.332.2344.
Issued By: / "/,17_:00 - - _ •ature:
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 Applicationc
S'ite'Utilities ✓ t4i411.k,� f l T;lip'Cx " FOR OFFICE USE ONLY
City of Tigard 1 ReceivedB (-747 Pet& _)/]i/�i(C�
13125 SW Hall Blvd.,Tigard,OR 97223 t-
ill � ;a �� ' r ' i _DateBy: L O�
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
Date/By: Other Permit No.:
TI G A R D Inspection Line: 503.639.4175Li: 'e°) Date ReadyBy: Iuris: 0 See Page 2 for
Internet: www.tigard-or.gov;� t7 Notified Method: Supplemental Information
11,
... 1 �£..v..,F . _a.:� .il...,r ani.... -U.. 3 . r
0 New construction 0 Demolition For special information use checklist.
Description Qty. Ea. Total
NI Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
u
y ca RTJfiSFR(1)bath 312.70
tg 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
0 Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler sq.ft.) Page 2
��.
, - :r...,..,lc�a?� ., ,k1 . ,tO '�' n Site utilities:
Job site address: (e1 / G 9\A No( 01K C* Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: Ti ga(-d , OR 97 J4 Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03
Cross street/directions to job site: ss i 5 rAi-1re N.)\,1
1 Manholes 18.76
cow(( V( 1 kAr\e CSA -c�Q_Sac- (-lc, Cavo Rain drain connector 18.76
n1Jc�0\< CA Sanitary sewer(no.linear ft.:Ot 64,51 5) � 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
Backwater valve 12.51
le1,t I' IONo
�1Ke `` Clothes washer 25.02
t 3graO� Seil��Q.c \6l� isecc\o el. (� j Dishwasher 25.02
to e (`(Naar\ne (OnNe CAI Cr). Drinking fountain 25.02
Ejectors/sump 25.02
mrr i ,ra A 1 ,!1 , Expansion tank 12.51
Name: tie Psr,,ecr Fixture/sewer cap 25.02
v Floor drain/floor sink/hub 25.02
Address: etioN SW 'b\ a• Garbage disposal 25.02
City/State/ZIP: '-\- \, ,3,c._, ,i bR 00 ,t...\ Hose bib 25.02
Phone:(503) SOLA - ss,‘ 5 Fax:( ) Ice maker 12.51
;fi "11' , g+ * T pE Interceptor/grease trap 25.02
Business name: gc,eA Gb\u s �L Medical gas(value:$ ) Page 2
Primer 12.51
Contact name: Gv. beaki-y Roof drain(commercial) 12.51
Address: (2, g� 00 Sink/basin/lavatory 25.02
City/State/ZIP: eA(i x j . ot5. DK q-7 V 5 Solar units(potable water) 62.54
Phone:( l 5 to.:2)5.255 Fax::( ) Tub/shower/shower pan 12.51
E-mailiu bk. ® pM \• Urinal 25.02
Water closet 25.02
,,+, � - r,'' 1 s
„s . ::_.. +'-'-'--------------°'--""'"""---'-"-"'''"'... Water heater 37.52
Business name: '.,, y3,-.-16, 1-- it,i tri nc.Yt.5 LL c. __ Water piping/DWV 56.29
?7 ,
Address: j 77, 7 _ Other: 25.02
City/State/ZIP: /4c K A ut c at -tt._ � Z_1' r`Z 70/. ---- Subtotal
Phone:O (, ..=3s Fax:( ) Minimum permit fee: $72.50
t Plan review (25%of permit fee)
CCB Lic.• "Z/3 iy 2, -- Plumbing Lic.no.: 1 g
- wZ v State surcharge(12%of permit fee)
Authorized signature:�, / :` TOTAL PERMIT FEE
Print name: 1 1 I t, • Date: This permit application expires if a permit is not obtained within 180 days
safter 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)
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
8439 SW NORFOLK CT, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Plumbing PLM2019-00166
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
PASS - NoCofO
Comments:
See inspection dated 4/30/19.
This inspection to close permit.
Violation Summary:
Inspector Contractor