Permit Support Document (7) Plumbing Permit Application
Building Fixtures REcElvf FOR OFFICL I.SE ONI.N
City of Tigard
4 13125 SW Hall Blvd.,Tigard,OR 97223
III Received ,
nr,, „,. , _ r. Date/By:, /0/3 a '•g.7-7.---
A .4,.. 2 i I 1 k Plan Review
Date/By: Permit No.:
i Phone: 503.718.2439 Fax: 503.598.1960 '' ' u IQ Other Permit No.:
Inspection Line: 503.639.4175
TI t,A K D ate Ready/By: Jura: El See Page 2 for
Internet: www.tigard-or.gov CITY OF VGA gdotifled/Method: 77..... ,, 87kilententa1 larormatitori,,v, ,,
-S,ottatiftijivitoir '-',.. :-'!;, :: -1_ 2;i, ),:,,,Foot sc„twp-$4:-.,*..,li,,,,1-.4..„..,,,.,t,---,,,„,
ED New construction 0 Demolition For special information use checklist
Description I Qty. i Ea. I Total
W Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
rnoit*Yoe, 0i. u.0.10.14 - ,,,,-,,,-- ;-,-., -.1--: :1°..':! SFR(1)bath 312.70
r 1-and 2-family dwelling I 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
0 Accessory building 0 Multi-fan .I I,'',,„
_ Each additional bath/kitchen 25.02
r
0 Master builder U Other: lit ) Fire sprinkler( sq.ft.) Page 2
, is ,
*-stti; -4ioa:TdA+*pN!o,., b1,-,t,-„,..oe...4,. i,- ''„,..., ,,,, ',y',- ',.'-',-,' Site utilities:
Catch basin or area drain 18.76
Job site address:13322 SW HILLSHIRE DR
Drywell,leach line,or trench drain 18.76
City/State/ZIP:TIGARD,OR 97223
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name:17-359 Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:______) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.:___) Page 2
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.:25104CA06500 Backflow preventer 31.27
Backwater valve 12.51
oiicitjinai tir.W04 5.":.
''''' -'' '-' d''''' ''' -'-' - -- Clothes washer 1 25.02 25.02
ROUGH IN WASHING MACHINE Dishwasher 25.02
PLEASE ADD TO EXISTING PERMIT#PLM2018-00226 Drinking fountain 25.02
Ejectors/sump 25.02
'........u.,.. .,„„, ,;....., , ,:- .,V,14, 16',' 1. .,;',17-. f4's, 4., 4, Expansion tank 12.51
Aigi'M,'It' : ' ''-/4w". '-' ' '47 11- --4''''' 44 -4-''''''lr.'"7"74 4'4' -Fixture/sewer cap 25.02
Name:PERREIRA,WILLIAM K
' Floor drain/floor sink/hub 25.02
Address:13322 SW HILLSHIRE DR
Garbage disposal 25.02
City/State/ZIP:TIGARD,OR 97223 Hose bib 25.02
Phone:(808)389-2728 Fax:( ) lee maker 12.51
'V ' Interceptor/grease trap lit:4 *0(14 Il ii, ',', CoL- 25.02 ..
Medical gas(value:$ ) Page 2
Business name:THE PLUMBERS INC
. Primer 12.51
Contact name:JUDAH HAMNES
Roof drain(commercial) 12.51
Address:90 NW 150TH AVE Sink/basin/lavatory 25.02
City/State/ZIP:BEAVERTON,OR 97006 Solar units(potable water) 62.54
Phone:(503)519-6644 Fax::(503)684-1202 Tub/shower/shower pan 12.51
Urinal 25.02
E-mail:JIIDAH@THEPLUMBERSINC.NET
Water closet 25.02
-eoNii/A06 R.
Water healer 37.52
Business name:THE PLUMBERS INC Water piping/DWV 56.29
Address:90 NW 150T11 AVE Other: 25.02
City/State/ZIP: BEAVERTON,OR 97006 . Subtotal ;.,S,.0...
Minimum permit fee: $72.50 --
Phone:(503)519-6644 Fax:(503)684-1202
Plan review (25%of permit fee) 4-----
CCB Lie.:177214 Plumbing Lie.no.:LMS106 .. ,
State surcharge(12%of permit fee) 1,db
Authorized signature: A . TOTAL PERMIT FEE-
Print d?
This permit application expires if a permit is not obtained ss ho ISO days
name:JUDAH .MNES Date:10/01/2018 after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Boani.
l:\Buildineemlits\PIMU-Pe(mitApp.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:
13322 SW HILLSHIRE DR, TIGARD, OR, 97223 January 25, 2019 at
10:57:23 AM
Record Type: Record ID:
Residential - Plumbing PLM2018-00226
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Corrections completed
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13322 SW HILLSHIRE DR, TIGARD, OR, 97223 January 14, 2019 at
10:08:18 AM
Record Type: Record ID:
Residential - Plumbing PLM2018-00226
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
FA I L
Comments:
Backsplashes to be sealed. OPSC 407
Provide missing shower strainer.
Violation Summary:
Inspector Contractor