Permit (65) CITY OF TIGARD PLUMBING PERMIT
II1e: COMMUNITY DEVELOPMENT Permit#: PLM2019-00294
Date Issued: 07/23/2019
T WARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S102DD00400
Jurisdiction: Tigard
Site address: 13816 SW FANNO CREEK DR 6
Project: Fanno Creek Village Subdivision: EDGEWOOD Lot: 3
Project Description: Unit 6.Replace main valve,demo tub/shower,and replace water heater.
Contractor: BRUNER PLUMBING Owner: SOLARES HOMES L L C
PO BOX 23985 13556 TWIN CREEK LN
TIGARD, OR 97281 LAKE OSWEGO, OR 97035
PHONE: 503-484-5105(CELL) PHONE:
FAX: 503-624-2173
FEES
Quantity Description Date Amount
2 ea Tub/Shower/Shower Pan 07/23/2019 $25.02
Specifics: 1 ea Water Heater 07/23/2019 $37.52
1 12%State Surcharge- 07/23/2019 $8.70
Type of Use: COM Plumbing
Class of Work: ALT 10 ea Minimum Fee Adjustment- 07/23/2019 $9.96
Plumbing
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 by calling 503.232.1987 or 1.800.332.2344.
Issued By: \........3>a,
Permittee Signature: 5� e\ -A_AC A-1Q'�
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 FOR OFFICE USE ONLY
3 z " ?r } " Received
City of Tigard PetmirlFo.: r
Date/By: �i�: 114 S.T i�KTN let-Gorr LF
a 13125 SW Hall Blvd.,Tigard,OR 97223
2y s Plan Review ether Permit No.:
2 Phone: 503.718.2439 Fax: 503.598.1960.E\j i.. Z 5 Z U y Date/By:
T I G A R D Inspection Line: 503.639.4175 ,a Date Ready/By: Jude: 10 See Page 2 for
Internet: www.tigard-or.gov i i b`. Notified/Method: Supplemental Information
TYP OWC s1x a ltl ,c 0.t'7k $CHtDUr
0 New construction ❑Demolition For special Information use checklist.
Description I Qty. 1 Ea. I Total
/6 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 •
1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
M
SFR(3)bath 500.32
❑Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
JOB:SITU INFORMATION ANp LOCATION; Site utilities:
Job site address: S\M f-0,yl~� Of o Dr. _ ' Catch basin or area drain, 18.76
6
City/State/ZIP: T(3011,11)6(1-10\00(6 R a,2'L 3 D Footing
rainleactine,or r ft.:
drain ag18e 2
p Footing drain(no.linear ft.:_} Page 2
Suite/bldg./apt.no.: 1 Project e: V v l VISO\A Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.Iinear ft: ) Page 2
Storm sewer(no.linear ft.: ) Page •
Water service(no.linear ft.:. ) Page 2
Subdivision: 1 Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF:WORK Backwater valve 12.51
,n p/� `+ N�} j,,n,,,, 7� �j�n t� Clothes washer 25.02.
a t2,q\tt+C'� `Mi9t 1� V tt, t ckonA o -V4 v 1S A kN e,l Dishwasher 25:02
OVId Yq0 tOtCL IrlU\tV �n tate:( . Drinking fountain 25.02
Ejectors/sump 25.02
; W PROPERTY OWNER : ❑ TENANT Expansion tank 12.51
Name:DO\\I -eVA Y (]V l Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02 •
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:(tAet)W - 39t,0 Fax:( ) Ice maker 12.51
APPLICANT r;: ❑ CONTACT PERSON Interceptor/grease trap 25.02
+� f ��nn `n Medical gas(value:$ ) Page 2
Business name:15nAVIe r V 1�`>nV�y` . I vt6
M•Y � J!iji Primer 12.51
Contact name: 1(
�� (� Roof drain(commercial). 12.51
Address: _(,,t`J, 3"4 Sink/basin/lavatory 25.02
City/State/ZIP: \ $ f ` r-o ()t. r '`)\ Solar units(potable water) . 62,54 _
U4 lJ 1 � �-
- Phone:01Y _..-.a- tt -- c 33)t4(1..�4 �-_ - .2 .0
►I 1251
E marl: p Vitit Urinal 25.02
�r vle� � Y" '-�iY yV' Water closet 25.02 _
CONT. ACTOR:: -1
. . .. .. .... . . ... ... Water heater ` 37.52 . 1 -�JG
Business name:fixiA ` Water piping/DW V 56.29
Address:/pO Z Other: 25.02
L (1\11(6k � 5t
City/State/ZIP'. {1 Subtotal �(f
1 ( � Minimum permit fee: $72.50 2. 6
Phone:( ) "`-kC Fax:( )
CCB Lic,: 0 Plumbing Lic.no. -1 1(4 Y6 Plan review(25%of permit fee)
�k 1 State surcharge(12%of permit fee) ) ,0
Authorized si:nature:4 J / TOTAL PERMIT FEE til-? 0
Print name: 'I r 4'''s `V� ,I r Te `i Dater -23 101 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:1Building\Permits\PLMU-PemiitApp.doc 10/01/09 440-4616Tt10/02/COM/WEB1.