Permit (220) INCITY OF TIGARD PLUMBING PERMIT
I COMMUNITY DEVELOPMENT Permit#: PLM2019-00330
Date Issued: 08/15/2019
T lc;�R f7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S 15/201 8700
Jurisdiction: Tigard
Site address: 8805 SW REILING ST
Project: Winder Subdivision: SCHECKLA PARK ESTATES Lot: 4
Project Description: Replacing 35 ft of sanitary sewer.
Contractor: NORTHWEST CONCEPTS&EXCAVATION Owner: JULIE WINDER
17242 S CARUS RD 8805 SW REILING ST
BEAVERCREEK, OR 97004 TIGARD, OR 97224
PHONE: 503-632-3400 PHONE: 503-319-6005
FAX:
FEES
Quantity Description Date Amount
35 If Sanitary Sewer 08/15/2019 $62.54
Specifics: 1 12%State Surcharge- 08/15/2019 $8.70
Plumbing
Type of Use: SF 10 ea Minimum Fee Adjustment- 08/15/2019 $9.96
Plumbing
Class of Work: ALT
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 b *.11ing 503.232.19'7 or1.801 1:2.2344.
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Issued By: Permittee Signature:
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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
Site Utilities 5 FOR OFFICE USE ONLY
City of Tigard Received
h
Date/By: a ,/v 7, i Permit N102_4440Z07 .
" Tigard,q 13125 SW Hall Blvd., OR 97223 '1 ' '''
111Plan Review
' Phone: 503.718.2439 Fax: 503.598.1960 •,. •J-, Date/By: Other Permit No.:
Inspection Line: 503.639.4175
T I G A R D Date Ready/By: Juris: 0 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
0 New construction 0 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)
:CATf:61WrillOaC.01. CLOONHIII!:!1:111111Rupillifili:::giniigniii,20N SFR(1)bath 312.70
W 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
0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
:',wTHF193,1iimifinin,!E-'44.0WiSHItEliTh,.. 1101Its...AND5iLOCATIONoilmioiiiiiiniinuiliiiiiNu Site utilities:
Job site address: , gog 50Ze.-A rina 51-- Catch basin or area drain 18.76
City/State/ZIP: ard
Drywell,leach line,or trench drain 18.76
-7,0 , Ok ot74 .H
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: '
j Project name: Manufactured home utilities 50.03
Cross street/directions to job site: 5\.,,) 5st/h N,Q, Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.j...0--) 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
!,PNIIHIHINIIIIIIIIEIIRAIIESI!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Clothes washer 25.02
R.111/4- e- ..5 it-e.- 4,\..,._ 4_,... 4.4....4-777.4.1 7 Dishwasher 25.02
e•rri, 044_,\I_ an -Ski irr 4 -4.,<. Drinking fountain 25.02
Ejectors/sump 25.02
0 iii4,,, , ,.janiiiiiiiiiw,c: Expansion tank
12.51
Fixture/sewer cap 25.02
Name: 3 ci../,,.,_ c„),,,,,,et R.
Floor drain/floor sink/hub 25.02
Address: qq0S-- .5(.../ li1 4`..5 5 7: Garbage disposal 25.02
City/State/ZIP: 76-4-44 (9)/2"" Hose bib 25.02
Phone:(52'3) 1 Fax ( ) Ice maker 12.51
ni)6;,'Ufgqiielm.,(12, 0hi0.:,..i :Nt,!,iiiiiiiiiRE,.,i,:Niiiii!f..'miiiiilioilWro..*ACt!!tERSOrspiiiIiimo Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name:
Primer 12.51
Contact name: C-7(ittit eet,f-t-
Roof drain(commercial) 12.51
Address: PC) g ,--z )7D7 Sink/basin/lavatory 25.02
City/State/ZIP: (NIA(,V/, ty-Ac 0 a COO lc Solar units(potable water) 62.54
k..- .'''' .. -- Tub/shower/shower pan -12.5-1---' - -: - ------ ---=
Phone:(r7- --2\ 07,1 Fax..(
)u.y -2k v )
Urinal 25.02
E-mail: 3,tt, (jk C9 Okf,\. (0 NI
- . Water closet 25.02
Water heater 37.52
ki
Business name:11 V") C54\(0 8V., chrA\ exc...c .)
„ 0,., (X S Water piping/DWV 56.29
Address: """?D.:4'' . S, 0 c_ut 5 QA Other: 25.02
City/State/ZIP: '5e awsz_f_e 0, D q"--)DI -1 Subtotal
Phone:(5D3 / I 0
Minimum permit fee: $72.50
-
-' ...q 7 Fax:( /
Plan review (25%of permit fee)
CCB Lic.: at 1-1 s-S Plumbing Lic.no.:
State surcharge(12%of permit fee)
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Authorized signature: 40i,
TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180 days
Print name: 1404,7 Q0-41'smile-4-- Date:etc.-jr- ii after 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(1 0/02/COM/WEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8805 SW REILING ST, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Plumbing PLM2019-00330
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor