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Permit ipqCITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit#: PLM2020-00057 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/04/2020 Parcel: 2S111DB14300 Jurisdiction: Tigard Site address: 15150 SW 92ND AVE Project: Arnett Subdivision: LAUNALYNDA PARK Lot: 30 Project Description: Plumbing for kitchen remodel:(1)clothes washer, (1)dishwasher,(2)hose bibs, (1)ice maker,(3)sinks, (2) tub/shower,(2)water closets, (1)water heater, and(1)water piping/DWV. Contractor: ANDERSEN HEATING INC Owner: ARNETT, JOAN L&MICHAEL G TRS 16285 SW 85TH AVE STE 410 16995 SW ARBUTUS DR TIGARD, OR 97224 BEAVERTON, OR 97007 PHONE: 503-992-6664 PHONE: FAX: 503-536-6615 FEES Quantity Description Date Amount 1 ea Clothes Washer 02/04/2020 $25.02 Specifics: 1 ea Dishwasher 02/04/2020 $25.02 2 ea Hose Bib 02/04/2020 $50.04 Type of Use: SF 1 ea Ice Maker 02/04/2020 $12.51 Class of Work: ALT 3 ea Sink 02/04/2020 $75.06 Type of Const: 2 ea Tub/Shower/Shower Pan 02/04/2020 $25.02 Occupancy Grp: 1 ea Water Piping/DWV 02/04/2020 $56.29 Stories: 2 ea Water Closet 02/04/2020 $50.04 1 ea Water Heater 02/04/2020 $37.52 1 12%State Surcharge- 02/04/2020 $42.78 Plumbing 1 ea Investigation Fee 02/04/2020 $90.00 1 ea Investigation 12%State 02/04/2020 $10.80 Surcharge Total $500.10 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: _" tte Signature: 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. 3t. : 015'f 2.0ta- Dog3Lp Plumbing Permit Application Building Fixtures FOR OFFICE USE ONLY City of Tigard a a ,^` Date/By:d J•� Permit No.:ipi !' ,0 _dou 7 IN - •• 13125 SW Hall Blvd.,Tigard,OR 97223 c Phone: 503.718.2439 Fax: 503.598.1960 ry Plan Review FEB202U DateBy: Other Permit No.: Ta�i1 fylZ/7f� TIGARD- Inspection Line: 503.639.4175 B DateReadyBy: furs: ld See Page 2for w I w Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF W®' ° ""'S °_ FEE* SCHEDULE ❑New construction 0 Demolition For special information use checklist Description I Qty. 1 Ea. I Total 0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OP•CONSTItIC'7O SFR(1)bath 312.70 j] 1-and 2-family dwelling ElCommercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building 0 Multi-family Each additional bath/Idtchen 25.02 ❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION: Site utilities: Job site address: Catch basin or area drain 18.76 City/State/ZIP: r t 6 ,e,�) C e q 7 z Z Drywell,leach line,or trench drain 18.76 ^ Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name: /'1,^,,v Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 5 yJ 5 et. 2� t- S,L 4 S t� q "t �t�i1 JC. 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.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer ,,/' 25.02 2_S` a� Dishwasher ,,_„/'. 25.02 2_ ICJ}. Drinking fountain 25.02 Ejectors/sump 25.02 - PROPERTY OWNER y0 TENANT Expansion tank 12.51 Fixture/sewer cap 25.02 tL Name: pet Z.� t � -A t, `A- a_vt G-77-T-- Floor drain/floor sink/hub 25.02 Address: 1 ci ro Su) 6/Z" ,it Garbage disposal , 25.02 City/State/ZIP: is.4 t .c ©2 9 72? '' Hose bib .e, 25.02 3z7 04 Phone:( ) Fax ( ) Ice maker _. 12.51 ,1 1 -i Interceptor/grease trap 25.02 Business name: Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: Roof drain(commercial) 12.51 Address: Sink/basin/lavatory „/'" 25.02 75'vc, City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax: :( ) Tub/shower/shower pan _ - 12.51 j-(A, E-mail: Urinal 25.02 ,x i imioviimiiii Water closet ?.. 25.02 0,,.t f,_.�.wk_,. ` ,u . - 's, .w ' ` Water heater / 37.52 Business name: i✓. ,s£Ls.L {'&e.L t-A.A.(I CJ4_L Water piping/DWV { 56.29 TZ, LJ Address: ,, f ,z,g� 5 LA) $ ifs�, ,f is Other: 25.02 r City/State/ZIP: r J G,4.e.,,,) ea_ 702,174 Subtotal / �L,j2 Phone:(611,3) ??2- &(D le 4 Fax:( ) Minimum permit fee: $72.50 CCB Lic.: , g2_/ , / Plumbing Lic.no.: PeI y Plan review (25%of permit fee) �� / State surcharge(12%of permit fee)1If) ,7 Authorized signs - TOTAL PERMIT FEE1/y G/ '3%► Print name: t This permit application expires if a permit is not obtained within 1 0+dayyss . t / Date: 3 2D 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(10/02/COM/WEB) .. -.4/W 1 Fd 5Od . ` )