Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2020 00061
TWARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/06/2020
Parcel: 2S 102AB00601
Jurisdiction: Tigard
Site address: 12075 SW LINCOLN AVE
Project: Ruggiero Subdivision:RTH TIGARDVILLE ADDITION,AMENC Lot: 63
Project Description: 36 ft.of storm sewer piping for roof runoff into swale.
Contractor: OWNER Owner: RUGGIERO, RYAN C & NICOLE S
RYAN & NICOLE RUGGIERO 12075 SW LINCOLN AVE
12075 SW LINCOLN AVE PORTLAND, OR 97223
TIGARD, OR 97223
PHONE: 541-521-8891 PHONE:
FAX:
FEES
Quantity Description Date Amount
36 If Storm Sewer 02/06/2020 $62.54
Specifics: 1 12%State Surcharge- 02/06/2020 $8.70
Plumbing
Type of Use: SF 10 ea Minimum Fee Adjustment- 02/06/2020 $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 by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee 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.
Plumbing Permit Application
', ,' ,
Site Utilities - - i,--• '- ., : • - FOR OFFICE USE ONLY
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City of Tigard ' L. 4„,),1,..„,.. 04 ''..-- ,..Received
lit 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: i/i_1-/97, 67 ,
Permit No.: /24„,,,,,,, 2„,.....au4
III
I Phone: 503.718.2439 Fax: 503.598.1960 FEB 3 202 3 DPlaatne/BReyv:iew 1
Other Permit No.:1./.1)-X10.-46i.t9a,
Inspection Line: 503.639.4175
TIGARD „ ,,,,, , ,,‘.,.., , , Date Ready/By: Juris: FZI See Page 2 for
Internet: www.tigard-or.gov (;I iy kji- i vt,-..,,L :40tifiedimethod: -7_- Supplemental Information
TYPE OF WO -
' " ' DIVISION FEE* SCHEDULE
0 New construction El Demolition For special information use checklist
Description Qty. I Ea. Total
0 Addition/alteration/replacement ErOther: eL4fv.„/v,( 0 0 4-5 (7.2) New 1-2-family dwellings(includes 100 ft.for each utility connection)
--.-- - CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
0 1-and 2-family dwelling El Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
El Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
0 Master builder RI/Other: ok.rry-ei 1,tAtts (.2., i Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION 99-7411t Site utilities:
Catch basin or area drain 18.76
Job site address: (.7.41 . 4(V‘.1 I/ivy...0 I v..ha„
Drywell,leach line,or trench drain 18.76
City/State/ZIP: -r,„,.,.„,,,L. riz. fri 7'2,3
Footing drain(no.linear ft.: ) Page 2
i
Suite/bldg./apt.no.: Project name: 21,1 \.,fi,v-D Ii2itkA cliaviik,6_ Manufactured home utilities 50.03
Cross street/directions to job site: Manholes • 18.76
444 Arti IA tO ''''VJ 1,;y-to k t,-, , o 1,- k(fl- i h4-141,-- Rain drain connector 18.76
' Sanitary sewer(no.linear ft.: _) Page 2
efil'i, 0 t eili\PI I/1 eq./0 i-
Storm sewer(no.linear ft.:36) i Page 2 916).54
• 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
DESCRIPTION OF WORK
Clothes washer 25.02
1,14t, of ttai-.11, rti 6.f thivvv- i)0,4 0,4 tetifv-rc vi I 17V C" c".rt. Dishwasher 25.02
11 A.044- Mk'%it/Y.-tilt i rill PK 1,,,,N Li-VI-tat, S-17,141rNAPCPliem Drinking fountain 25.02
4"V*146 • Ejectors/sump 25.02
[4:P1201)fiTit:b4t4i ItA:11011h1,r,1111M19'9,h,1fig,X*,---17: _., , , Expansion tank 12.51
9,9, 999YEll,lb 11'9999V,191,90 49,.9'9911,'', A, - ` ,.%
Fixture/sewer cap 25.02
Name: .01 t, 1 „4,)ri tv't
Floor drain/floor sink/hub 25.02
Address: !WI (9i1P41 Li1lext471 V.." ii-Vt/ Garbage disposal 25.02
City/State/ZIP:1-it pAlt.I re., eri 7/1" Hose bib 25.02
Phone:(441 ) 6 7.4 $ t'?I Fax:( ) Ice maker 12.51
'-e.-.,,plikAIP istr, ,-fir-CONTACT-PERSON In
terceptor/grease trap 25.02
..4,.."
Medical gas(value:$ ) Page 2
Business name:
Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address:
0 Pk Sink/basin/lavatory
25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pat 12.51
Urinal 25.02
E-mail:
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: 6/2„v4/C.,-,t- Water piping/DWV . 56.29
Address: Other: 25.02
I-A Pk's,
City/State/ZIP: Subtotal
Phone:( ) Fax:( ) Minimum permit fee: $72.50 701„.52)
Plan review (25%of permit fee) --
CCB Lic.: Plumbing Lic.no.:
State surcharge(12%of permit fee)
--
Authorized signature:7 -- TOTAL PERMIT FEE
Print name: Pi 1 Date: This permit application expires if a permit is not obtained within 180 days
ldve....,P..4, ,met, 1 7...,/./.9te
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
IABuildingTermits\PLMU-PemitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)