Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2020-00119
Date Issued: 03/18/2020
T I G AR 1) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S 103AA03700
Jurisdiction: Tigard
Site address: 12300 SW 106TH DR
Project: NEWTON Subdivision: CLYDESDALE Lot: 17
Project Description: Replacing(1)water heater and re-piping home.
Contractor: SHERWOOD PLUMBING COMPANY Owner: NEWTON, ELIZABETH ANN FAMILY TRU
22718 SW MARTIN CT BY NEWTON, ELIZABETH ANN TR
SHERWOOD, OR 97140 12300 SW 106TH DR
TIGARD, OR 97223
PHONE: 503-349-5429 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Water Piping/DWV 03/18/2020 $56.29
Specifics: 1 ea Water Heater 03/18/2020 $37.52
1 12%State Surcharge- 03/18/2020 $11.26
Type of Use: SF Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $105.07
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. 2.1987 or 1.800.332.2344.
Issued By: 1 w Permittee Signature: c're Cfr •en /
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.
RECEIVED
MAR 1 8 2020
Plumbing Permit ADplication CITY OF TIGARD
Building Fixtures BUILDING DIVIS! / FOR OFFIr'F. 1'SF. ONLI'
City of Tigard r>own;� I _ ���� .� U't�C���`?
13125 SW Hall Blvd..Tigard•OR 07223 f�er Rrv�•
IMP
Phone 503.715.2439 Fax: 503.598.1960 There
Ouhw Paint N^'
Inspection Line: 503.639.4175 w., id tee P.ge t for
TIGARD Here Realyndr -
Internet: www.tigatd-or.gov Naill drMahod: Suppkmeeu/Iarormatle.
TYPE OW WORK PEE'SCHEDULE
a
❑Newt construction ❑Demolition Nxsprelal Gr[araraadn Itat eherJ/!ot
-- Description ) Qty. ' Fa. ) Total
Adliticm/alfaatio&rcplacenenf 0 Other New 1-2-fami dweg)ngs(includes 100 R.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
(yy.s2 and 2-thmily dwelling ❑Commercialiindtan'ial SFR(2)bad 437.78
❑Acec® ily
ary building 0 Multi-fam SFR(3)bed 500.32
❑Master builderEach additional htld ea kitch 25.02
0 Other Ere sprinkle L-a9-ft) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
lob site address: 7 h/�� OM/ I 0 1 A. Catch basin a men lain [&J6
city/sum/zip, T t Q. R D ,leach line, trench drainI III 76
1 1,w. .', _-_ Footingoting drain(nu linear It:_) Page 2
��g'1i*•no.. Project triune: ! Manufactured bonne unities 50.03
(.loss street/directions lo jab site•. Manhole 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear R.:_) Page 2
Stone sewer(no.linear if.:_J Page 2
Water service(no.linear it:_) Page 2
Subdivision: 1 Lot a6.: Fixture or item:
Tax no.: Deckfbw preventer 3i27
DESCRIPTION OF WORK Backwater valve 1251
n �_,f�/� ',,�. •,, Clothes washer 25.02
f eg. •r e. _el- . ^ vL V a"v^A• . Dishwasher 25.02
ll `/t a e6b K ( .V.rniira 9e ) Drinking fountain 25.021
Ejectors'snop 25.02
0 PROPERTY OWNER ' 0 TENANT Expansion tack 12.51
FixtunJacwe
Nome: cap 25.02
Floe drain/floor siokAsub 25.02
Address:
Garbage disposal 25.02
CdyrState/7.1P:
Hose bib slil'_ 25.02
Phone( ) Fax:( 1 Ice make 1251
PHMACAPff 0 CONTACT PERSON !elerttpier/grease trap 25.02
&sines name: ittf# IP Medical gas(vldue:S_) Page 2
Contact rimer Primer
1 12.51Roof drain avalo q Address: l12.51��a Sinklbasin/Invalory 25,02
ovo y(i,..
CiryiS1atd 1 r
ZlP:� -1�( r q j� Solar units(potable water) 62.59
Pi"'kV 3) I Oro -0', p Fex: ( ) Tublshowedshower pan , 12.51
bill": ' Urinal 25.02
8. _ a . • g ._.i..�s i 1.: R.s. /_I -•a 4 Water closet
CONTRACTOR - _
N ����
w• •,er ip,I 37.52
Btrineu name: �►f , d a ._.,I)►R./ ..__
L.✓A •. / , Water piping/DWV - I 56.29
Adbsr ►/ / I Other 1
'`J 25.02
Ciy/SYat/t/ZIPP:: .v1 °1 71'/) Subtotal
Phone:(G ) � w 1/� ) Fax:( ) Minimum permit fee. 572.50
CCU l.c.: w0 "I PIWII Ing Lie,am: Plc review (25%apemen fear)
Authorized aiyianue: State surcharge(129k of permit fee)
TOTAL PERMIT FEE
Prim Minn: e �.�c-vl Dele:y 1 �j T1Y pp•u application expires 11,wont a set aatdew wMYi.Las day*
after It has beet accepted u ongiele.
'fee ranhomtagy set by Tn•couuy Buiamg hiduury Service Bond.
t 1601a0 4646la7(10a130Cp4/wtis)