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Permit CITY OF TIGARD PLUMBING PERMIT $ COMMUNITY DEVELOPMENT Permit#: PLM2013 -00433 T LGARO 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/19/2013 Parcel: 2S111CC08400 Jurisdiction: Tigard Site address: 15755 SW GREENS WAY Project: Hill Subdivision: SUMMERFIELD NO.2 Lot: 111 Project Description: Add walk -in shower in powder room Contractor: ALL SCOPE PLUMBING & CONSTRUCTION LLC Owner: HILL, JAMES J & GLORIA J 18859 SW BUTTERNUT ST 15755 SW GREENS WAY BEAVERTON, OR 97007 TIGARD, OR 97224 PHONE: 971- 295 -6724 HONE: 503 - 927 -0713 FAX: FEES Quantity Description Date Amount 1 ea Tub /Shower /Shower Pan 12/19/2013 $12.51 Specifics: 1 12% State Surcharge - 12/19/2013 $8.70 Plumbing Type of Use: SF 60 ea Minimum Fee Adjustment - 12/19/2013 $59.99 Class of Work: ALT 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 . . is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility • stification Cente . Those rules are set forth in OAR 952 -001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or ect questions to OUNC • cal •' 5e .232.1987 or 1.800.332.2344. I - =uedBy: / / 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 Applic • Building Fixtures C FIVED City of Tigard Received ll Date/By: /A Aj / ? Permit No.: � /3' d 33 13125 SW Hall Blvd., Tigard, OR 9 19 2013 II = Plan Review • Phone: 503.718.2439 Fax: 503 Other Permit No.: r , Inspection Line: 503.639.4175 � j 'nl��' 06°F t +A�PL�i Date/By: T I c n R U Internet: www.tigard- or.gov BUILDING IJ�VI��` ' Date Ready/By: tur;g: Supplemental e Page 2 for Notified/meth Information TYPE OF WORK FEE* SCHEDULE ❑ New construction ❑ Demolition For special information use checklist Description I Qty. I Ea. I Total iri Addition/alteration /replacement ❑ Other: New 1 - 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 312.70 0-1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 437.78 ❑ Accessory building ❑ Multi - family SFR (3) bath 500.32 Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: i575-5 S1.J Catch basin or area drain 18.76 �' Drywell, leach line, or trench drain 18.76 City/State /ZIP:l'( g 7-7.-4 _ C �" t Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: Project name: ;1‘ Manufactured home utilities 50.03 Cross street/directions to job site: u _ (t,'4 Manholes 18.76 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: I Lot no.: Fixture or item: Tax map /parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Auld 1-v'1 (k % V\ 5hs-n. nr` G. pooI.,,t‘ r t' a 4w\ Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 • PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: �y .. Q41 N 111 Fixture/sewer cap 25.02 Address: 1 575,E 51,,) C►K *a` Floor drain/floor sink/hub 25.02 1 s1 Garbage disposal 25.02 City/State /ZIP: 1 � 1 PQ r , / Q (I att.,, 9 L' Hose bib 25.02 Phone: ( .` ) Z a ` G 7 Z � Fax: ( ) Ice maker 12.51 0 APPLICANT CONTACT PERSON Interceptor /grease trap 25.02 (value: $ g as 'II, n W ,, d �` Medical ) Page 2 Business name: KQ, Primer 12.51 Contact name: i Lot N Address: Pd (1:0 R I 1 et_b Roof drain (commercial) 12.51 Sink/basin/lavatory 25.02 City/State /ZIP: , k . . , a • • = *gat Solar units (potable water) , 62.54 Phone: (553 ) 9 $ 9 .21? 3 Fax: : ( ) Tub /shower /shower pan q 12.51 /A , 51 E -mail: 1 L P y L1 l v Urinal 25.02 " C_8 ]_ NTRACTO R a Water closet 25.02 Water heater 37.52 Business name: 'j/Z , (j 4 /l/) Water piping/DWV 56.29 Address: / A,r P crA) / 1 TTEeM r Sr • Other: 25.02 City/State /ZIP: j'/ r, (��� �'1Df3T Subtotal Phone;�o3 ) 1 7 j Fax: ( � ) ,� //� -7 , Minimum permit fee: $72.50 a . S 7 q '' � '" . " � "�� � , Plan review (25% of permit fee) , � CCB Lic.: 1 / / / or Plumbing Lic. no.: '` l i State surcharge (12% of permit fee) g . 70 Authorized signatur•: "/' " TOTAL PERMIT FEE g j .d.o Print name: / //1,,i , , Date: This permit application expires if a permit is as not obtained within 180 days av -� -/ - - �� 9® a fte r it h as been accepted 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) Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 15755 SW GREENS WAY, TIGARD, OR, 97224 Residential - Plumbing 399 Plumbing final 2014-01-03 (null) PLM2013-00433 PASS - No C of O Violation Summary: Inspector Contractor