Permit (18) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2016-00282
f O A R ID 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/01/2016
-f
Parcel: 25111 DB05100
Jurisdiction: Tigard
Site address: 15249 SW ALDERBROOK PL
Project: Stanley Eischen Properties LLC Subdivision: SUMMERFIELD NO.7 Lot: 409
Project Description: (1)clothes washer,(3)sinks,(2)shower,(2)water closets,and(1)water heater for interior remodel.
Contractor: ASSURED PLUMBING INC Owner: STANLEY M EISCHEN PROPERTIES LLC
PO BOX 230816 15755 SW OAK HILL LANE
PORTLAND, OR 97281 TIGARD, OR 97224
PHONE: 503-985-9093 PHONE:
FAX: 971-249-3145
FEES
Quantity Description Date Amount
ea Clothes Washer 05/27/2016 $25.02
Specifics: 3 ea Sink 05/27/2016 $75.06
2 ea Tub/Shower/Shower Pan 05/27/2016 $25.02
Type of Use: SF 2 ea Water Closet 05/27/2016 $50.04
Class of Work: ALT 1 ea Water Heater 05/27/2016 $37.52
Type of Const: 1 12%State Surcharge- 05/27/2016 $25.52
Occupancy Grp: Plumbing
Stories:
Total $238.18
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
Building Fixtures RECEIVEP
Received r�
City of Tigard /'e//`0 Permit No.: M /f '\ f�a
111 ni 13125 SW Hall Blvd.,Tigard,OR 972p9 ,,
Date/By: /t jilo i.L a
11, y Plan Review �pc� itp
1 Phone: 503.718.2439 Fax: 503.598:19b0 2 6 2016Other Permit No.:� �C /�
Date/By:
Inspection Line: 503.639.4175 ... Date Read Juris: ® See Page 2 for
l 1 C.:1 K P
Ready/By:
www.tigard-or.gov k_,Iif r.�RI Notified/Method: Supplemental Information
� d ll)� �'
TYPE O�ING DIVISION FSE• SCHEDULE
❑New construction 0 Demolition For special information use checklist
Description I Qty. I Ea. Total
®Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
® 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 15249 SW Alderbrook Place Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name: n
SCAM {' lb`5)Manufactured home utilities 50.03
Cross street/directions to job site: 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: , Lot no.: Fixture or item•
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve / 12.51
Clothes washer ✓ 1 25.02 � „
2 tub showers/W.H/2toilets/3 sinks/1 washer box Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
C! PROPERTY OWNER + 0 TENANT Expansion tank 12.51
Name:Stanley Eischen Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:15755 SW Oak Hill Lane
Garbage disposal 25.02
City/State/ZIP:Tigard,OR 97224 Hose bib 25.02
Phone:( ) I Fax:( ) Ice maker 12.51
0 APPLICANT ® CONTACT PERSON Interceptor/grease trap 25.02
Business name:TL Remodel&Construction Inc Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Tim Labunsky
Roof drain(commercial) 12.51
Address:PO Box 1996 Sink/basin/lavatory �3 25.02 7 o ,
City/State/ZIP:Lake Oswego,OR 97035 Solar units(potable water) 62.54
Phone:(503)984-2783 Fax::( ) Tub/shower/shower pan ✓ 2 12.51 2.s--;c,-1.
E-mail:TLRemodel@yahoo.com Urinal 25.02
CONTRACTOR Water closet ✓ 2 25.02
/ SL o‘1
Water heater �/ 1 37.52 3,7,s,
Business name:Assured Plumbing Inc Water piping/DWV 56.29
Address: PO BOX 230816 Other: 25.02
City/State/ZIP:Portland,OR 97281 Subtotal ao,,G S,
Phone:(503)985-9093 Fax:( ) Minimum permit fee: $72.50
CCB Lic.:199423 Plumbing Lic.no.:PB1055 Plan review (25%of permit fee)
State surcharge(12%of permit fe• 5^
Authorized signature: TOTAL PERMIT EE 'a..3e, /f
Print name:Miguel Dorantes Date:5/26/16 This permit application expires if a permit is not obtain . :1 •
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616TO 0/02/COM/WEB)
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
15249 SW ALDERBROOK PL, TIGARD, OR,
97224
Residential - Plumbing
399 Plumbing final
FAIL
August 30, 2016 at 8:56:23
AM
PLM2016-00282
David Young
Seal back of kitchen sink counter top at window. 407.2
Violation Summary:
Inspector Contractor