Permit (67) CITY OF TIGARD PLUMBING PERMIT
111 2 . COMMUNITY DEVELOPMENT • Permit#: PLM2017-00346
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/28/2017
ffO+a 9
Parcel: 1S 133CCO2100
Jurisdiction: Tigard
Site address: 11611 SW TALLWOOD DR
Project: KANAHELE Subdivision: PEBBLECREEK Lot: 15
Project Description: Replace(50)feet of water service.
Contractor: KENNEDY PLUMBING Owner: KANAHELE, KRISTEN L TRUST
13985 SW FARMINGTON RD BY KANAHELE, KRISTEN L TR
BEAVERTON, OR 97005 11611 SW TALLWOOD DR
TIGARD, OR 97223
PHONE: 503-643-5535 PHONE:
FAX:
FEES
Quantity Description Date Amount
50 If Water Service 08/28/2017 $62.54
Specifics: 1 12%State Surcharge- 08/28/2017 $8.70
Plumbing
Type of Use: SF 10 ea Minimum Fee Adjustment- 08/28/2017 $9.96
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 if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the ules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You , obtain a copy of the rules
or direct questions to OUNC b calling 503.242.1987 or 1.800.332.2344.
o
Issued By: � Permittee Signature:
1r7; A 6- `4 -4iiikAlk
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 complet o .f • project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application
Building Fixtures RECEIVE FOR OFFICE USE ONLY
City of Tigard Received
III 141 13125 SW Hall Blvd.,Tigard,OR 97223 AUG 2 8 2017 Date/By: AI ,2E/7 / Permit No.:72,71401.61/7„.a34/6
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
TIGARD
Inspection Line: 503.639.4175 CITY OF !CARD Date/By:to Other Permit No.:
Internet BUILDING �yIIRltwww.tigard-or.gov or gov i Ready/By Juns I El See Page 2 for
+a ,.. tified/Method
Information
❑New construction ❑Demolition For special information use checklist
®Addition/alteration/replacement Description I Qty. I Ea. I Total
❑Other
New 1-2-family dwellings(includes 100 ft.for each utility connection)
a4 P o soTlo `" SFR 1 O bath 1
, . 312.70
® 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
❑Accessory building ID Multi-family SFR(3)bath 500.32
III Master builder Each additional bath/kitchen 25.02
❑Other
ft.). I pg
a.: Fire sprinkler( s q Page 2
F. .V ,; ..i ; 0 �.` 71#14 •�f 1 l *41# y Site utilities:
Job site address:11611 SW Tallwood Dr Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97223 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name:
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
Subdivision: Water service(no.linear ft.:50) 1 Page 2 62,54
I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
' 1 1 � 1 Backwater valve
..,.. � . ,,�:� � � � fs� ', 12.51
.' Clothes washer
replace water service 25.02
Dishwasher 25.02
Drinking fountain 25.02 •
Ejectors/sump 25.02
� ; 0 / d � Expansion tank,A. . _ ., .a. "
12.51
Name:Kristen Kanahele Fixture/sewer cap 25.02
Address:11611 SW Tallwood Dr Floor drain/door sink/hub 25.02
City/State/ZIP:Tigard,OR 97223 Garbage disposal 25.02
Hose bib 25.02
Phone:
( )503-407-7114 Fax ( )
�'� � ,��a 4 �" � � y� �,: 4 ,, , Ice maker 12.51
d 'N. W - 117 . Interceptor/grease trap
. .,, ,��� ..,� ,. �. 25.02
Business name:Kennedy Plumbing Medical gas(value:$ ) Page 2
Contact name:Joel Dirickson Primer 12.51
Address: 13985 SW Farmington Rd. Roof drain(commercial) 12.51
Sink/basin/lavatory 25.02
City/State/ZIP:Beaverton,OR 97005
Solar units(potable water) 62.54
Phone:( )503-643-5535 I Fax::( ) Tub/shower/shower pan 12.51
E-mail:jdirickson@kennedyplumbtng.com Urinal 25.02
h ¢
IL Water c ose
t 25.02. < . „* AR DR � ! Water heater 37.52Business name:Kennedy Plumbing
Water piping/DWV 56.29
Address: 13985 SW Farmington Rd.
Other 25.02
City/State/ZIP:Beaverton,OR 97005
Subtotal 62.54
Phone:( )503-643-5535 Fax:( )503-643-33 Minimum permit fee: $72.50 72.50
CCB Lie.:10967 Plumbing Lic.no.:34-42PB Plan review (25%of permit fee)
Authorized signature: N. State surcharge(12%of permit fee) 8.70
~______ TOTAL PERMIT FEE 81.20
Print name:Joel Dirickso i qIIIIIIIIIIIIIIW Date:8-28-17 This permit application expires if a permit is not obtained within 180 days
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)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11611 SW TALLWOOD DR, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Plumbing PLM2017-00346
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
1 . Note: backflow device for irrigation has been removed, no longer using irrigation
system, could not find serial# on device.
Violation Summary:
Inspector Contractor