Permit (105) ,,,,ir.„,. CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2017-00354
T[ a; 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/31/2017
Parcel: 2S101AB01700
Jurisdiction: Tigard
Site address: 7420 SW HERMOSO WAY
Project: MICHELS Subdivision: HERMOSO PARK
Project Description: Moving kitchen sink,and installing dishwasher and garbage disposal. Lot: 11
Contractor: OWNER Owner: MICHELS, FRANK S&PATRICIA
FRANK MICHELS 7420 SW HERMOSO WAY
7420 SW HERMOSO WAY PORTLAND, OR 97223
TIGARD, OR 97223
PHONE: 503-892-9507 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Dishwasher 08/31/2017 $25.02
Specifics: 1 ea Garbage Disposal 08/31/2017
$25.02
Type of Use: SF 1 ea Sink 08/31/2017 $25.02
Class of Work: ALT 1 12%State Surcharge- 08/31/2017 $9.01
Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $84.07
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by _tie Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain - .p : the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: -----�"f�
EINIMIlitto-
Call 503.639.4175 by 7:00 a.m.for the next available inspec'.. .ate.
This permit card shall be kept in a conspicuous place on the job site unti completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbin! Permit Application
Building FixturesNii(S)
Received
City of Tigard DateBy: , /'3i I I3 - Permit No,: /04411720 1) C(i
13125 SW Hall Blvd.,Tigard,•.' 1:11S-
Plan Review
lig Phone: 503.7182439 Fax: 51 8.1960 '���• Date/By: Other Permit No.:
I I c n It l) Inspection Line: 503.639.4175 ��G k Date Ready/By: Juris: El See Page 2 for
Internet: www.tigard-or.gov � Supplemental Ntifid/MWd entalInformahon
TypE.OF SCIIEDULE
❑New construction 't .1 heck
For special information use clist
,� Description Qty. Ea. I Total
®Addition/alteration/replacement i er: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTIOTJ SFR(1)bath 312.70
y dwelling and 2-famil
® ❑Commercial/industrial SFR(2)bath 437.78
❑Accessory buildingSFR(3)bath 500.32
0Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORI IA.TION AND LOCATIO$ Site utilities:
Job site address:7420 SW Hermoso Way 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:f`illiNt t5 Manufactured home utilities 50.03
Cross street/directions to job site:72nd Ave to Hermoso Way 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:Hermoso I Lot no.:10 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DEscoprioN OIr 'WORiZ
Backwater valve 12.51
Clothes washer 25.02
Move kitchen sink install diswasher and disposal Dishwasher / 25.025
,-.-.);-
Drinking
Drinking fountain 25.02
Ejectors/sump 25.02
;4 PROPERTY;OWNER" I j CAN`T Expansion tank 12.51
Fixture/sewer cap 25.02
Name:Frank Michels
Floor drain/floor sink/hub 25.02
Address:7420 SW Hermoso Way
- Garbage disposal 25.02
City/State/ZIP:Tigard,OR 97223 C�
Hose bib 25.02
Phone:(503)8929507 Fax:( ) Ice maker 12.51
❑;APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name ',Icy-v. u S 661X-
Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory ' 25.02 -v<a"
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
Water closet 25.02
CONTRACTOR Water heater 37.52
Business name: Y"w _S ___ _ 67t y fee-) Water piping/DWV 56.29
Address: Other: 25.02
City/State/ZIP: Subtotal 73. .As
Phone:( ) F... ) Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lic.: P1 t g Lic.no.: State surcharge(12%of permit fee) 4(r 01
Authorized signature: c --'-` _ } TOTAL PERMIT FEEt. 0-7
Print name:Frank Michels Date: J�/'Z'"I 701 This permit application expires if a permit is not obtained within 180 days
(J WJ V after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:\Building\PermitsiPLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)