Permit (90) CITY OF TIGARD PLUMBING PERMIT
r
2 .' COMMUNITY DEVELOPMENT Permit#: PLM2017-00411
TfGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/09/2017
Parcel: 2S112C600700
Jurisdiction: Tigard
Site address: 15174 SW CHANDLER LN
Project: WESTWOOD HOMES LLC Subdivision: MANGOLD SUBDIVISION Lot:
Project Description: 20 ft.of water service and 20 ft.of sanitary sewer to connect existing house to sewer.
Contractor: H &H MECHANICAL Owner: WESTWOOD HOMES LLC
5757 SE WILLOW LN 12700 NW CORNELL RD
MILWAUKIE, OR 97267 PORTLAND, OR 97229
PHONE: 503-975-9787 PHONE:
FAX: 503-659-2979
FEES
Quantity Description Date Amount
20 If Sanitary Sewer 10/09/2017 $62.54
Specifics: 1 12%State Surcharge- 10/09/2017 $15.01
Plumbing
Type of Use: SF 20 If Water Service 10/09/2017 $62.54
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $140.09
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 . - rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
,
Issued By: e / r Permittee Signature: / '',/
0.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 EIVEP
j
Building Fixtures
City of Tigard a Received
Permit No.: ) �y�L
41 13125 SW Hall Blvd.,Tigard,OR 97223 PlaReview�U �7 P1/4"
Hl�l��7" W l�!
= Plan
• Phone: 503.718.2439 Fax: 503.59 1 / Other Permit No C^
44,42121
Inspection Line: 503.639.4175 OP l i U R� Date/By: U
T I C A I:I1 Date Ready/B7uris: See Page 2 for www.tigard-or.gov RUI DI G DIVISION
Notified/Metthod: Supplemental Info
rmation
TYPE OF WORK FEE* SCHEDULE
Ncw--_" - _" 0 Demolition For special information use checklist
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement Other:(`t'r t TA r,(4- New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
0 Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: er, Catch basin or area drain 18.76
�?.r r r Drywell,leach line,or trench drain 18.76
City/State/ZIP: ;n Footing drain(no.linear ft.: ) Page 2
il,'1':,y t lam- t L 1 ,i
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.:J I Page 2
Storm sewer(no.linear ft.: ) Page 2
/� Water service(no.linear ft.:� / Page 2
Subdivision: ,t t' ,,- / '7 , 1 -I e ( Lot no.:( Fixture or item:
fC�� d'f' L' C' fi�
Tax map/parcel no.: 7 Backflow preventer 31.27
DESCRI1IION OF WORK
Backwater valve 12.51
25.02
hiwisAst LAI-7%zq '5 Clothes washer�.fi, 4't 1,1.�t ✓ 47..:414 / _C r (c �aii'i.t ,Lii> Dishwasher
25.02
Drinking fountain 25.02
Ejectors/sump 25.02
r il Pi2.01 RRA#1(O1R J t TA ` Expansion tank 12.51
Name:Same as applicant Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
IAPPLICANT ❑ c6NTiCT PERSON Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name:Westwood Homes LLC
Primer 12.51
Contact name:Matt Fricke
Roof drain(commercial) 12.51
Address:12700 NW Cornell Rd Sink/basin/lavatory 25.02
City/State/ZIP:Portland,OR 97229 Solar units(potable water) 62.54
Phone:(503)406-2442 Fax::( ) Tub/shower/shower pan 12.51
E-mail:Matt@westwoodhomesllc.com Urinal 25.02
"' Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:H&H Mechanical
Water piping/DWV 56.29
Address:5757 SE Willow Lane Other: 25.02
City/State/ZIP:Milwaukie,OR 97267 Subtotal
Phone:(503)975-9787 Fax:( ) Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lic.:178122 Plumbing Lic.no.:
State surcharge(12%of permit fee)
Authorized signature: 1t'' TOTAL PERMIT FEE
-
`` A._....-....,_,/
� "" ^'' This permit application expires if a permit is not obtained within 180 days
Print name:Dustin Hue Date:70/10:// 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:
15174 SW CHANDLER LN, TIGARD, OR, 97224 October 10, 2017 at
2:33:55 PM
Record Type: Record ID:
Residential - Plumbing PLM2017-00411
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor