Permit (83) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2017-00436
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/24/2017
f 4a a1 Et D9 Parcel: 1S133DC10400
Jurisdiction: Tigard
Site address: 13230 SW BRITTANY DR
Project: BENCE Subdivision: BRITTANY SQUARE NO.3 Lot: 70
Project Description: (1)shower pan for bathroom remodel and(1)backflow preventer.
Contractor: OWNER Owner: BENCE, CHRISTOPHER S&LAURA J
CHRIS BENCE 13230 SW BRITTANY DR
13230 SW BRITTANY DRIVE TIGARD, OR 97223
TIGARD, OR 97223
PHONE: 503-740-4584 PHONE: 503-740-4584
FAX:
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 10/24/2017 $31.27
Specifics: 1 ea Tub/Shower/Shower Pan 10/24/2017 $12.51
1 12%State Surcharge- 10/24/2017 $8.70
Type of Use: SF Plumbing
Class of Work: ALT 29 ea Minimum Fee Adjustment- 10/24/2017 $28.72
Type of Const: Plumbing
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 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. 987 or 1.800.332.2344.
Issued By: •ermittee Signature:
ISL/Lt AAA4 41/(1.L.e
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.
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1
Plumbin Permit A licatioECa
Building Fixtures
FOR OFFICE USE ONLY I
City of Tigard OCT 4 2017 ReDaceived
<l /fO�/l? y3
/ i Permit No.:
III ■ 13125 SW Hall Blvd.,Tigard,OR 97223 y. / ` 'Z //%`"" �Ul,
Phone: 503.718.2439 Fax: 503.598.1Ty TIGARD Plan Review Other Permit No.: 1
R DateBy:
TIGARD Inspection Line: 503.639.4175 BUILDING DIVISION
Date Ready/By: Juris ® See Page 2 for 1
Internet: www.tigard-or.gov Notified/Method. Supplemental Information
T 'E OF 01t " .FEE* "SC :DULE I
0 New construction" El Demolition For special information use checklist. 1'
Description Qty. Ea. Total
®Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) I
CATRY OF CONSTRTJCT` SFR(1)bath 312.70
® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 I
SFR(3)bath 500.32
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
El Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 l
JOB SITE INFORMATION AND LOCATION' Site utilities: I'
Catch basin or area drain 18.76 I
Job site address: 13230 SW Brittany Dr. x
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tig •d Oregon 97223
Footing drain(no.linear ft.: ) Page 2 i
Suite/bldg./apt.no.: Project name:Master Bath Renovation Manufactured home utilities 50.03
7.
Cross street/directions to job site:SW 135th 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: 1 Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 1 31.27 31.27
Backwater valve 12.51 '
x ESCRIPTION OF WORK =
;, A '.
Clothes washer 25.02
Full master bath renovation.Shower footprint change.
Dishwasher 25.02
Re-routing shower water lines approximately 4 feet Drinking fountain 25.02
Also adding a sprinkler system with backflow preventer Ejectors/sump 25.02
to PROPERTY OIIiEJCtt TENANT Expansion tank
12.51
Name:Chris Bence Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 13230 SW Brittany Dr.
Garbage disposal 25.02
City/State/ZIP:Tigard Oregon 97223 Hose bib 25.02
Phone:(503)740-4584 Fax:( ) Ice maker 12.51
APPLICA T ,. ❑ coN'1" 'PERSON ;" Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name:n/a
- Primer 12.51
Contact name:ChrisBence
Roof drain(commercial) 12.51
Address:13230 SW Brittany Dr. Sink/basin/lavatory 25.02
City/State/ZIP:Tigard Oregon 97223 • Solar units(potable water) 62.54
Phone:(503)740-4584 Fax: :( ) Tub/shower/shower pan 1 12.51 12.51
E-mail:chrisbenceCgmail.com Urinal 25.02
,o Water closet 25.02
ONTRACTO* 1' '_
Water heater 37.52
Business name:n/aWater piping/DWV 56.29 56.29
Address: Other: 25.02
City/State/ZIP: Subtotal 70.07 j
Phone:( ) Fax:( ) , Minimum permit fee: $72.50 72.50
Plan review (25%of permit fee) 18.13 1
CCB Lic.: /7 Plumbing Lic.no.:
State surcharge(12%of permit fee) 8.70
Authorized signature. TOTAL PERMIT FEE 99.33
Print name:Chris Bence Date:10/24/2017
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\PLMO-PermitApp.doc 10/01/09 440-4616T(10/62/COM/WEB)