Permit (144) CITY OF TIGARDli PLUMBING PERMIT
1 COMMUNITY DEVELOPMENT Permit#: PLM2018-00304
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/21/2018
T f'tAR• Parcel: 2S111 DB09000
Jurisdiction: Tigard
Site address: 15490 SW OAKTREE LN
Project: JENKINS Subdivision: SUMMERFIELD NO.10 Lot: 551
Project Description: Relocating(1)clothes washer.
Contractor: 3 MOUNTAINS PLUMBING Owner: JENKINS,T JOYCE WATTS
524 N TILLAMOOK ST 15490 SW OAKTREE LN
PORTLAND, OR 97227 TIGARD, OR 97224
PHONE: 503-670-1342 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Clothes Washer 06/21/2018 $25.02
Specifics: 1 12%State Surcharge- 06/21/2018 $8.70
Plumbing
Type of Use: SF 47 ea Minimum Fee Adjustment- 06/21/2018 $47.48
Plumbing
Class of Work: ALT
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 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., u't Si.nature: IA
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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 lANACIFAIIVE ' ' FOR OFFICE USE ONLY
l. City of Tigard
-q 13125 SW Hall Blvd.,Tigard,OR 97223 t\N 21 20\fi't
z Phone: 503.7182439 Fax: 503.598.196d'- -,.., i 0 n BPD3Ria:tie,:113,iRBvevedYvie67 1414 i r 67r...- OtiPerlmeritPNern.(4-HNO.:IY)194)11-61)3611
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Inspection Line: 503.639 4175
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TYPE OF WO! III DING In V FEE* SCHEDULE
A '&11'
D New construction 111 Demolition For special information use checklist.
Description I Qty. I Fa. I Total
"4 Addition/alteration/replacement r Other:Washer New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312/0
e I-and 2-family dwelling 0 Commerciallindustrial SFR(2)bath 437.78
SFR(3)bath 500.32
0 Accessory building 0 Multi-lannly
Each additional bath/kitchen 25.02
0 Master builder 0 Other:__.... Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Catch basin or area drain 18.76
Job site address:15490 SW Oaktree Ln
- 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.: Project name;
Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 1- - 18.76
Rain drain connector 18.76
-- Sanitary sewer(no.linear ft.: ) I Page 2
Storm sewer(no.linear ft:____) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision:Summerfield Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventcr 3L27
, 1
Backwater valve 12.51
DESCRIPTION OF WORK
Clothes washer 1 25.02 25.02
Moving washer connections(H/C Supply,Drain).
Dishwasher 25,02
Drinking fountain 25.02
Ejectors/sump 25.02
LEI PROPERTY OWNER 0 TENANT Expansion tank 12.51
Fixture/sewer cap 25.02
Name:Joyce Watts Jenkins
Floor drain/floor sink/hub 25.02
Address:15490 SW Oaktree in
Garbage disposal 25.02
City/State/ZIP:Tigard,OR 97224
Hose bib 25.02
Phone:(971)242 9431 Fax:( ) Ice maker 12.51......_
0 APPLICANT L CONTACT PERSON Interceptor/grease trap 25.02
_. _....._.-
Medical gas(value:$ ) Page 2
Business name;
Primer 12.51
Contact name:Ben Jenkins
Roof drain(commercial) 12.51
Address:14380 SW McFarland Blvd
Sink/basin/lavatory 25.02
City/State/Z1P:Tigard,OR 97224 Solar units(potable water) 6254
Phone;(971)242 9431 Fax::( ) Tub/shower/shower pan 12.51
Urinal 25.02
E-mail:eben.jenldns@jlive .com
Water closet 25.02
CONTRACTOR
Water heater 3752
Business name:Three Mountain Numbing
Water piping./DWV 56.29
...,„,.._
Address;524 N.Tillamook St. Other: 25.02
City/State/ZIP:Portland,OR 97227 Subtotal a5"-. Os
Phone:(503)213 4520 Fax:( ) Minimum permit fce; $7250 7
Plan review (25%of permit fee)
COI Lie.: 169499 Plumbing Lie.no.:PB99
9 •
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, 6-otee.Are - State surcharge(12%of permit fee) r-7
Authorized signature: 1-. . -
TOTAL PERMIT FEE tri,,
This permit application expires if a permit is not obtained within 18 days
Print name: (.7i,ye_c 1,,ri. 47.--,c_ivx/;its Date: ,/,..,0/./g,
after it has been accepted as complete.
*Fee methodology set b,Tri-Courity Building Industry Service tins d.
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