Permit (29) CITY OF TIGARD PLUMBING PERMIT
II - > COMMUNITY DEVELOPMENT
Permit#: PLM2019-00006
Date Issued: 01/09/2019
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S103DB00500
Jurisdiction: Tigard
Site address: 11015 SW PARK ST
Project: WASHBURN Subdivision: MIRA PARK Lot: 1
Project Description: Replacing(1)tub/shower.
Contractor: TNT PLBG&CONST LLC Owner: WASHBURN, RYAN&ROBYN
19845 SW PIKE ST 11015 SW PARK ST
ALOHA, OR 97007 TIGARD, OR 97223
PHONE:
PHONE: 503-341-2009
FAX: 503-649-5050
FEES
Quantity Description Date Amount
1 ea Tub/Shower/Shower Pan 01/09/2019 $12.51
Specifics: 1 12%State Surcharge- 01/09/2019 $8.70
Plumbing
Type of Use: SF 60 ea Minimum Fee Adjustment- 01/09/2019 $59.99
yp 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 1.80¢.342,23 4.
Issued By: •-rmittee Signature: Cr/1
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 I FOR OFFICE ISE oNLA
City of Tigard Dateive ii 1 //1 Permit No.: - , //4'- ._. ,
11111 II 13125 SW Hall Blvd.,Tigard,OR 97223 JAN 9 2019 Plan Reviewl/
I Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.: 1
CITY OFTIG
ARD Line: 503.639.4175 Iy Date Readyy'/B Juris: Fi See Page 2 for 1
TIGARL) ���
Internet: www.tigard-or.gov Notified/Method: Supplemental Information :1
! .,,, ✓ ,I • fi ,'° /.. c, ,fir`
For special information use checklist I
❑New construction ❑Demolition I
Description Qty. Ea. Total
Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) s
iii.--,741x7 _,.; "" v" % 5 '., %4 ,m. SFR(1)bath 312.70
1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
0 Accessory building 0 Multi-family
Each additional bath/kitchen 25.02 1
0 Master builder 0 Other: Fire sprinkler(_sq.ft.) Page 2
j ,; t„ '1 : a , Site utilities:
(17 1 Catch basin or area drain 18.76 _J
Job site address:
' r �� T Drywell,leach line,or trench drain 18.76
City/State/ZIPle
:
/'✓ i/ ;.,/ 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 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: Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
c''''''''''kVit�,� ;x9a Backwater valve 12.51 --Iv zi % `i
Clothes washer 25.02
h I a'/ L7-,1.-1 . a 1/1 Dishwasher 25.02
Drinking fountain 25.02 -i
Ejectors/sump 25.02 1
" . I Expansion tank 12.51
Name: t o o I Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: Garbage disposal 25.02 1
-i
[City/State/ZIP: Hose bib 25.02 _-
Phone:( ) Fax:( ) Ice maker 12.51 {i
', s, ' t4t: ' Interceptor/grease trap 25.02
Business name: (0c- �,,`f/„'`� Medical gas(value:$ ) Page 2 - I
N�el`j-� Primer 12.51
Contact name: Tarzlayi / e:7(-/C-/C -,/c7' Roof drain(commercial) 12.51 I
Address: /1767 Z/_ z9(�/��Z,^c,.1i, (d/e 69, Sink/basin/lavatory 25.02 II _____I,
City/State/ZIP: C ak-,,f f 7k y'2 0 75- Solar units(potable water) 62.54
Phone:(5-C'A 7q l__ / 7 2 IJ Fax:: _)____-..- Tub/shower/shower pan f 12.51 IA ,5-1 j
// '( _ Urinal ( 25.02
E-mail: 1�Lf"h 2Q/,d a (a/1
Water closet 25.02
:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11015 SW PARK ST, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Plumbing PLM2019-00006
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor