Permit (39) CITY OF TIGARD PLUMBING PERMIT
IS ' COMMUNITY DEVELOPMENT
Permit#: PLM2019-00018
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/10/2019
T r` ,A,li Dg Parcel: 2S115AD07000
Jurisdiction: Tigard
Site address: 10603 SW RIVER DR
Project: Mckee Subdivision: DOVER LANDING Lot: 53
Project Description: Replacing(1)water heater.
Contractor: JEFFS HEATING&COOLING INC Owner: MCKEE, BRAD A&TIFFANY J
23875 JOHNSON RD 10603 SW RIVER DR
WEST LINN, OR 97068 TIGARD, OR 97224
PHONE: 503-557-4635 PHONE:
FAX: 503-557-3870
FEES
Quantity Description Date Amount
1 ea Water Heater 01/10/2019 $37.52
Specifics: 1 12%State Surcharge- 01/10/2019 $8.70
Plumbing
35 ea Minimum Fee Adjustment- 01/10/2019 $34.98
Type of Use: SF 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 503.232.1987Ziwyr"jr --,---......Eermittee
or 1.800.332.2344. J/
Issued By: Signature: �,/
Call 503.639.4175 by 7:00 a.m.for the next available inspe on 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
Site Utilities FOR OFFICE LSE ONLY
RECity of Tigard �'" ) DateB d
x 13125 SW Hall Blvd.,Tigard,OR 97223 i A I fc) /1,/ ?9e ,ZUC / oe f I
= A N 1 2019 Plan Review Other Permit No.:
Phone: 503.718.2439 Fax: 503.598.1960 Date/By:
T I G A R D Inspection Line: 503.639.4175 _ Date Ready/By: Juris: H See Page 2 for
Internet: www.tigard-or.gov CITY° (.i. ; R ohfied Method. Supplemental Information
LxlJILL)UUatG PIVIS
: >TYPE OF WORK i . SCHEDULE
For special information use c
hecklis
t
[I New construction ❑Demolition
Description Qty. Ea. I Total
IKK(Idition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY.OF CONSTRUCTIONr.. SFR(1)bath 312.70
l, SFR(2)bath 437.78
and 2-family dwelling ❑Commercial/industrial
SFR(3)bath 500.32
❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
10 1:(SITE INFORNkTION AND LOCATION.;', Site utilities:
Catch basin or area drain 18.76
Job site address: !� �
Drywell,leach line,or trench drain 18.76
City/State/ZIP: 1 I c 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
, Y DESCRIPTION O WOR : Backwater valve 12.51
r _ µ
Clothes washer 25.02
_ ► t-- C-� (' , , "'r Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
-
0 PROPERTY OWNER �rrrN
- Expansion tank 12.51
Fixture/sewer cap 25.02
Name:
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
[ ' '',:;-"e.'A APPLICANT ' ❑ CONTACT'PERSON P : Interceptor/grease trap 25.02
fe� S hi
Medical gas(value:$ ) Page 2
Business name:
J /l 71 ljt, ,1t/ CCS-`/3'I. O Primer 12.51
J,,,,, ,i(✓ei ,A,/ �+
Contact name: f
Roof drain(commercial) 12.51
Address:25 7Y JC'1.) ft,S(I 4 Sink/basin/lavatory 25.02
City/State/ZIP: 1/1/1(-7:>)-
/'V(- ) /its x` Solar units(potable water) 62.54
Phone:(j(3) / go3f Fax: :603)5,3-7465 Tub/shower/shower pan 12.51
Urinal 25.02
I E-mail. i,:. Cyt ,.,r, (Cr .4._}I Y aEt ►1i-C.- `C-C Ivk
- Water closet 25.02
± ONTRA 'OR
.t Nater heater f 37.52
Business name: S'A Y1§,e Water piping/DWV 56.29
Address: Other: 25.02
City/State/ZIP: Subtotal
Phone:( ) Fax:( ) Minimum permit fee: $72.50
.. i Plan review (25%of permit fee)
CCB Lie.: .. (1 1 .. Plumbing Lic.no.:,. -"f, -8 p�
L- J I State surcharge(12%of permit fee) R t o
Authorized signature: I . `_,,�= �r _ TOTAL PERMIT FEE 6..4,,2. j j
Print name:Je Fr�- This permit application expires if a permit is not obtained within 180 days
r � �/� h, `' Date:///0/19after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1\Building\Permits\PLMU-PermitApp.doe 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:
10603 SW RIVER DR, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Plumbing PLM2019-00018
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
1 . Replace water heater- approved
Violation Summary:
Inspector Contractor