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Permit (37) CITY OF TIGARD PLUMBING PERMIT "`777 2 COMMUNITY DEVELOPMENT Permit#: PLM2019-00029 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/23/2019 Ti a Parcel: 2S114BC04500 Jurisdiction: Tigard Site address: 10496 SW BONANZA WAY Project: Dixon Subdivision: RIVERVIEW ESTATES NO.2 Lot: 82 Project Description: Gas water heater replacement. Contractor: OWNER Owner: DIXON FAMILY TRUST DIXON FAMILY TRUST 10496 SW BONANZA WAY 10496 SW BONANZA WAY TIGARD, OR 97224 TIGARD, OR 97224 PHONE: 503-360-6905 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Water Heater 01/23/2019 $37.52 Specifics: 1 12%State Surcharge- 01/23/2019 $8.70 Plumbing Type of Use: SF 35 ea Minimum Fee Adjustment- 01/23/2019 $34.98 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 . :II 0 32.2344. Issued By: e _ ,/— rmittee Signature: q / A/L ____,_______ , ;(•_..,.,../.1.„7„ • 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 RECEIVED FOR OFFI(;F USE OIL\ Ci of Tigard Received 74 st Date/By: C j/Jif ‘,. --7,-.... Permit No.: G}'� Cj 13125 SW Hall Blvd.,Tigard,OR 97223 N 2 1 0(� / t" f - / L Plan Review Phone: 503.718.2439 Fax: 503.598.1911 ' Date/By: Other Permit No.: TIRD Inspection Line: 503 639 4175 CITY OF ('(t bQlO Date Ready/By: ® See Page 2 for Internet www.tigard-or.govNICI, p/^OpR ,Notified/Method: Supplemental Information � � r Jurist1-.it .... 0 New construction 0 Demolition For special information use checklist Description Qty. I Ea. Total Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) ' f1 ''+I `ELL1C'11L1I _ SFR(1)bath 312.70 54 1-and 2-family dwelling �������" �� � ❑Commercial/industrial SFR(2)bath 437.78 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 JO `y 1E ' f iWiiii1v A Nll3 1 676'' N' Site utilities: J ..:11-02s.4%,:-. �� s : t ©,(,F"r?( ,S{, ► 0 A -( Catch basin or area drain 18.76 Job site address: t,�"G .�W /� City/State/ZIP: 6 C9 /Z Z'17C DryweFrohn 1,leach line,or trench drain 18.76 ¢¢ 7 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: 1 Project name: )( xQ tv (0 c Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 f r (:)(.4.,���� TT) t O R � --Fp ��� Z nib Rain drain connector 18.76 C n �+1 ,` r&n , 1 is o� ! r bW-666(0 'Er Sanitary sewer(no.linear ft.: ) Page 2 t ` J W�`'- LL)L V t(/ Storm sewer(no.linear ft.:_) Page 2 13,0 1.' Water service(no.linear ft.:_) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.274 Of Backwater valve 12.51 "' � Clothes washer 25.02 OWN - Po l2 -14- t2 PL orm- E'N!} Dishwasher 25.02 or G 6 o,2 G tin -- 1 C Drinking fountain 25.02 t'fi-� 2 Ejectors/sump 25 02 4: Expansion tank 12.51 Name: V 'to `t Iv Fixture/sewer cap 25.02 C a`f to s� 130 tJ 2. ` r�`` Floor drain/floor sink/hub 25.02 Address: �,(,J r r Q� Garbage disposal 25.02 City/State/ZIP: S D o[2_ L1l / Hose bib 25.02 Phone:(5j 0 ,-€7cps.- Fax ( o3) �pw---6p '2 Ice maker 12.51 Interceptor/grease t��� t�'e4c3'` �1t,5Q1'� trap 25 02 Business name: Medical gas(value:$ ) Page 2 Contact name: E t�) D( xo Primer 12.51 �o q Q w"s CO � CiiAV Roof drain laatony(commercial) 125.012 Address: l Sink basin/lavatory 25.02 City/State/ZIP: G- D OA__ 9-7 �u( Solar units(potable water) 62.54 Phone:(3 ( 61,70C-0C- Fax: :(S3) C)7.4 ,e2S- Tub/shower/shower pan 12.51 Urinal 25.02 Email ( XC)v j,\t oto. • A ,t c o t s� w 4 TO1� F;.'; ater c oset 3 `� Water heater t 37.52 Business name: D W G� S�" ) _ p � , `^�`r `-1 Water piping DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal 'S/7, Phone:( ) Fax:( ) Minimum permit fee: $72.50 7 Plan review (25%of permit fee) _ CCB Lia: Plumbing Lic.no.: State surcharge(12%of permit fee) T-70 Authorized signature: Gly ((7 TOTAL PERMIT FEEPrint name: 0 WiON Date: l/ (zt This permit application expires if a permit is not obtained wit n 1 0(Lys after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1:/Boilding\Peneits\PLMU-PennitApp.doc 10/01/09 440-4616T(10/02/COM/WEt3) City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10496 SW BONANZA WAY, TIGARD, OR, 97224 March 1 , 2019 at 9:08:27 AM Record Type: Record ID: Residential - Plumbing PLM2019-00029 Inspection Type: Inspector: 399 Plumbing final Aaron Cillo-Gobel Result: PASS - NoCofO Comments: Corrections completed Violation Summary: Inspector Contractor