Permit CITY OF TIGARD PLUMBING PERMIT
1114
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' COMMUNITY DEVELOPMENT Permit#: PLM2019-00148
I[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/15/2019
Parcel: 2S 103C C03200
• Jurisdiction: Tigard
Site address: 13984 SW AERIE DR
Project: CONSOLO Subdivision: EAGLE POINTE Lot: 7
Project Description: Replacing(1)dishwasher,(1)garbage disposal,(1) ice maker,and(3)sinks for remodel.
Contractor: KENNEDY PLUMBING Owner: CONSOLO, JIM E& MARTHA L
13985 SW FARMINGTON RD 13984 SW AERIE DR
BEAVERTON, OR 97005 PORTLAND, OR 97223
PHONE: 503-643-5535 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Dishwasher 04/15/2019 $25.02
Specifics: 1 ea Garbage Disposal 04/15/2019 $25.02
1 ea Ice Maker 04/15/2019 $12.51
Type of Use: SF 3 ea Sink 04/15/2019 $75.06
Class of Work: ALT 1 12%State Surcharge- 04/15/2019 $16.51
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $154.12
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: •ermittee Signature: '-
Call 503.639.4175 by 7:00 a.m.for the next available inspection d-�
This permit card shall be kept in a conspicuous place on the job site until compl,: . of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application
Building Fixtures FOR OFFICE LSE ONLY
Cityof Tigard Received
2g Permit No.:
III
13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: G/�iS�/af � � ���- ��'�
_
Plan Review
///
Phone: 503.718.2439 Fax: 503.598.1960���� Y Other Permit No.:
Date/By
ine
T I G A RD Inspection Line: 503 639 4175 Date Rudy/By. Juris H See Page 2 for
Internet: www tigard or goV1C1 Nohlted Method %-2(, Supplemental Information
to
❑New construction ❑ Demo of�\ sVO For special information use checklist
C Ca O Description I Qty. I Ea. I Total
®Addition/alteration/replacement El 00‘,0\‘`'��LD New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF,CONWOJCTION SFR(1)bath 312.70
® I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
111 Accessory buildingSFR(3)bath 500.32
❑Multi-family
Each additional bath/kitchen 25.02
❑ Master builder ❑Other:
Fire sprinkler( sq.ft.) Page 2
JOB Brit"1NORMATION AND LOCA116P'1 - " . . Site utilities:
Job site address:13984 SW Aerie Dr Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97223 - Drywell,leach line,or trench drain 18.76
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:
Backflow r v n r
Tax map/parcel no.: p e e to 31.27
tis•*'''''' PSI of orW RK
Backwater valve 12.51
�z , ; F � ," �:a6,, , Clothes washer 25.02
I(.t-G4,.�,,n CL- cry..0.t�'� '',1c ^2 I Dishwasher 1 25.02 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
®� PROPERTY OWNER
❑ Tt "" '" Expansion tank 12.51
Name:Jim&Marta Consolo Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 13984 SW Aerie Dr
Garbage disposal 1 25.02 25.02
City/State/ZIP:Tigard,OR 97223 Hose bib 25.02
Phone:( )503-704-8964 Fax:( ) Ice maker 1 12.51 12.51 1
.. ®
APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name:Kennedy Plumbing Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Joel Dirickson
Roof drain(commercial) 12.51
Address: 13985 SW Farmington Rd Sink/basin/lavatory 3 25.02 75.06
City/State/ZIP: Beaverton,OR 97005 Solar units(potable water) 62.54
Phone:( )503-643-5535 Fax: :( ) Tub/shower/shower pan 12.51
E-mail:jdirickson@kennedyplumbing.com Urinal 25.02
-� •-•- Water closet 25.02
'CONTRACTOR
- _ �� Water heater 37.52
Business name:Kennedy Plumbing Water piping/DWV 56.29
Address:13985 SW Farmington Rd Other: 25.02
City/State/ZIP:Beaverton,OR 97005 Subtotal 137.61
Phone:( )503-643-5535 Fax:( ) Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lie.: 10967 Plumbing Lic.no.:34-42PB
s State surcharge(12%of permit fee) 16.51
Authorized signature: TOTAL PERMIT FEE 154.12
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Print name:Joe ' ickson Date:4-11-19 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.
Is\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(I 0/02/COM/WEB)