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Permit Support Document (8) Plumbing Permit Application ..) r.to Building Fixtures RECt.i V • FOR (11:1:1( :. USE ONLY City of Tigard " 13125 SW Hall Blvd.,'Tigard,OR 97223 : 3 Phone: 503.718/439 Fax: 503.598.1960 II ,., Received ermit No.: 0 2U1 I, Date/BY, /A di t, j / -."--- P 14/11.2)i (.." -60z). 1 7 Plan Review Other Permit No.' Inspection Line: 503.639 4175 .v: - Ty of- ItGA"'i * , DEC 2 TIGARD LJIiebarietidyny. hire Ei5 See Page 2 for Internet: www.tigard-or.gov s , gAitethod: 2iii;:,„' - Supplemental Information --,...""" ..-- MO a " i„,-,, '1,,fe-7- -701117,,0"'nfirr: .s.,----"Jalighrt.' Tyry. rsir 0.. Jere-, iie144 ° $.4 t it l' , sA,<,,,,,,,,, ' 'Ay l - ' ^:"P'' ,,,,- ' .":,,,, ,sarq t",, 0 New construction 0 Demolition For special information use checklist Description I Qty. I Ea. I Total 1:3)Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) 68:TideRy iiessivmih(7i-._o_N ,'- : ,Nh,,,..' V;1;' 1-1, ., SFR(1)bath 312.70 ..L_.,SFR(2)bath 437.78 i4 I-and 2-family dwelling 0 Commercial/id '. ' ,3.-.. ,,,7"1‘.,„ 0 Accessory building 0 Multi-family •- ,.• „ SFR(3)bath 500.32 f Each additional bath/kitchen 25,02 0 Master builder 0 Other: li 4 Fire sprinkler( sq.fl.) Page 2 40-B itSVINFOi4tION ;i:t4D-LOC;SifbN ,-Iseiii,-F==41:'irk- Site utilities: . . . .1'Oitr'r' ,36..';:' Catch basin or area drain 18.76 Job site address:3:„1.3,14POrtrjcl Ave q'.2 i"..1 " ..` ---- 3 /A ,..).-1,1 /A.Ari,,,, Ci--; ...-' Drywell,leach line,or trench drain 18.76 City/State/ZIP:Portland,OR 97225 Footing drain(no.linear ft.: ) Page 2 .--. Suite/bldgJapt.no.: I Project name:Coppa 18-411b 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:Tangela I Lot no.:5 Fixture or item: ... _ Tax map/parcel no.: 18135DC05000 Backflow preventer 31.27 Backwater valve 12.51 Clothes washer 25.02 Replace tub and add hose bib-please add to existing permit#P1,1112018-00517. .44114. Dishwasher 25.02 Drinking fountain .. .... .. ... .. -. _ 25.02 Ejectors/sump 25.02 '',4Roptiifv.6,1,. ..iii .--' -" ' ,-11 TEOktir 1,,k1r.,... ‘,717 Expansion tank 12.51 !'"4,P- Ft,' '''Plk'"" """''' " '"liwg,''' ,41lo Fixture/sewer cap 25.02 Name:James Coppa Floor drain/floor sink/hub 25.02 Address:3134 SW 73"i Ave Garbage disposal 25.02 City/State/ZIP:Portland,OR 97225 Hose bib 1 25.02 25.02 Phone:(503)936-3606 Fax:( ) Ice maker 12.51 A11,116ANt, --.. .,',q- ,CONTACE,',-,PER$614, .'lq,)' Interceptor/grease trap 25.02 Business name:The Plumbers Inc Medical gas(value:S ) Page 2 Primer 12.51 Contact name:Judith Hamnes Roof drain(commercial) 12.51 Address:90 NW 150th Ave Sink/basin/lavatory 25.02 , . _ City/State/ZIP:Beaverton,OR 97006 Solar units(potable water) 62.54 Phone:(503)519-6644 Fax::( ) _Tub/shower/shower pan 1 12.51 12.51 Urinal 25.02 E-mail:judalviPtheplumbersine.net . 7 '7, 'n.N„,--=- ' I,,- 7 T Water closet 25.02 toroit ,. .4,0-'' AO'- ..,‘, ,o' . , Water heater 37.52 - . Business name:The Plumbers Inc Water piping/DWV 56.29 Address:90 NW 150th Ave Other: 25.02 City/State/ZIP: Beaverton,OR 97006 Subtotal Minimum permit fee: $72.50 Phone:(503)519-6644 Fax:( ) Plan review (25%of permit fee) CCB Lie.: 177214 Plumbing Lie,no.: PB447 - / Authorized signature('l) ' jodai ai State surcharge(12%of permit fee) TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days Print name: Aii (/c,1 ,- Date: 12/19/2018 after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. ----v-Ss:‘, DruildingTermitrPhMti-PermitApp doe 10/01/09 440-4616T(10/02/COMAVEt3) ef .3„, City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 9392 SW TANGELA CT, TIGARD, OR, 97223 January 24, 2019 at 10:25:13 AM Record Type: Record ID: Residential - Plumbing PLM2018-00517 Inspection Type: Inspector: 399 Plumbing final Aaron Cillo-Gobel Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor