Permit (164) NI CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2019-00345
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/27/2019
Parcel: 2S104AD02801
Jurisdiction: Tigard
Site address: 12945 SW WALNUT ST
Project: BEELER Subdivision: None Lot: None
Project Description: Connecting existing house to sewer:40 ft.of sanitary sewer.
Contractor: HALS CONSTRUCTION INC Owner: BEELER, BECKY
20666 S HWY 213 12945 SW WALNUT ST
OREGON CITY, OR 97045 TIGARD, OR 97223
PHONE: 503-656-4999 PHONE:
FAX: 503-656-5961
FEES
Quantity Description Date Amount
40 If Sanitary Sewer 08/27/2019 $62.54
Specifics: 1 12%State Surcharge- 08/27/2019 $8.70
Plumbing
Type of Use: SF 10 ea Minimum Fee Adjustment- 08/27/2019 $9.96
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 1.800.332.2344.
Issued By: A.004101r •ermittee Signature: A
Call 503.639.4175 by 7:00 a.m.for the next available inspection Fate.
This permit card shall be kept in a conspicuous place on the job site until co pletion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application
Site Utilities ,l; FOR OFFICE USE ONLY
Cityof Tigard Received
g Date/By:
ii C �ermit No.i�i_/"o '�X��`jS
- 'I 13125 SW Hall Blvd.,Tigard,OR 97223 2 -./n1.;.-. Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.: _���,�_100
T I GARD Inspection Line: 503 639 4175 Date Ready By: Iun IO See age 2 for
Internet www.tigard-or.gov Notified Method: Supplemental Information
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For special information use checklist.❑New construction ®Demolition
Description I Qty. [ Ea. I Total
0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
ryyORY OF cii* UCTONW ! 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 ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
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vl . .JOB 1SITEC INFORMA'ffO 1� D LO t l'!Iai O1 T_ Gh '.-'-''''''''''i'''''.
W I Site utilities:
Job site address:12945 SW Walnut St. Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97223
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name:BEELER Manufactured home utilities 50.03
Cross street/directions to job site:Walnut(looks like 129") Manholes 18.76
Gravel road off of Walnut.It looks like 129th Rain drain connector 18.76
Sanitary sewer(no.linear ft.:._zro t Page 2 Q.571
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
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Rip 1111 ':-:':7',141,,f SP(
Backwater valve9, � q ' IIES" PT()i4mO WOni 0 A , ''' 12.51
r"7 ,,,00111t;!,-, , ,1 „ , 0 , >> R ' , -
Clothes washer 25.02
Sewer Connection for existing home.
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
VIII4'%''''Z''''''
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i6j Expansion-- ® PIpETk9wR aI pb tI, 711, 1 , 12.51
Name:Becky Beeler Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 12945 SW Walnut St.
Garbage disposal 25.02
City/State/ZIP:Tigard,OR 97223 Hose bib 25.02
Phone:(503)539-1496 Fax:( ) Ice maker 12.51
Adif APP ANT j . COCT " ON � Interceptor/grease trap 25.02
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Medical gas(value:$ ) Page 2
Business name:Sinclair Construction,LLC
Primer 12.51
Contact name:Lou Pacino
Roof drain(commercial) 12.51
Address:470 2"Street Suite A Sink/basin/lavatory 25.02
City/State/ZIP:Lake Oswego,OR 97034 Solar units(potable water) 62.54
ub/shower/showec-pan. - 12.51 .
Phone'(971)217-51437-3143 Fax::( ) -- ,__...--
TUrinal 25.02
E-mail:lou@sinclairbuilds.com
�� _ f moo �ba lice �a, a Water closet 25.02
,�i ,vw,,,, '1' coN 'RAe o �1 , �) it.
i, k.� �. : ,W .a o i� ''1.: 4..., _ I�(� = . - Water heater 37.52
Business name:Hals Construction Water piping/DWV 56.29
Address:20666 S HWY 213 Other: 25.02
City/State/ZIP:Oregon City,OR 97045 Subtotal ;5
Phone:(503)226-49990 Fax:( ) Minimum permit fee: $72.50 -72 . 0
Plan review (25%of permit fee)
CCB Lie.:34434 Plumbing Lic.no.: 3- 5-j /pn
State surcharge(12%of permit fee) ,7o
Authorized signature: TOTAL PERMIT FEE t,"/,
Print name:Lou Pacino Date:8/13/19 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.
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