Permit ITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00558
TIGARD' 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
DATE ISSUED: 12/17/2007
PARCEL: 2S110BC -01400
SITE ADDRESS: 12040 SW BULL MOUNTAIN RD ZONING: R -4.5
SUBDIVISION: BULL MOUNTAIN VIEW ESTATES LOT: JURISDICTION: TIG
PROJECT: BULL MOUNTAIN VIEW ESTATES SUB
Project Description: Permanently connect existing house to sewer, storm & water service.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: 55 ft
WATER CLOSETS: WATER LINE: 55 ft
DISHWASHERS: RAIN DRAIN: 55 ft
Owner:
FEES
ANDREW LOUD
12040 SW BULL MOUNTAIN Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 12/17/2007 $165.00
[TAX] 8% State Surcha 12/17/2007 $13.20
Phone : Total $178.20
Contractor:
TROY ELLIOTT PLUMBING
PO BOX 1958
NORTH PLAINS, OR 97133 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 309 -5750
Reg #: LIC 152130
PLM 34 -402PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued B Per Si nature(
A' / / , .�.�i % g /'
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application F , t = FOR OFFICE USE ONLY
City of Tigard l"a 'i, - ‘-- Received permit No.: J/ a
. Date/By: ` ' 17 07 G� -"/ •
q 13125 SW Hall Blvd., Tigard, OR 97223 1 . l O O � r ` {"'°✓
Plan Review
• Phone: 503.639.4171 Fax: 503.598.196 v " Date/By:
: Other P rmit No.:
Inspection Line: 503.639.4175 t %"‘,:.A r m'i Date Read /B ® See Page 2 for
Pa
TIGARD ° 'yl ° �c Ready /By: AA g
Internet: www.tigard or.gov _ i�.
V .,,� r "r. 1. 1�$� Notified/Method: l Y Supplemental Information
TYPE OF WORK * v+ FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist.
Description Qty. 1 Ea. 1 Total
Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
0 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
El Accessory building ❑ Multi - family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other: Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: 1 Z 0 'tO S c,., f&4.0_ wl-rJ Catch basin or area drain 16.60
City/State /ZIP: "-i-rG r4ie...4 d lZ Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: Project name: 1�twL� Footing drain (no. linear ft.: ) Page 2
1�'Cf� �5i
Manufactured home utilities 1 10.00
Cross street/directions to job site: Manholes 16.60
- 6i[.1-_ WI PO £ /Zd 14 Rain drain connector 16.60
Sanitary sewer (no. linear ft.: & • ) Page 2 5s .'5"
Storm sewer (no. linear ft.: BO) Page 2 55 of
Water service (no. linear ft.: Page 9t) ) P 2 �-
'
Subdivision: 1 Lot no.: Ss
Tax map /parcel no.: Fixture or item
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
(.111,n14.?Cc Ai41)%i L01.40 '%ci ptn 13c -tc- 5c"t_0,'K 5'la.tvl Backwater valve _ 16.60
A tmn w✓lam-
Clothes washer 16.60
Dishwasher 16.60
❑ PROPERTY OWNER 1 ❑ TENANT Drinking fountain 16.60
I Ejectors /sump 16.60
Name: AKI CJ,� LE- Lott 1i7 Expansion tank 16.60
Address: t -
Z O O 5-. '3 ,,„ J2i) Fixture /sewer cap 16.60
City /State /ZIP: t G.4 / QZ_EZi �� Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: L4.16,57- /7/44.,5 ?6%/ oj7 ew Interceptor /grease trap 16.60
Contact name: tJ t L 4,1 Medical gas (value: $ ) Page 2
Address: 7 3 S S w ( 58 -3- vN rr Primer 16.60
Roof drain (commercial) .
City/State /ZIP: ( ) 1660
���'i.Jt= z'_to�J � Ofd q 70�'�
Sink/basin/lavatory 16.60
Phone: ( ) 730 - S 7 I Fax: : ( 5t3) 6-0 - 76
Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: I ,.� / L•t 6 - r '� a 1 � Water heater 16.60
Address: 1 Other:
City /State /ZIP: Subtotal ! 65 a'
Minimum permit fee: $72.50
Phone: (5 Z ) 3 _ 5- .. Fax: ( Residential backflow minimum permit fee: $36.25
CCB Lic.: Pl Lic t.: Plan review (25% of permit fee)
15 / 3v g 3 -4
State surcharge (8% of permit fee) j 3 G"
Authorized signature:_ ' TOTAL PERMIT FEE
178 ="
Print name: : r 6 . 44/ Date: /Z r 37 - ] 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.
1 : \ Building \Permits\PLM- PermitApp.doc 06/26/06 440- 4616T(10/02 /COM/WEB)
CITY OF TIGARD • . ; •
BUILDING DIVISION PERMIT #: 2 .. -f:
f�LM..OtD7 f.(I5,,13
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: .12/1712007
Phone: (503) 639 -4171 its A,
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: •1/25/: 1391 TIME: 7:00AM PAGE: 23
SITE ADDRESS: 12040 SW BULL MOUNTAIN F3() CLASS OF WORK:
SUBDIVISION: BULL MOUNTAIN VIEW ESTATES LOT #: TYPE OF USE:
PROJECT NAME: BULL MOUNTAIN VIEW ESTATES SUB
DESCRIPTION: Permanently Connect existing house to sewer, storm & water service.
OWNER: LOUD, ANDREW PHONE #:
CONTRACTOR: TROY ELLIOTT PLUMBING PHONE #: 503-309 - ?x,760
Inspection Request Scheduled For: Date: 1/25/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 063957 -01 971- 255 -6686 N
Corrections /Comments/ Instructions:
lg PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
n FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 6 \\`"^v Date: 1 2,51T) Phone #: (503) 718-
CITY OF TIGARD = +:
BUILDING DIVISION r PERMIT #: pl,.IM7007- otM8
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: . 12/ 17,00.97
7/;10!37
Phone: (503) 639 -4171 pf(l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1/73r2008 TIME: 7:00AM PAGE: 16
SITE ADDRESS: 12040 SW BULL MOUNTAIN R[) CLASS OF WORK:
SUBDIVISION: BULL IVIOUNTAIN VIEW ESTATES . LOT #: TYPE OF USE:
PROJECT NAME: BULL MOUNTAIN VIEW ESTATES SUES
DESCRIPTION: Permanently connect existing house to sewer, storm & water service.
OWNER: LOUD, ANDREW PHONE #:
CONTRACTOR: TROY ELL.JOT'TT PLUMBINL-3 PHONE #: 503"303- ;7f;0
Inspection Request Scheduled For: Date: 1/ 23/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 063 60a-849-8326 N
Corrections /Comments /Instructions: �Q
0 ‘..c. �, , \ e C : o A- , - r 1-\-d' - 1 7-2 ✓ ran i`2,
, (21 - o r ( i . r . o P s=,
7 PASS PARTIAL APPROVAL ❑ CANCEL I 1 NO ACCESS
1 FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: ) Date: 1 1 2 3 10T) Phone #: (503) 718- 1
CITY OF TIGARD
BUILDING DIVISION PERMIT #: Pi_M2007- OO6;9
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1211112007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1/221200 TIME: 7 :01AM PAGE: 16
SITE ADDRESS: 1204(1 SW BULL. MOUNTAIN RD CLASS OF WORK:
SUBDIVISION: BULL MOUNTAIN VIEW ESTATES LOT #: TYPE OF USE:
PROJECT NAME: BULL MOUNTAIN VIEW ESTATES SUB
DESCRIPTION: InE :tall 90' of private carter service for lot 2.
OWNER: WEST HILLS DEVELOPMENT, PHONE #: 503 - /30-{ 7t_43
CONTRACTOR: TROY ELLIOTT PLUME3ING PHONE #: 503 -309 -5750
Inspection Request Scheduled For: Date: 1/22/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 063639 503 Y'
Corrections /Comments /Instructions:
N� 7� C w
C L t ,mot,(, S +-t rc eve- /�'' $1 O F IPS1'
P ✓te rr Re.5u I ✓ -et L4 1 , ., , e_sL
n PASS ❑ PARTIAL APPROVAL n CANCEL n NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Q7) h4.A-_i t I 1 Date: I 1 ?.2tAD Phone #: (503) 718-
CITY OF TIGARD ,,; �� . •
BUILDING DIVISION PERMIT #: p1142007-00558
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/'1712007
Phone: (503) 639 -4171 FIL
44- Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1221/2007 TIME: 7 :03AM PAGE: 3
SITE ADDRESS: 12040 SW L3ULL. MOUNTAIN RC) CLASS OF WORK:
SUBDIVISION: BULL MOUNTAIN VIEW ESTATES LOT #: TYPE OF USE:
PROJECT NAME: BULL. IVIOI.JNTAIN VIEW ESTATES SUB
DESCRIPTION: Permanently connect existing house to sewer, storm & Water service.
OWNER: LOUD, ANDREW PHONE #:
CONTRACTOR: TROY ELLIOTT PLUMBING PHONE #: 503
Inspection Request Scheduled For: Date: 12/2112007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
340 5 orm drain 062044-01 503-.936-2577 N
A-Ait S te, - �-4 -,
Corrections /Comments/ Instructions:
•
•
,PASS 1 PARTIAL APPROVAL ❑ CANCEL 7 NO ACCESS
n FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: UM \fv2N^ --- i '\ " Date: (7J 7/1/4/10 Phone #: (503) 718-