Permit �'u`.'$,v ",4 CITY F TIGARD , �,�,�� , ��
PLUMBING PERMIT
'4. ' COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00289
�f ' DATE ISSUED: 7/6/2007
TI G A R D
r !, ! r^ 13125 SW HaII Blvd Tigard, OR 97223 503.639.4171
PARCEL: 25111 DB -09100
ZONING: R -
SITE ADDRESS: 15510 SW OAKTREE LN
SUBDIVISION: SUMMERFIELD NO.10 LOT: 552 JURISDICTION: TIG
PROJECT: UPRIGHT
Project Description: Backflow preventer for irrigation.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
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: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
UPRIGHT, COLLEEN M Description Date Amount
15510 SW OAKTREE LN
TIGARD, OR 97224 [PLUMB] Permit Fee 7/6/2007 $36.25
[TAX] 8% State Surcha 7/6/2007 $2.90
Phone : Total $39.15
Contractor:
CASEY'S PLUMBING INC
PO BOX 30075
PORTLAND, OR 97294 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 253 -0030
FAX 503- 262 -8251
Reg #: LIC 147298
PLM 26 -725PB
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 By: Permittee Signature: (/
CaII 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.
1 05 07 02:15p Case's Plumbing 5032628251 p.1
Plumbing Permit Application �� hi � , uxn it ,�
. v =a ii ;7� a f f)R' l',.i,1C 1 rl SI () \1 /' hT r r ,,,,l,",-It � i �ir,r,
lr # tr + ; ai r 011 � Ox rm I .t. r ., e, { • o �., + " ,, ),,,,, , Vi ,,, 4 , ,„ „,, q A � `! ,
r
'�� City of Tigard ,/ .
i * v 13125 SW Hall Blvd., Tigard, OR 97223 Q lb . 1 i i ' P erm i t V DO "'Ob�9
5
zt 1 Phone: 503.639.4171 Fax 503.598.1960 �+ /7l, Other Painit No.:
. ���
1 t
f Gzi� ` D Inspection Line: 503.639.4173
��`0/ , a e / r�* a Date Ready /By ]uric: O See Pa
Internet: www.tigard or.gov/ Page 2 for
�,7 1,. .4. if+ed/Metllod: Su..lemental Information
TYPE OF WORK r /O -./ FEE* SCHEDULE
❑ New construction ❑ Demolition Fors, dal In onnatlon use checklist
Descri , tion
Addition/alteration / replacement ❑ Other Ea. Total
New 1- 2-11rmily dwellings (includes 10011. for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 249.20
.]irl- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
❑ Accessory building ❑Multi - family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
JOB SITE INFORMATION AND LOCATION Fire sprinkler ( sq. fl.) p 2
Site utilities
Job site address: 5 5/o s
e-e- 1/1 'e-- Catch basin or area drain 16.60
City/State/ZIP: - 77", . r 0 a Drywell, leach line, or trench drain S 16.60
Suite/bldgiapt. no.: Project name: Footing drain (no. linear ft.: ) Page 2
Cross street/directions to job site: Manufactured home utilities 1 10.00 _
/l Manholes 16.60
$� Rain drain connector 16.60
Sanitary sewer (no. linear ft: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: Lot no.: Water service (no. linear ft.: ) Page 2
Tax map /parcel no.: Fixture or item
DESCRIPTION OF WORK Absorption valve 16.60 Backflow preventer Page 2
Backwater valve I6.60
Clothes washer 16.60
Dishwasher 16.60
_+ PROPERTY OWNER Drinking fountain 16.60
0
Nance: P +e �M r r - �j Ejectors/sump 16.60
� � " ` Expansion tank 16.60
Address: S /0 5 0 -
��r " Fixture/sewer cap 16.60
City /State/ZIP: G 7 72- 9 72 0 --V - Floordrain/floorsink/hub 16.60
Phone: ( 3 G f n a Fax: ( ) Garbage disposal 16.60
�.. APPLICANT ❑ CONTACT PERSON Hose bib 16.60
Business name: t Ice maker 16.60
ti Interceptor /grease trap 16 -
Contact name:
Medical gas (value: $ ) Page 2
Address: / ` . • 0 75 Primer 16.60
City /StateiZlP: a-n d - a =MI Roof drain (commercial) 16.60
Phone: ( 5b3 ) 3_ 003 Fax:: (5p3) ,,,16 -g' .5 Slnl:lbasinJlavatory 16.60
E -mail: (; Cj $ S a Tub /shower /shower pan 16.60
..,� � k. �I' ►'1Cae$� /11G Urinal 16.60
CONT' CTOR Water closet
PA 16.60
Business name: QSe is T A ✓!7 • 1}1. 4 C Water heater
i 16.60
Address: _� y 6 . 5 9 S Other: __-
City/State/Z1P: 1 /Q 61/e • a g Subtotal
Phone: Minimum permit fee: $72.50
3 .-QO 3 0 Fax: (9)3) v 2- � 5 / Residential backflowminimum it fee: $36.25 3( 0 ` 5
CC$ Lic.:. (9 g Plumbing Lic. no.: ac.. ,, 5P4 Plan review (25 %ofpermit fee)
Authorized signature: / � State surcharge (8% of permit fee) el
e
TOTAL PERMIT FEE M
Print name: . • Q dilt4"11111111?j .. 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.
AnuildlnalPermiliWPLM -Perms App.doe 0626146 440.4616T(I0ro2ACoM / wEn)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007 -00248
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: c. 2007
Phone: (503) 639- 4171 j�l
Inspection Requests (24 Hrs.): (503) 639 -4175 �!� _
INSPECTION WORKSHEET FOR DATE: 10/180007 TIME: 7:01AM PAGE: 49
SITE ADDRESS: 15610 SW OAKTRE E LN CLASS OF WORK:
SUBDIVISION: SUMMERFIELD WO.10 LOT #: 55' TYPE OF USE:
PROJECT NAME: UPRIGHT
DESCRIPTION: Eiaz :kf ow preventer for irrigation.
OWNER: UPRIGHT, COLLEEN M, PHONE #:
CONTRACTOR: CASEY'S PLUMBING INC PHONE #: 503 - 75341030
Inspection Request Scheduled For: Date: 10/18/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 051640-01 503.71E -2426 Y
Corrections /Comments /Instructions:
• a-'- Cie a- . e T r 1 (2/t. Tc.) t..9 iu✓u e
II-, rut k w 'C, Vic dk •j-1 C C ✓v Y- f e t Zi evil oi- a
CAvC
5S°1 PASS PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
1 FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 0 M'`""' Date: / 0)) D Phone #: (503) 718-