Permit I , q CITY OF F TIGARD GA ® PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00532
TIGA_FT 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/5/2007
PARCEL: 25111 BA - 04200
SITE ADDRESS: 14040 SW 98TH AVE ZONING: R-4.5
SUBDIVISION: MCDONALD ACRES LOT: 017 JURISDICTION: TIG
PROJECT: MCMILLAN
Project Description: Fixtures
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: 2 OTHER FIXTURES:
TUB /SHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
MCMILLAN, ROBERT L AND
MARGARET R Description Date Amount
14040 SW 98TH AVE [PLUMB] Permit Fee 12/5/2007 $72.50
TIGARD, OR 97223 [TAX] 8% State Surcha 12/5/2007 $5.80
Phone : NA Total $78.30
Contractor:
ANCTIL PLUMBING INC
16900 SW MERLO RD
BEAVERTON, OR 97008 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 642 -7323
FAX 503- 642 -7755
Reg #: LIC 24184
PLM 26 -162PB
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.
i
Issued By: , L.. -.our / Permittee Signature! 474-1----2-2..\____ a_-
u.
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.
. 1
Plumbing Permit RECELVED FOR UfFICl 1 SE 0 \I.1
City of Tigard 0 /A / 1 �W ` 5/ O Permit xo� , A 7
13125 SW Hall Blvd, Tigard, OR 9722DEC 0 ! Plan Review
2007 � -�
Phone: 503.639.4171 Fax 503.59 .� i Date/By. Permit No.:
24- Hour Inspection Line: 503.639.4 OF rIGARD
._ K 'I_1 i . Date Ready/By: foci,: y a8
Internet: www.tigard- or.gov II[AING DNIS • . r i Notified/Method J Supplemental Information
TYPE OF WORK FEE* SCHEDULE . --
❑ New construction ❑ Demolition For special information use checklist
Description 1 Qty. 1 Ea. 1 Total
Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 R for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
./ 11- 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 0 Other: Fire sprinkler ( sq. fl.) Page 2
JOB STIE INFORMATION AND LOCATION Site utilities
Job site address: 1 140 40 SW g8 4 i Catch basin or area drain 16.60
City/State/ZIP: / ( 6./i G 9 7 2.L_ Drywell, (each line, or trench drain 16.60
/ r Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: Project name: i-1 e 111.11 G
Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
,,I( , ,5 1-i . L b - (u SY Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: I Lot no.:
Water service (no. linear ft: ) Page 2
Fixture or item
Tax map /parcel no.: Absorption valve 16.60
DESCRIPTION OF WORK Badkftow preventer Page 2
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
PROPERTY OWNER ( . ❑ TENANT Drinking fountain 16.60
Ejectors/sump 16.60
Name: / ` " A L i t l i / 1 - 4 .1 Expansion tank 16.60
Address: / Li b �d 54 , 9 �8 h 4,--ti- Fixture/sewer cap 16.60
City /State/ZIP: 77, A 47/2 '9 72_2_41 Floor drain/floor sink/hub 16.60
Garbage disposal 16.60
Phone: ( ) Fax: ( )
❑ APPLICANT 13 CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: Interceptor /grease trap 16.60
Contact name: Medical gas (value: 5 ) Page 2
Address: Primer 16.60
City/State/ZIP: Roof drain (commercial) 16.60
Phone: ( ) I Fax: : ( )
Sink/basin/lavatory 'Z 16.60
Tub /shower /shower pan r 16.60
E-mail: Urinal 16.60
CONTRACTOR Water closet / 16.60
Business name: 1:1_,1 t. 4 • I p/,_, , „ t- c__ Water heater 16.60
Address: /G 1 � d() �4� /�L j A T 44 Other:
P�� lv -_I Subtotal
City/ Sate/Z1P: tx _ i __L e.f 06C
`'� 7 Minimum permit fee: 572.50
Phone: (3123 ) 692- f 2_ 7) Fax: (.t7>) ) .e./2,-775 Residential backflow minimum permit fee: 536.25
CCB Lic.: Z.4-/ / Sy Plumbing Lic. no.: u- l4„LIl3 Plan review (25% of permit fee)
/1� _ State surcharge (8% of permit fee)
Authorized signature:
!� 4 t- TOTAL PERMIT FEE 1 ' . 3o
Print name: r-i 4 a�„.., 41 Date: 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.
L\ Building\ Permits\PLM•PamitApp.doc 12/30/05 440- 4616T(l0/02/COM/WEB)
CITY OF TIGARD
•
BUILDING DIVISION PERMIT #: PLM2007 -00532
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 121
Phone: (503) 639 -4171 A l° I1
Inspection Requests (24 Hrs.): (503) 639 -4175 _. 'I I.,
INSPECTION WORKSHEET FOR DATE: 12/6/2007 TIME: 7 :05AM PAGE: 23
SITE ADDRESS: 14040 SW 98TH AVE CLASS OF WORK:
SUBDIVISION: MCDONALD ACRES LOT #: 017 TYPE OF USE:
PROJECT NAME: MCMILLAN
DESCRIPTION: Fixtures
OWNER: MCMILLAN, ROBERT L AND, PHONE #: NA
CONTRACTOR: AN {11L PLUMBING INC PHONE #: 503 -642 -7323
Inspection Request Scheduled For: Date: 1216/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
322 3hrovver pan 0609611 -02 503.642-7323 N
Corrections /Comments /Instructions:
•
X1 PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 0 ?-A J\' \1x Date: 1 2 b \ D7 Phone #: (503) 718-
CITY OF TIGARD .. L
BUILDING DIVISION PERMIT #: R.M2007 00!.52
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/502007
Phone: (503) 639 -4171 � i � , r +�
Inspection Requests (24 Hrs.): (503) 639 -4175 ...' p ' I
INSPECTION WORKSHEET FOR DATE: 12/6/2007 TIME: 7:08AM PAGE: 24
SITE ADDRESS: 14040 SW 98TI I AVE CLASS OF WORK:
SUBDIVISION: MCDONALD ACRES LOT #: 017 TYPE OF USE:
PROJECT NAME: MCMILLAN
DESCRIPTION: Fixtures
OWNER: MCMILLAN, ROBERT L AND, PHONE #: NA
CONTRACTOR: ANCTIL PLUMBING INC PHONE #: 503 -642 -7323
Inspection Request Scheduled For: Date: 12/6/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 060968-01 503.642 -7323 Y
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
(l FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: II i-)... - \\iL-~- Date: i 21( 1 O Phone #: (503) 718-
Case Activity Listing 10/8/2008
9: 1 4:46AM
' . 6GEL/�- Case #: !LM2007 -00532
Assigned Done Updated
Activity Description Date 1 Date 2 Date 3 Hold Disp To By By Notes
PLM 1010 Application received 12/5/2007 None RECD BB 12/5/2007
BB
PLM1020 Permit created 12/5/2007 None DONE BB 12/5/2007
BB
PLM 1030 Check for parcel tags 12/5/2007 None DONE BB 12/5/2007
BB
PLM 1260 PLM signature on 12/5/2007 None DONE BB 12/5/2007
application BB
PLM 1280 Issue permit 12/5/2007 None DONE BB 12/5/2007
BB �;
PLM2320 Plumbing rough -in 12/5/2007 12/6/2007 12/6/2007 None PASS JW 12/6/2007 060968 -01 — 503- 642 -7323 VM -
STI Y
PLM2322 Shower pan 12/5/2007 12/6/2007 12/6/2007 None PASS JW 12/6/2007 060968 -02 503- 642 -7323 VM -
STI N
_wL J Li ‘.1u
Le /ce /ar N.I e C..AN (---^-
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