Permit i
Ili q CITY OF �I�� PLUMBING PERMIT
° ` COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00271
TrGARD DATE ISSUED: 6/16/2008
1 3125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S136DA-02100
SITE ADDRESS: 11530 SW 72ND AVE ZONING: MUE
SUBDIVISION: FRUITLAND ACRES LOT: 015 JURISDICTION: TIG
PROJECT: BEACH
Project Description: Water service replacement, less than 100'.
CLASS OF WORK: OTR 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: ft
WATER CLOSETS: WATER LINE: 100 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
DAYLE BEACH
11530 SW 72ND AVE Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 6/16/2008 $72.50
[TAX] 12% State Surcha 6/16/2008 $8.70
Phone: 503- 684 -0647 Total $81.20
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.
Issue y: � ���� Pe rmittee Signatur • ,...
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.
fur -'%16 08 12:26p Casey's Plumbing 5032628251 p.l
Plumbing Permit Application RE I " ' FC < 914° i i' sl i '` ":
L� L 't :A f a s c > r ,t , t ,t:i::,11 ' Ali" .
ir, ml t • ived
City of Ti 0, /� Da ' x Permit No.: �-r/ 8-1,0 7i
" 13125 S W Hall Blvd., Tigard, OR 97223 Date/By:
Plan Review Phone: 503.639.4171 Fax: 503.598.' °" 108 Other Permit No.:
Dat
�1 Inspection Line: 503.639.4175
Date Read
T IaA RD Ready/By: 1 El See Page 2for
,..: Internet: www.tigatd or.aov CITY UP- i I Dl
ARotified/Metho1: Supplemental Information
TYPE OF WORIgUILDING DIVISION FEE* SCHEDULE
DIVISION
❑ New construction ❑ Demolition For special information use checklist
Description j 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
. - and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
0 Fire sprinkler ( sq. ft.) Page 2
.108 SITE INFORMATION AND LOCATION Site utilities
Job site address: I / 53.) ..3L-0 7,2n i Catch basin or area drain 16.60
rt
City/State/ZIP: --17, ( r oe_ 1 ' 0. "J Drywell, leach line, or trench drain
16.60
�J mj
Suite/bldg. /apt. no.: Proect name: Footing drain (no. linear ft.: _) Page 2
Cross street/directions to job site: Manufactured home utilities 1 10.00
r / Manholes 16.60
3111 u t7 �` ( (i ' 53 (; Rain drain connector 16.60
Sanitary sewer (no. linear ft.: , ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Water service (no. linear ft.: toy) ( Page 2 55 -•o 55 -•a() Subdivision: Lot no.:
Tax map /parcel no.: Fixture or item
Absorption valve 16.60
DESCRIPTION OF WORK
Backflow preventer Page 2
(/UGc 4-,e 1,- a IVb`L� i �i 2.,9,,i7N7 Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
D
PROPERTY OWNER ❑ TENANT Drinking fountain 16.60
Ejectors/sump 16.60
Name: . C-&k Expansion tank 16.60
Address: , 1 '5 30 -) up "- 7,-vt ei Fixture/sewer cap 16.60
City / State/ZIP: •� fiuursink/hub 16.60
tjc�cf.zr �� �a��� Floor drain/
Phone: f ) Zf l `� may'? Fax: (.5 j 4 Garbage disposal 16.60
APPLICANT ❑ CONTACT PERSON Er Hose bib 16.60
t Ice maker 16.60
Business name: .04/ S
, ,lam /U 1Y} ,6,;, �7 ,'ZG Interceptor /grease trap 16.60
Contact name: ► // S J Medical gas (value: $ ) Page 2
Address: / .,,3 6 p - o 7 5 Primer 16.60
City/ Slate/ZIP: ,y- /gyp e z 9 7 a94 Roof drain (commercial) 16.60
Phone: (503 )X253_ 6030 Fax:: 6v3) 02.E -8'.75 Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail: ease;
t~ s h, C.0 !✓TCCk54 lif. Urinal 16.60
CONT CTOR Water closet 16.60
Business name: Ctz&- 15 P lit I q -1-/7 C. Water heater 16.60
Address: p 3 , 6 --( 75 Other:
City /State/ZIP: t' Ot-7t /a n/ e P y 7d 9 T Subtotal
Minimum permit fee: $72.50 1 ,
X
Phone: 663 53 -00 3 0 Fax: (5)3) ,24 0 2- ,y, / Residential back minimum permit fee: $36.25
CCB Lic.: / 4C - 7�.4 Plumbing Lic. no.: ,.6, _ 7� 5Pg Plan review (25% permit fee) �D
Authorized signature: t �, (2.(0 State surcharge /o of permit fee) , SO �-
T AL PERMIT FEE
Print name: BLG (a- (--ct- p_ , ate: This permit application expires if a permit is not obtain with
- r l 180 days after it has been accepted as complete. %1
*Fee methodology set by Tri- County Building Industry Service Board.
1:l auilding 'u'ermiii\PLM•PennitApp.doc 06✓26/06 440- 4616T( i NNM?/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM200B•00271
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/16/2008
Phone: (503) 639 -4171 ' p
Inspection Requests (24 Hrs.): (503) 639 -4175 R_ _..
INSPECTION WORKSHEET FOR DATE: 6/17/20083 TIME: 7:00AM PAGE: 28
SITE ADDRESS: 1'1530 SW 72ND AVE CLASS OF WORK:
SUBDIVISION: FRUITLAND ACRES LOT #: 015 TYPE OF USE:
PROJECT NAME: BEACH
DESCRIPTION: Water service replacement, Tess than 100'.
OWNER: BEACH, DAYLE PHONE #: 503- 684 -0E47
CONTRACTOR: CASEY'S PLUMBING INC PHONE #: 503- 253.0030
Inspection Request Scheduled For: Date: 6/17/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 071473.01 503-253-0030 Y
Corrections /Comments /Instructions: 1 Ott-) A �c ri
r f it L'I ✓�'c a 5 t w O INQt..) 8` —v4
c it. i fie- Pt"-1
igl PASS PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspectok!�� -)1 \\ "—e- Date: C `i - Phone #: (503) 718-