Permit CITY TIGARD PLUMBING PERMIT
44, Iw DEVELOPMENT SERVICES PERMIT #: PLM2005 - 00376
. , DATE ISSUED: 8/10/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 2S 104AC - 01500
SITE ADDRESS: 13055 SW HAMPTON CT ZONING: R -4.5
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Emergency 15' water service repair.
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: 15 ft
DISHWASHERS: - RAIN DRAIN: ft
Owner: FEES
AUNGIER, LOIS M +
GEISLER, W PAUL, CO- TRUSTEES Description Date Amount
11302 SW BARBUR BLVD [PLUMB] Permit Fee 8/10/2005 $72.50
PORTLAND, OR 97219 [TAX] 8% State Surcha 8/10/2005 $5.80
Phone : 503- 624 -1427 Total $78.30
Contractor: -
DETEMPLE CO INC
1951 NW OVERTON ST
PORTLAND, OR 97209 REQUIRED ITEMS AND REPORTS
Phone : 503- 227 -2641
Reg #: LIC 2510
PLM 26 -25PB
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•
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: - - `
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.
AU /1e /2005 /WED 08:33 AM DETEMPLE PLUMBI CO FAX No, 503 274 7686 P. 001
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City of Ili and
131 S'l 1.4111 Blvd., Tigard, OR 97223 1 1� U L "I Plan Review I U + P u :
Phone: 503.639.4171 Fax: 503.598,1960 y'i ap f ( Da Y , • Other PemutNo.:
24-Hour Inspection Line: 503.639.4175 , Vr y, ` , �� .
Internet: www of ttgaxd or us O F , bate Rmdy/13y Jwi See Pane 2 for
�iiTY [ . 1111 , n iv 1 b I IN Notified/Method: ) � I Supplanting information
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❑ New Construction D Demolition F or special lnformaton use checklist
Description I Qty. j Ea. I Total
® Addition/alteration/replacement ❑ Other New 1- 2- family dwellings (includes 100
.i'. y i \ r i t " (? Y vzc).., c : 2:; i . . y �v 11. for each utility connection) Y, a l t ,,. . r t SFR (1) bath 249.20
0 1- and 2 family dwelling 0 Commercial/industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi -- oily �R ( bath 399.00
[] Master builder Q
Each additional bath/kitohen 45.00
} :F cr t rs ,a Otl+$r s y r .� „ • FirespnnlCler( sq. (
S Page
yr , t ?: .' � 1.. `, - ' 6 � , '2 .. _1: t ., x �. .
_.._. _._ . ._... z _:.. _. _....._._ ......_ _� . o ,.. , l ., ., .... � F . •.. site RtAltles
Job site address: 13055 SW Hampton Court Catch basin or area drain 16.60
City/State/Z.IP; Tigard, OR 97223 Drywell, leach line, or trench theist 16.60
Suite/bldg./apt. no.: I Project name: Rental (Lois Auogitr) Footing drain (no. linear ft.: ) Page 2
Manufsotured home utilities 110.00
Cross street/directiona to job site: Manholerr 16.60
Rain drain connector 16,60
Sanitary sewer (no. linear ft.: ) Page 2
Stour sower (no. linear R.: , .) Page 2
Subdivision: Lot no.: service (no. linear ft ( : 1S•) ' Page 2 55`.
Tax map /parcel no.: Fixture or item
r -, r ,.. ,,.- ,:4 -• r w " , a 1, Absorption valve 1 ]6.60
.',‘r,"..,-y- R r � 3 ( ..\ r ' � ( r P c4 S� f f ��"1 : :`
.._ :. . ... .+.. _.( i, _...... r .. ; L Y i.:rb, .,. .?•? .. ... ,a_�.�IL. , :. ♦ t.i ) r Baoktlowpreventer Page 2
Emergency 15' water service repair _ .. _ _ eater valve 16.60
. Clothes washer 16.60
Dishwasher 16.60
•' S v r r f t r ?t <' t`
Drinking fountain _ 16.60
-
--._.. ..._,._._....... __ . ..._:.� .a_�.,....r .__ Ejeotc¢s/aump 16.60
Name: Lois Aungler
_ ,.
Expansion tank 16.60
Address: 15260 SW Alderbrook Dr. Fixture/sewer cap 16.60
_
City/State/ZIP: Tigard, OR. 97224 Floor drain/floor sinklhub 16.60
Phone: (503)624.1427 Fax: ( ) Garbage disposal 16.60
-,.`,;:i1„:!...;,..;..:=:: ✓ ( .t ai. a - :`,:i 1 ;.:- !,:'% e Y ..'..•:";
� C < x, > 1 � r r ` f C Y \ n � . Hose bib
' 16.60
.n.._.,v .> 1... c...., \ ..... .... ....1 �J .,, h. . , .. t. 11 . _ t
,_. ,- _- ...... .'! ��,.,,.. Ise maker . 16.60)
Business tease. Intercepter /grease crap 16.60
Contact name: Medical gas (value: $ ) Page 2
Address: Primer 16,60
City/State/ZIP: drain (oo®meroial) 16.60
Sink/basin/lavatory 16.60
Phone: ( ) I Fax: ( )
Tub/shower/shower pan 16.60
E -mail: Urinal 1660
r v . \ i ,.` ``` .. .< r ti ,;'; k : ( il l ,. 3..b r) , :: •
16.60
Business name: DeTemple Co., Inc. Water heater 16.60
Address: 1951 NW Oveton Other
City/State/ZIP: Portland, OR 97209
&gbtotal € CO.
Minimum permit fee: $72.50
Phone: (503) 227..2641 Fax: (303) 274.7686 Residential back low minimum permit foe: $36.25 12
CCB Lie.: 2510 • 6 r Plumbing Lie. no.: 26 -2SPS Plan review (25% of permit fee)
,
State surcharge (8% of permit fee)
Authorized sigastur • �� / , TOTAL PERMIT FEE 'C)
Print name: Shalynn Garcia ' r �riiP Date: 08.10.05 This permit application expires if a permit is not obtains within
r - • 180 days after It has been accepted as complete.
• "Fee methodology set by Tri-County Building Industry Servioe Board.
Imeraldlns\Parmite ermitacronec 06/05 444- 4616T(10/02/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM200S -00376
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/10/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 818/2005 TIME: 7:07AM PAGE: 1
SITE ADDRESS: 13055 SW HAMPTON CT CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: AUNGIER
DESCRIPTION: Emergency 15' water service repair.
OWNER: AUNGIER, LOIS M + PHONE #: 503-624 ,
CONTRACTOR: DE TEMPLE CO INC PHONE #: 503 - 227 -2641
Inspection Request Scheduled For: Date: 8/19/2005 Pour Time:
•
Code # Inspection Description Confirm # Contact # Message
330 Water service 013940-01 503- 849 -2353 N
Corrections /Comments /Instructions:
•
SS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date/ /T/1 Phone #: (503) 718 -