Permit CITY F TIGARD
PLUMBING PERMIT
C OMMUNITY DEVELOPMENT PERMIT #: PLM2007 - 00559
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/17/2007
PARCEL: 2S 110BC -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: Install 90' of private water service for lot 2.
CLASS OF WORK: NEW 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: 55 ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
WEST HILLS DEVELOPMENT
735 SW 158TH AVE Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 12/17/2007 $72.50
[TAX] 8% State Surcha 12/17/2007 $5.80
Phone : 503 -730 -8758 Total $78.30
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 1 Permittee Signature: W \ W
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 d , ,--/ 1 FOR OFFICE USE. ONLY
L� � . °7 �� / R eceived
City of Tigard �±i�� , Permit No /
a 13125 SW Hall Blvd., Tigard, O' 9% f Date/By: /� /7 Q 7
.4.- � Plan Review
G a Phone: 503.639.4171 Fax: 50 +i "'• 119, 1,,'� . l U , i�„
TIGARD DDate/By: Other Permit No.:
Inspection Line: 503.639.4175 l is h, D Read /B RI See Page 2 for
Internet: www.tigard � p Ready /By: Notified/Method:
(( Supplemental Information
TYPE OF WORK FEE* SCHEDULE
(New construction ❑Demolition For special information use checklist.
Description 1 Qty. 1 Ea. I 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
,1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
I=1 Accessory building El Multi-family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: t c _4 p 5,.. )24Lc- i44174) g:› Catch basin or area drain 16.60
City /State /ZIP: lrtlG> oe Drywell, leach line, or trench drain 16.60
Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: l Project name: BL--.L J E57 � -
/ Manufactured home utilities 110.00
Cross street/directions to job site: Manholes 16.60
r
?I,tLI wt rA) 'R 4 - Ro' Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Water service (no. linear ft.: 90 ) Page 2 SS Subdivision:'" 4 " . Thj 5 .5 1 Lot no.:
Fixture or item
Tax map /parcel no.: Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
P „ t „ s ) '7 - c-o G-e- S U jo Le r - - 2 Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
(j/PROPERTY OWNER ❑ TENANT
/ Ejectors /sump 16.60
Name: LA3 mu_ Expansion tank 16.60
Address: 7 3s S �J ) 7i Ax Fixture /sewer cap 16.60
City /State /ZIP: "' ks ,,, t4 ita:,J / or,.. `'1.7006 Floor drain /floor sink/hub 16.60
Phone: (5-e..• ) 73„, - 7S'y Fax: (9. 3 ) 6.11 - 76 G ( Garbage disposal 16.60
2 APPLICANT ❑ CONTACT PERSON
Hose bib 16.60
�/ \ Ice maker 16.60
Business name: (� a.sT t1' -> LJ Interceptor /grease trap 16.60
Contact name: . yj,7E 1,4 S ` ,h3 ` , J G Medical gas (value: $ ) Page 2
Address: Primer 16.60
City /State /ZIP: Roof drain (commercial) 16.60
Phone: ( ) Fax:: ( )
Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: , rte ,/ Z.L.,<., f 1-.) i3 Water heater 16.60
Address: li Other:
City /State /ZIP: Subtotal SS �o
Minimum permit fee: $72.50
Phone: ( soy ) 3c _ 5 - 75 Fax: ( ) Residential backflow minimum permit fee: $36.25
CCB Lic.: 1 5 umbiir g Lic. no.: 3-q _ -4pe.. Plan review (25% of permit fee)
State surcharge (8% of permit fee)
•
Authorized signature:
TOTAL PERMIT FEE If -7Z 5�'
Print name: J w 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.
I:\ Building \Permits\PLM- PermitApp.doc 06/26/06 440- 4616T(10 /02 /COM/WEB)
CITY OF TIGARD ►'
BUILDING DIVISION PERMIT #: PLM2007- 005r,9
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 121171?:007
Phone: (503) 639 -4171 .I
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1/24/2008 TIME: 7 :02AM PAGE: 73
SITE ADDRESS: 120 40 SW BULL MOUNTAIN RD CLASS OF WORK:
SUBDIVISION: (BULL MOUNTAIN VIEW ESTATES LOT #: TYPE OF USE:
PROJECT NAME: BULL MOUNTAIN VIEW ESTATES SUB
DESCRIPTION: In.:tall 90' of private water servico for lot 2.
OWNER: WEST HILLS DEVELOPMENT, PHONE #: rb03- 73043758
CONTRACTOR: TROY ELLIOTT PLUMBING PHONE #: r;O3 309 - 5750
Inspection Request Scheduled For: Date: 1/2412008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 0E 503-049-8326 N
•
Corrections /Comments /Instructions: `-
N 5 f C' NNt L 1 ct ��s �L✓ Mt y c
C \.c � S � — 2 �r�e,rrw�c. A-1" t 1 L c- r 0 e MtP 51
0fe roArc.
0 1�..
❑ PASS lyi,PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
•
Inspector: Y3 Date: I( :LW, Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PL.M2007 -005 8
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12,117/2007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1/32J2008 TIME: 7:01AM PAGE: 17
SITE ADDRESS: 12040 SW BULL MOUNTAIN RD CLASS OF WORK:
SUBDIVISION: BULL MOUNTAIN VIEW ESTATES LOT #: TYPE OF USE:
PROJECT NAME: BULL MOUNTAIN VIEW ESTATES SUB
DESCRIPTION: L'e:rrn:: nanny connect existing house to sewer, storm & water service.
OWNER: LOUD, ANDREW PHONE #:
CONTRACTOR: TROY ELLIOTT PLUMBING PHONE #: 503.309-6760
Inspection Request Scheduled For: Date: 1/22/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Watt, st ivice 063638-01 503.936.2577 N
Corrections /Comments /Instructions:
"eer Pte rrA (r-t. Al 2o IPSO e,1" f Jot 1-x,1
C k s 4- - ��� - s �e r ekc,; -- o r w s�
P f� fr«,,�. R w�,, RL�ucvt.
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 11 / -4-� ► ��` -�-- Date: i'1 -- 2,zi161 Phone #: (503) 718-
Case Activity Listing n L to /a/2oo8
EL1 _ 9:23:26AM
�+C Case #: !LM2007 00559 - ----
Assigned Done Updated
Activity Description Date 1 Date 2 Date 3 Hold Disp To By By Notes
PLM1010 Application received 12/17/2007 None RECD DEB 12/17/2007
BLD
PLM1020 Permit created 12/17/2007 None DONE DEB 12/17/2007
BLD
PLM1030 Check for parcel tags 12/17/2007 None DONE DEB 12/17/2007
BLD
PLM1260 PLM signature on 12/17/2007 None DONE DEB 12/17/2007
application BLD
PLM1280 Issue permit 12/17/2007 None DONE DEB 12/17/2007
BLD Cf
PLM2330 Water service 1/21/2008 1/22/2008 1/22/2008 None �i�tr l — JW 1/22/2008 063639 - 01 — 503 - 936 - 2577 — VM -
STI Y - 180
PLM2330 Water service 1/23/2008 1/24/2008 1/24/2008 None A6 JW 1/24/2008 063783 - 01 — 503 - 849 - 8326 — VM -
STI N
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Page 1 of 1 CaseActivity..rpt