Permit r CITY OF T I G® D PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 - 00186
DATE ISSUED: 5/9/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 110BC -08000
SITE ADDRESS: 12438 SW ASPEN RIDGE DR ZONING: R -
SUBDIVISION: THORNWOOD LOT: 051 JURISDICTION: TIG
PROJECT: DEBIEN
Project Description: (5) Fixture remodel
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: 1 URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES: 1
TUB /SHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
DEBIEN MARIE
12438 SW ASPEN RIDGE DR Description Date Amount
[PLUMB] Permit Fee 5/9/2007 $83.00
[TAX] 8% State Surcha 5/9/2007 $6.64
Phone : 503- 670 -7920 Total $89.64
Contractor:
JACK HOWK PLUMBING
PO BOX 20698
PORTLAND, OR 97294 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 235 -8784
FAX 503- 491 -2932
Reg #: LIC 23847
PLM 26 -208PB
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 ' �: �� W I / �/�/ Perm Signature: /��� /j� f p71
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.
-4
PAD ubrllag. Permit A lication A _ M atis la c r- r -c� �. E . nom =�tie , r , vE iifr477.4.,
a City of Tigard
Rip tt=, ` D aXc!By Permit No.:pu.j ` 0--Ov1 0C9
13125 SW Hall Blvd., Tigard, OR 97223
MAY PI aaRCvicw
l .., : C ,i Phone; 503,639,4171 Fax: 503.598.1960 9 20 Other Permit No.
;n, �., Data/By:
Inspection Line: 503.639.4175 CITY Rear! If►
),TINARD, p CITYO'F tIGAR Y Y' h.. H SeePsrgc2for
- sit Internet; www.tigard- or.gov i n - Notified/method: Suppfemeniellnformafion
TYPE OF WORK B' wtis�. Di SlO'
FEE* SCHEDULE
❑ Ncw construction ❑ Demolition For special i formarinn use checklist
Description 1 . Fn, Total
1 T Addition/alteration /replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
p CATEGORY OF CONSTRUCTION SFR (I) bath 249,20
-
.h1 - and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family
SFR (3) bath 399.00
❑ Master builder ❑Other; Each additional bath/kitchen 45.00
Fire sprinkler (_. ___ sq. ft.) Page 2
. JOB SITE INFORMATION AND LOCATION . Site utilities --
Job site address: _ A it r ` l �J Catch basin or area drain 16,60 Tr
City/State/ZIP: • /. Izi O -A' Drywell, leach line, or trench drain 16.60
• Suitc/bldg. /apt, no,: Project name: t �` Foocing drain (no. linear ft,; __) Page 2 `
Cross street/directions to .job site: Manufactured home utilities _ 110.00
1 Manholes 16.60
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
6—Pl .DDE�SCR PTION OF WORK . Backflow prcvcntcr Page 2
i r � .(/ _ 2 a/ 2r Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
iI PROPIEIYTY OWN'Ele -,0 TENANT Drinking fountain 16.60 /
' ' ' Ejectors /sump 1 16.60 G
Name: --
n • o 4 v Expansion tank 16.60
Address: r , c 4 w� e r Fixture/sewer cap
� 16.60
City /State /ZTP: 7 . -rr� j�P Floor drain /floor sink /hub 16.60
Phone: (0 '
j•-..--- ,�� i c : ( ) Garbage disposal 16.60
h APPLIC'AN'T'•.: d. CONTACT PGSON." Hose bib 16 •
60
_ ..... ........ ............. Ice maker 16.60
Business name: WOLCOTT dba JACK H O W K f f I Interceptor/grease trap 16,60
Contact name: t 0- i / Medical gas (value: $ ) Page 2
Address: P.O. BOX 20698 _ Primer 16.60
City /State /ZIP: PORTLAND OREGON 97294 Roof drain (commercial) 16.60 �--s
Phone: (503) 235- 8784 Ilex: : (503) 491 -2932 Sink/basin/lavatory 16,60 ��� .f ....
Tub/shower /shower pan 16.60 t*,
E-mail: Urinal
. 16.60
CONTRACTOR ' i
water closet 16,60 , boG
Business name: WOLCOTT dba JACK HOWK frt. Water heater 16.60
Address: P.O. ROX 20698 Other:
City /Statc/ZIP; PORTLAND, OREGON 97294 Subtotal re
Minimum permit fee: $72.50
Phone: (503) 235 -8784 Fax: (503) 235 -8784 Residential backflow minimum permit fee: $36,25
CCB Lic,: 23847 Plumbing Lic. no.: 26 -208PB Plan review (25% of permit fcc)
State surcharge (8% of permit fcc) KM,
Authorized signature: ,I, � 11teot
��// L �� - TOTAL. PERMIT *
Print name: T /� " L. / Date: , ■ D: This permit application expires if a permit is not obrai ii p , Ui''/ ,
180 days after it has been accepted as en
* e meKiedef 1 minty tiding Industry Service Board.
1 FAX BACK TO JACK NQlW • n ( A \ ®.O1 _1011
CITY OF TIGARD . -
BUILDING DIVISION PERMIT #: PLM2007 -00186
13125 SW Hall Blvd., Tigard, OR 97223 D ATE - ISSUED: 5/9/2007
Phone: (503) 639 -4171 a du i
Inspection Requests (24 Hrs.): (503) 639 - 4175 Ail l. �
INSPECTION WORKSHEET FOR D 6122/2007 TIME: 7:01AM PAGE: 12
`
SITE ADDRESS: 12438 SW ASPEN RIDGE CA \_/'‘ CLASS OF WORK:
SUBDIVISION: THORNWOOD LOT #: 051 TYPE OF USE:
PROJECT NAME: DEBIEN
DESCRIPTION: (5) Fixture remodel
OWNER: MARIE, DEBIEN PHONE #: 503- 670 -7920
CONTRACTOR: JACK HOW}: PLUMBING PHONE #: 503 - 235 -8784
Inspection Request Scheduled For: Date: 5/22/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Mes .ge
320 Plumbing rough -in 048826.01 503- 235.8784
Corrections /Comments /Instructions:
P c am- . Iry — --
1 - K.1(.4 kr cf,...(k \ i - j z_ ,A__
I. e v - T-es ( ''''
•
C , • ` s.
1 l\-
I I PASS H PARTIAL APPROVAL n CANCEL I I NO ACCESS
X FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ( Date: �' / ®-7 Phone #: (503) 718 - -242---
CITY OF TIGARD , ,„
BUILDING DIVISION PERMIT #: PLM2007 -00186
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/9/2007
Phone: (503) 639 -4171 _ °I+'
Inspection Requests (24 Hrs.): (503) 639 - 4175'! ..
INSPECTION WORKSHEET FOR DATE: 5/17/2007 TIME: 7:00AM PAGE: 79
SITE ADDRESS: 12438 SW ASPEN RIDGE DR CLASS OF WORK:
SUBDIVISION: TI-IORNWOOD LOT #: 051 TYPE OF USE:
PROJECT NAME: DEBIEN
DESCRIPTION: (5) Fixture remodel
OWNER: MARIE, DEBIEN PHONE #: 503670.7920
CONTRACTOR: JACK HOVVK PLUMBING PHONE #: 503 -235 -8784
Inspection Request Scheduled For: Date: 5/17/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
395 Misc. inspection 048434 -01 503 - 235.8714 Y
Corrections /Comments /Instructions:
4;\,\
•
/ ZP - /•./ / ________
•
i" ai./17 _4011 Z ---- -
❑ PASS XARTIAL APPROVAL n CANCEL n NO ACCESS
I I FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: ( Date: !/ Phone #: (503) 718-