Permit a ,, T:-.' CITY OF TIGARD PLUMBING PERMIT
O PERMIT #: PLM2007 -00464
COMMUNITY DEVELOPMENT
RD' '. 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/15/2007
TIGA
PARCEL: 2S 111 AB -01700
SITE ADDRESS: 09230 SW ELROSE CT ZONING: R - 4.5
SUBDIVISION: ELROSE TERRACE LOT: 013 JURISDICTION: TIG
PROJECT: ELROSE
Project Description: Line work to connect sewer. Septic to be pumped and filled or removed.
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: 100 ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
BEARD, JOHN D + LYNN C CO -TRS
9230 SW ELROSE CT Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 10/15/2007 $72.50
[TAX] 8% State Surcha 10/15/2007 $5.80
Phone : 503- 639 -6882 Total $78.30
Contractor:
WESTSIDE UNDERGROUND UTILITIES INC
30585 NW EVERGREEN RD
HILLSBORO, OR 97124 -1855 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 969 -4631
Reg #: LIC 110690
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.
Ib Issued B / , � Permittee Signature: �, •
Call 503.639.4175 by 7:00 a.m. for an inspection that busi ess 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.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PL12007- 00484
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10!15/2007
Phone: (503) 639 -4171 �►
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/16/2007 TIME: 7 :01 AN PAGE: 29
SITE ADDRESS: 09230 SW ELROSE CT CLASS OF WORK:
SUBDIVISION: ELROSE TERRACE LOT #: 013 TYPE OF USE:
PROJECT NAME: ELROSE
DESCRIPTION: Line work to connect sewer. Septic to be pumped and filled or removed.
OWNER: BARD, JOHN D + LYNN C CO - TRS, PHONE #: 503 - 6306682
CONTRACTOR: WESTSIDE UNDERGROUND UTILITIES INC PHONE #: 503-969-4631
Inspection Request Scheduled For: Date: 10/16/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
507 Sani1av sewer 057690-01 503-969-4631 Y
Corrections /Comments/ Instructions:
s ac.. #4.■ e i 4131 -A.
P tk.�.�. � St, p ti‘ L amok, A- u t 9v ∎ AR., Pu .¢.,--
•
n PASS Egl PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CilAiV► 1 L_— Date: 1 )1'ro s7 Phone #: (503) 718-
Case Activity Listing �lo /g/2oos
-- - - -- _ diAL7 I41:34A _
M
CCEL Case #: PLM2007 -00464
Assigned Done Updated
Activity Description Date 1 Date 2 Date 3 Hold Disp To By By Notes
PLM1010 Application received 10/15/2007 None RECD BB 10/15/2007
BLD
PLM1020 Permit created 10/15/2007 None DONE BB 10/15/2007
BLD
PLM 1030 Check for parcel tags 10/15/2007 None DONE BB 10/15/2007
BLD
PLM1270 Ready to issue permit 10/15/2007 None REDY BB 10/15/2007
BLD
PLM1280 Issue permit 10/15/2007 None DONE BB 10/15/2007
BLD
PLM2505 3anitary sewer ` 10/15/2007 10/16/2007 10/16/2007 None ART JW 10/16/2007 057690 -01 — 503- 969 -4631 VM -
STI Y —180
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