Permit tii;•a, CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00389
TIGAR 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/3/2008
PARCEL: 2S 110DD -05000
SITE ADDRESS: 15650 SW OLD ORCHARD PL ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.3 LOT: 141 JURISDICTION: TIG
PROJECT: BARKER
Project Description: Tub to shower conversion.
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: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
BARKER, CAROLYN M
15650 SW OLD ORCHARD PL Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 10/3/2008 $72.50
[TAX] 12% State Surch 10/3/2008 $8.70
Phone : Total $81.20
Contractor:
BATHTUB SOLUTION
11747 NE SUMNER
PORTLAND, OR 97220 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 -595 -8827
FAX 503 -595 -6051
Reg #: LIC 165987
PLM PB -312
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.
l
Issued B 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.
FROM :BATH FITTER PORTLAND FAX NO. : 503 595-8051 Oct. 03 2008 09: 57AM P2
- --- Plumbine Permit Application
Building Fixtures I k rtL4V:MiririVMMARRZIMT'W
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WW1? City of Tigard Received / ii ifi.
a A Pennit No .0 • ■ -- _01
e., , qiii.,. 13125 S'S,V Hall Blvd., Tigard, OR 9723 r p
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other Permil No.'
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le -;', k 0 Phone: 503,639.1 171 Fax: 503.598.1960 0 k
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Internet: www.tigar . .-
5 Inspection Line: 503.639.4175 ,... . BI c agt 2 f
d-or.gov liklk , k)pi.t -1 nady/lly:
' if 1113 - Itj ■ ' Wird Supplemental Information
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0 New construction 0 D ton For special infirtnatIon use checklist.
- • '
, _.____ Description 1 Qty. 1 Ea. l Toiar
!!: ddition/alteration/replacement 0 Other: New 1- 2-family dwellings (includes 100 ft. for each utility connection)
REFFir 2
V I Plirl "'(01;0644fAr0 i.iI i '-PR ( I ) hatIt ' 49 20 1
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■ ,,.. 4,..,, lat., .i• ' L 1 ii, 1 :0 ;i- ...,, AY .v ; 1, N 4 0{ 1■ '. ' .ig A . : la WI (i • :' '. i 64 '
"544 and 2-family dwelling 0 Commercial/industrial SPR (2) bath 350,00
1t. (3) bath 399.00
0 Aucessory bu _ $17
ilding D Multi -family _._ .
.,. .._, ..,..,........ „ „ . - Each additional bath/kitchen 45.00
ID Maater builder D Other:
e
Fire sprinkler ( sq. ft.) Page 2
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i m a . „., . ., 4". „, ,,,,, „„ ,,,,,,,.„4 ..,,, ,,,,, . io. ,.., „, m :■&,.,,,, ,, A A , ., 140a ,.N.! ..'.,,,;''... ,I '...i,...,r1F , _ic ot.....es
_.... . .. . ,
Job site address: \ 5 (pc() 5i (.,_ or i -?. , - Catch basin or area drain 16.60
City/State/ZIP; k .' e. ,.. j - 1 a_ ci Dr leach line, or trench drain 16 60
1 _..... -
rooting drain (no. linear ft.: ) Page 7
Suite/bldg./apt, no.; ' 1 Project name: &
- Manufactured home utilities 110.00
C:ross street/directions to job site:
• . Manholes
It.uin drain connector 16.60
,......,. .... - -
Sanitary sewer (no. linear ft.: ) Page 2
. ..... ........ ..,. . ••-
Storm scwcr (no, linear ft: ) Page 2
Water s ervice (no. linear It : ) Page 2
Subdivision: I ,oi. no.:
.... Fixture ur item
Tax map/parcel no.:
wormy li • t , ,„ ... to , v , „4. „ ; ,„ 1 . , , Ii „,.,. 6 ., i , ,,,
i,i . u ,,
..,,„„ , . ,so,y Absorpti
pr on valve 16.60
w 1 B ae c
, ., 1 a
: ,w 0 e, , ■ ■ . ow preventer Page 2
___. ..
+i) 4 > \,\.. 6 t.)g-r .. Backwater valve 16.(i0
Clothes washer 16.60
_
. _
Dishwasher 16.60
-- 7'777(0
. ,: ‘ 3 , t. , ,,,, , .; -t.t;k• I ., -. i!miii.mtia;r6glifiltiRiil .:mgviwiNtioqui,eigf.,'Izzo:,,:,h,TN Drinking fountain 16.60
to ; A, , ,, ;it, ,,, s. ,„„ .., mow 01,,R, „Im,,,,,H.,,, itai,, „ v. thte t■4 60:,:x.,o1:,.. f ,t •
-,.., Foectors/sump 16.60 ,
Name: COv II LA (5 0-t te--cr Expansion tank 16.60
_
Address: 5 (p c , 5 Li btrl 647. tiu-4 e .. ...... Fixture/sewer cap 16.60
City/State/7TP: ---r-, :( . r-.) L., a ‘., ci 1-7-z,c4 Floor drain/floor sink/1mb 16.60
' )11'4 -- -
16.60
Phone; ( e- j --- b," t ?„,!() i2( q Fax: ( ) Garbage disposal
-,7 ' , .i . 4 7 . 17 7.%..;;; .. -+.■ !Tose bib
, 011 litigiqiiiii;NR,W11, 00 i±,14.14
„,..,, , r.,, 1, '', ,,,,, 017)1.1.7.',,,,70,1er.o,t.,'■1?;J vA, , .,•&7.ofjvpu,,,;!.,y,CAtiaffil d ,,,, ... ,6 ,..)1Vr 1 4 Or d ii1C 01, ' . a.1 ,4, .:A. , :t .- ) . l maker 16.60
16.60
Businass name: 64t-t4 R-4e 1 . Interceptor/grease trap 16.60 , ..._
..._
._ .,
Contact name: `Eit. 1k- ...._._ Medical gas (value: $ ) Page 2
Address: H - L --4.-- (I) L. SJ AAA. e_r Primer 16.60
....____
City/State/Z1P: OC)r r 62- c i 3 Z:Z-Z) Roof drain (commercial) 16.60
Sink/basin/lavatory 16.60
Phone: ().;) .5 5 - I Fax: : (,n3) 5 --1 5" L9 LI ''57
'rub/sh(Jwer/Shower pan I 16.60
E-mail: e (A i ,,,t-t- je ...,:
Urinal 16.60
griadatURAINE00 Water closet 16.60
- - ....
Business name: 1 ( tte--/ - at / f 4,
- Water heater 16.60
Address: 1AI-4-v.1- A.) 4_, S ,)/V\e_r Other
Subtotal
City/State/ZIP: Q Dr" --i (,) ,(1- ( 1: ; ) . 2.2.. 12 _
Minimum permit fec:: $72.50 ----)1 50
l'hone: (651/ - ,,-(4 --1, "k -
; ) e C i Fax: (e6 41 )3) 6 5 Residentitti baokn m
ow in n iinio permit fee: $36.25 f
i VIr il")
Plan review (25 0 0. perm.t _cc,
CCFS
Lie.: i ts5,- ---- -
7 5 -/- Plumbing Lie. no.: e 5 3 t 2._ .•
- State surcharge (12% of permit fee) r 7c..)
Authorized signature: c LD - 2 , -. "- -- " --L--- t TOTAL PERMIT FEE • : 0
Print name: a,-.5 A.f9f.kt \ _ A VIC ti N.) 1 1)ate: This permit application expires if a permit is not obtained within
ISO days after it haii been accepted am complete.
*Fee methodology set by Tri-counry Building Industry Service Board.
brwildinErTertnita \ Pi ,N1F rinit A pp,eloo 1 2127)O(. 440-461 Cr(1 0/02/( (17VTilir RR)
CITY OF TIGARD • ``
BUILDING DIVISION PERMIT #: I,LMI 2008 -003B9
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1002003
Phone: (503) 639 -4171 ,Dili
Inspection Requests (24 Hrs.): (503) 639 -4175 ...J.4- - __ i
INSPECTION WORKSHEET FOR DATE: 10/6/2008 TIME: 7:00AM PAGE: 36
SITE ADDRESS: 16650 SW OLD ORCHARD PL CLASS OF WORK:
SUBDIVISION: SUMMEI20=1FLi7 NO .3 LOT #: 141
TYPE OF USE:
PROJECT NAME: BARKER
DESCRIPTION: Tub to shower convt isio n.
OWNER: BARKER, CAROL.. M, PHONE #:
CONTRACTOR: BATHTUB SOLUTION PHONE #: 503-596-8827
Inspection Request Scheduled For: Date: 10/6/2008
Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 076310 -01 503 - 596.2287 Y
Corrections /Comments / Instructions:
K PASS ❑ PARTIAL APPROVAL III CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: dr vYh/1,-) \ '4\ • Date: 1/ (L,' CSC`: Phone #: (503) 718 -