Permit l yi . . CITY OF TIGARD PLUMBING PERMIT
` ' ` ' ° COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00343
T R
1G"D 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/21/2008
PARCEL: 1S133DB-03400
SITE ADDRESS: 11569 SW SHEFFIELD CIR ZONING: R -12
SUBDIVISION: BRITTANY SQUARE NO. 2 LOT: 058 JURISDICTION: TIG
PROJECT: ERICKSEN
Project Description: Replacing 60 ft. of water service.
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: SEWER LINE: ft
WATER CLOSETS: WATER LINE: 60 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
STEVEN ERICKSEN
11569 SW SHEFFIELD CIR Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 8/21/2008 $72.50
[TAX] 12% State Surch 8/21/2008 $8.70
Phone : 503 -579 -6371 Total $81.20
Contractor:
CASEY'S PLUMBING INC
PO BOX 30075
PORTLAND, OR 97294 REQUIRED ITEMS AND REPORTS
•
Contact # : PRI 503 -253 -0030
FAX 503- 262 -8251
_ Reg #: LIC 147298
PLM 26 -725PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicablelaws. 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 B / 'I Permittee Signature g "fr, Ce - Y521✓
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.
INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for: /Lr ,/ --316 REQUIRED ON GREEN INSPECTION CARD.
./ • Code I Inspection Description I PASS Date I B ✓ Code I Inspection Description PASS Date By
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground /slab cover
410 Fill 110 Temporary electrical service
415 Crading 115 Electrical service
205 Footing 120 Electrical rough -in
805 MFG - Structure grading /footing 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain • 145 A/C or heating unit circuit •
225 Post /beam structural 150 Hot tub /spa /pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors • 199 Electrical final •
• 240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG- Structure set -up MEC - Mechanical Permit
•
280 Insulation 605 Post /beam mechanical
285 Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping
899 MFG - Structure final 625 Duct work
498 Grading final 630 Fire damper
299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection:
699 Mechanical final
BUP - Fire Protection System Permit •
905 Sprinkler underfloor /slab PLM - Plumbing Permit
• 910 Sprinkler rough -in 305 • Plumbing underslab
915 Fire alarm rough -in •
310 Crawl drain
920 Suppression trip test 315 Post /beam plumbing
995 Misc. inspection:
998 Alarm final 320 Plumbing rough -in
999 Sprinkler final 322 Shower pan
330 Water service
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert/catch basin
410 Fill . 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing 399 Plumbing final
210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
• 498 Grading final 595 Misc. inspection:
499 Final inspection _ 599 Final inspection
•
i:\ Building \Forms \InspCard- AOP- Blank.doc 02/02/07
i .
r a CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 - 00343
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/21/2008
PARCEL: 1S133DB-03400
SITE ADDRESS: 11569 SW SHEFFIELD CIR ZONING: R - 12
SUBDIVISION: BRITTANY SQUARE NO. 2 LOT: 058 JURISDICTION: TIG
PROJECT: ERICKSEN
Project Description: Replacing 60 ft. of water service.
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: SEWER LINE: ft
WATER CLOSETS: WATER LINE: 60 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
STEVEN ERICKSEN
11569 SW SHEFFIELD CIR Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 8/21/2008 $72.50
[TAX] 12% State Surch 8/21 /2008 $8.70
Phone : 503 -579 -6371 Total $81.20
Contractor:
CASEY'S PLUMBING INC
PO BOX 30075
PORTLAND, OR 97294 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 253 -0030
FAX 503- 262 -8251
Reg #: LIC 147298
PLM 26 -725PB
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 B Permiftee 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.
Ru,tg 20 08 02:23p Case's P l u m b i n g 5032628251 p.1
�., 14
EIVED O
Plumbing Permit A r ��; v-2 >I FOR OFFICE USE ONLY
City of Tigard Received „
a 13125 SW Hall Blvd., Tigard, • ., (9.71i41 • - Date/By: m a ,� i
Jet 398.198 it' m
K Plan Review
Phone: 503.639.4171 Fax: t `J91P1 `�Jyo - gay. Other Permit No.:
T 7 GA R D 9 4
Inspection Line: 503
Date ReadvBy. Juris: El See Page 2 for
Internet: www.tigard orkj ilY OF TIGARD Notified/Method: 7416unvlemental Information
It4)IVISION FEE• SCHEDULE
ED New construction ❑ Demolition For special information use checklist.
Description I gty. 1 Ea. 1 Total
.'Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 fl. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
. 12(1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
•
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other: Fire sprinkler ( sq. ft) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: ♦i \ 1L bo ��Q- 1 a Catch basin or area drain 16.60
City / State/ZIP: ; �8( r t I Op_ q -1 Drywell, leach line, or trench drain 16.60
- i d,(�,� Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: Project name: '
Cross street/directions to job site:
Manufactured home utilities 110.00
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: Lot no.: Water service (no. linear IL: Page 2
Tax map /parcel no.: Fixture or item
Absorption valve 16.60
DESCRIPTION OF WORK
Backflow preventer Page 2
t ) J< /\. .S./- - V 1 Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
PROPERTY OWNER TENANT
Drinking fountain 16.60
c Ejectors/sump 16.60
Name: ( ) ue .� ,, y i r, Expansion tank 16.60
Address: 11 . 6 L,2q cj �I�.Q - ,,( C Fixture/sewer cap 16.60
City /State/ZIP: - {1 CI I � 2. Cn Floor drain/floor sink/hub 16.60
Phone: ( ,0 W (p �`-1 l Fax: ( ) Garbage disposal 16.60
, APPLICANT ID CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: /Sy � WJ �7 : } zt.
1 . Interceptor /grease trap 16.60
Contact name:
/ C� 5 e,t4 J Medical gas (value: $ _ ) Page 2
/�
Address: P.� /6 0 -x !/ C 7 S Primer 16.60
City / State/ZIP: y -/. -l e l 9 7 a9i. Roof drain (commercial) 16.60
Phone: (5o3 ) 53_ 6030 Fax: : 603 ) a6 .2 -r..75 J Sink/basin/lavatory 16.60
P Tub /shower /shower pan 16.60
E -mail: Ca ao,vicas'/ /le Urinal 16.60
JJ CONTiACTOR Water closet 16.60
Business name: ' n
L f� .5 r y �$ r At m � L
G1 /)t. - l7 C. Water heater 16.60
Address: R,f2 !,80 30.0 .5 Other:
City /State/ZIP: , r7 /a d , P 9 5 41 Subtotal
/ Minimum permit fee: $72.50 -�1
Phone: 6)3 ;253-00 3 v Fax: (51;3) o 2- g: 2 s / Residential backflow minimum permit fee: $3625 rZ
CCB Lic.: / 47,9.9 g Plumbing Lic. no.: o94, _, z2512,8 Plan review (25% of permit fee) •
` �7
0% State surchar_• - : • c o permit fee) ; . 7
Authorized signature: �'j'�. .. 7 --�
✓`� TOTAL PERMIT FEE .-%020.2.c, ,, C _ ����
Print name: .8re, h Q ` 1fJ ` a te: /, /�j Ca- I 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 Boar
t:l Building \PennitsfPLM- PennitApp.doc 06(26106 440 -4616I(10J02/COM!%'EB) Si
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2008 -00343
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/21/2008
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 „'!
INSPECTION WORKSHEET FOR DATE: 8/22/2008 TIME: 7:01AM PAGE: 22
SITE ADDRESS: 11569 SW SHEFFIELD CIR CLASS OF WORK:
SUBDIVISION: BRITTANY SQUARE NO. 2 LOT #: 058 TYPE OF USE:
PROJECT NAME: ERICKSEN
DESCRIPTION: Replacing 60 ft. of water service.
OWNER: ERICKSEN, STEVEN PHONE #: 603 - 5736371
CONTRACTOR: CASEY'S PLUMBING INC PHONE #: 603-253 -0030
Inspection Request Scheduled For: Date: 8/22/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 07450302 5033434947 Y
Corrections/Comments/Instructions:
c 1 e c ; c,a,, k P4 ,/,,k cr a- c- y o a v,ter• r ,�.,� f Al
12 0 A r ` l J 1" `.•-k , \ 1 G W °U `/ -1/44 cc . .cip G4 (.L4tit��J�
Cade. FaL.�,LDQ 9,(
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: gm \ A...A \fti.. Date: .r + 2 9, VO VI Phone #: (503) 718-
i .
r a CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 - 00343
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/21/2008
PARCEL: 1S133DB-03400
SITE ADDRESS: 11569 SW SHEFFIELD CIR ZONING: R - 12
SUBDIVISION: BRITTANY SQUARE NO. 2 LOT: 058 JURISDICTION: TIG
PROJECT: ERICKSEN
Project Description: Replacing 60 ft. of water service.
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: SEWER LINE: ft
WATER CLOSETS: WATER LINE: 60 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
STEVEN ERICKSEN
11569 SW SHEFFIELD CIR Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 8/21/2008 $72.50
[TAX] 12% State Surch 8/21 /2008 $8.70
Phone : 503 -579 -6371 Total $81.20
Contractor:
CASEY'S PLUMBING INC
PO BOX 30075
PORTLAND, OR 97294 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 253 -0030
FAX 503- 262 -8251
Reg #: LIC 147298
PLM 26 -725PB
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 B Permiftee 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.