Permit - •
1 4 I CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2009 -00020
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/6/2009
PARCEL: 2S 110AB -01200
SITE ADDRESS: 14195 SW 112TH AVE ZONING: R -4.5
SUBDIVISION: COLE'S ACRES LOT: 004 JURISDICTION: TIG
PROJECT: MILES
Project Description: Install 100 ft. water service.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: 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: 100 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
ALICE MILES
14195 SW 112TH AVE Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 2/6/2009 $72.50
[TAX] 12% State Surch 2/6/2009 $8.70
Phone : Total $81.20
Contractor:
LOVETT EXCAVATING INC
PO BOX 86280 REQUIRED ITEMS AND REPORTS
PORTLAND, , O R 97286
OR
Contact # : PRI 503 -504 -2847
FAX 503- 288 -1630
Reg #: LIC 125507
PLM 26 -773PB
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 By: Permittee Signature: < d - x-'`" pp t1 c1, t on
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.
w 02/06/2009 08:56 5032881630 PRESIDENTIAL PLUMBIN PAGE 02/04
PPum it ?ermit AQplieah'oi
RECEIVED I ,,t: t H t tl
City of Tigard ]tom ( o h
VIr 13125 SW Floll Blvd., Tigard.OB 6 2009 07 O q > () u • • • �r 20
Phone: 503.639.4171 Fax :503,5 SP ckLaFurmieNo.:
T F. r Inspection Line: 503,639,4175 !)eta fio.dy
interact: www. turd- or.go* I OF TIGARD NonscdfMct see Pagel for
- � � St � , . • 6tt TateWomanise g nd
TYPE OF DIN r . a: Flair SCHIDULE
❑ New construct= Q Demolition For in • mention use ttkedrittt
® Addition /ahem:ion/replacement ❑ Other; Desert. ion Qty, 'e. Total
New I. ftumily dwellings (include/ 100 R for each utility monodic*
CATEGORY OF CONSTRUCTION SFR (1) belt — 249,20
0 I- anti 2- family dwalling ❑ Commercial /industrial SFR (2) beds 350 00
0 Accessory building 0 Multi-family SFR (3) bath OM 399.00
Master builder d e : Fire p ddtticnal bath/kitchen IME 45" 11.1
.TOR SITE INFORMATION AND LOCATION Fire sprinkler C__,.. sq. ft)
J, I /' //. Site utilities
Catch basin of area drain 16,60
MY/Stake/ZIP! .-^ 444—d OK i U Dr lino, or trmull drain in 16.60
Suitc/bldgispt. no_: Project name: ClN-\ yam. 'ia in v15 an Footin6 drain (nu. lime ft.: --) IMMETEIMIIIII
Cress streel/dire s to job site:
Manufactured home udtiues NM 110.00 NM
_Manholes
Rahn drain ammeter 16.60
Sanitary sewer (no. linear ft,:_ J Pap 2
Storm sewer (nc. linear ft: ) NM Page 2 —
Subdivision; no.:
wetter (no, linear ft.; _.) �_ • •
Tsui map/pored no.: Fixture or item
DESCRIPTION OP WOW Absorption valve 16.60 MIN
I .s ft, � / . ' ye,- le- 7 rn dr.
/ hi c horn. C = 16 60 MIMI
• • ._ ' 30 Clothes washer 3 " Min
Dfshwalther 16.60
PROPERTY OWNER 0 TENANT T Dtinldng f ountain 16,60 ME III
1�'ar»c: PlJr�t')r71d h✓nSD(1 : • 16.60
� 5 E ixwr e / or3 tank 16.60
IMMII
Address: I � j t:j 5 W �) t,-, �V,t'_
Fittwtdsewer cap IIIIIII 16.60 Milli
City/State/ZUP:+rGlr�r4. alit 7zZ Floor drain/floor eirk/hub M. 16.60
Phone: ( ) Pax: ( ) Garbage disposal 16,60 ME
CI APPLICANT Hose bib 16.60
Cd NIAC7t POISON
Business name: ice maker 16.60 i
Interceptor/grease .m trap 16.60 MI
Comet name: , , n la -•-4 . 1- la -•-4 . 1- Medical cal sa (value: $ ) P e Z
Address' pQ L O k Primer INIM 16.
City /State/ZIP: Af.i74 j -, f Dr x/ -7 2 -f'a Roof Moen (commercial) no 16.60
— Phone: ( I) ) 7 g ( - Fax:: Sinlr/besfn/lFVabory 16.60 MEI
Tub/shower /shower pan 16 iiiiiii
F,- mail:Ci • • Ad£rnle[b . (dvs-1 Urinal
CONTRACTOR
16.60
Water closet 16.60
Huainan tame: 0 Lt r PxCa IAA }1, Q 13 4 .• D3 P/A,..i-v, • Water heater MIE 16.60
Address: P F k- t -(p , t) Ocher
City/State/zip: it, r Y /'t, UYZ e}? Co drbtotal
Phone: (S03) 7s , - . • pax: (S (i3) �$1g -1 t 3 0 Residential backflow minimum •errna fee: $36.25 2."'s
CCB Lic: 1 2_, Ss L - 7 Plumbing Lie. no.: . - 7-) 3 p ic Plus review 5% of )
Authorized signature: , , l permit fee ��
Pr int na . .. 1 v
T + 1
This permit application ,» 07 ti°„t ''� Da te: / This nnn expiwe ifs permit Is not obtained withis
-- - �+5� =! 180 days after tt has been accepted its complete.
*Fee reertmetology set bym- Ccurny Building Industry Service Board
t: tweiseveamlplrt ,tic- semlitAss doe 12 eases rT(ltuonereovse)
CITY OF TIGARD � � /7 :- i v
BUILDING DIVISION PERMIT #: PL M2009-00020
0t1p2p
13125 SW Hall Blvd., Tigard, OR 97223 1 \ DATE ISSUED: 2/6/2009 1
Phone: (503) 639 -4171 � "�� „ F Il l r I � �---
Inspection Requests (24 Hrs.): (503) 639 - 4175; __L i� //,s--s
INSPECTION WORKSHEET FOR DATE: 2/11/2009 TIME: 7:00Am AGE: 9
SITE ADDRESS: 14195 SW 112TH AVE I CLASS OF WORK:
SUBDIVISION: COLE'S ACRES / LOT #: 004 TYPE OF USE:
PROJECT NAME: MILES /
DESCRIPTION: iresi ill 100 ft., w �p' �-- water service. L # ..c7
( S W MIl_F_ AL ICE Awl'A sw- PHONE #: P
CONTRACTOR: LOVE1T EXCAVATING INC 7, 0 ,. (eyAc, PHONE #• 503-5042047
Inspection Request Scheduled For: Date: 271//2009 ` 1, �/ our Time:
L
Code # Inspection Description Confirm # Contact # 0 Me-sag- w, "1 Iu
330 Water service 080491-01 503.208.152.7 Y �!I`'W I \
Corrections /Comments/ Instructions:
/'' GU ins bo
L 1.4V Ai - "_ /1_ cam a '..L.i.
EJ t‘_)/A - c/i/L. - /70 .c-e .
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1 PASS ❑ PARTIAL APPROVAL ❑ CANCEL (l NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: t7//I Date: 1 V Phone #: (503) 718D-4