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Permit CITY OF TIGARD PLUMBING PERMIT ! 2 COMMUNITY DEVELOPMENT Permit #: PLM2009-00107 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/04/2009 Parcel: 2S101AC00200 Jurisdiction: Tigard Site address: 7020 SW GONZAGA ST Subdivision: Lot: 0 Project: Davis Project Description: Replace up to 100 feet water service. Owner: FEES FOREST PARK ENTERPRISES LLC Quantity Description Date Amount 2104 HOT OAK RIDGE ST 100 If Water Service 05/04/2009 $55.00 LAS VEGAS, NV 89134 1 12% State Surcharge - 05/04/2009 $8.70 PHONE: Plumbing 18 ea Minimum Fee Adjustment 05/04/2009 $17.50 Contractor: - Plumbing OWNER PHONE: FAX: Type of Use: SF Class of Work: . ALT Type of Const: Occupancy Grp: Stories: Total $81.20 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952- 001 -0100. — You may obtain a copy of the rules Issued By: alci -� n „ 11 V p (� Permittee Signature: �\ n n 2 V I Q n �.L + r 1 1 VC Ca 503.639.4175 by 7:00 a.m. for an inspection that business day. l I V 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. !I a CITY-OF TIGARD PLUMBING PERMIT IN COMMUNITY DEVELOPMENT Permit #: PLM2009-00107 j- G A RD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/04/2009 Parcel: 2S 101 AC00200 Jurisdiction: Tigard • Site address: 7020 SW GONZAGA ST Subdivision: Lot: 0 Project: Davis Project Description: Replace up to 100 feet water service. Owner: FEES FOREST PARK ENTERPRISES LLC Quantity Description Date Amount 2104 HOT OAK RIDGE ST LAS VEGAS, NV 89134 100 If Water Service 05/04/2009 $55.00 1 12% State Surcharge - 05/04/2009 $8.70 PHONE: Plumbing 18 ea Minimum Fee Adjustment 05/04/2009 $17.50 Contractor: - Plumbing OWNER n i ii PHONE: FAX: it II low— or' - . Type of Use: SF �' Class of Work: ALT Type of Const: Occupancy Grp: i`, Stories: ' II 0 IL 1 1 416 Total $81. ,• ' = - Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules Issued By: 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. 05/04/2009 01:00 FAX 702 838 1817 JOHN PAULDINE a 003 . _ ; . Plumbing Permit Application Building Fixtures i' R OFFICE: (?SE': oNL''. , City of Tigard Received F , .1 ` ' O q t I p ermit No.: pt t! 2( °. a C)1, 11 14 w 13125 SW Hall F31vd., Tigard, OR 97223 Plan Review p Phone: 503.639.4171 Fax: 593.598.1960 Date /ley: other Permit No.. Inspection Line: 503.639.4175 Date Ready /By: ,{ J�r;a�: El Svc Pape 2 For T I G A' R.I? Internet: www.tigard- or.gov _ Notified/Method: 11l^ Supplemental Information TYPE OF WORK FEE" SCHEDULE. Far special information use checklist. ❑ New construction ❑ Demolition Description I Qty. I Ea. I Total Addition /alteration/replacement ❑ Other: New 1- 2-faintly dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 249.20 ® 1 - and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 SFR (3) bath 399,00 El Accessory building 0 Multi - family Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: Fire sprinkler (_ - sq. R.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Iob site address: 7020 SW Gonzaga Catch basin or area drain 16.60 City /State /ZIP: Tigard OR 97223 Drywall, leach line, or trench drain 16.60 Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: Project name: Manufactured home utilities 110.00 Cross street /directions to job site: from hwy217 take 72" Ave exit (The exit Manholes 16.60 before I -5 exit) go South on 72 aprox 3 blocks to Gonzaga St ( across fr to Rain drain connector 16.60 drive way to Lowes )turn right, house is at end of street on right side. Sanitary sewer (no. lima 1t.: ) Pagc 2 Storm sewer (no. linear 11.: , ) Page 2 Water service (no. linear It,: Lj) , Page 2 Subdivision: Lot no.: Fixture or item _ Tax map /parcel no.: Absorption valve 16.60 DESCRH.PTION OF WORK Backftow preventer Page 2 ' replace pipe from water meter to house. Backwater valve 16.60 Clothes washer 16.60 `-" Dishwasher 16.60 Drinking fountain 16.60 04 PROPERTY OWNER [1 TENANT Ejectors /sump 16.60 Name: Sltriley Davit Expansion tank 16.60 Address: 7020 S W Gonzaga Street Fixture /sewer cup - 16.60 City /State /ZIP: 97223 Floor drain/floor sink/hub 16.60 phone; ( 971 )230-8840 Fax (7(2) g39 - /5? I '7 Garbage disposal 16.60 Bose bib ,.. , APPLICANT (� CONTACT PERSON - _ Ice maker 16.60 Business name: CO • . - I/ . •c• . e / - I) ' i s "J Interceptor / trip 16.60 T Contact name: / r C.'/J ,,4 S L r= -, 'Medical gas (value: $ ) Page 2 Address; Primer 16.60 City /State/ZIP: Roof drain (commercial) 16.60 Sink/basin/lavatory 16.60 Phone: ( ) Fax:: ( ) - Tub /shower /shower pan 16.60 E -mail: - urinal 16,60 CONTRACTOR Water closet 16.60 Business name: Water heater 16.60 -, Other: Address; - Subtotal City /State/7R: Minimum permit fee: S72.50 'emit J 72 C 0 F ax: ( ) Residential backtlow minimum 'emit fee; 536.25 Phone: ( ) Plan review (25% of pennit fcc) CC/3 Lie,: Plumbing Lie. no.: State surcharge (12% of permit fee) r CD Authorized signature: SI r A _ ' JQ. -tJ1 5 TOTAL 1'ERMT1" FEE r . '2C) Pont name: Shirley A. Davis) mat G _ 6 .- This permit application expires U e permit is not. obtained within - 11341 days after it has been accepted us complete. oFnn rneihndnloov sal by Tri-r nnty Rrtitdina Iothr.lry Cn'vi ' l tvi 05/04/2009 00:59 FAX 702 838 1817 JOHN PAULDINE Z002 • Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701,455 (4)) This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not submit this statement. This statement will be filed with the permit. Please check the appropriate box „ J I own, reside in, or will reside in the completed structure and my general contractor is: Name CCs# Expiration Date I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. or i will be performing work on property I own, a residence that i reside in, or a residence that I will reside In, if I hire subcontractors; I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit, i have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. Print Name of Perrot Applicant X I EA, 5.4.09 signature of PermitAp b Permit #: _ Address : � , '< Issued by Date This Copy for Permit OffQe May. 4. 2009 2: 05PM Ham r s McMonagl e No. 0024 P. 1 CITY OF TIGARD COMMUNITY DEVELOPMENT DEPARTMENT PLANNING DIVISION 13125 SW HALL BOULEVARD TIGARD, OREGON 97223 PHONE: 503 -639 -4171 FAX: 503 - 624 -3681 (Acts: Patty /Planning) EMAIL patty@tigard- or,gov Ti U A It L� r REQUEST FOR 500 —FOOT PROPERTY OWNER MAILING UST Property owner information is valid for 3 months from the date of your request INDICATE ALL PROJECT MAP & TAX LOT NUMBERS (i.e. 1S134AB, Tax Lot 00100) OR THE ADDRESSFS FOR ALL PROJECT PARCELS BELOW: 12550 SW 134th Ave. Tax Map 2S -'1 - 04AC TL 2700 PLEASE BE AWARE THAT ONLY 1 SET OF LABELS WILL BE PROVIDED AT THIS TIME FOR HOLDING YOUR NEIGHBORHOOD MEETING, After submitting your land use application to the City, and the project planner has reviewed your application for completeness, you will be notified by means of an incompleteness letter to obtain your 2 final sets of labels. IF YOU HAVE BEEN NOTIFIED BY PLANNING TO OBTAIN YOUR LABELS, PLEASE INDICATE THAT YOU NEED 2 SETS OF LABELS. The 2 final sets of labels need to be placed on envelopes (no self - adhesive envelopes please) with first class letter - rate postage on the envelopes in the form of postage stamps (no metered envelopes and no return address) and resubmitted to the City for the purpose of providing notice to property owners of the proposed land use application and the decision. The 2 sets of envelopes must be kept separate. The person listed below will be called to pick up and pay for the labels when they are ready. NAME OF CONTACT PERSON: Steve Bloomquist PHONE: 503 - 639 - 3453 (ext 19) NAME OF COMPANY: Harris McMonagle FAX: 503 - 639 - 1232 EMAIL: steye ®h - mc. corn This request may be ernailed, mailed, faxed, or hand delivered to the City of Tigard. Please allow a 2 -day minimum for processing requests. Upon completion of your request, the contact person listed will be called to pick up their request that will be placed in "Will Call" by the company name (or by the contact person's last name if no company) at the Planning /Engineering Counter at the Permit Center. The cost of processing your request must be paid at the time of pick up, as exact cost can not be pre - determined. PLEASE NOTE: FOR REASONS OF ACCURACY, ONLY ORIGINAL MAILING LABELS PROVIDED BY THE CITY VS. RE -TYPED MAILING LABELS WILL BE ACCEPTED. Cost Description: $11 to generate the mailing list, plus $2 per sheet for printing the list onto labels (20 addresses per sheet). Then, multiply the cost to print one set of labels by the number of sets requested. I - EXAMPLE - - COST FOR THIS REQUEST - 4 sheets of labels x $2 /sheet $$02 x 2 sets = $16.00 _ sheet(s) of labels x $2 /sheet = 5 � sets = 1 sheets of labels x $2 /sheet for interested patties x Z sets= $ 4.00 sheet(s) of labels x $2 /sheet for interested patsies = sets = .R\1RRdTR T.TS1P = 4l i_f10 GF.NRRATI? T.IST = $ 1100 TOTAL = $3L00 TOTAL =$ 0 ----- J. w https:/ ay.accela.com, jetspeedlporta( �-- �r w e Edit View Favorites Tools Help A - Lo - �, Page Tools - _. . .... 4 Oi H -i 1.0 CD D CO 01 �AV h III�N Inspection Detail Conditions (0) ` Documents (0) ID h- in Ins n Type Address Case # • .. =_ 330 Water service 7020 SW GONZA.GA ST , TIGAFRD, OR 97 FLhS2E�OS GO M M x -J IY Request date �aaww Request Time t zwr - • 05,05!20 ©9 11;47 Requestor'sPhoneNumber fi _= R Comment 1- GE ..-1 -- I o a m N CC m.. a in coin A o m m a M `- ,- . Scheduled Date Schedule Time H un r� eD r, y i- t� 05/05/2009 F- sir- , mCZocnw v = Inspection Date Inspection Time Rerun Department In u. 05105!2009 11: 7 FAIL Building G w i = Resuft Comment �- { - z _ LAS VEGAS AND AGREED TO HAVE HIM •CFHE TENET) DO THE PLUMBING WORIG.. TENET IS NOT A o _ : PLUMBING CONTRACTOR AND AS SUCH IS NOT LECENSED To PERFORM PLUMBING WORK. in ; This permit should be issued to a licensed plumbing contractor only, _ _ - ' Further, an electrical permit must be issued to a licensed electrical c-ontracbor For the replacement of the yr: z =_ electrode conductor and around system. a ce - __ CAP Type Internal Use Only - : - Building/Res/Plumbing/N4 09 RES- 130000 -00195 Reports - w -_ Luz - ` )i• My Report - > Case Specific Perrni F- oHr,��- 1. • a x <I D Q > Export IAFS Payment a a D a w 0 Irk- Export Permit Activity ALLA0_CCM _ - »Inspectons - D Miscellaneous__ .isiezrai _� ,: { . !Ar�aeta J ttomatia... - Inbnx Microsoft . — - .` rtc'�r r \!1,5J11Jr�CJr_ iii - J i'lJ 1J1 "f� J f-IJy r _ • `_,A E/! L � ° I r 1 r.l i https:; ,�ay.accela.com;'jetspeediportal +r X p - File Edit View Favorites Tools Help te e' - 0 7 - i_ Page ■ '.". Tools v (01‘• 2,, .= CAP ID: PLM2009 -00107 E El] 0 I Cancel l Reports ., i Help — Inspection Detail Conditions (0) Documents (0) E- . E F. Inspection Type Address Case # 330 Water service 7020 SW GONZ.AGA ST , TIGARD OR 97223 PLM2009 - 00107 Request Date Request Time Requestor's Phone Number 05/05/2009 11:47 Request Comment . i Ii i 1 Scheduled Date Scheduled Time 05/05/2009 — E' Inspection Date Inspection — '' pection Time Result Department Inspector it 05/05/2009 11:47 FAIL Building Gary Noble f Result Comment - ^ 1k., inc fLJU-C •tItiv I'LL/NOEL' 1 nC r‘.‘._ i "ii+.I C t ririol .7 11'l inc l7! -i`t MUC. nC 1 ULCJ IiC 1 PlC U1'VIVCK ur 1 ric nuU Li v c lig - ' LAS VEGAS AND AGREED TO HAVE HIM (THE TENET) DO THE PLUMBING WORK. THE TENET IS NOT A LICENSED I — f' PLUMBING CONTRACTOR AND AS SUCH IS NOT LECENSED TO PERFORM PLUMBING WORK. ii This permit should be issued to a licensed plumbing contractor only. _ i' Further, an electrical permit must be issued to a licensed electrical contractor for the replacement of the grounding - p electrode conductor and ground system. 2 — ' - Ii CAP Type Internal Use Only = - 1 _ - 1 • Building/Res /Plumbing /NA 09RES 00000 - 00196 11 Reports -- J [ry - ilt __ .- )0-My Reports -- )Case Specific Permits — _ _ )Cashier ~,; > Export - I.AFS Payment > Export - Permit Activity .= >Inspections >Miscellaneous i °I(d. '' : 0 Internet 100% - , . s � a' t . ' r • n 4 t .t0:.;. ... Inbox - Microsoft D Edit Inspection 1 ,r i,.- © 01. v gD a 12 :15 PM r5tc, (_.! r ?i1S lfl_iC� I1�J / jJ 'e /� 1I�r�fll sC �`_ 1j�1 � , a ,- 1 ?, o -- - ■ U, https: / /ay.accela.corn jetspeed /port f R I � ,‘t. ,‘t. , - .P , ( 11 File Edit View Favorites Tools Help - r - Page f Tools 'r (6)" a .3 CAP ID: PLM2009 - 00107 =u ( _ a C ancel } Reports 4 t ; Help Inspection Detail Conditions (0) Documents (0) - Inspection Type Address Case # g. 330 Water service 7020 SW GONZi GA ST , TIGARD, OR 97223 PLM2009 - 00107 - E. Request Date Request Time .- Requestor's Phone Number - 05/05/2009 11:47 Request Commen —, I Scheduled Date Scheduled Time = • 05/05/2009 - I Inspection Date Inspection Time Result Department Inspector M. � 05/05/2009 11:47 FAIL Building Gary Noble °i.._l' 1 ` Result Comment jl AFTER FURTHER INVESTIGATION I HAVE FOUND THE TENET IS THE PERSON WHO INSTALLED THE WATER SERVICE LINE Pi —! TC THE HOUSE AND PLUMBED THE PVC WATER PIPING IN THE GARAGE. HE TOLD ME THE OWNER OF THE HOUSE LIVES IN ,- h LAS VEGAS AND AGREED TC HAVE HIM (THE TENET) DO THE PLUMBING WORK. THE TENET IS NOT A LICENSED j � — - it PLUMBING CONTRACTOR AND AS SUCH IS NOT LECENSED TO PERFORM PLUMBING WORK. --- ' This permit should be issued tc a licensed plumbing contractor only. c.... -I...� ..I....�P... -.I ........M1:i ...... -i 1�.. ._�.... 4 a.. 1. ..1 ..1=...a �..-�I ^.....a,.�. -�..,P t.... at... ....1�......�=...a =.F aL, .. �... ... =J ;.... — CAP Type Internal Use Only u r , Building /Res /Plumbing.. NA. 09RES -00000 -00195 —x. J ,i; J L Reports , > - My Reports )Case Specific Permits = _ D Cashier -- )Export - IAFS Payment )Expert - Permit Activity = > Inspections — >. Miscellaneous =L Ddne N & 6 Internet +, 100% p J t4 - cce ,:�t`,\ry - z Inbox - Microsoft ... I 5 Edit Inspection 1 t` L4. 0 12:14 PM