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Permit a CITY OF TIGARD PLUMBING PERMIT ° , COMMUNITY DEVELOPMENT PERMIT #: PLM2006 -00479 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/8/2006 PARCEL: 1S136DD-03400 SITE ADDRESS: 11740 SW 68TH PKWY 100 ZONING: MUE SUBDIVISION: TIGARD TRIANGE COMMONS LOT: 008 JURISDICTION: TIG Project Description: TI plbg. fixtures.other's icemaker,primer's. CLASS OF WORK: ALT GARBAGE DISPOSALS: 1 MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS; 10 TRAPS: STORIES: WATER HEATERS: 3 CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 5 URINALS: 2 GREASE TRAPS: LAVATORIES: 2 OTHER FIXTURES: TUB /SHOWERS: 2 SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: 1 RAIN DRAIN: ft Owner: FEES LARSON, IRVING UJENNIE E TRS Description Date Amount BY JUDY L STROJNY 555 CHESTERTOWN ST [PLUMB] Permit Fee 11/7/2006 $547.80 GAITHERSBURG, MD 20878 [PLMPLN] Plan Review 11/7/2006 $136.95 Phone : [TAX] 8% State Surcha 11/7/2006 $43.82 Total $728.57 Contractor: WESTERN PLUMBING 9460 SW TIGARD STREET TIGARD, OR 97223 REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 639 -5296 FAX 503- 684 -9015 Reg #: LIC 2439 PLM 34 -29PB 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: 1 _ 40 , � Permiftee Signature: , .-e , p 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. ;9'"%5 . a / Bui ing Fixtures , 0 ► _ 03 00 Plumbing Permit Application rOlR Orrl(:I: t,til O,NL.) 71 City Of Tigard I r f 1 /j� 2006 Received Pe rmit N a 13125 SW Hall Blvd., Tigard, OR 97 3' ° Jf � DAY 1 % d f Ra i - on Phone: 503.639.4171 Fax: 503.5 98.1960 DD Plan Review Other Permit NoS Q2 ...04, 7 T I G A It D Inspection Line: 503.639.4175 , ,_ - ,"•.," - - ' '' " Date Ready /By: e Read ) wi'" El See Page 2 for Internet: www.tigard- or.gov ,. . r -- ° ^ n ^I .-- �� N // / d b / Supplemental Information TYPE OF WORK , FEE* SCHEDULE _'. ❑ New construction ❑ Demolition For special information use checklist Description 1 Qty. 1 Ea. 1 Total ❑ Addition/alteration/replacement %Other: I-1.C_ New 1- 2-family dwellings gs (includes 100 ft. for each utility connection ` . CAT RY OF CONSTRUCTION . SFR (1) bath 249.20 ❑ 1- and 2 -family dwelling XCommercial /industrial SFR (2) bath 350.00 _ ❑ Accessory building ❑ Multi - family SFR (3) bath 399.00 Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 N' • r. ..d0$ SITE INFORMATION AND LOCATION , . Site utilities Job site address: 1/ ?V SU/ G, / 0V Catch basin or area drain 16.60 e. City /State/ZIP: 1© ®/Z Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: /00 I Project name: 0//94 7t Footing drain (no. linear ft.: ) Page 2 • Manufactured home utilities 110.00 Cross street/directions to job site: t. Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 e_ Storm sewer (no. linear ft.: ) Page 2 Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2 Fixture or item Tax map/parcel no.: Absorption valve 16.60 'DESCRIPTION OF' "WORK Back flow preventer Page 2 ir . i'," ? "4 f, 2,4 Backwater valve 16.60 Clothes washer ` 16.60 Dishwasher / 16.60 /t, 1pQ '❑ 'PROPERTY OWNER ' E • ❑ TENANT Drinking fountain 16.60 Ejectors/sump 16.60 Name: Expansion tank 16.60 Address: Fixture/sewer cap ►1 16.60 City /State/ZIP: Floor drain/floor sink/hub a /O 16.60 ado , Phone: ( ) Fax: ( ) Garbage disposal / 16.60 /10 • (00 ' _ CI' APPLICANT.. .❑ CONTACT PERSON ' ' Hose bib 16.60 Ice maker / 16.60 16 , /00 Business name: Interceptor /grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: Primer & 16.60 `7 q, City/State/ZIP: drain (commercial) 16.60 1 _ /� 16.60 ?�7jp Sink/basin/lavatory ,.... 7 16.60 I I tp1 al J Phone: ( ) Fax: ( ) Tub /shower/shower pan a E-mail: Urinal 16.60 ;, . . CTOR ' - _ C Water closet 3 16.60 � y n Business name:'jl/ -r J ,4t,/h e hi/C. Water heater 16.60 4( Address:9 0 ✓ -776/W /!(t 0/0/ Other: , 1 City / State/ZIP: � 44 04 q ,23 X Subtotal : �- �� Min imum permit fee: $72.50 Phone: ( ) 4.39-....04 Fax: (j J ) G8�'" 9015 Residential backflow minimum permit fee: $36.25 1 8 S � �i' 39 Plumbing Lic. no. :3tjr ,d Plan review (25% of permit fee) . /3 4. 5 CCB Lic.: s7 State surcharge (8% of permit fee) i /f Authorized signature: 0:02:•,4(.0•42,..,,,-- TOTAL PERMIT FEE ?ma, . Print name: T40 ja. '; 1 Date:W/ Lyp' 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 Board. t:\ Building \Pennib\PLMF- PetmitApp.doc 04/06/06 440-4616T(I0/02/COM/WFB) 67/ 01 CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2006-00479 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/8/2006 Phone: (503) 639 -4171 A Inspection Requests (24 Hrs.): (503) 639 -4175 ,. ° I.. INSPECTION WORKSHEET FOR DATE: 3/9/2007 TIME: 7:01AM PAGE: 77 SITE ADDRESS: 11740 SW 68TH PKWY 100 CLASS OF WORK: SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 008 TYPE OF USE: PROJECT NAME: OMA DESCRIPTION: TI plbg. fixtures.other's icemaker,primer's. OWNER: LAR SON, IRVING UJENNIE E TRS, PHONE #: CONTRACTOR: WESTERN PLUMBING PHONE #: 503 - 6395298 Inspection Request Scheduled For: Date: 3/9/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 044540 -01 503-639-5296 N Corrections /Comments/ Instructions: 1 /1"1-P PASS 111 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS Ili F_ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: k ' e/ Date: 5 0 Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2005.00479 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/8/2006 Phone: (503) 639- 4171 Inspection Requests (24 Hrs.): (503) 639 -4175 A; � INSPECTION WORKSHEET FOR DATE: 2 TIME: 7 :00AM PAGE: 20 SITE ADDRESS: 11740 SW 68TH PKWY 100 CLASS OF WORK: SUBDIVISION: TIGARD TRIANGE COMMONS LOT #: 008 TYPE OF USE: PROJECT NAME: OMA DESCRIPTION: TI plug. fixtures.other's icemaker,primer's. OWNER: LARSON, IRVING UJENNIE E TRS, PHONE #: CONTRACTOR: WESTERN PLUMBING PHONE #: 503 - 639-5296 Inspection Request Scheduled For: Date: 2/21/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 043671 -01 503 - 639 -5296 N Corrections /Comments / Instructions: - i - ❑ PASS Id, PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL NLCALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: , ik,ev Date: Q —Ad 7 Phone #: (503) 718 -