Permit C ITY OF TIGARD PLUMBING PERMIT
zi DEVELOPMENT SERVICES PERMIT #: PLM2006 - 00408
'� II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 91512006
PARCEL: 2S 101 AA - 04900
SITE ADDRESS: 12300 SW 69TH AVE ZONING: MUE
SUBDIVISION: WEST PORTLAND HEIGHTS LOT: 022 JURISDICTION: TIG
Project Description: Added (1) hose bib.
CLASS OF WORK: OTR 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: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
MONEGO, JOSEPH A/CHERYL A +
MONEGO, JAMES A Description Date Amount
12300 SW 69TH AVE [PLUMB] Permit Fee 9/5/2006 $72.50
TIGARD, OR 97223 [TAX] 8% State Surcha 9/5/2006 $5.80
Phone : Total $78.30
Contractor:
POWER PLUMBING CO
P BOX 19418
PORTLAND, OR 97280 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 244 -1900
FAX 503- 244 -8825
Reg #: LIC 52378
PLM 34 -150PB
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: Q rip Permittee Signature: c �nn
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.
RAg 31 2006 2:42PM POWER PLUMBING CO. 503 244 8825 p.l
...
.i_ • -
Plumbing Permit App ielltn GENEVA' l t►l: t ►l I i[ l 1 l: ►.1
City of Tigard Received . - • , - Permit No \A.._ / 0 / 0 ( %
13125 SW Hall Blvd., Tigard, OR 97223 '
Phone: 503.639.4171 Fax: 503.598.1960 AU G ,, 1 20 - r:: Other Pe mitNo.:
..
24- Hour Inspection Line: 503.639.4175 • ! 1
Date , fats. BI see Page z ror
Internet: www.ci.tigard.or.us CITY OF Tic g supplemental bromides
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❑ New construction ■ Demolition For special inforraaion use checklist
Description i Qty. 1 Ea. 1 Total
ini4cIdition/alteration/replacement ■ • New 1- 2- family dwellings (includes 100 ft. for each utility connection)
••; i 1 r t t�, . �n«i+�..P.. i T3 i 'V . Ti 5Y ✓: s i . .'wJl. a
"+* "'"- :`�x ,-1:. °..isc a. ,;. , .:, ,, t ' . i- mo t; rkl SFR(1)batfi 249.20
.E
I 1- and 2- family dwelling ■ SFR (2) bath 350.00
❑ Accessory building ■ SFR (3) bath 399.00
Each additional bath/ldtchen 45.00
❑ Master builds ■ Other:
Mi. Fire sprinkler ( sq. ft.) Page 2
>< t::� , -r'' 74117 , 7"1 -` pug L ° . -. ,, ' I : v t. i ryt 't}..... - wil
.1 .ti --1-4-...,,,AIL-1. 99 I :ll J I d 1 -I • y .', 4 i; h I . t ; e. 1 . r t d nr:Lc
a ... ., .�.= ?'�' <' - � ` 3�T'ii�fi r "1- Si?k�- .:i� ?. ii„JK�t�`s.al:'�....., �.c a . ..s�,.2ktGr�y r ?:'#' Site uHlides
Job site address: - ` �t.iarii ■ q Catch basin or area drain 16.60
City /State /ZIP: ` J o [hyweh, leach line, or trench drain 16.60
SuiteJbIdgJapt. no.: Project name: 1 Footing drain (no. linear ft.: ) Page 2
��' `� Manufactured home utilities 110.00
Cross street/directions to job site: / , ' f v IA.k.
Manholes 16.60
Ram drain connector 16.60
Sanitary sewer (no. linear ft: ) Page 2
Storm sewer (no. linear it: ) Page 2
Subdivision: 1 Lot no.: Water service (no. linear ft: ) Page 2
Fixture or item
j Tax map /parcel no
_ .,, Absorption valve 16.60
' -f s ; : :W «°F ` 't imt.... ,gl A ...1 ? - r . J -,P Backflow preventer Page 2
�* ��� li£ Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
;acar�aa-.c+ c-,r' 1'i °F�::S:_ 1, i 'ma { •0 °_.rr 5}T:iti f 's"� thinking fountain 16.60
'yr,Efs,L Y , '_,' ... t4j,,4-1 imli;e, . S1' kb � L. A . ` ?'} I.a.... - - till Ejectors/s 16.60
Name: A . i / a Expansion tank 16.60
Address: Fixture/sewer cap 16.60
Floor drain/floor sink/hub 16.60
Garbage disposal 16.60 Ili _
rv�,.k I = a7�� uai'�r : I t �: � I z t lfIJFl > Hose bib ' 16.60 f l' Lob
a . y , v .! -. ik'it' 1 C -- .E ! : T `' k UJ• r c I ,� - .K L
7 ;. :�' z:,lw't::�t- ....,.,tu (i'fJt "r r-- r "14h, ,i. 3_ . ..,: L. _. .> Ice maker 16.60
Business name 1 • ,e4/ Pr/ vsz5 Interceptor/grease trap 16.60
Contact name: A .A. • ' - '1/ Medical gas (value: $ ) Page 2
Address: p v' 6 14 '1) g Primer 16.60
City/State/ZIP: � r j - Qft o co LA- to Roof drain (cotiuccwcial) 16.60
Ziy - a- I ( ) y $q25 T ub s owes/ vat° 16.60
Phone: ( )
Fax:: � 1
Tub/shower/shower pan 16.60
E- mail:
d _ Urinal 16.60
~ a i f � � � JI �Y water closet 16.60
Business name: iiIIIIMMIIIIIM Water heater 16.60
Address: t �! Other.
.411 'lu .i■�, Subtotal ""� Z,ojO
City/State/ZIP: , C! ell a,' Minimum permit fee: 572.50
1.,1444-101 O b Fax: ( ) 2) 4 - gyt5 Residential backflow minimum permit fee 536.25
Phone: ( ) Plan review (25% of permit fee)
CCB Lie.: rj V Plumbing Lic. no.: !a .
State surcharge (8% of permit fee) Cif V
Authorized signature: ' . . TOTAL PERMIT FEE ce 3 t)
i EINOMMIIMI Date: • l ar Q Thb 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 Build Industry Service Board.
I: Building%Pamiu\PLM -Pe nn3App.doa 06/05 440-4616T(10/02/COM/WEB)
r -
CITY OF TIGARD
BUILDING DIVISION - PERMIT #: PLM2006 -00408
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9 /5/2006
Phone: (503) 639 -4171 X1
Inspection Requests (24 Hrs.): (503) 639 -4175 'I I..
INSPECTION WORKSHEET FOR DATE: 9/7/2006 TIME: 8:19AM PAGE: 2
SITE ADDRESS: 12300 SW 69TH AVE CLASS OF WORK:
SUBDIVISION: WEST PORTLAND HEIGHTS LOT #: 022 TYPE OF USE:
PROJECT NAME: LANDMARK FORD
DESCRIPTION: Added (1) hose bib.
OWNER: MONEGO, JOSEPH A/CHERYL A +, PHONE #:
CONTRACTOR: POWER PLUMBING CO PHONE #: 503-244-1900
Inspection Request Scheduled For: Date: 9/8/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 036174 -01 503 - 2441900 N
Corrections /Comments /Instructions:
As pe.ez J *- t Wort e! b 6 Ti..r 4-- C . .
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 63 Date: al j 1p34, Phone #: (503) 718-