Permit C ITY OF TIGARD PLUMBING PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: PLM2009 - 00027
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/17/2009
PARCEL: 1 S133CD -16700
SITE ADDRESS: 13845 SW ASHBURY LN ZONING: R - 25
SUBDIVISION: PEBBLECREEK NO. 3 LOT: 057 JURISDICTION: TIG
PROJECT: HUDSON
Project Description: Replace 70 ft. of water service and install new water heater.
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: 1 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
MARTIN & S HUDSON
13845 SW ASHBURY LN Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 2/17/2009 $72.50
[TAX] 12% State Surch 2/17/2009 $8.70
Phone : Total $81.20
Contractor:
ARS RESCUE ROOTER
PO BOX 2830
CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 235 -8784
FAX 503- 491 -2932
Reg #: LIC 127325
PLM 34 -168PB
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.
^ n �
Issued By: (� i ` � p / Permittee Signature: Q Q Alpo; l ; 1
d V
Call 503.639.4175 by 7:00 a.m. for an inspection that business day. ` �� 1
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.
'' JUL-20-2004 22:58 P.001
Plum P er mit AppRE
Building Fixtures
OR OFFICE USE oNe.v
14 City of Tigard FEB 17 2009 Rooc,ved
+ 13125 SW ` Hall Blvd,, Tigard. OR 97223 Datc/P • I Z 0 9 _4, Permit No.: P
Plan Renew r�ri ��
: Phone: 503.639,4171 Fax: 503. Other Permit
Inspection Line: 503,039.4175 r OF TIGARD DatoBy' No..
T IC: =�t P
Internet: www,tigard -or gov BUILDING DIVISION Date Readygy � a
Scc l fooformutioa
r
Notified /Method' Supplementa l l
TYPE OF WORK FEE* S IMBUE
❑ New construction ❑ Demolition For special in or »urtiorr use checklist
Addition/alteration /replacement ❑ Other; Descn.aon Fa Total —
New 1- 2- family dwellings ■ includes 100 ft. for each utility connection i
CATEGORY OF CONSTRUCTION SFR (I) bath _ 249.20
in 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath
35n.00
❑ Accessory building DI Multi-family SFR ∎31 bath 399,00
Master builder ❑ Each additional bath kitchen
❑ Oltter: 45.00
JOB SITE INFORMATION AND LOCATION Site sprinkler ( sq, ft.) Page 2
r sjr
Site utilities
,. � Catch basin or area drain 16.60
City /Statc /ZII': -4 '..0 " Drywell, leach line. or trench drain �
Suite/bldg. /apt, no.: Project name: "1 0 / 1 Footing drain (no. linear fl.: ) — P age 2
Cross street/directions to job site: Manufactured home utilities 1 IO.UO
Manholes 16.60 =
Rain drain connector 16,60
Sanitary sewer (no. linear ft : ) N
Storm sewer (no. linear ft.: _ ) P age 2
Subdivision: Lot no.: Water service (no. linear ft.: Jai" K4=i CS °
Tax map /parcel no,; Fixture or item
• DESCRIPTION OF WORK Absorption valve Day Page 2 -�
�/���j� —,� k{Iow preventer Page 2
OW 1 .mil " " . ' , r / .), cam'/ -. r (. Backwater valve 16 60
Aig` r` �'Wi V IJ t r • ater Clothes washer _ 16.60 MIN
� Dishwasher ME 16,60
`1 PROPERTY OWNER Drinking fountain 16.60
N r Jr ejectors /sump 16.60
.., i
Expansion tank 16
�• Fixture /sewer cap 16.60
City /StatetLlP: f�
Floor draiNtloorsink /hub
Aar ' j� "9: "' 16,60
Phone:
r 0 . - ", Fax: ( ) Garbage disposal 16 60
yr
III APPLICANT 4O CONTACT PERSON Hose bib 16.60
Business name: ARS dba JACK HOWL: / Ice maker 16.60
Rescue Rooter — Interceptor /grease trap 16.60
Contact name; JOYCE DENNIS
Medical gas (value: $ ) Page 2
Address; P.O. BOX 2830 Primer 16.60
City /State /L1P: CLACKANIAS, OR 97015 Roof drain (commercial) 16,60
MEI
Phone: (503) 235 -8784 Fax:: (503) 491 - 2932 Sink/basin/lavatory
E -mail: JOYCEr )JACKHO %'K -COt�I Tub/shower/shower pan 16.60
Urinal 16.60 NM
–
CONTRACTOR Water closet
16.60 MEM
Business name: ARS dba JACK HOWK /Rescue Water heater . 16.60 re VA
Address: P.O. BOX 2830 Other: _ IM
City /State /ZIP; CLACKAMAS, OR 97015 Subtotal ��j O
Phone: (503) 2.35-8784 Fax: (503) 493. 2932 ThMinimunt permit fee: $72.50 I
Residential backflow minimum permit fee: $36.25 i t
CCB Lic.: 127325 Plu t .ing Lic. no.: 34 -168 P Plan review (25% of permit fee) Mpg
Authorized signal e: ` Jr / State surcharge (1 2% of permit fey �;
`rear -4l TOTAL PERMIT �� 1 � �
lh1/ iii Dat s iMna/' This permit application expires If a permit 15 not .. taim�r� Ir.
180 days after it has been accepted as coal • •
*Fee methodology set by Tri -County Building industry Service Hoard.
t 'Av;Idina\rurmitsU'r.MF -P. Please FAX BACK - I : 503-491-2932'
. ,
CITY OF TIGARD
...r'
BUILDING DIVISION
Ad i PERMIT #: PLM2009-00027
I DO CC ,.,..
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2117/2009
Phone: (503) Requests 639-4171 hoolvitlii?` 1 bl
Inspection (24 Hrs.): (503) 6394175 L .,-,4 11.
INSPECTION WORKSHEET FOR DATE: 2/19/2009 TIME: 7:01AM PAGE: 32
SITE ADDRESS: 13845 SW ASHI3URY LN CLASS OF WORK:
SUBDIVISION: pa3BLECREEK NO. 3 LOT #: 057 TYPE OF USE:
PROJECT NAME: HUDSON
DESCRIPTION: Replace 70 ft. of water senrice and install new water heater.
OWNER: HUDSON, MARTIN & SUE PHONE #:
CONTRACTOR: ARS RESCUE ROOTER PHONE #: 503-235
Inspection Request Scheduled For: Date: 2/19/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Mess()
330 Water service 080609-01 503
Corrections/Comments/ Instructions:
1 10 1 r ci.),
(7 ) ,,,,,....v..,,t„..... ir--;:re ,----- 6-k,
( • ,
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i_... IIIJ PARTIAL APPROVAL 0 CANCEL El NO ACCESS
I] FAIL El CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: ...) ()-2------ D ate: ?// °1 Phone #: (503) 718- 2_Yz-i