Permit - :
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., CITY OF TIGARD
PLUMBING PERMIT
' ° ` COMMUNITY DEVELOPMENT PERMIT #: PLM2007 - 00132
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/4/2007
PARCEL: 1S125DB-04100
SITE ADDRESS: 09505 SW 74TH AVE ZONING: R - 4.5
SUBDIVISION: BOULEVARD HEIGHTS LOT: 024 JURISDICTION: TIG
PROJECT: SCOTT
Project Description: Fixtures for basement. Other fixture: Ejector pump.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: 1 BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES: 1
TUB /SHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
JASON SCOTT
9505 SW 74TH AVE. Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 4/4/2007 $83.00
[TAX] 8% State Surcha 4/4/2007 $6.64
Phone : Total $89.64
Contractor:
JUDSONS INC
PO BOX 12669
SALEM, OR 97309 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 363 -4141
FX Go 's 199 • Moo
Reg #: L1C 34604
PLM 24 -22pb
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: (5)'Z•
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.
/02/2007 17:01 5033998760 JUDSONS INC PAGE 01/02
• '
PIumbing Permit ApnEtion,,iElVE FOR OFFJCE LSL ONLY' -
City Qf. Tigalyd RE! 1 J'f1/o -? ive P ermit No
13125 SW ]Tall Blvd,. Tigard, OR /Q 3 DBy 7 _ 1 /, - m • Phone: 503639.4171 Fax: 503598.196 L to Pl Datc/8 y: Other Permit No.:
Inspection Line; 503,639,4,175 " , D are R ead /13
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❑ New construction ❑ Demolition • FOP special information use checklist
�-�(^ Description � Ea. 1 Total
i' 'ddition /alteration /replacement •
yy ❑ Other: Ne'tY 1- 2- family dwellings (includes 100 ft. for cach utility connection)
-,, I i1 i'E�4( ::., '•o • i i 1�; : .T.•'' ililiru , 1 ' ` i W ' ty,,. i tti V' i J ' . �(J Wad { .;q iii t f ��� ii i ;.; ps2 i ; I� i I ; , ;, SFR 1 bath 9
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[t- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
ID Accessory building ❑ Multi - family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
E Master builder ❑ Other:
Fire sprinkler ( sq, R,) Pap 2
1 i� 2. � , - : °txl`, �;�; 7� t�t� 4 i , y r,' , , 1 r<. �. t , , s � _r: ;: _
�. 1. j,;,, : :4;. i/t5g �:u ?iiA i l y ti i1Y ' 1,4 ` ' ` 61}. ft, 1 iir 3';�,:' ?I' ft i i1�141, ::
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.lob site address: 9505 SW 74th Ave Catch basin or area drain 16.60
City /State/ZIP: Tigard OR 97223 Drywell, leach line, or trench drain 16,60 1 - 1 Suite/bldg./apt. no.; Project name: Jason & Michelle Scott Footing drain (no. linear ft.: •_) Page 2
Manufactured home utilities 110,00
Cross street/directions to job site: cross street: SW Elmwood St
° Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no, linear ft,; ) Page 2
Storm sewer (no. linear ft,: _ ) Page 2
Subdivision: I Lot nn,: Water service (no. linear ft.: ) Page 2
Tax map /parcel no.: Fixture nr item
.,;: '.r; piiti,: . •.,Etl ti •1 iEi: Ifll ' : ,;, , Absorption valve 16.60
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rough in, top out & set fixtures for basement Backwater valve 16.60
remodel Clothes washer 1 16.60 16.60
Dishwasher ]6.60
,' r , r rr l , 1 Drinking fountain 16.60
;: i I' t I k i 5. 1 ∎ : i �: 1 (1,$. :1'r �.
tiSlr, ^s�,;�'�� ,4tt <�r.. ul4's i . ', a e �� i�, 3,�i 1,!,� �� r r V II� ' ':0't: s�t:.;' 1 >kii�l; „:a,0 M.... `,� r �' �� GSf Ejectors /sump 1 16.60 16.60
Name: Jason & Michelle Scott Expansion tank 16.60
Address: 9505 SW 74th Ave _ Fixture /sewer cap 16.60
City /State/ZIP: Tigard, OR 97223 Floor drain /floor sink/hub 16,60
Phone: (503 ) 925 -1805 Fax: ( ) Garbage disposal 16.60
4:4 }{esc bib
16.60
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ice maker 16.60
Business name: In1DSON t s t INC. Interecptor /grcaae trap 16.60
Contact name: Daxyl Rose/ Sonny Mauldin Medical gas (value: $ ) Page 2
Address; PO Box 12669 Primer 16,60
City/State/ZIP: SALEM, OR 97309 Roof drain (commercial) 16.60
Sinlc/basin /lavatory 1 16.60 16.60
Phone: ( 503 363 -4141 . Fax :: ( 503)- 399 -8760 Tub /shower /shower pan 1 16,60 16.60
F, m :-il: :'. i ir.r' ( ; h;!
! Urinal 1 6.60
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, ' ,; ;, ., •,;,• ,.:. 1! 1 i lE " 1 1'1',1 f ri; S , {�:." Water cl et 16.60
16.60
i -., ,.. �� ,,';�:f5r;�' C$ ��hibS�, � ; � 1 } i:� ''';1 1, 1
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Business name; JUDASON' S, INC. Water heater 16,60
Address: PO BOX 12669 Other:
Subtotal 83.00
City /State /ZIP: SALEM, R 97309 X09 Minimum permit fcc: $72.50
Phone: { 503 363 -4141 Fax: (503 ) 399 -8760 Residential backflow minimum permit fcc: $36.25
CCB Lie.: 34604 b I V I 1 Plumbing Lie. no.: 24_ _ 0. Plan review (25% of permit fee)
Stato surcharge (g% of permit fcc) 6.64
Authorized Signature: to., $ ` of • 1 , � iii rte' TOTAL PERMIT FEE 89.64
Print name: Jane Ann DOSS Date: 4 1 This permit application expires if a permit is not nhtained within
180 clays after it has been accepted as complete.
/ � *Fee methodology set by Tri- County Building Industry Service Board.
##493305
1;alilding \Permits \PLM -PermitAPp.dac 06/26/06 440- 4616T(10 /ovcomiw6B)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007 -00132
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/412007
Phone: (503) 639 -4171 *R
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/512007 TIME: 7:03AM PAGE: 32
SITE ADDRESS: 09505 SW 74TH AVE CLASS OF WORK:
SUBDIVISION: BOULEVARD HEIGHTS LOT #: 024 TYPE OF USE:
PROJECT NAME: SCOTT
DESCRIPTION: Fixtures for basement. Other fixture: Ejector pump.
OWNER: SCOTT, JASON PHONE #: 503-925 -1005
CONTRACTOR: JUDSONS INC PHONE #: 503 - 363-4141
Inspection Request Scheduled For: Date: 4/5/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
305 Plumbing underslab 046033 -01 503- 363 -4141 Y •
Corrections /Comments /Instructions:
•
•
PASS n PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
I p
Inspector: ��itr t - Date: vs/o -Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLh112007 -00132
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 41412007
Phone: (503) 639 -4171 Paw > %di/10 ,
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/11/2007 TIME: 7:00AM PAGE: 18
SITE ADDRESS: 09505 SW 74TH AVE CLASS OF WORK:
SUBDIVISION: BOULEVARD HEIGHTS LOT #: 024 TYPE OF USE:
PROJECT NAME: SCOTT
DESCRIPTION: Fixtures for basement. Other fixture: Ejector pump.
OWNER: SCOTT, JASON PHONE #: 503- 925 - 1806
CONTRACTOR: JUDSONS INC PHONE #: 503 -363 -4141
Inspection Request Scheduled For: Date: 4/11/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 046330 -01 50.E -363 -4141 Y
Corrections /Comments /Instructions:
I t.J , 54. f i f-I- I w E j e „kb ✓ Pw,- te p S
JJ �^ i ti.o. c � S vJ C -1-C a• C l ci p -r f I LA,—
e -eJ sTr OS PS C.
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 0014 n-T I ')---"`- Date: Li' 107 Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007 -00132
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/4/2007
Phone: (503) 639 -4171u Inspection Requests (24 Hrs.): (503) 639 -4175 ....„ :_
INSPECTION WORKSHEET FOR DATE: 7/5/2007 TIME: 7:03AM PAGE: 61
SITE ADDRESS: 09505 SW 74TH AVE CLASS OF WORK:
SUBDIVISION: BOULEVARD HEIGHTS LOT #: 024 TYPE OF USE:
PROJECT NAME: SCOTT •
DESCRIPTION: Fixtures for basement. Other fixture: Ejector pump.
OWNER: SCOTT, JASON PHONE #: 503 - 925.1805
CONTRACTOR: JUDSONS INC PHONE #: 503 - 363 -4141
Inspection Request Scheduled For: Date: 7/5/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final . 051428 -01 603-363-4141 Y
Corrections /Comments /Instructions:
cav & t' i iW ltil ih.,}
•
x PASS PARTIAL APPROVAL n CANCEL n NO ACCESS
ff FAIL ❑ CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: CD Ifi raw `c\ l Date: '-) ) c) b7 Phone #: (503) 718-