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Permit
CITY TIGARD PLUMBING PERMIT Te , i DEVELOPMENT SERVICES PERMIT #: PLM2005 - 00460 �'� � I DATE ISSUED: 9/14/2005 = 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1 S135DB -08800 SITE ADDRESS: 11160 SW 93RD AVE ZONING: R - 4.5 SUBDIVISION: ASHBROOK FARM LOT: 023 JURISDICTION: TIG Project Description: Replace shower valve. 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: TUB /SHOWERS: 1 SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft • Owner: FEES JEFF ROAKE 11160 SW 93RD AVE Description Date Amount TIGARD, OR 97223 [PLUMB] Permit Fee 9/14/2005 $72.50 [TAX] 8% State Surcha 9/14/2005 $5.80 Phone : 503- 620 -6932 Total $78.30 Contractor: CROWN PLUMBING 5429 SE FRANCIS PORTLAND, OR 97206 REQUIRED ITEMS AND REPORTS Phone : 503- 771 -9449 • Reg #: LIC 42671 PLM 34 -70PB • 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: - 717,6 . 21 Permittee Signature: 1--rc 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. J/2005 06:41 503 -771 -9454 CROWN PLUMBING PAGE 01 �II1 iglg Permit A s - !s . � 1 IV O) 1 ; 1 i l ' i f t i U kt ()l`1 1c r l d' bL t1 \.I ti' :I ., • (City ®�'' 'i�;�t ;r¢i AL ` : Permit NC-.7 l G�3 a b . 13125 SW i aai Blvd., Tigard, OR 97223 �' Phone: 50? 6:1).4171 Fax: 503.598,1960 s. Nun Review S��' LO t >*,rd " I Date/By: Other Petc,4it Nn.: 24- (tour In gip ' lion Line: X03,639 4175 �] �' 1-,1 i°1 I •. ' , Iuris: Internet: w ne ci.tigard.gr,us �' - - Date [t dfMetb y; S See cat 2 for r '•,k!t: ; • I' --r; + tJOeiedMretbod' - TAT" 5upplementallnfornteitou • � .L + r : • .V:: w. ',t v ;' /yr : '' ,.; i'r': , l +spa ?'.. ''4•."4).'."."'''"`""'•'';''''':•'"':''''''''' ;.,'••, t i , r t ?1,; r -ot Wit. t =' y ' ti ' ,l': .li1� �i -�� a {' ' � ,� „•. .J�iJ�'r�'�Ik _ � ' Fw4 n17 t' y. : , YvLL , ) , - .: . ,,, :.... 1' 1`t�i:, :.. i .. °t:y .... -..., ' +:� \� ' C . :1 _,x ., ."1 +11,,.rv ❑ hlcwv on ;fl 1 ❑Demo i[ion For special infonm use ckerklist. �.�...-_ _ -'- Description rrion - tv, Ea. Total ® Addition .alt ration /replacement • CI Other: "" _,, ^ New l- 2-family dwellings (include 1(10 ft. for each utility connection) ' � l J'r 1 7,•:, ;; "r' >i;'; '..r,';;,.ii,5':4i: gi ' mi, : . `4:.:; , i.' j , �' cif. '4 i.i ' :11 - `f t •`..'19 ' . O.l�''' �., r y'c' :; . .r -�r.,1 SIR (1) bath 4 • 1i:l , i '.. - �,4 . , • ;a° . ,;, , ?•t.• � ) 2 9 20 0 1 - and. 2 - . "aridly dwelling ❑ Comr:• ercial /industrial SFR (2) bath 350.00 ❑ Aceessoi ,r b wilding . ❑ .Multi.. Family , - , SFR (3) bath 399.00 '�'�'""° -- Each additional bath/kitchen 45.00 © Masterb liiror ❑ Other: -- - - - '1,77-4r;`;(41 - .;,: i':f: ,., - Fire sprinkler ( sq. fl -) Page 2 1 ! ( 7`.. t'+ ti 4 "� "k' ��� A' ,4:%:r,k• -4 ;,,,L,:; ,:; ia '[` ;.r: !rjrit `. ' .`iu N1(1 i' ii ,.r. p ` ' 3 r �' `;; .rj . , t' f z_ 1u ,.r a ., ..... r..r, .. !„ .,,:; ,.,, , ..; ...!.,i: +;),• 7 . 4 . Site utilities Job site add- acs: 11160 SW 93rd AVENUE Catch basin or area drain �_ 16.60 I City/State/Z:17); FIGARD, OR 97223 Orywell, leach line, or trench drain 16.60 Saitrlbldg. /a at, no.: Prcrjeet name; Footing drain (nn, linear LL.; _,•) w Page 2 "- -•' Manufactured home utilities 1.10.00 Cross street/ lart coons to job site: , -- --^-- - ' M anholes 16.60 „- _ Rain drain connector 16 - 60 - _- _ _ _� Sanitary sewer (no. linear ft.; ) Page 2 ` Storm sewer (no. linear ft,: l Page 2 Subdivision: Lot no.: Water service (na, linear ft,: ) Page 2 -- ..... .�� 'lax reap /par :el no.: -" Fixture or item , ^ -., . , ,,._ Absorption valve 16.60 s• ' ,i�'tii.i ' ;` i ;; 'aim ; ::,7. ;. s .. ,,1 - -: ._Y. : <" gg r : ( '. I'. ',,� .P'; {i1:,: .. ,,:,( .. ''ir ?rY;p'� ? ,cr !�'.. .: :., ,. ; � 'r; � 'M1 , - - - : Fr + igni4,4 ;:.11:3., .., . i 7.4',' "` „•' F ;> i �,� , ,3 ,i; ; :. :,,tir:x. r i ,1.. . - . , '..�r.rR1.,., . h.._ .r.: Backflow prtwcttter Page 2 REPLACEP SENT SHOWER VALVE • Backwater valve 16.60 �� Clothes washer 16.60 _ •:' . Oishwashcr - -• ^�- 16.60 y ... n::... . i,.S)' I ,,, .R,.;...: -, '�, {;.::;'? , ; �"r�"""'' DrinRin ^fountain rro, r ► 'r` i..:; : ..j„ ,, ._ _,; t• °•: d ° it'r���Q� h`tFi•h°lt r:°N Itt•,i,,: ";,;t'•'':; ",: = :❑LATE,' , a.;a -___ 1660 �- Cton /sum 16.60 NLIme; RtOA ;C�, JG.I'T _ Expansion tank . -� 16.60 - Address; SA in, AS ABOVE '. , _. -- Fixture/Sewer tute /sewer cap � 16.50 City /State/11 '': FIoor drain /floor sink/hub 16.60 __ Phone: (503) :4214932 'Fax; ( w ) - G arbage disposal 16.60 -- ^r�r:;" -*^ .• w-� - -�;- ,,,•..r- u,T�. � �. Bose bib ;_;hill ;r i"' „4 ' : a' ; qy ' ; ,., .-t. ':- iS%alt�i,lt;,;,•, a' -;ri' ;?'re i•;i?i'd;: 16.60 6 . >;�a> 't til! ?I ?I : ..if :... ,. . �• °�!:i.'J -i; : � J,W. ::.: lee maker 16,60 Business nan c: CROWN PLUMBING,. _ lnterceptorMreasctrap 16.60 Contact nan : DENNIS UNDERWOOD, DISPATCHER Medical gas (value: $ ) �_ Page 2 Address: 5429 SE FRANC:I:S STREET Primer I6.60 City /State /ZI': PORTLAND, OR 97206 Roof drain (commercial) 16,60 Sink/basin/lavatory (503) 771 -9449 Fax:: (50.:) 771 -9454 - - 16.60 - 'rub/shower/shower pan I 16.60 E - mail: - :;.::,., -> i; � Urinal 16.60 }.P:, ':;t.9,a. =t, �;f ■ ;v�'r � :;�� ...... :.i• ;1 jb.•:..,n . „ :,�:. 1111..::...: ' ,.,..�: ;.' "lit' ^i?;: i:,t, Water closet Business nary e: CROWN PLUMBING "- 16 60 Water heater 16,60 - Address: ;429 SE ICRANC1S STREET Other: City/State/Z11.: PORTLAND, OR 97206 . Subtotal Minimum permit fee: $7 r''hanc: (503) .'T -9449 Fax: (503; 771 -9454 Residential baeldlow minimum permit fee: $36.25 7 Z .S0 CC13 Lie.: 42 i7) Plumbing :.ic_ 110 r OPB Plan review (25% of permit fee) Authorized si Fitt turn: State surcharge (8% of permit 'fee) , . YO .' _ TOTAL PERMIT FEE e, 3c, Print name: 10 en pis Underwood Date: 09 -12 -2005 • This permit application expires if a permit Is not obtained within - - 180 days after It has been accepted as complete. *Fcc methodology sel by Tri- Count 13uilding Industry Service Board. I: \n1111gi, \rermitsl :Li _l' rmirApp 400; 12/03 440- s1 cr(tt (e /COM/WEa) • CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2005 -00460 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/14/2005 Phone: (503) 639 -4171 / iatiiyp�gl'�I +I Inspection Requests (24 Hrs.): (503) 639 -4175 .. ' -_-. INSPECTION WORKSHEET FOR DATE: 9/20/2005 TIME: 7 :07AM PAGE: 65 SITE ADDRESS: 11160 SW 93RD AVE CLASS OF WORK: ' SUBDIVISION: ASHBROOK FARM LOT #: 023 TYPE OF USE: , PROJECT NAME: ROAKE DESCRIPTION: Replace shower valve. OWNER: ROAKE, JEFF PHONE #: 503 - 620 -6932 CONTRACTOR: CROWN PLUMBING .7 1)2A4 In.„ () PHONE #: 503 - 771 -9449 Inspection Request Scheduled For: Date: 9/20/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 016100 -01 503-771-9449 i s c -. "7 3 S Corrections /Comments /Instruction • ii) � kr O ett,„„ic ,,% i o k7(.-eA^ (0/IL- - k---vn‘ I__ _ms■ /1.0b/O .c , CfV i r d- ■r' . 0 PASS n PARTIAL APPROVAL I li CANCEL n NO ACCESS ❑ FAIL n CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED )et' v� Inspector: -- Date: 9 /4 Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION �- PERMIT #: 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 � I �� Inspection Requests (24 Hrs.): (503) 639 -4175 J INSPECTION WORKSHEET FOR DATE: TIME: - PAGE: / 10 SITE ADDRESS: 1116 b CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: g' 0446 - DESCRIPTION: F cppL, -e ,fiL,, OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message ° I q r L . 0(` 1 11 /4 v, I I' /AI O /'7e - =v I Corrections /Comments /Instructions: �) . de C ( PASS U PARTIAL APPROVAL CANCEL ❑ NO ACCESS I I FAIL CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED Inspector: D ate: Phone #: (503) 718- E r z PLM2005 -00460 ,,a +,, 9/14/2005 9/30/2005 7:41 AM 110 III 11160 SW 93RD AVE ASHBROOK FARM 023 ROAKE Replace shower valve. ROAKE, JEFF 503 - 620 -6932 CROWN PLUMBING 503 - 771 -9449 9/30/2005 399 Plumbing final• 017035 -01 503 - 771 -9449 Y r/'