Permit I
CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2006 -00466
. I II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/10/2006
PARCEL: 1 S 135DB -05400
SITE ADDRESS: 11390 SW 94TH AVE ZONING: R - 4.5
SUBDIVISION: MILLER LOT: 001 JURISDICTION: TIG
Project Description: jaccuzi tub, shower install. Replace mixer valve other fixture.
CLASS OF WORK: ALT 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: 2 SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
BALES, MARY ELIZABETH +
TERRY VERN Description Date Amount
11390 SW 94TH AVE [PLUMB] Permit Fee 10/10/200€ $72.50
TIGARD, OR 97223 [TAX] 8% State Surcha 10/10/200€ $5.80
Phone : 503- 819 -4316 Total $78.30
Contractor:
PAUL'S PLUMBING
5516 SE FOXFIRE WAY
MIKWAUKIE, OR 97222 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 245 -9092
Reg #: LIC 60961
PLM 3 -237PB
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: , 64it/i/` -04-- Permittee Signature•
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.
P r
`j'c'-cON co U // Plumb g Permit Application nt�t�
3 2, Washington County Phone: 503 -846 -3470, Fax: 503 -846 -3993, Inspec � R ec ines ►5�3 -846 -3699
..). 155 N. 1 AV, Suite 350 -12, Hillsboro, OR 97124 www.co.washin J: ton ..or
012EGO Land Use Approval: Project # Pe ' ' al ./Y10----, ' OQc kb
°, Ii t�4T�-
TYPE OF :WORK . ,_ , FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist.
Description Qty. Ea. Total
Ad dition/alteration/replacement ❑ Other: New 1- 2 family dwellings (includes 100 ft. for each utility connection)
Eft ' . ; CATEGORY OF CONSTRUCTION, _ - SFR (1) bath 318.00
- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 408.00
❑ Accessory building ❑ Multi - family SFR (3) bath 498.00
❑ Master builder ❑Other: Each additional bath/kitchen 90.00
. _ . . Fire sprinkler (# sq. ft.) By Sq. n.
- JOB ' SITE - INFORMATION =AND, L . CATION, .. a Site utilities
Job site address: / ( ' At 14\ \ /�
( 3 �/S `(� /'►-C� "ei Catch basin or area drain 14.50
City /State /ZIP: T c t ( / Q g 7 ?--)' 3 Drywell, leach line, or trench drain 14.50
Suite /bldg. /apt. no.: Project name: �� �F� •
Footing drain (each 100 ft): # of ft. 42.00
pc. S
77 Manufactured home utilities 96.00
Cross street/directions to job site:
S / , //� Manholes 14.50
k/ lS/ 6 � ' e t-� Ott re { o 9 1 1 .4 " -I '' --
`L Rain drain connector 14.50
Sanitary sewer (each 100 ft.): # of ft. 42.00
Storm sewer (each 100 ft.): # of ft. 42.00
Subdivision: Lot no.: Water service (each 100 ft.): # of ft. 42.00
Tax map /parcel no.: R 'e o q Fixture or item
Absorption valve 14.50
° ' ' ' .DESCRIPTION O WORK' . . , ' ,',:i. '' , "
Backflow preventer 14.50
` -y` 5 h g-a- !. it i i -1-Gt. 6 Backwater valve 14.50 .
J r Clothes washer 14.50
A c Dishwasher 14.50
Drinking fountain 14.50
Ejectors /sump 14.50
. ❑ PROPERT■''OWNER ; , ❑'TENANT „ .
Expansion tank 14.50
Name: ./In/� i
' ci 4 . VS 4. � Fixture /sewer cap 14.50
Address: V ''4( aZ CZ/1-1Vit/ Floor drain /floor sink /hub 14.50
City /State /ZIP: Garbage disposal 14.50
.' / �J�� Phone: C 1...4 2 . l
3) L O1 .. � Fax: ( ) Hose bib 14.50
�/ APPLICANT Ice maker 14.50
'❑ . . ❑CONT PERSON.
- Interceptor /grease trap 14.50
Business name: Medical gas (value: $ ) By Value
Contact name: Primer 14.50
Address: Roof drain (commercial) 14.50
City /State /ZIP: Sink/basin/lavatory 14.50
Tub /shower /shower pan 14.50
Phone: ( ) Fax:: ( )
Urinal 14.50
E -mail: Water closet 14.50
. CONTRACTOR ° `. ' . Water heater 14.50
Business name: ra - s ti �, „ Other:
Address: 6,5/L � g cu,,, ' a,c F , r . � t a, t,�1 � J Other:
Subtotal
City /State /ZIP: A l f (GOei- .;c.aee``t i o 1' V--2-et..------ Minimum permit fee 7o7.Sb
Phone: (603) aq , c a ? Fax: ( ) Plan review (65% of permit fee) $
CCB lic.: (7 0 ( Lic. no.: 3 ?-3 ? f State surcharge (8 %ofpernitfee) $ S.F�
(��/ TOTAL PERMIT FEE $ 7 z 3)
Authorized '� F / (i at ,,, 41_1.- This permit application expires if a permit is not obtained within
signature: S(>L��� , l O 180 days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry Service Board
Print name: Date: 440 -46I6T (7 /03 /COM /WEB)
10/.1)72.0§Y
CITY OF TIGARD
13125'S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
PAUL'S PLUMBING
5516 SE FOXFIRE WAY
MIKWAUKIE, OR 97222
Plumbing Signature Form
Permit #: PLM2006 -00466
Date Issued:
Parcel: 1 S135DB -05400
Site Address: 11390 SW 94TH AVE
Subdivision: MILLER
Block: Lot: 001
Jurisdiction: R - 4.5
Zoning: TIG
Remarks: jaccuzi tub, shower install. Replace mixer valve other fixture.
Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the plumbing
permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing
Signature Form prior to the start of the work to the address above, ATTN: Building Division.
No plumbing inspections will be authorized until this completed form is received
OWNER: PLUMBING CONTRACTOR:
BALES, MARY ELIZABETH + PAUL'S PLUMBING
TERRY VERN 5516 SE FOXFIRE WAY
11390 SW 94TH AVE MIKWAUKIE, OR 97222
TIGARD, OR 97223
Phone #:503 -819 -4316 Phone #: 503- 245 -9092
Reg #: LIC 60961
PLM 3 -237PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X �.
Signature of Ad Plumber
If you have any questions, please call 503.718.2433.
•
CITY OF TIGARD _
BUILDING DIVISION PERMIT #: PLM2006-00466
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/10/2006
Phone: (503) 639 -4171 o�j�l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/13/2006 TIME: 7:04AM PAGE: 79
SITE ADDRESS: 11390 SW 94TH AVE CLASS OF WORK:
SUBDIVISION: MILLER LOT #: 001 TYPE OF USE:
PROJECT NAME: BALES
DESCRIPTION: jaccuzi tub, shower install. Replace mixer vatve other fixture.
OWNER: BALES, MARY ELIZABETH +, • PHONE #: 503 - %4316
CONTRACTOR: PAUL'S PLUMBING PHONE #: 503 -245 -9092
Inspection Request Scheduled For: Date: 11/13/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Mes
399 Plumbing final 039611 -01 503- 519.1206 Y
Corrections /Comments /Instructions:
•
•
`; PASS H PARTIAL APPROVAL n CANCEL n NO ACCESS
FAIL CALL FOR INSPECTION I 1 ADDITIONAL FEES ASSESSED
Inspector: -ih Date: // 1,S 0.6 Phone #: (503) 718- Z-6 •Y f
CITY OF TIGARD A
BUILDING DIVISION PERMIT #: PLM200&00466
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/10/2006
Phone: (503) 639 -4171 .. ,, "Alt
Inspection Requests (24 Hrs.): (503) 639 -4175 "__..
INSPECTION WORKSHEET FOR DATE: 11/3/2006 , ! TIME: 7 :01AM PAGE: 59
SITE ADDRESS: 11390 SW 94TH AVE CLASS OF WORK:
SUBDIVISION: MILLER • LOT #: 001 TYPE OF USE:
PROJECT NAME: BALES '
DESCRIPTION: jaccuzi tub, shower install. Replace mixer valve other fixture.
OWNER: BALES, MARY ELIZABETH +, PHONE #: 503-819-4316 •
CONTRACTOR: PAUL'S PLUMBING PHONE #: 503.24&.9082
Inspection Request Scheduled For: Date: 11/3/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
32.2 Shower pan 039261 -01 503- 519-0299 Y
Corrections /Comments /Instructions: �//
ry
7 i " y J
f ,
--- ----w
/ '
y
/ /
A"ASS I ] PARTIAL APPROVAL ❑ CANCEL [ I NO ACCESS
I FAIL n CALL FOR INSPECTION 1 ADDITIONAL FEES ASSESSED
i hvro 718- '2_191
Inspector: Date: Phone #: (503) 718