Permit CITY TIGARD PLUMBING PERMIT
` { DEVELOPMENT SERVICES PERMIT #: PL /19/20 -00580
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/19/2005
PARCEL: 25111 BD -00411
SITE ADDRESS: 14965 SW 96TH AVE ZONING: R -3.5
SUBDIVISION: DARMEL NO. 3 LOT: 031 JURISDICTION: TIG
Project Description: Replace fixtures & change direction of tub.
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: 1 OTHER FIXTURES:
TUB /SHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
KIMBERLY ZENZANO Description Date Amount
14965 SW 96TH AVE •
TIGARD, OR 97224 [PLUMB] Permit Fee 10/19/200`. $72.50
[TAX] 8% State Surchari 10/19/200`. $5.80
Phone : 503 684 - 9057 Total $78.30
Contractor:
POWER PLUMBING CO
P O BOX 19418 REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97280
Phone : 503- 244 -1900
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 -669 or 1- 800 - 332 -2344.
•
Issued By: � Permittee Signatur-: 1111 _ • _A
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.
Plumbing Permit Appl .I " , 'T / FOR OFFICE I. 1 ONLY
City of Tigard a %U f 4 3.--- 0 /�� - N :: ) ,2g()
u 13 i25 SW Nall B Tigard, ud, OR 97223 OM 200
Phone: 503.639.4171 Fax: 501598.1960 �:.r .0:1,,1 Other Permit No.:
24- Hour Inspection .Lae: 503.639A175 j,l ` :' 1 Date > !d See Page 2 for
Intemet wt*aw_a�_ ig ni.a r.us CITY OF Noti T1/fr.. Supp tal
BU D!VI ILDING DIVI£ION
TYPE OF WORK FEE' SCHEDULE
❑ New coon ❑ Demolition For Wired inmlian use dm-Mt
0 Additio lalteaation lacement ❑ Other: New tam ( ( Ea. N n Tea
� 1� 1- family dwellings (includes 100 ft_ for each utility nnutia))
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
TC 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
❑ A building ❑ Multi- family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master bu ❑ Other
Fire sprinkler ( sq. il.) Page 2
JOB SI'M'INFORMATION AND LOCATION ' Site utilities
Job site : I Ln k. D COL) 1 l t \L Catch basin or area drain 16.60
City/StatelZEP: ' G. r d 1i - 0 .. - - , ' - Drywall, leach line, or treat drain 16.60 j
Suite/bldg./apt apt no.: Y\ W.. I Project name: r (- r� Pouting drain (na. liners it: Page 2 j h
L Maatufactruod home utilities 110.00
Cross street) to job site: /3 o d� - t c \ Ct c ., 1 l 1�' l • 1c ■ - Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear It. ) Page 2
Storm sewer (no_ linear Pt: _) Page 2
Subdivision: 1 Lot no.:
Water service (no. linear ft.: j Page 2
Fixture or item
Tax no.:
Alumina] valve 16.60 9
I D�RIPTION OF WORK I;ar3 iiow prevtrtta r Page 2
QS\Qr -\'\ V;1 D C 1 Q_ I(1'1 -CL. t () t•1 .--c-ol -An Backwater valve 16.60
\ c' Q_t N6 ` c t 11k ` 4-\6 . 1 Clothes washer 16.60
Dishwasher 16,60
it5i( Tknnlamg fountain 16,60
PROPERTY OWNER , 0 TENANT
Ejectors/sump 16.60
Name: 7 e_07 PA t 0 .: t c) _I b o r, wi' K.i () lbQ-c I Li Expansion tank • 16.60
Address: •I I ,C p /_, (AD � � S2 - .� 1 Fixture/sewer cap 16.60
City/State/ZIP: --\ 1r i O c\t`i 7L-f Floor drain/floor sink/hub 16.60
Phone: Ildi (C Ll - C(Dr-D'--'1 Fax: ( ) Garbage disposal 16.60
. (k APPLICANT ❑ CONTACT PERSON Hose bib 16.60
/ Ice maker 16.60
Business name:
9 L Interceptor /grease trap 16.60
C o n t a c t as ee: 7 Q 1 - - - ) 7 £ E r i r\ t ( Y . CI \-i Medical gas (value: $ ) Page 2
l "1
Address` \ U C > G J 1/4_ 1/4_ n ) �"10' -1 Ti'0 Primer 16.60 .
i Roof drain (commercial) 16.60
City/ ?Z[P: 1 C�( - ci- 01L O ; lZ ?,
Pho ` LQ�-1- °10` =2) ) I Fax :: ( )
Sink/basin/lavatory 16.60
Tub/shower/shower pan I 16.60
E-maiL Urinal 16.60
CONTRACTOR Water closet ` 16.60
Business name lYl�Q( il ,. l h I Water heater 16.60
Address: S�f Z ✓ _ ! _,r-• ,, ..-. - ri • . _ _ / Other
`���1JJ Subtotal
C /StaterBP L _ - ` V v . Mmrmam permit fee: $72.50
Phone: (W ' 3 ° i - / 9Z Y Fax: (g3) G ZU -t ' 3 , Residential backtlow minimum permit fee: $36.25
CCB I. Plumbing Lic. no.: �/ f
0 7 ? Plan review (25% of pe nit fee)
� _ p q t Slate surcharge (8% of permit fee)
AutlECttlzOd _
: \ ► 1 l �), f tQ X' o TOTAL PERMIT FEE
I Print name: ( Date: I This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
x
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005 -00680
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/19/2005
Phone: (503) 639 -4171 ■air 7pu�t�;� l ��
Inspection Requests (24 Hrs.): (503) 639 -4175 �'!'i "`:_..
INSPECTION WORKSHEET FOR DATE: 11/7/2005 TIME: 7:05AM PAGE: 6
SITE ADDRESS: 14965 SW 96TH AVE CLASS OF WORK:
SUBDIVISION: DARMEL NO. 3 LOT #: 031 TYPE OF USE:
PROJECT NAME: ZENZANO
DESCRIPTION: Replace .fixtures . &change direction. of tub.
OWNER: ZENZANO, KIMBERLY PHONE #: 503 -684 -9057
CONTRACTOR: POWER PLUMBING CO PHONE #: 503- 244-1900
•
Inspection Request Scheduled For: Date: 11/7/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 020497 -01 503.684 -9057 N
Corrections /Comments /Instructions:
SASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I I FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: � Date: t t /aj Phone #: (503) 718-
N
CITY OF TIGA.R ti�
BUILDING DIVISION PERMIT #: PLM2005 -00580
13125 SW Hall Blvd., Tigard, OR 97223 �u. DATE ISSUED: 10/19/2005
• Phone: (503) 639 -4171 h��u fm„i ;�l�lil
Inspection Requests (24 Hrs.): (503) 639 -4175 :�' W
L
INSPECTION WORKSHEET FOR DATE: 10/20/2005 TIME: 7:09AM PAGE: 62
SITE ADDRESS: 14965 SW 96TN AVE CLASS OF WORK:
SUBDIVISION: DARMEL NO. 3 LOT #: 031 TYPE OF USE:
PROJECT NAME: ZENZANO
DESCRIPTION: Replace fixtures & change direction of tub.
OWNER: ZENZANO, KIMBERLY PHONE #: 503- 684 -9057
CONTRACTOR: POWER PLUMBING CO PHONE #: 503- 244-1900
Inspection Request Scheduled For: Date: 10/20/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 018835 -01 503-684-9057 N
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ! 1 ` I Date: 10 12a ` 1 Phone #: (503) 718-