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Permit • il � � CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT PERMIT #: PLM2006 -00585 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/12/2006 PARCEL: 2S 114 BB -08600 SITE ADDRESS: 16300 SW 104TH AVE ZONING: R -12 SUBDIVISION: SWANSONS GLEN LOT: 027 JURISDICTION: TIG Project Description: Replace 50' of water service. 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: SEWER LINE: ft WATER CLOSETS: WATER LINE: 50 ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES DAN GOTT Description Date Amount 16300 SW 104TH AVE TIGARD, OR 97224 [PLUMB] Permit Fee 12/12/200E $72.50 [TAX] 8% State Surcha 12/12/200E $5.80 Phone : 503- 624 -9884 Total $78.30 Contractor: DETEMPLE CO INC 1951 NW OVERTON ST PORTLAND, OR 97209 REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 227 -2641 FAX 503- 274 -7686 Reg #: LIC 2510 PLM 26 -25PB 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: -� z , ate Permittee Signature: __CR_ C\ `I N 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. DEC /12 /2006 /TUE 01:47 PM DETEMPLE PLUMBING CO FAX No. 503 274 7686 P.001 • Plumbing Permit Application l'OR 01:11C USE ONLY C O f Tl •/. - / Received /� I 1 Dntc/Byi, '42 • 9, Permit No � � v: 13125 W "1 `t ` ard, OR 9722 , 7 , a ',.i,.' 1 'tYi 1 1 . • ' ... Rik: 5033981 60 . B view : . _ :. /� Datc/y:.. • : Other permit No,: t: ,'1 , Go, i',. : 503.639-4175 . • ` . . Date Ready/By: funs:' ' .E3 Seep e 2 for. TIG'AFD •.P' • � '' Page • , ., et: www,ttgard- or.gov Notitied/Method: ,!emental .. . .: ...... , ... , .._ � ..,,- :., ::.:.,., - ,,,a.„„ „�;, w,v,�s:,. ,<�. .�.rTnformutio , r , Su n M ' ..,. . -... ..... ._.... 1 . n " w t ■ ....a,.,... . .. n„o-. . -,... „ ^. ^+} " 'rv,: . . , .... ... ...............r..,.F,�.. ,, ,, it -,.. a, � . , .,,......, ,,,:w„ ..... .. ?po � p�.;,: !!``1^ .�,...' ,.,,CY., ;,fir..:, %M" ,, . ,+ n .t J� 41I� 0 ! V ............. .. .. . .. ... . .... .._.a,,.w „ a,v. .,t. UYS 4'� �5�. .. _.. .., _.... ...... .. . .. . � , w . . „ . .. .. ... , , .. n.tvwal:y „:h: ° Y! „49,Y, � Jx. ,1.. .y. .. < . ,.. . .. . ..__ ...... :1 � ,,, A7 ..,,,. e., R... .,........_...c. ....,... ....._,. , .� s�.r., �. ,.. ... R....,. _....a .. �: G' t.:;.... a.. �.. ^. } , ..:i:.µ ...... �. :r.l. ..... . .:.., ...........r.,�•.: ,Ye. .. ,w ,�... .. v .�Y'^ , ....n...r.. ^v. [] New construcii� : ., O. Demolition' y d n ' , For special ; »�or ,anon use checklist. ' a v . •' . , Description 1 Qty I • . E. ` Total ® Addition/al ,.'b a rel ��. ❑ Other: • . New 1- 2 -faml dwellin s Includes• 100 ft: for each utili connection . .... o� i....,�,� ...,:.i,; . .,rr:rr:,.w:M:^_, x,•,• r . v . .. .i dc574ylg7r;,,! 1 <..:' . :rrv: •.e'.,... > "�; ,: { ;:;"�e:;i "pA ^.YZ.rw::;f'�.ca:• ... , . „ °'''' ;:� t y \rt1e(i ( 1 Ihw 1.7.,71- ; "�,.'.:. ,r, r t,. ' SFR(1)bath 24920 ) • . 0.1 - and 2s `;+- .welling ❑Commercial/industtial ' • - SFR 350.00' • ' ❑ Accessory building El Multi - family SFR (3) bath 399.00 Each additional bath/Intchen 45.00 Q Master builder. ID Other:* .:. V. J. I .. ... .... ... '.., ,.. ..! _( .. .,: ... .. .,., �� .� ' �; y .'::, :.. '`}':: t..r - , • • ,:,, � Firo splillklor ( sq: ft.). • Page 2' _ to :� u� .6 �_1 rt a �� >ta:lu " ",`ef'c t,. • .,. .:...:: .....: �` �...: �,., 1: ..:.. j., �, lr._. i a' �,^ I �, ,...,,.:..�..:..x�,,�.a,,,.,�t " -' "'' .. . . : ...... .:•:.: •::,: :.. a „ . Sit u tiliti es ' • Job site address: 16300 SW 104 Ave . • : . " , • • • Cetch.basin or area drain . ' • • 16.60 City /State /Z1P: Tigard, OR 97224 - .. Drywell, leach' line, or trench drain • • • . 16.60 • • Suite/bldg. /apt_no.: ,. , I Project name: Gott, Dan • . Footing drain (no. linear ft: _) • Page 2 :. ' Mariufacturcd home utilities 110.00 Cross street/directions to job site: • -. - ' Manholes " . , -. - • 16,60. .. Rain drain connector ' • • • 16.60 Sanitary sewer (no. linear ft.: ) , . Fage 2 ' Storm sewer (no: linter ft.; _)" Subdivision: I T of no.: Water service (no. linear ft.: 50') 50 •. Page 2 55.00 Tax x re or Item ax map /parcel no to FI it OnVBVe • C: Y • Dl:k tv I': :............... :.,.,' . ..... % ",,:Y..,,'<.:_•,.,1 ')1 . t f1 i b e ..C. a ......: r ':g'.. . ,.,,.n,�,a�; _ . Backflow pr ,„ Page 2 Replace 50' of water. service : ' , Backwater ' Backwater valve '16.60' Clothes washer 16.60 . ' Dishwasher 16.60 ^ar:.r r.<ra;x +..•.r.: ":arse. ^ce::e a,cA S,Fyx:;' ::,tie ...y::.,: >..r:> :N , ,r.u;„ • v �w ; i a e ,Y . �. Dunkin fountain 16.60 "''1! .aril . C ,.r:'% "' - ° .� i;: "i;�` g m�. t r� r •�:•S.' � . ... .......... ... ..".. :., ,.c.,.�;,':•i� "� ,;: r ...ar!,•• .., ���., .... ...,,,,:;{�o!r.;.1r ., w ti:w _ w'. tFwcrr,. :.... _..,.;..,�.:. gjxtors /sump 16.60 Name: Dan Gott Expansion tank . 16.60 Address: 16300 SW 104 Ave • ' . ' Fixture/sewer cap • 16.60 • City /State /ZIP: Tigard, OR 97224 • Floor drain/floor sink/hub 16.60 ' Phone: (503)624.9884 Fag: ( ) .• ' . , Garbage disposal 16.60 .l ... .•,: •, - n':; ^. .,:. as T` ".1T•.: /, ':l'. "'F`:; ;' %'d ",' tR '�_' a,:V;m ,: "..,;._..,:�.: >:, „ .,...., «'., „,.,, - .,�...,..ti,..,,. '' s Floacblb 16.60 .p.,w:: ,�s•wrr'rr..x.: e ...� r,: ,: , ,;:,,.,:.„.,. .•. :.'i.i.,' „:':.o r .. .,.,.„,. .x.,...... . G4...,.V.a L ir'r,.V { .,. :..; ....Mr.,,.. r .........::.: 1 Ch.,ci4��' ..� .. ......... .............. � ...,....... ,, i1., 1.,.. r ..�i.I� _......,.. � &fit " - �,`�+Y�„� : l maker ' . 16.60 ' Business name: same as bel ' Interceptor/grease trap 16.60 • .Contact name: - ' Medieal:gas (value: $ ) " 'Page 2 " • • Address: - • 5 Primer 16.60 City/State/ZIP: • Roof drain (commercial) . . 16.60 Phone: ( ) f Fax:: ( ) ` • • •' ' SinI /basxn/lavatory .. , 16.60 . 1. Tub /shower /shower pan .. 16.60 E -mail: .. • Urinal 16.60 .::,..., �::::... ti;.,:-. :. a„ v:. v.•: n, S :. vv,: aa._ r• .w, ....._..,:,,, .:i :,::K. yct. -r . •r - ;; c at �iat4 ..,.,. �. .r . " ? ,.,,.._. atercloa 16.60 Business name: DeTemple Co., •Inc. - ' ' ' Water heater . • 16.60 • Address: 1951 NW Overton ' , Other City /State /Z P: Portland, OR 97209 Subtotal . 55.00 Minimum permit fee: $72.50 . 72.50 • Phone: (503) 227.2641 ' , Fax: (503) 274.7686. . " Residential backflow minimum permit fee: $36.25 • CC$ Lic,: 2510 Plumbing Lie. no,: 26-25 I'S Plan review (25% of permit fee) . . State surcharge (8% of permit fee) ' 5,50 . Authorized signa ' . TOTAL PERMIT F 3E • 78.30 I Print name: Shalynn Garcia • Date: 12.12.06 This permit application expires if a permit is not obtained within '- 180 days after it has been accepted as complete. *Pee methodology act by Tri- County Building Industry Service Board. I: ABUTlein6 \PermitslPLM 06/26 106 . •--� 440 -06 ) - CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2006-00585 13125 SW Hall Blvd., Tigard, OR 97223 ,__ • • DATE ISSUED: 12/12/2006 Phone: (503) 639-4171 Avolov tilq\ Inspection Requests (24 Hrs.): (503) 639-4175 A - ti. DATE: 12114/2006 PAGE: INSPECTION WORKSHEET FOR TIME: 7:02AM 45 SITE ADDRESS: 16300 SW 104TH AVE CLASS OF WORK: SUBDIVISION: SWANSONS GLEN LOT #: 027 TYPE OF USE: PROJECT NAME: GOTT DESCRIPTION: Rep1aCe'54r 'otitirater. service: OWNER: Gorr, DAN PHONE #: 603-6249884 CONTRACTOR: DETEMPLE CO INC PHONE #: 503-227-2541 Inspection Request Scheduled For: Date: 12114/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 330 Water service 041075-01 503-227-2641 N Corrections/Comments/Instructions: PASS n PARTIAL APPROVAL n CANCEL 0 NO ACCESS FAIL n CALL FOR INSPECTION I I ADDITION , FE S ASSESSED Inspector: air Date: 1 / ,06 Phone #: (503) 718- , • CITY OF TIGARD _ . ,.,1 NJ 0?) q6 BUILDING DIVISION PERMIT #: 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 : illop I litl Inspection Requests (24 Hrs.): (503) 639 -4175 _,� `__ INSPECTION WORKSHEET FOR DATE: 1 TIME: g/ 1 PAGE: l SITE ADDRESS: \ (Q I 60 9 614 CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: t Inspection Request Sc For: Date: Pour Time: Code # , Inspection Description Confirm # Contact # Message V6 Pim --' .4- Corrections /Comments/ Instructions: \i UicA - '. j V .S IP 4 AL* . ! 0 vv, Lik eki; t4-e I iM9MIA6 11 t 1111, r et-Nr cP• 6V - 6 ,,-P \NI Liti _ A 1 t) Lk_ c,ac,e_j 12/14 / 0 co (cA) _, .C.' Y1k_L�5t r c b/l — ) /p (0 32- - 4 c - L-42 %c e- to / / 6-C- '. i AS PASS PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED )///),- Ins ect : Date: / 6/9/0 V 718- 2qZ� p or. Date. Phone #: (503) 718 CITY OF TIGARD °- ' - •e�I�� / 610'00 ��` BUILDING DIVISION PERMIT #: i 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 !zit fl\ Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: ) D/r ,, TIME: PAGE: SITE ADDRESS: I (.G/3 O 0 ) 6 '4 P')14 - CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message `444 P L m Uj6J 91- Le - Corrections /Comments /Instructions: 1 0-14 46/1/L■fti W 0 -0 - 1 c(" 4 C.A.-- C V (/' ---- 4 C. mow (2.9_,r" 59--. (off 1 4...... . jit it.. ..,..,// PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS FAIL H CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED \li &., o t e6 2*21f° Inspector: Date: Phone #: (503) 718 - e