Permit •
C ITY O PLUMBING PERMIT
ire I DEVELOPMENT SERVICES PERMIT #: PLM2006 -10003
~I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 3/1/2006
PARCEL: 1S134DA-05100
SITE ADDRESS: 11330 SW 108TH AVE ZONING: R -4.5
SUBDIVISION: DOREEN COURT LOT: 008 JURISDICTION: TIG
Project Description: Remodel bathroom
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: 2 OTHER FIXTURES:
TUB /SHOWERS: 2 SEWER LINE: ft
WATER CLOSETS: 2 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
ROBERT & L HENEGAR Description Date Amount
11330 SW 108TH
TIGARD, OR 97223 [PLUMB] Permit Fee 3/31/2006 $99.60
[TAX] 8% State Surcharp 3/31/2006 $7.97
Phone : Total $107.57
Contractor:
POWER PLUMBING CO
P O BOX 19418 REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97280
Contact # : PRI 503- 244 -1900
FAX 503- 244 -8825
Reg #: LIC 52378
PLM 34 -150PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -0001 !: - : II rough OAR 952 - 0001 -0100. You may obtain copies of these rul- -.1r direct questions to OUNC by
calling :03-246-66% ,800- 332 -2344.
Issue. By: � • Permittee Sign
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Feb 28 2008 10:02AM POWER PLUMBING CO. 503 244 8825 p.1
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� Plumbin Permit At • "° r E® tout ►It OI •F I :1. 11SM: ON I.i
City of Tigard Received
2 8 2 Pe rmit No.: n
13125 SW Hall Blvd., Tigard, OR 9722 ?--[[ Q Date/Ft . i O�) /, o
Qn Plan Review
Phone: 503.639.4171 Fax: 503.598.1$b
f4 i '6/' ,;
24 Hour Inspection Line: 503 639 4175 -RAIL ' lir Date/By: Other Permit No..
ea
[ntemet www ct tigard ar us F - �(�pR� Notified/Method: Date R dy IB Y ' lE1 See Page 2 for
fied/Met
hod
tu � ^° + l
- Supplemental
c� y � „t'L+� i a # y�� § 5 -•.+ u . 6.tf i ��?:?, ,� ssr.0 - ... �`i: i � �' ' � s.zr� �+ � � ae. U1�'r rc ' .�. x u rc^ :ke � 1 Pp lemental lnforma
rA,,d ,i - 'v.a .uf 3- !1 '� 1 �, ? {i� `^ .e. - R W 'a� .;lip g -i!; s. ` + ; , C I 4i i 1 ,` I! , �;.L`i+e�t A pr.. trV" V _,e {
1 ,:z ^4I,,..�...i :44.,: ;u 4:, :aqi, - , ,,,t,;, .:ae.r,.._- e.:S4L."_:_1t,L, , :: ; i..,:us.14i.49:e: iLt7: ''..a.: Al:3tl, iii ht m2:4., i it .z;; 3, .e :igh - .. r { ,, ` SS 't }' %,- - 9 _Y'`ler ?- _
❑ ew construction ❑ Demolition FOP special information use checklist.
- a'- • ddition/alteration/replacement ❑ Other
Description Qty. I Ea. I Total
,1 R New 1- 2- family dwellings (includes 100 ft. for each utility connection)
:1-1,1 i5 `�i � dw >li t .h'�, .i f y e t Ls Y i st'� ps 7 �� + t t'tr �.xa a � i�
to. e i .t. =,,,I.WATS,., I . i �rt= c' ` @r,.��+.' _"� ` V ' `t SFR (1) bath 249.20
- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
II Accessory building 0 Multi- family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other:
, y �� .�. a 1.�. F> I. .t��°'�„ t ta t� r,rt -, tr x ^'a r r tn+e }� , ii , ,� Fire sprinkler ( sq. It) Page 2
I.: rA5' . 'i : VII kM. �. " df Mn. rl� t 1 .1 x13 t r ` t , .Wra t
�n,o t..u, i121. mil-, , ... Site utilities
Job site address: 1 3.5u Cif ' O Catch basin or area drain 16.60
City /State/ZIP: Al --D--3 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt no.: Proect name: i.� Footing drain (no. linear ft.: ) Page 2
Cross street/directions to job site: Manufactured home utilities 1 10.00
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 no.: Water service (no. linear ft.: ) Page 2
Tax map /parcel no.: Fixture or Item
° tt a Absorption valve
r � . 1 1 �n't ` ^ � jai r 3 �� t . ,F, Eel s i t arP
� ., i.. rz t r pFNk. i" _.. _. -.:....Are-. . �: . Backflow preventer Page 2
16.60
J a'vw� J b- 21.114-c, i Backwater valve 16.60
Clothes washer 16.60
Dishwasher 1 6.60
X' ? ti ..,1.-i....-1-. ie '" d } J r ti . ig date t 3ti•^r` : N If "x' Apt i Drinkin fountain
`I ' . ti: t 1( .: htmN -,.a. -A ,, 1'i ` �r � E g 16.60
I ,_.. '� "` z.._,.- ��„�.= Ejectorslsurnp 16.60
Name: €2T 4. Iti.I /3 • , i N f C. c f} 2 Expansion tank 16.60
Address: H 330 u log -
t 1 Fixture /sewer cap 16.60
City /State/ZIP: r ee 02 Q7 aa3 Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
� �` ,. t - iffM 4 -I w ' t ii il t g j ° irg-•i i l i ` � ;, 1� W f t a`la(z Hose bib 16.60
a • N `a ... .,<€. it + m a (u lu - - > t mi:t•5 VK .1 , i'' „.V:
s Ice maker 16.60
Business name: �� fir
nw , ��. 1 -f /� Interceptor /grease trap 16.60
Yl
Contact name: l , Akii _ � Medical
P Q 1 n� I gas (value: ) Page 2
Address:
1' "l Primer 16.60
City/State/ZIP: 4? 1 Cj i 1'1 t Roof drain (commercial) 16.60
Phone: ( ) ra l..' Li 19 Oda I Fax: : ( ) a' '4.-nZ Sink/basin/lavatory Z 16.60
E -mail: Tub /shower /shower pan Z 16 . 6 0 33 2.4)
Urinal 16.60
. , -„} iii ; la r tr g �, 6 .c • [ k" c. "' i ''''Yi S' �.l + _"'- : Mit:Tt i M
i � ,., , Im e:tG ;. , - - i 0 lt .] .• . ®� .� ,° ) .qE: ter.... 1 r ). Water closet 16.60 4 2,0
Business name: P I fir 1 Water heater 16.60
1• �i �J
Address: Ct _ I t& J r _ _ - I_ 'i� Other:
`! sc1G� �� / l 4� � �� //lA.[/ 1 Subtotal � ( 7j .
City/State/Zip:
Phone: t.' ii JJ !Y Minimum permit f $72.50
( ) �� Fax: ( ) � "1 -� � G Residential backflow minimum permit f ee : $36.25
CCB Lic.: C5Z3 Plumbing Lic. no.: 34 50pb Plan review (25% of permit fee)
Authorized signature: r�� /t, /\ State surcharge (8% of permit fee) 5 4
Print name: ,, JJ� TOTAL PERMIT FEE . 2451
eiG
I r S „b S.- '� Date: 2,9'/ , This permit application expires if a permit is not obtained within 111
1$0 days after it has been accepted as complete.
"Fee methodology set by Tri- County Building Industry Service Board.
i. \ Building 1 Pcrtniu\PLM•PertnirApp. doe 06/05 440-4616T(l0/o2/COM/WBB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: P1_1'412006-10003
11 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/112006
Phone: (503) 639-4171 *art 00
Inspection Requests (24 Hrs.): (503) 639-4175 7.1.11.,
INSPECTION WORKSHEET FOR DATE: 4/27/2006 TIME: 7:04AM PAGE: 107
SITE ADDRESS: 11330 SW 108TH AVE CLASS OF WORK:
SUBDIVISION: DOREEN COURT LOT #: 008 TYPE OF USE:
. PROJECT NAME: HENEG AR
DESCRIPTION: Remodel bathroom
'OWNER: HENE_GAR, ROBERT & LINDA PHONE #:
C ONTRACTOR: POWER PLUMBING CO PHONE #: 503-244'1900
Inspection Request Scheduled For: Date: 4127/2000 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 0213772-01 03-264 190(1
Corrections/Comments/Instructions:
SS 0 PARTIAL APPROVAL I I CANCEL n NO ACCESS
I FAIL n CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: i k Date: // // , 'YOY Phone #: (503)
CITY OF TIGARD PL-4/
BUILDING DIVISION • ' ' "` PERMIT #:_2 /'
0U _ _ / , 003
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Y '
Phone: (503) 639 -4171 / illtiitN iii
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: • PAGE: '
SITE ADDRESS: / (3 30 / 0 p A--o-e_____ CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3- 2 i-- 0 Co Pour Time:
Code # Inspe tion Description, Confirm # Contact # Message .
3 2 d '`-7.-,.,,,' �.. 'y am ?36- l R 3 0
Corrections /Comments /Instructions: w l /
6 J ' 1
("S PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ItYll l e 7 6 k 'l/ Dat Phone #: (503) 718 -