Permit C ITY CAF 'TIGARD PLUMBING PERMIT
���A '
DEVELOPMENT SERVICES
PERMIT #: PLM2006 -00311
'd`' G � 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/22/2006
PARCEL: 2S110BA -01000
SITE ADDRESS: 14185 SW 117TH AVE ZONING: R -7
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: New SF sewer connection.
CLASS OF WORK: GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: 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: 100 ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
WILLIAM & HICKOK
14185 SW 117TH AVE Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 6/22/2006 $72.50
[TAX] 8% State Surcha 6/22/2006 $5.80
Phone : 503- 620 -8396 Total $78.30
Contractor:
OWNER
REQUIRED ITEMS AND REPORTS
Contact # :
Reg #:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: TJ �� Permittee Signature: II.e e, f3 N
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Jun 22 2008 10:05RM Tabor Accounting Group 503 - 620 -3083 p.3
08/22/2008 08;30 FAX 6035981980 . CITY OF TIGARD Ql 002
i Permit Avnlicatign I r' 1, i f l i I. I I '-I I ■ /�
City
Of Tigard c . ; !� 6 1 Pun rt Nos l OQ OV 3) 1
1312.7 6W Wall Blvd, need, CiR 07213 - r, R e v i e w -1 e
Mel; 503.639.4171 Fax 503598. I960 D g
24 -Flow l cn Li e]iLaer peel i °�(n� l�,cv0� QQ J 1
m 503.639.4175 , ' hol
�L - i � Dm,aq� ear e; ® t« Fyn t w
Myrna Www,ltylloor.5av Noti0 �l 6: ' '' r s. • • rosin arM■r6N
`' ., ' h n i; r ,rV .11 % 00.1nV*K` i ' _,, . f ';'•,'' 1 t •, ., %...1', 'P' g01**,S . i, .. „ 'r Sl
0 New 000sauCloa 0 Demolition le/brauglow vie s terdrf4.
Dourly/ion I (?4r. 1 9a. 1 Tao!
0 Addltie,alafle retfaslnplacemaat 0 Other: Newt. 2.Amily d minim (Ieoludee 1001 Sir each utility cc n.etice)
;5 ;;$', „ y, e ' , ', ", i ; . * RC4TION. , ', `' "C. .'"!:..„,ii 51R 0) WA' 210.210
O 1 -sad 24blulily dwQlIm 0 Coettaerroiel /indwtrial SFR (2) both 3!0,00
O Acceeeorybuilding 0 Muni-tin Spf! ()both 694.00
• •
;soh additional bmrh/klfeltio 15.00
O Mauer builder , CI Other: Pin sprinkler (,_60. t.) Page 2
,;;.`' '" :b:'' I M t I;' W ,T C N„ :4;, ; Site ■tilitlsr - -
3cb lids MOM; ) � n 1 t 1 ii + h it V i!i Iv & W 066th Lewitt or teat drnie 16.60
City/20.02M ,2-Z Drywall, leach ant or trench drain 16.60
Suitt:/b14g.h k rm.! Pn joot DIM.: footing drain (nee linter ft: ) Pap 1
Manuteco ncd home utilities 110
Cross str s* /dire ors to job taw.
Manholes 16,60
- Rabe dreit connecter 18.60
snowy sewer (no, ling L: _) Pago 2
Dom Kora (no. linear R.: rA_) r1862
9ubdlr6fon; Lot no.: WONT serviee (ao. !!near ft.: I Pap 2 -
Ton nwsiplparal boo: Fixture or Wen
Abrorphon valve 16.0
l : ' +: , .';`+ ;', •'10M; , ,y( n
' ' . . • : I. Beane,/weenier Pate �
in • „ L - I . . • , Bed Wake valve J 18.60
Ciorhee nosh.. 16.60
Dintanmbor 16.60
... Drinking tibentain 16.60
' ' 4WDtki ' ; r • , .1 „ •, 0, 7$iVAra. �ee
N•'' laarmmp 1540 0
Name: L) t i I 1 L`,1N,4:14 S hArei,fu 14% c- k-u !c. Qapanaian task 16.60
Addle"! ) LI 1 51 5 5W 1 1 7-bh ,q V/ Rwerrdeeww 4104• 16.60
CIgr1Stallalp: ' ► i 6-M) i4O ht. � ti-.24-0 -i Floor droirsoar.ielcrhub 16.60
Phony; y3) a - tal( Fast: ( ) Getbliae e1166061 16.60
V :M.4 ; 1. •.Y.0' �'011.1.1r • :1 - , Cr CO14TA r *Y $O .. I .. ' i c e k 16.6
r` ; .. t' J
` ! ice cooker 16.40
Business nam6; I,tWaap er/i roeo b 16.60
Contact oama: - Medical gas (mks S ) P 3
Address: PAT O' 16.60
Ci Siate/Z3P: Roardnift (commercial) 16.60
6ibkreesiMsuesoly 16.80
Phone: ( ) I Fax ( ) Tub.4bowerrshowee tttoi r 16.60
&mai: uri.u, 16.60
' ; . .t 'Col tAT0A' •;,. :, 1 :'! _ Weise Omer 16.60
Swam Mohr Warr homer I 16.60
Addssst: Oth.rr f _
BrrMoeal
Cft oState/Z1P:
Minimum print fa: $71.50
Phone: ( ) Flea. ( ) ReAd,ntia) badrnow minimum pent foe; 536.25
CCH 1.3c..
Jc.: Plumbing Lit, no.: plan review O5%ofperadt fbs)
Stith wrclurp (I% of remit fee)
Autl1Qrisod 1ilstan ue: Pe
PERMIT q' 3 TOTAL
Print noose; .�� a 1 - / 1 / 0 Date: , Telt permit application empbte et t permit n cot ebtalged *Mlle I fee d.yu alter It lift bees rsespa.d as rota ie.
W t) ►L ice ") by 1\t-14 ° 55° Tr6 / U 0 a yes mwhodotoiy met by Tri •Cooney oultdin, industry 9arvle. B oard
osooetrompliaroLt+Pom tpp h• 11360, t:basie1(1tre2RONA1ls)
CITY OF TIGARD
BUILDING DIVISION f PERMIT #:P)MT ° to' 00 3/
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 A,,,tb,,,. \ Nyp 9
Inspection Requests (24 Hrs.): (503) 639 -4175 . JJ — __- ,c
INSPECTION WORKSHEET FOR DATE: TIME: ` PAGE:
SITE ADDRESS: 1 44 gS I IT' t. CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: IN; ; 1 ( i F PHONE 4 ) . 3 ) 515 -% 4 - g - 0
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: , 0 G Pour Time:
Code # Inspection Description Confirm # Contact # Message
(4 'IP .
Corrections /Comments /Instructions:
viij ,^,k—ye t 47(1 -1,K. ,r(?4 7
1 S ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
t i Ins I' ] ector: Date: P hone #: 503 -w` z p ( � (503) 718
FROM BRIAN CLOPTON EXCAVATING 503 682 0967 (WED)JUN 28 2006 14:34/ST.14:33/No.68O 4 1997 P 1 • y > z n 0
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