Permit C ITY Or TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2006 -00369
:� DATE ISSUED: 8/2/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S103CD 04400
SITE ADDRESS: 13530 SW 121ST AVE ZONING: R -4.5
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Backflow preventer for irrigation.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
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: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
MICHAEL BROWN
13530 SW 121ST AVE Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 8/2/2006 $36.25
[TAX] 8% State Surcha 8/2/2006 $2.90
Phone : 503 -590 -6879 Total $39.15
Contractor:
POWER PLUMBING CO
PO BOX 19418
PORTLAND, OR 97280 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 244 -1900
FAX 503- 244 -8825
Reg #: LIC 52378
PLM 34 -150PB
WARNING: If the electrical grounding system is rendered ineffective due to replacing metallic piping with
nonmetallic piping, it shall be the contractor's responsibility to notify the homeowner of the hazard.
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: - �jj , ) 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.
Aug 02 2006 8:01AM POWER PLUMBING CO. 503 244 8825 p.1
Plumbing Permit Application' fi e® FOR OFFICE USE ONLY
City of Tigard �� 6 Rec ' t -V il
U Permit 136 � �
13125 SW Hall Blvd -, Tigard, OR 97223 � LOO Plan Review
�
Phone: 503.639.4171 Fax: 503.598.1960 G zt4,• i r,+4�1ls' I y'x Date/By: Other Permit No.:
24- Hour Inspection Line: 503.639.41 75 F ( \ G r 'II Date Re ad /Sy: 1�` :. El See Page e 2 for
Internet: www.Ci• tigard.or.us - s � ` t - \' - te Notifiied/Metho Supplemental Information
• ^" :� .tom .• r �• .... .W:. �'- 1 =i B o a . i V WI,' 4 ngimiw llbriillltipti. ipaz •_:::r =:::
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,1� (� ].a.; .t }�f�, "�s:iy��•� •��. .1.. �!!I� �I�I���I li,�'•ltatt• ulalia! r75� ,A=.tti�•= lia'- a.
❑ New construction ❑ Demolition For special information use checklist.
Description j Qty_ I Ea. I Total
Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft for each utility connection)
' 3 s{'.''' g'_{"' n.r .r..- :�G _�= clis:x�.a;. «p;iate ..tuma.. - , . DL ri ( - a fi . 1. € "�
�= 1 n AF a z €; 6 f 1
!1:�.t.k =E dl �=a� l., I�i � �I:tV�.. 1�iieVSti�aeil .ta't� -.� ::� � "2: .._. __- ........ -._ ,tL �� 1� �t �I t 1 i ����I "1 Li��e SFR 1 ( ) bath 249.20
!1 I - and 2- family dwelling El Commercial /industrial SFR (2) bath 350.00
0 Accessory building ❑ Multi - family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other:
IF m 4 ,11 � 11 ^lo rt ' r a tio , t , ,� a I 3' , , Fire sprinkler ( sq. ft.) Page 2
=s:._ p , s c . .. ... .f 116._.Nrl G` >.. L �
ill €t1.1 ! � _" �.utai- t1t, s,Rarma : .�..■_,.. _. '1 1
Site utilities
Job site address: ! 3 3 + . t� I d. 5 cw_i Catch basin or area drain 16.60
City / State/ZIP: • • /tom / c4-10„)..-5 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no
� Pr ject name: €(Al► 6 Footing drain (no. linear ft.: ) Page 2 .12 Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
Rain drain connector 1 6.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: Lot nn.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.:
.410i! t k��Y a i - atl °'fit min `Q�1 1 a �I l $�d� 8 ,11.:141P-
Eit ton valve 21
d lil I ...... �:: : 'f' :1 • ,- 4 }
° -._:....��::...., ut�lR iii�x,��ii.c.r, , a.,_;, � s.k * . -__.._ Backflow preventer Page 2
P) Y` a t b 6 _ Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
_ }} + ll 1 s a x. • ^ Y nnt *i� ?^ 2 C Drinking fountain 16.60
- _ ils'�iC� 3 I °� M1', 1 � ly � . ,� : �=Pul g
,1ic:_. -,. yam,! 11 is,.I i s `. -it -i: ` .. --- -- ----7� Ejectors/sump 16.60
!�v _I lt_li1 A. _ ♦ Expansion tank 16.60
Address: ; \jyL. et-6_ i • o v-e_ Fixture/sewer cap 16.60
City /State/ZIP: Floor drain /floor sink/hub 16.60
)
Phone:
( SI 0 -- P ♦ 11 Fax: ( ) Garbage disposal 16.60
ri7tlutimf I✓ i Hose bib 16.60
. i 7,1- " , - ,, .1k-V! : ( y sa `s I.al (; ts. t i i - xsds ; t ids t �' , ° k , T t l! a ?11 1
Ice maker 1fi.60
Business name: °61.4..2 � . �V -I _L�� Interceptor /grease trap 16,60
Contact name: Medical gas (value: $ ) Page 2
Address: t" () f Qtr 1g 4 Primer 16.60
City /State/ZIP: Pte- 1 C \ ' ( j _ - 7 ) ( . ( ) Roof drain (commercial) 16.60
Phone: ( ) ) h 4f k its O () I Fax: : ( ) D "t y - b E T ow /shows 16.60
Tub /shower /shower pan 16.60
E -mail:
Urinal 16.60
1 igi i a
,x c c iilf _ci : :ci:::F = s ? 2r _... c -. = ya ,
, = Y
i n €�°!: =sts : ! t _ 1 ' o , l l ' _ Water closet 16.60
.'�.... _i."it:e_i�t; _€, ea ) 1 , ��Y� ;1 �., ... l J r:: ! � ��;:� ss a�1u. 3'a. _..1, s. • sw W
Business name: P ( PJ Water heater 16.60
Address: r�1 -� Blvd Other:
City/State/ZIP: R ' 1 SA 4 1'1 - 1.a - Subtotal 2'1 5 5
Minimum permit fee: $72.50 3lv z 5
Phone: ( ) y k4 1 CI (1) Fax: ( ) a.4 y - R � 5 Residential backflow minimum permit fee: $36.25
CCB Lie.: S 23 - 7 s Plumbing Lic. no.: 34-)50 f'6 Plan review (25% of permit fee) •
Slate surcharge (8% of permit fee) 2 5 0 Authorized signature: j TOTAL PERMIT FEE 3g ) 5
Print name: LI S .� �, Cj-' Date: g1,),) D6 This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
is 1131.61ding \PermitslPLM- PermitAppdoe 06/05 440-4616T(I0/02lCOM/WEB)
CITY OF ��U��������
��mu o �.�m mn����na��
: BUILDING DIVISION ' -
PERMIT #: PL&42006-00369
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 812/2006
Phone: (503) 639-4171
Inspection Requests (24 (6O3) G30'4175 ,..,_.14.- c
.
INSPECTION WORKSHEET FOR DATE: 8N17y2006 TIME: 7:01AM PAGE: 53
SITE ADDRESS: 13630 SW 121ST AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: BROWN
DESCRIPTION: BsmWlmm pvwvnntev for irrigation.
OWNER: BROWN, MICHAEL PHONE #: 503-690'6879
CONTRACTOR: POWER PLUMBING CO PHONE #: 503-2441900
Inspection Request Scheduled For: Date: 8/17/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
396 Misc. inspection 036119-01 603-690'6979 Y
•
Corrections/Comments/Instructions:
74/K
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PARTIAL APPROVAL ri CANCEL I NO ACCESS
I | FAIL CALL FOR INSPECTION pi ADDITIONAL FEES ASSESSED
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Date: ~ mm �� ��• Phone #: (503) 718-
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