Permit r r � ITY , OF TIGARD PLUMBING PERMIT
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COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00187
DATE ISSUED: 5/2/2008
1 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1 S133DD 12500
SITE ADDRESS: 11945 SW 126TH PL ZONING: R -4.5
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT: 162 JURISDI TIG
PROJECT: RAMSDEN
Project Description: Replacement of existing fixtures for kitchen remodel.
CLASS OF WORK: ALT GARBAGE DISPOSALS: 1 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: 1 URINALS:
•
GREASE TRAPS:
LAVATORIES: • OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: 1 RAIN DRAIN: ft
Owner:
FEES
DEBBIE & DA RAMSDEN
11945 SW 126TH PL Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 5/2/2008 $72.50
[TAX] 12% State Surcha 5/2/2008 $8.70
Phone: 503 - 691 - 6075 Total $81.20
Contractor:
FOSTERS PLUMBING LLC
10100 SW EVERGREEN CT
WILSONVILLE, OR 97070 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 951 -2050
FAX 503- 482 -5310
Reg #: LIC 175244
PLM PB328
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.
C e'
Issued • 0 / , 0 1 P ermittee Signature. I • 0,1 / . (lJ�_."-_-
I
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.
Apr 28 08 11:50a Brian Pascoe 503 -682 -3433 p.2
_ umbing Permit Application
Building Fixtures pox O FI USE - ONLY
Received
i City of Tigard , �� D $ • Pcrmis v.,.: 6 1 tl g -- 0/
• 13125 SW Hall Blvd-, Tigard, OR 97223 DateiHy
Plan Review
Phone: 503.639.4171 Fax: 503 - 598.1960 Date H}: nthcr Pcnnit No.:
■
Inspection Line: 503
T I G'AR D Dale Ready; /By: in ' 1 Id See Page 2 fur
Internet: ,vw,v,tigard- or.gov
Notified/Method O Supplemental Information
TYPE OF WORK FEE' SC'HEDI'F.E
❑ New construction ❑ Demolition For. special information use checklist.
Description Qty 17. - 3 71 Total
Addition /alterati place ment ❑Other: Ncw 1- 2- family dwellings (includes t(>O II. For each utility connection)
CATEGORY OF CONSTRUCTION SFR (11 bath 249.20
- 631 1 - and 2-family dwelling ❑Commercial /industrial SFR (2) bath 350.00
❑Accessory building El Multi-family SFR (31 bath 399.00
Each additional bat Ii/kitchen 45.00
❑ Master builder ❑ Other: _-
Fire sprinkler ( sq 11.1 Page 2
JOB SITE INFORMATION AND LOCATION
Site utilities
Job site address: r / / 415 s Lv i .2 (O' f /Ct C e., Catch basin or area drain 16.60
City /State/ZIP: 77 C6,,, /J 2 Dry'wel1. leach line, or trench drain 16.60
Suite/bldg. /apt. no.: / Project name: 11 Gc.a+ti 5 elem. Footing drain (no. linear ft.: l Page 2
Mansllrctureel home utilities 110.00
Cross street/directions / to job site: ,, /2 /-jy ') /3 L' � - - --
/, .i / E Z. is s ,4 /-2 3 -I-0 /e_ eY1 /' c & Manhole. 16.60
,/7 Rain drain connector I6.60
/26 / Ge--- Sanitary sewer (no. linear ft- _1 Page 2
Storm sewer (no. linear ft_: ) Page 2
Subdivision: Lot no.: Water service (nn. linear It.: ,) Page 2
Fixture or item
Tax map /parcel no, _
Absolption valve 16.60
DESCRIPTION OF WORK _ Back tlow preventel Page 2
i -eiZe.Ce d t Si4/C seC.-Ile C /� i y� tly e s' Backwater vase -.._ 16.60
S 'j L/v✓4SI' -L'L in -/ A kit.....' ('hi ties washes 16.60
Dishwasher / 16.60
® PROPERTY OWNER Drinking Fountain 16.66
❑ TENANT
II� iy //
Ejectors/sump 16
Name: 17e- 6 Jr :r: A.4. d D.:4 --cc , _ 5 c/
_ L "s�nzrnn tank 16.60
Address: 11Q q i - ' ` '1,1_ & -1( /Jz ,C� I'ISt /sew r cap 16,60
City / State/ i� i G i f& ! Floor drain /floor sink /hub 16.60
Phone: (513 ) & /.. (,:;(,: 7 . 5 .-- Fax: ( ) Garbage disposal / 16.60
APPLICANT CONTACT PERSON Nose hie 16.60
El CONTACT
Ice maker 16.60
Business name: � ti
7 i ' 4,4..A_, i" L /�_S ;,--,2 ti: J /G �' Entctccplortgrease IraP 16.60
Contact name:
��i Gc a 4,3 Gr E Medical gas (val $ ) Page 2
Address: to s- 7 ,,, ,...,..i 1 ( G✓ ,)r Primer 16.60 �
City / State/ZIP: (��1 j' , -. tle jt _ 11 `? ( ` 7 i. Roof drain (commerciall 16 60
Phone: j J', Sink /hasinitavalory / 16.60
( ) >L_ _g cc Fax: :tomi .� J
'rub'shower /shower pan 16.60
E mail: 1 1: ti : ' V ? d� C t e ,'l • Urinal
/ 16.60
CONTRACTOR Water closet 16.60
Business name: /..._v 5 -; A" 6, #t `4 / L C Water heater 16.60
Address: / 5 � 'Z: -K -
€,,_4)i e -. Other:
(�i
City/State/ZIP: L : /3 67 c,.' c,.' �(r J Subtotal
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Phone: Minimum permit ree' $72 50
(5 3 ) I p 51 --- ZL S3 Fax: (yt;) `f v L - 5 3 / C. Residential hack Dow minimum permit lee' 936.25 92,5
CC Lic 11'7 ; 224 ti 4 649 Plumbing Lic. no,: r j3 _-j: '7 i 6 , Plan review (25% of permit lee) tert
Authorized signature: �' - [(( State surcharge (12 %orpermit tee) 6 7
' ,'r, /C Tal'Al. PERMIT Ftili
Print name. � /J >� cL .s cv Date: - 17a ,` . This permit application expires if a permit is not obtained within l
1811 days after it has been accepted as complete.
"Fee methodology set b''rri- Counts 13uddine I nduslry Service Board.
CITY OF TIGARD , ...
BUILDING DIVISION
PERMIT #: PiM2008-00187
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/2/2008
Phone: (503) 639-4171 km
Inspection Requests (24 Hrs.): (503) 639-4175 A. - AIL
INSPECTION WORKSHEET FOR DATE: 5/16/2008 TIME: 7:00AM PAGE: 5
SITE ADDRESS: 11945 SW 126TH PL CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 162 TYPE OF USE:
PROJECT NAME: RAMSDEN
DESCRIPTION: Replacement of existing fixtures for kitchen remodel,
OWNER:. RAMSDEN, DEBBIE & DANA PHONE #: 503-691-6075
CONTRACTOR: FOSTERS PLUMBING LLC PHONE #: 503-951-2050
Inspection Request Scheduled For: Date: 5/16/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 070016-01 503-522-8600 N
Corrections/Comments/Instructions:
C14,..
•
X PASS n PARTIAL APPROVAL 0 CANCEL n NO ACCESS
I I FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: alk/wit---" i' \\%,..../2--- Date: STK, IM cn !hone #: (503) 718-
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