Permit A • CITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2005 -00518
'=--� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/4/2005
PARCEL: 2S 109AD -09600
SITE ADDRESS: 14631 SW 126TH AVE ZONING: R -7
SUBDIVISION: PARSONS MLP97 -0017 LOT: 001 JURISDICTION: TIG
Project Description: Replace fixtures in kitchen and (2) baths.
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: 3 OTHER FIXTURES:
TUB /SHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: 2 WATER LINE: ft
DISHWASHERS: 1 RAIN DRAIN: ft
Owner: FEES
DEREK & EN RICHARDS
14631 SW 126TH AVE Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 10/3/2005 $116.20
[TAX] 8% State Surcha 10/3/2005 $9.30
Phone : 503- 646 -8411 Total $125.50
Contractor:
ROYAL PLUMBING
14035 SW 6TH ST
BEAVERTON, OR 97005 REQUIRED ITEMS AND REPORTS
Phone : 646 -8824
Reg #: LIC 121274
PLM 34 -3llpb
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: 17 Permittee Si�nture:� )"=
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.
10/03/2005 07:52 5032136035 LARRY DICKINSON PAGE 01
Elect Cal Permit A to I tllt� l lc . I . ()Nil
City of Tigard 1VE® R -- .: d
13125 SW Hall Hlvd„ Tigard, OR 9722 D,zk 5---__p PcrmirNo.
Phone: 503.639.4171 Fax: 503,598.1 20 5 , .., , P(sn krv'cw
�T 0 `/j 2 .l ,' ( "' DatcR3 ; Other Permit: _ /
I nspection Line: 503.639.4175 -tall. " ' .. i . Dar Ready/By; 7 y�
Internet: www.ci,tigard.neus t un a: ® ace Page 2 a for
r
PI 1 Y OF TICARD Notified/Method: Supptcmontal rnfotmatian
• ' is ' .''O:i.'f e.: 'A il ii... .: .. PLAN .REVIEW' • . •
0. New construction G Addition/alteration/replacement Please check all that apply:
❑Service over 225 amps. Demolition ❑ Other: . , comm I
Ps • [)Hazardous location
CATS y OF C:OP1ST�tttCTPON °Service over 320 amps - rating ❑Buildng over 10,000 sq. R,
of 1 - and 2- family dwellings 4 or more new residential
1- and 2 family dwelling ❑ Commercial /industrial ❑ Accessoy building DSystcm over 600 volts nominal units in one structure
Multi- family [] Master builder 0 Other: ❑Building over three stories ❑ Feeders 400 amps more
JOB :S33L itNFORMATlON AND LOCATION DOccupant head over 99 persons ❑Manufactured structures or
(� t:J / ❑ligress/lighting plan RV park
lob no,; Job site address: / T 26/ Dliealth�tre facility. ❑Other:
City/State/ZIP; �� j Submit,/ sets of plans with any of the obovc,
\ L' 41 `• • 97D...3.4 - -q _ The above are Mot applicable to temporary construction service.
Suiee{b }dg. /alrl, no.: Project nu ^ ns; �i i „ • FEE" SCfEDULE
,� ��(�/ �, � " ter _ Darripeiy* I Qiy. I red
Cross street/dircctionc to job site: f'_( ` v` j 3.67 Y'1t New residential single` or multi- family dwelling unit.
Includes attached garage.
1.000 sq, 5l o R. I
145,15
Subdivision: � - Lot no.: Ea. a. a. a d'1500 sq. sq. R or portion 33.40
Tax map /parcel no.: Limited energy, residential En 75,00 — 2
DESCRQ'flON OF WORK Limited energy, arm- residential 75.00 2
I i "-- r I Each ii : service and/or d/ modular
1 . �� i f 1 .1r • l dwcllin_ service and /or feeder 90.90 2
g f�� . A __�� _A _ M IT.: _ 1? i t) {� '' Services or tbede
r ra insr llatinn. alteration, and /or Matadi)
200 amps or less 80.30 2
•
- l k :. OPERTV OWNCR2 • . "}------
I ❑ TENANT 201 amps to 400 amps 106.85 2
Nye 401 amps to 600 amps 160,60 2
-/ 601 amps to 1,000 amps 24460 2
Address: t.1 - ) _ Over 1,000 amps or volts 454.65 2
City/State/ZIP: _ W � I q ^1~ - - Temporary only 66.85 2
{ W� f / a a Temporary services or feeders inetaltatfon, alteration, and /or
Phone; ( 505) F ax: ( ) relocation
� 200 amps or IcEC 06.85 • t
Owner installation: This installation is being made on property that I own which is not
intended for sale. lease. rent or exchange, according to ORS 447, 449. 670. and 701, 4 0 1 amps to 400 temps 100.30 2
X 401 amps to 600 amps 133.75 2
Owner signature: _ Dare: circuits - rte or exteneion, per p anel
`--�.'AirF2'f(ANT• :J •.Q CONTACT PERSON A. Fee for branch circuits with - - —
Business name: - service or feeder fee. each
branch circuit 6.65 2
Confect name: H, Fee for branch circuits
without service or feeder fee,
Address;
each branch circuit 46.85 2
Each add•I branch circuit 6.65 2 _
City/State/ZIP:
Miscellaneous (service or feeder not included)
Phone: ( ) Fay. : ( Pump or irrigation circle 53.40 2
E -mail: - Sign or outline lighting 53.40 2
Signal
. •:..,;,_.• ;, .., . - E er0R • e (a tcrat t
..__: n ..•::., _; - energy panel, alteration. limited-
)4us)nessname: �' 1 OT• or
extension.
_ i S on. Describe: 2 2
i
Address: jo, ` inch additional inspection over nnowabtc in any of the above
City/State/ZIP; _r Per inspection 62.50
di _'A i /"" ' • '' Investigation per hour (1 hr min) 62.50
N...t-' Phrntc, (.9..,_3 S - '2 Fax: (+ /.?- �_ ` ` industrial plant per hour 73.75
' E
CCS Lic. Electrical L;c.: ELECTRICAL PERMIT •rE ,.:•..',... -
` � � 5 y a.6 � , Su prv. Lic.; 37a,
Subtotal Mr ■■
Suprv. Electrician signature requi
� -, " Plan review (25% of permit fee)
/ � / ��� 17atc;�� ^ 2 _� Stott surcharge (8% of permit fee) Win/ Print na
Authorized signature: TOTAL PERMiT FEE i '51).,)�l�
This permit appacetinn expires if a permit Is nor obtained 'Albin IN
•
Print name: days alter it has been accepted as cnmplere
Date; ' Fee Incthodolusy set by Tri- County Building industry Service Bnard
Otteitnlnatrermh.:F.r t .rermhntoune 17147 •... Number of inspections per permit allowed.
440.151 7111 0/O210 OM/W t:R
CITY OF TIGARD r ,
BUILDING DIVISION PERMIT #: PLM2006.00518
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/4/2005
Phone: (503) 639 -4171 / o nmei � lpuiu� iil ) PI („
Inspection Requests (24 Hrs.): (503) 639 -4175 ...'=W �J1�
INSPECTION WORKSHEET FOR DATE: 10/17/2005 TIME: 7 :04AM U PAGE: 6
SITE ADDRESS: 14631 SW 126TH AVE CLASS OF WORK:
SUBDIVISION: PARSONS MLP97 -0017 LOT #: 001 TYPE OF USE:
PROJECT NAME: RICHARDS
DESCRIPTION: Replace fixtures in kitchen and (2) baths.
OWNER: RICHARDS, DEREK & ENDRE PHONE #: 503646 -8411
CONTRACTOR: ROYAL PLUMBING PHONE #: 646-8824
Inspection Request Scheduled For: Date: 10/17/2005 Pour Time:
Cod # Inspection Description Confirm # Contact # Message
320 P lumbing rough -in 018521 -01 503- 944 -9745 Y
Corrections /Comments /Instructions`
I Ytt
PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
1
Inspector: Date: / v Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: RLM2005-00518
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/412005
Phone: (503) 639-4171 _ t
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 12/2/2005 TIME: 7 : 19 AM PAGE: 28
SITE ADDRESS: 14631 SW 126TH AVE CLASS OF WORK:
SUBDIVISION: PARSONS MLP97 LOT #: 001 TYPE OF USE:
PROJECT NAME: RICHARDS
DESCRIPTION: Replace fixture in kitchen and (2) baths.
OWNER: RICHARDS, DEREK & ENDRE PHONE #: 503-646-8411
CONTRACTOR: ROYAL PLUMBING ' PHONE #: 646-8824
Inspection Request Scheduled For: Date: 12/2/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 022834-01 971-404-8798 N
Corrections /Comments/ Instructions:
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oPPv,r.- iv, -,---- --
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t pA'ss I I PARTIAL APPROVAL D CANCEL . n NO ACCESS
' II FAIL n CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector:
,.,
— . . . Date: Phone #: (503) 718-