Permit . CITY OF TIGARD PLUMBING PERMIT
°. COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00060
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/12/2007
PARCEL: 1 S 133DD -13800
SITE ADDRESS: 11952 SW 127TH PL ZONING: R -4.5
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT: 175 JURISDICTION: TIG
PROJECT: SCHMITT
Project Description: Kitchen remodel. (1) sink, (1) water line for frig.
CLASS OF WORK: OTR 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: 1 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
LORI SCHMITT Description Date Amount
11952 SW 127TH PL
TIGARD, OR 97223 [PLUMB] Permit Fee 2/12/2007 $72.50
[TAX] 8% State Surcha 2/12/2007 $5.80
Phone : Total $78.30
Contractor:
MODERN PLUMBING
11120 SW INDUSTRIAL WAY
TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 691 -6166
FAX 503 -691 -6771
Reg #: LIC 87906
PLM 34 -250PB
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: - — 274 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.
Feb. 12. 2007 1:45PM Modern P1 umbing No. 2326 P. 2
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City of Tigard 5ECE
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• Phone: 503.639.4171 Fax: 503.598.1960: EB ,
1, .. 13123 SW Hall Blvd., Tigard, OR 97 2
Plan Rt.-Jew
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Date By.
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T j C: Av. D Inspection Line: 503.639.4175
Date Reaty/g
kids: et sec Psygc 2 fbr
• Internet: www.tigard-or.gov
CITY OF TIC:AM?... Ntifma4thod,
.
suppleamna, Information
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aNew construction 0 nemolitioo . For 'edit, information use checklist
Desori . ti on, ; Qty. Et MEM
Et Addition/alteration/replacement El Other
New 1 al
dwings (iuclutles 000 ft. for each utility connecticta)
" • • : : , , • , ,
' - '':' ..: ' . • eOit'Y': OF Oiclii.i.66460::: '. : :. l' : ' .:.: . stint (J)6;4 249.20
811- and 2-family dwelling ID Commercial/industrial SFR (2) bath 350.00
El Accessor building ' 1:1MUlti-fumily SFR (3) hai 399.00
- Each additienal bathikitchen 45.00
0 Master builder []Other:
Page 2 MI
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Job site address: ( 1 q 5 ,--. 1 :x-7-4-1, P I a e...e.... Caicil,*ai,'•••,eiarea drain 16.60
City/State/ZIP ------ \ ,o, a rct 6{2 9 _ Drywell,140 line, or treneli drani 16.60
Suite/bIdgiapt., no.: Project naute: fOoling illi. linear IL: ) Page 2
Manufactined home utilities 110.00
Cross street/directions to job site; '
-
Manholes 16.60
Rain drain connector 16.60
Sanitary sewee linear 11: ) Page 2
Storm sewer (n�. linear ft: __.) Page 2
Subdivision;
Lot no.: Water service (no. linear it.: ) Page 2
Fixture or item
Tax map/parcel no.:
16.60
Page 2
Backwater valve MN 16.60
Clothes washer 16.60
. ,. ' thinking fountain Dishwasher 16.60 1111
16.60
Ejectors/sump 16.60
e-- _
Name; C . \ I r \ Expansion tank 16.60 MI
Address: /
Fixture/sewer cm 16.60
City/State/Z1R.
Floor draithloor sink/hub 16.60
Phone: ( ) nue ( ) Garbage disposal 16.60
' : ', • . . • 0 A p r i*. vi i, . : . , i, rii . s o k: -,;. liose .bib MN
Ice maker f 16.60 ft, 6 ■
I, ., :-.9 t •,t, ' 7
Interceptor/grease trap 16.60
Contact name:
Medical gas (value: $ ) Page 2
Address:
Primer 16.60
City/Slate/ZIP: Roof drain (commercial) 16.60
Sink/basin/lavatory. 16.60 /fr 43 (..)
Phone'( ) I Fax: ; ( )
Tub/shower/shower pan 16.60
E
Urinal 16.60
: .....'.::'...'''?:,:. ': .1.:::..1•:: ,,: '•'''..: • "::::' :;.C.P.:!57.T.Y.4F1P.,:','.:: d',:::::' :. ::: ,•:. : .2.: ,,'., ,...‘: ,.,:.:,:: wale, closet 16.60 IIIIIII
Business name: MODERN PLUMBING CO. Water heater 16.60
Address: 11120 SW INDUSTRIAL WAY Other. ME
Subtotal
City/State/ZIP; TUALATIN, OR 97062
Mininium permit fee: $72.50 - 1
Phone: (503) 691-6166 Fax; (503) 691-6771 Residential bacidlow minimum permit feet $36.25 '
CCB Lie. : 87906 . bing Lie, no.: 34-250PB Plan review (25% of permit fee)
Slate surcharge (8% of permit fee) 4 0
Authorized signature: ,
grif TOTAL PERMIT FEE I
Print name: A e.,1 ci - y --- a 6 ec, C '.... Datv 2 7 � This penult application expires Ea permit is not obtained within
180 days after It has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board
I: \thildingTcnnibatM ost2s/06 440.4516T(iwa1/c0WWEB)
CITY OF TIGARD •
BUILDING DIVISION PERMIT #: PLM2007 -00060
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/12/2007
Phone: (503) 639 -4171 ull��d j���
Inspection Requests (24 Hrs.): (503) 639 -4175 �'
INSPECTION WORKSHEET FOR DATE: 7/31/2007 TIME: 7:07AM PAGE: 27
SITE ADDRESS: 11952 SW 127TH PL CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 175 TYPE OF USE:
PROJECT NAME: SCHMITT
DESCRIPTION: Kitchen remodel. (1) sink, (1) water line for frig.
OWNER: SCHMITT, LORI PHONE #:
CONTRACTOR: MODERN PLUMBING PHONE #: 503-691 -6166
Inspection Request Scheduled For: Date: 7/31/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 053083 -01 503 -691 -6166 Y
Corrections /Comments /Instructions:
•
Caic-'t%I
PASS ❑ PARTIAL APPROVAL n CANCEL n NO ACCESS
I I FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CE) `l ti p- Date: ) /3 /WU) Phone #: (503) 718-
.
CITY OF TIGARD
BUILDING DIVISION • PERMIT #: PLM2007 -00060
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/1212007
Phone: (503) 639 -4171 la� ,� , mat,
�� +
Inspection Requests (24 Hrs.): (503) 639 -4175 J { __..
INSPECTION WORKSHEET FOR DATE: 4/19/2007 TIME: 7:01AM PAGE: 24
SITE ADDRESS: 11952 SW 127TH PL CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 175 TYPE OF USE:
PROJECT NAME: SCHMITT
DESCRIPTION: Kitchen remodel. (1) sink, (1) water line for frig. •
OWNER: SCHMITT, LORI PHONE #:
CONTRACTOR: MODERN PLUMBING PHONE #: 50 - 69 1 -6 166
Inspection Request Scheduled For: Date: 4/19/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 046798-01 503-691 -6166 Y
Corrections /Comments /Instructions:
•
I PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CrL + Date: '/f)'9 /Y") Phone #: (503) 718-
CITY' OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007 -00060
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/12/2007
Phone: (503) 639 -4171 flgl i
Inspection Requests (24 Hrs.): (503) 639 -4175 °$'f �!
INSPECTION WORKSHEET FOR DATE: 4/24/2007 TIME: 7:01AM PAGE: 41
SITE ADDRESS: 11052 SW 127TH PL CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 175 TYPE OF USE:
PROJECT NAME: SCHMITT -
DESCRIPTION: Kitchen remodel. (1) sink, (1) water line for frig.
OWNER: - SCHMITT, LORI PHONE #:
CONTRACTOR: MODERN PLUMBING PHONE #: 503 -691 -6166
Inspection Request Scheduled For: Date: 4/24/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 047023-01 503-691-6166 N
Corrections /Comments / Instructio
/ 'i eP- '
ice/. /� � . / -1 k-e/rfrL,(
IIMIIM
i " t. (i>N
l
n PAS 0 ❑ PARTIAL APPROVAL ❑ CANCEL )40 ACCESS
r FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
v t : 0 /... e._
Inspector: Date: 1 472. LV 8 ? Phone #: (503) 718- 2)7 2->t
CITY OF TIGARD 0. •
A ' ., 1
BUILDING DIVISION PERMIT #: RLM200 f -0006L I
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 21/2f2007
Phone: (503) 639- 4171 .6a'TTT06T ,I
Inspection Requests (24 Hrs.): (503) 639 -4175 J �I L .
INSPECTION WORKSHEET FOR DATE: 2J2712007 TIME: 7:01A1 t PAGE: 43
SITE ADDRESS: 11952 SW 127TH PL CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 175 TYPE OF USE:
PROJECT NAME: SCHMITT
DESCRIPTION: Kitchen remodel. (1) sink, (1) water line for frig,
OWNER: SCHMITT, LORI • PHONE #:
CONTRACTOR: MODERN PLUMBING PHONE #: 503 - 691 -6166
Inspection Request Scheduled For: Date: 212712007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 1)43977-01 503 -691 -6166 N
Corrections /Comments /Instructions:
. - (- 4/79---/
4 1 1- 1 3 7S n PARTIAL APPROVAL n CANCEL NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
i ii 4 Inspector: /I // �' !1 718-
1 spector: V %� Date: Phone #: (503) 718