Permit C ITY OF TIOLARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00174
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/24/2008
PARCEL: 1S133DD
SITE ADDRESS: 11646 SW 128TH AVE ZONING: R - 4.5
SUBDIVISION: VILLAGE AT SUMMERLAKE PARK N04 LOT: 121 JURISDICTION: TIG
PROJECT: PADBURY
Project Description: Replacing existing water service with 40 ft. of new water service.
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: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: 40 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
CRAIG & JU PADBURY
11646 SW 128TH AVE Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 4/24/2008 $72.50
[TAX] 12% State Surch 4/24/2008 $8.70
Phone : Total $81.20
Contractor:
CRAIG ANDERSON PLUMBING INC
2730 SE 15TH AVE
PORTLAND, OR 97202 REQUIRED ITEMS AND REPORTS
Contact # : PR! 503- 232 -1060
FAX 503 -232 -5263
Reg #: LIC 100658
PLM 26 -524PB
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 B Permittee Signature: g �C- j // 2� �v✓
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 24 08 08:45a Craig Anderson Plumbing 5032325263 p.1 . ' 14cCS)
Plumbing Permit Applicatio `
'
k Site 'Utilities �d \ Q�
e �t N e 1 QQ FOR, OFFICE OSE ONL//Y '
City of Tigard p� !. �� % xei�e L a L , 073 Permit No.: / )b . . y� I�� ) / 7
1� ;tcld c 1 _ L 1t/ (�
■ a 1312' SW Hall A1vd,. Tigard - OR 97223 '`, `( ®; Flan Itrvr
Phone' 363.639.4171 fax: 503.598.1960 c � Othe: Permit No.
� t} ate :i3y:
faspc•a Line: 503.639.417{
T CG.4 Et•D d � Date ReadyrBy: ad H
is See Page 2 for
lnTeu;et. utv.v.n -nr S OY \ tictiSicdiMC[tu(i: Supplemental Information
f TYPE OF IVOR . FEE* SCIIEO1 :176
❑ New construction Q Demolition
For special information use checklist.
Description Qty. I Ea. l Total
® A dditionialleration /replacemetnt ❑ Other: New I- 2- family dwellings (includes 100 It for each utility connection)
CATEGORY OF CONSTRUCTION ' SFR (I) bath 249.20
® I - end 2- Family dwelling ['Commercial/industrial SFR (2) bath ' 350 00
1=1 Accessory building [1 Multi-family SFR (3) bath 399.00
Each additional bath /kitchen 45 00
❑ Muster builder El Other: Fire sprinkler ( sq ft.) Page 2
• JOB SITE INFORMATION AND LOCATION Site utilities
Job site address' 1 1646 SW 120 Ave . Catch basin or area drain 16.60
City/State/ZIP: Tigard. Oregon 97223 Drywell. leadh fine, or trench drain I 16.60
I Footing drain tile. linear ft.: _) Page 2
Suito :blelg.la'pt. our: Project name:
Manufactured home utilities 110.00
Cross strectidirections to job site:
Manholes 16 6:)
, SW Katherine & SW 128th
Rain drain connector 16 69
Sanitary sewer (nu. linear II : ) Par 2
Storm sewer (no. linear ft : ) Pace 2
Subdivision: Lot no.: Water service (no, linear ft.: 40) I Pane 2 55.00
Fixture or item
Tax map /parcel no.: ,
Absorption valve 1 16.60
DESCRIPTION OF WORK Ba2Ictiow preventer ( Page 2 i
• Replace existing wafer service Backwater valve 16.60
Clothes washer 16.60 i
Dishwasher 16.60
Drinking fountain 16.60
❑ PROPERTY OWNER ❑ TENANT
- - Ejectors/sump 16.60
Name: Julie Padhut,
Expansion tank 16.60
Address: l 1646 SW 128 Ave Fixture/sewer cap 16.60
I City /State /ZIP: Tigard, OR 97223 Floor drain /floor sink /hub 16.60
1 Phone: ( ) Fax ( ) Garbage disposal (6.60
- IZ APPLICANT lose bib 6.60
_ ❑ CONTACT PERSON
Ice maker 16.60
Business n Craig Anderson Plumbing Inc. lnlereeptor,'greasetrap 16.60
Coaled name: Craig Anderson Medical gas (value, S ) page 2
Address: 2730 SE 15 Ave Pruner 16.60
City /State /ZIP: Portland, OR 97202 Roof drain (commercial) 16.60
5ink,'basin'lavutory 16.50
Phone: (503) 232 -1000 Fax: : (503) 232 -5263
1'u';vshnwerlshowcr pan { 16.60
E -mail c :rtlei5S'ggwestoflice.net
Urinal '16_60
CONTRACTOR • . . ..
Water closet 16.60 i
Business name: Crain Anderson Plumbing Inc. Water heater 16.60
Address' 2730 SE 15 Ave Other:
City/Suite/7.1P: ;'Sin :e'Z.IP: Pui tlanJ, OR 9'2 �� Subtotal
•
I j Minimum penult fa:: 572 50 7250
Phone: (503) 232 -1060 ' Fax: (503) 232 -5263 Residential backflow minimum permit fcc: 536.25 . i
C C[I Lit.' 100658 e 5 /. _/ Plumbing Lic. no.: 26 -52 tFB Plan review (25% of permil fee)
Stare surcharge (12% f operrnit Ice) , 70
Authorized signature: - t',// TOTAL PERMIT FEE 7_
Print name: Craig A nde ( san �� Date: 4/24/08 This permit application expires if a permit is not ohtaine • ithirta g
180
is ys after it has been accepted as complete.
'`Fee methodology set by Tri- County Building Industry Set v ice Board
S' 3uld .r :_hermit Pznnirkppdoe 1127HJ6 440 - 4656'1]5 ru?.'COM,•lwEn)
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM20()8 pf)174
,,A, 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4124/2008
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 515(2008 TIME: 7:01AiVi PAGE: 52
SITE ADDRESS: 11646 SW 128TH AVE CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMERLAKE PARK NO4 LOT #: 121 TYPE OF USE:
PROJECT NAME: PADBURY
DESCRIPTION: Replacing existing water service with 40 ft. of new water service.
OWNER: PADBURY, CRAIG & JULIE PHONE #:
CONTRACTOR: CRAIG ANDERSON PLUMBING INC PHONE #: 503 - 232 -1060
Inspection Request Scheduled For: Date: 5/5/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
3(39 Plumbing final 069292 -01 503- 522 -2283 N
Corrections/Comments/Instructions:
Ca fc
•
Ca PASS ❑ PARTIAL APPROVAL _ CANCEL n NO ACCESS
FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: 11 \ ,...J� \ \ Date: ‘) 1 DT, Phone #: (503) 718 -
r
CITY OF TIGARD • r ,-
BUILDING DIVISION PERMIT #: t=°1.N12O;".t.C44 4
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4i2412008
Phone: (503) 639 -4171 #.4 Hglp
Inspection Requests (24 Hrs.): (503) 639 -4175 J4.4.
INSPECTION WORKSHEET FOR DATE: 4130,2008 TIME: 7 :06AM PAGE: s
SITE ADDRESS: 11646 SW 128TH H AVE CLASS OF WORK:
SUBDIVISION: VILLAGE: AT S I IMMER LA' _ PARK NO , - 4 LOT #: 121 TYPE OF USE
PROJECT NAME: €s'AI I.r1-:;Y
DESCRIPTION: fZ69-p>acinq { xit ing w; :tte.° F :.l with 40 ft. of 1 ° al4:r
OWNER: PAGE Y, CRAIG & .JUl.1F: PHONE #:
CONTRACTOR: CRAIG Al'41 : :1 -ISO •i i 1.11 31 ,';; INC PHONE #: • w0 'L32 -1C 0
Inspection Request Scheduled For: Date: 413 R 2 (X - t Pour Time:
Code # Inspection Description Confirm # Contact # Message
,,, }{ • Aer service 0 909t -01 503 5:;):2-2283
Corrections /Comments/ Instructions:
LAJ 9 1.' Pre,. V24
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° 1VZ . - 7gS 0 230
❑ PASS [I PARTIAL APPROVAL fI CANCEL n NO ACCESS
I I FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: c Date: 1-06 a ?: Phone #: (503) 718-