Permit ,.
MI CITY OF TIGARD' PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00424
•
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/18/2007
PARCEL: 2S 109AB -04400
SITE ADDRESS: 14362 SW 134TH DR ZONING: R -7
SUBDIVISION: THREE MOUNTAINS ESTATES LOT: 037 JURISDICTION: TIG
PROJECT: MOLUF
Project Description: Replace 50' of water service.
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: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: 50 ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
STEVE MOLUF
14362 SW 134TH DR. Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 9/18/2007 $72.50
[TAX] 8% State Surcha 9/18/2007 $5.80
Phone : Total $78.30
Contractor:
ROTO ROOTER - WEST OFFICE
25599 SW 95TH B
WILSONVILLE, OR 97223 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 682 -9774
FAX 503- 685 -9754
Reg #: LIC 13989
PLM 37 -76PB
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 • - stions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issu d By: Z. Permittee Signature: 0 /d( 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.
•
09/18/2007 10:46 5036859754 ROTO ROOTER PAGE 01/02
1 .
Plumbing Permit ,A, licatio- (rEivE
I ,
Cif oiFTigard Receives ,Q
• 13125 SW IIa11 Bivd., Tigard, OR 97223, P 1 8 2007 Dakn3Y; I v \/ / 5 ` permit No„ q _ KlT T ,�/�� /,
' 1 . Phone: 503. 639,4171 Fax; 503.598; 3'960 Plea Resew "S•�7
Date/gy: Other Permit ro,:
'I' I t : R 1 i Inspection Line figs d 3X175 CigY OF TIGRR® Date head /a
v o
,e,, le a i al Notificdin tr er B eoPage E far
,; �,.; %.i y
�� . t 3u t ::::: ral information
❑ New construction 0 Demolition For edal inform�i
.sPs an use checkllsr,
I Addition /alteration/replacement 0 O — Description Qty, Ea Total v
„ . ,: ,; , t, .5 �� t , New 1- 2 -family dwellings (includes 100 ft. fin each utility connection)
_, S r .: 1
'; �. ; �.' ",';�:.:: `'.;,� <.`:: ,. ,: SFR ( bath 249.20
1t2 I, and 2- family dwelling 0 Commercial/industrial SFR (2) bath 350.00
0 Accessory building 0 Multi - family SFR (3) bath 399,00
[] Mailer builder Each additional bath/kitchen 45,00
Other:
—
fl ' §i r ;� '; n ; ::.=:',::„ — Fire sprinkler ( sq. f .) Page 2
�� ` ., ' . ^�. ,. „ ::... ... .... •;e::.y.: : :, iF.,i � %..I'`' " , S1tCUtllftie9
'Tab site address: 1.A ` • + •, c 1 y (;),
'" I Catch basin or area drain 16.60
City /State/ZIP: i \ n If■.6 (9.A a LA Dtywcll, leach line, or trench drain 16,60
Suite/bldg. /apt no.: Project name: looting drain (no, linear it.. _) Page 2
Cross street/directions to job site: Manufactured home utilities 110.00
—
— Manholes 16.60
- _ Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
----- Storm sewer (no, linear ft.:___) Page 2
Subdivision: I Len no.: Water service (no. linear ft.: Sts) Page 2 u 1 / 45-
Tax map/parcel no.: Fixture or item
u.i;: r,i .0:r v'll; "?^ `ye5, ;r,., 'r' �,r... �nu��,,,,,�� , i;;; :•. - ;,,x;:,.s; Absorption valve 16,60
*f� , ., ,»�i. <, , x.,., ... f
, A.a:c,.
. �.+;�1; `�r, „ ::a- ,,. . d Baetcfiow preventer p
11�2�� _ .� 1 CQ Backwater valve 1660
Clothes washer 16.60
Dishwasher 16,60
7 u: Drinking fountain 16.60
Rjcctors/sump 16,60
Name: _
,`� �� Expansion tank 16.60
Address: S(1 g ���1g _ Fixture/sewercap
1.6,60
City/Statc/ZIP: Floor drain/floor sink/hub 16.60
Phone: ( ) Fax ( ) Garbage disposal 16.60
: . . : ;:;' f ' , ` r ' . '':+. �kS�„�'F,K,1`J.C�.i.L7Y',Ii. :5�' i l ^E py. �-
`::...n •` 1.i.A'M..,— ., ..m • a l�.� ' , ,:Y, Wma... a .. i ma
16,60
Business name:
interceptor /grease trap 16,60
Contact name: J aXY\1.Z. \ AID coo Medical gas (value: $ ) Page 2
Address: Primer ' r
City/State /ZIP: Roof drain (commercial) , r
Phone: (4:13) t,05`1 ..O1�1� -1 1 Fax: ; ( ) SinlubasiNlavatory
E- ma Tub /shower /shower pan 16.60
��hoc p, rV�,
}dy LDi sp Urinal 16,60
� h • ; r,.:,. '; ,. ,`, Water closet 16.60
Business name: a 0 .4 0 k `.r Water heater 16.60
Address: a. _____ _ a , 95: t-\ _ Other:
City /State/ZIP: U� X 157 l 1 t.-12. Fi\,p7 'qr�( "--1 (' Subtotal 72.50 �
l �� Minimum perrrrrt fee: $72,50
Phone: (. - Fax; ( ) Residential backflow minimum permit lee: $36.25 a
t>2 Q��
'S
CCB Lie.: `' Plumbing Lie. no.: J"1 ._-) Plan review (25% of permit fee)
Authorized signature_ 1 10/ State surcharge (R% of permit fee) ,-
{ 0 TOTAL PERMIT -
Pont name: -31 'i
27
Q \ Q - This permit application expires if a permit is not obtained within
180 days after it hats been accepted as complete.
.
CITY OF TIGARD - 4
BUILDING DIVISION PERMIT #: PLM2007- 00424
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/18/2007
Phone: (503) 639- 4171 ' ( I +�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/19/2007 TIME: 7:00AM PAGE: 27
SITE ADDRESS: 14362 SW 134TH DR CLASS OF WORK:
SUBDIVISION: THREE MOUNTAINS ESTATES LOT #: 037 TYPE OF USE:
PROJECT NAME: MOLUF
•
•
DESCRIPTION: Replace 50' of water service.
OWNER: MOLUF, STEVE PHONE #:
CONTRACTOR: ROTO ROOTER - WEST OFFICE PHONE #: 503-682-9774
Inspection Request Scheduled For: Date: 9/19/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 055943 -01 503 -932 -5581 N
Corrections /Comments / Instructions:
CA
.r4, P i.-6 (A
PASS I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: h J i I Ii Date: 9 I 0 to `7 Phone #: (503) 718-
•