Permit 4 CITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2006 -00371
°�'I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 8/3/2006
PARCEL: 25111 DC -02300
SITE ADDRESS: 15785 SW ALDERBROOK CIR ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.8 LOT: 470 JURISDICTION: TIG
Project Description: Relocate drain for tub to shower conversion.
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: 1 SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
PHYLLIS WALL
15785 SW ALDERBROOK CIR Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 8/3/2006 $72.50
[TAX] 8% State Surcha 8/3/2006 $5.80
Phone : 503- 639 -2801 Total $78.30
Contractor:
MRP SERVICES
PO BOX 33585
PORTLAND, OR 97292 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 652 -2626
FAX 503 -241 -6565
Reg #: LIC 106824
PLM 3 -265PB
WARNING: Do not render an electrical grounding system ineffective by replacing metal water service piping with
non -metal materials until a grounding system acceptable to the City of Tigard is installed, inspected and approved.
OPSC, Section 604.8, exception.
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: '� ^ L . Permittee Signature: c_x L \N
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.
Plumbing Permit Application Foie OFFICE L SI. ONLY
City of Tigard Dam/BV� 3 "06 /)�� Permit Nub' j y, 00 GU 7
13125 SW Mall Blvd., Tigard, OR 97223 Plan Review
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Phone: 503,639,4171 FEW: 503.598 -1960 EI N9 ■ r')oi i ll tV � `' DatDace./By: Other Penait No.:
•
24- Hour Inspection Line: 503.639.4175 . �� i`V pate Ready /By: Jurio: gl See Pee 2 rur
Internet: www.ci.tigard.or.u5 41 I ( nn Natified/Method: Supplemental Information
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❑ New wnstrt}otion
° eUIL() ' r I r apecurl information use checklist.
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vt D escription Qt Ea Total
• Other: " :t New - 2- family dwellings (includes 100 ft. for each utility connection)
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aria +• r ., y,• . y .. °^ ''M1= TR1T u; dt',:�i.;'' '"'�rb7r ity. K ' ; SFR (1) ,20
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- and 2-laniily dwelling [J Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
0 Master builder ❑ Other: Fire sprinkler ( so. fr.) Page 2
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Job site address: I. I A . ' &4 60
/ fill` i C atch basin or arca drain 16,
City /State /ZIP: 7• ' e / q-7 Drywell, leach line, Or [rench drain 16.60
Suite/bldg./apt. no.: Project nume: ,- j.„1.,
Footing drain (no. linear tt,; Page 2
Cross street/directions to job site: Manufactured home utilities l 10 -00
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Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no, linear ft_: _) Page 2
Scrum sewer (no. linear ft.; ) Page 2
Subdivision: l Lot no.: Water service (no. linear ft.: Page 2
Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
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_r Backwater valve 16.60
Clothes washer 16.60 .4 ' / Dishwasher 16.60
� • � � , � ��� , Drinking fo untain NM 16.60
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Name; ral I / NI` .° Expansion tank 16.60
Address: • 4 • VI : Mr ,I ' Fixture /sewer cap MN 16.60
City /State /ZIP: , l / Floor drain/floor sink/hub 16.60
Phone: 3 �3° - Fax: ( ) Garbage disposal 16.60
?'t,' ,:[ : (:� ^•? '77.^ J." - � ia... + � ,..a . e'. i,al, 1]ose bib 16.60
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, Business name: rn g_ 'P .��12� Interceptor /grease trap 16.60
Contact name: 1 a 44- I i .I/t/ Medical gas (value: $ ) Page 2
Address: , C.. 0 4 4, Primer 16.60
City/State/ZIP: b y Roof drain (commercial) 16,60
Phone: ) , .
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�p V Urinal � 16.60
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Business name: A i 9 ' 1 . : .i . • _ # 1 Water heater 16 60
Address: I n / . X '5 '3 5!' Other: IIMIIIIIIIIII
City /State/Z1P: 0 k , ' • 6 _ter. A i ' 7 i S mom
Mi n i mum permit fee:' $72.50
Phone: (63) A- - / ,`, Fax: ( I ) ). , rr 1 Residential backflow minimum .ormit fee: $36.25 • 'SO
CCII LiC -: / 1 ). plumbing Lie. no.: 3 a 1�'. / Plan review (25% of permit fee)
State surcharge (8% of permit tee) WI
Authorized signature: �� , <
���- 1 ; .- � /L�l' - TOTAL PERMIT FEE lat!' vrig
Print name: - �7tltlf /11 Fi s r(f s0, Date; t - aa if This permit application expires if a permit is nor obtained within
ISO days after it hub been accepled as complete.
"Fee methodology set by Tri- County Building industry Service Board.
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• CITY OF TIGARD
BUILDING DIVISION -.r .
-y PERMIT #: PLM200S -00371
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/30006
Phone: (503) 639 -4171 4i " �
Inspection Requests (24 Hrs.): (503) 639 -4175 '7 ..
INSPECTION WORKSHEET FOR DATE: a/9E2006 TIME: 7:04AM PAGE: 62
SITE ADDRESS: 15786 SW ALDERBROOK CIR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD N0,8 LOT #: 470 TYPE OF USE:
PROJECT NAME: WALL
DESCRIPTION: Relocate drain for tub to shower conversion.
OWNER: WALL, PHYLLIS PHONE #: 603 - 639 -2801
CONTRACTOR: MRP SERVICES PHONE #: 503-652 -2676
Inspection Request Scheduled For: Date: t319f2006 Pour Time: `\,_
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 034621 -01 503 -652 -2626 Y
Corrections /Comments /Instructions: ,../._ „jag
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?A ' PASS • PARTIAL APPROVAL ❑ CANCEL 1 I NO ACCESS
Pj AIL 74 LL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Z/ Dater Phone #: (503) 718-
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| BUILDING DIVISION � � ' PERMIT °�~°"~~~~^"~~= ~~"°"~°"~~"~ : PLhd2O06-00371
I 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8V5/2006
Phone: (503) 639-4171
Inspection Requests �4Hmj (503) ����
Hrs.): e���
INSPECTION WORKSHEET FOR DATE: 8/7y2006 TIME: 7:O2Am PAGE: 60
SITE ADDRESS: 15785SWALDERBR()()KClR CLASS OF WORK:
SUBDIVISION: SUh8K4BRF(ELDN[>.8 LOT #: 470 TYPE OF USE:
PROJECT NAME: WALL
DESCRIPTION: Relocate drain for tub to shower conversion.
^ OWNER: WALL, PHYLLIS PHONE #: 503-639-2801
CONTRACTOR: kHRpSBRVICES PHONE #: 503-652'2626
Inspection Request Scheduled For: Date: 8y7y2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough-in 034463-01 603-662-2626 Y
Corrections/Comments/Instructions:
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Vrg-ASS .
| | PARTIAL APPROVAL r7 CANCEL I I NO ACCESS
FAIL | | CALL FOR INSPECTION I | ADDITIONAL FEES ASSESSED
xk / 7 �~^ ~ ~� �� � > Inspector: Do1e� ~ �� �v Phone #: /6U8) 718' . .