Permit r T.
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a CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 - 00326
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/4/2008
PARCEL: 25111 DC -02500
SITE ADDRESS: 15745 SW ALDERBROOK CIR ZONING: R -
SUBDIVISION: SUMMERFIELD NO.8 LOT: 472 JURISDICTION: TIG
PROJECT: MIER
Project Description: Interior plumbing. Other fixture: ice maker.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: 1 BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
ROBERT MIER
15745 SW ALDERBROOK CIR Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 8/4/2008 $72.50
[TAX] 12% State Surch 8/4/2008 $8.70
Phone : Total $81.20
Contractor:
JOHN D PLUMBING
7472 SW FIR STREET
TIGARD, OR 97223 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 620 -7600
FAX 503 -598 -9355
Reg #: LIC 89537
PLM 34 -257PB
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.
i
Issued B. %f' Permittee Signature: / 4 y., 0 - �_
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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
Building Fixtures roil Off lcl 1 SE O \L'I
•
. City of Tigard ` e ® b'' « ay 47 �yiy
Permit No.: � ) �`-0O3A (p
Ill 13125 SW Hall Blvd., Tigard, OR 97223 ` �
e Phone: 503.639.4171 Fax: 503. '1 ; ® ®® 1 Review
Other Permit No.:
T I G.A R t, Inspection Line: 503.639.4175 `• _ , Da Date Ready/By: Jurist la See Page 2 for
w
Internet ww.tigard or.gov �l� Notified/Method: Supplemental Information
TYPE OF WORK PV -- O
FEE* SCHEDULE
�e� For special information use checklist
❑New construction
❑ et ®����\� Description I Qty. Ea. I Total
g Addition/alteration/replacement ❑ ` ct i O New 1 - 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSI nxm. ION SFR (1) bath 24920
X t 1 - and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other.
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: I €7 It 6 5 t 9 4 Lb ER 13 2.00K of es. . Catch basin or area drain 16.60
City/ State/ZIP: 17 C j ( o e . q 7 Z c f- Drywell, leach line, or trench drain 16.60
M Footing drain (no. linear ft.: ) Page 2
Suite/bldgJapt. no.: I Project name: "lice:
Manufactured home utilities 110.00
Cross street/directions to job site: S(A) S Pr7T
LE Manholes 16.60
e _ a R' K 6 Q TO geA tk-i, Q E- - Rain drain connector 16.60
3 QOO K C ( . Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.: -
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
i1k1SThLi- ICC 1 A-KE2 L-I JL I t S'f1E2 i Backwater valve 16.60
A EK 'HEATER_ Clothes washer / 16.60
`� Dishwasher 16.60
PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60
Ejectors/sump 16.60
Name: Expansion tank 16.60
Address: r 5 7 11- 6 z ER_ i3 (3 0 f Cc R_ . Fixture/sewer cap 16.60
City/State/ZIP: 17 G it1-(Zt ( Q (.. q 7 Z ZCF- Floor drain/floor sink/hub 16.60
Phone: ( )
Fax: ( ) Garbage disposal 16.60
❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60
Ice maker F 16.60
Business name: Interceptor /grease trap 16.60
Contact name: Medical gas (value: $ ) Page 2
Address: Primer 16.60
City/ State/ZIP: Roof drain (commercial) 16.60
Sink/basin/lavatory 16.60
Phone: ( ) I Fax: : ( )
Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
pp CONTRACTOR r Water closet 16.60
,,
Business name: � -- {-E' UJ ( O � • �L. V M t t 1 G Water heater I 16.60
Address: 7L .1 Z c-w 'Fife_ -1.- Other.
City/State/ZIP: •" j j G P Q b 0 [a - 9 7 Z Z 3 Subtotal U
i Minimum permit fee: $72.50 I
Phone: (y b) 0 2-0-- "7(p 0-0 Fax: (CQ3 , -ci 3 5 _ Residential backflow minimum permit fee: $36.25 1 L • s.)
CCB Lic.: 1S q' 3 7 Plumbing Lic. no.: 34- - 2,.. F f . Plan review (25% of permit fee)
State surcharge TOTAL (12% PERMIT FEE
permit fee) 8, 10
Authorized signature: iAr 2,00
Print name: 70 f r 6 k 0 M ( (� Date: /L rQ This permit application expires if a permit is not obtained within
J 180 days after it has been accepted as complete.
CITY OF TIGARD _
BUILDING DIVISION PERMIT #: PI.M 00 00326
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/412008
Phone: (503) 639 -4171 /F�bj m� i p�� ll
Inspection Requests (24 Hrs.): (503) 639 -4175 s °IL
INSPECTION WORKSHEET FOR DATE: 9/17/2008 TIME: 7:00AM PAGE: 18
SITE ADDRESS: 15745 SW ALDERBROOK CIR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.8 LOT #: 472 TYPE OF USE:
PROJECT NAME: MIER
DESCRIPTION: Interior plumbing. Other fixture: ice maker.
OWNER: MIER, ROBERT PHONE #:
CONTRACTOR: JOHN D PLUMBING PHONE #: 50620 -7600
Inspection Request Scheduled For: Date: 9/17/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 075561 -01 03- 784 -5680 N
Corrections /Comments /Instructions:
C CA rt. f r 1.,_ -„ k-
K PASS ❑ PARTIAL APPROVAL n CANCEL n NO ACCESS
n FAIL I I CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: (J ,J \ \` 4^^' Date: CAI r) ) on( Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: Pl M7008- 003:26
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/4/2008
Phone: (503) 639 -4171 4 1
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/5/2008 TIME: 7:00AM PAGE: 29
SITE ADDRESS: 1 5745 sw ALDERt3ROOK CIR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.8 LOT #: 472 TYPE OF USE:
PROJECT NAME: MIER
DESCRIPTION: `
Interior plumbing. Other fixture: ice maker.
OWNER: IVIIIMR, ROBERT PHONE #:
CONTRACTOR: JOHN D PLUMBING PHONE #: 503 -620 -7600
Inspection Request Scheduled For: Date: 8/5/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 073717 -01 503-620-7600 Y
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 6 1 ‘ \ "` Date: ( "1 - S 7 ' ) , C 1 . . - cI i Phone #: (503) 718-