Permit il 6 -u
CITY OF TIGARD PLUMBING PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00185
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/2/2008
PARCEL: 2S111DB
SITE ADDRESS: 15260 SW ALDERBROOK CT ZONING: R - 7
SUBDIVISION: SUMMERFIELD NO.7 LOT: 403 JURISDICTION: TIG
PROJECT: MOEN
Project Description: Installing backflow preventer.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
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: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
MYRTLE MOEN
15260 SW ALDERBROOK CT Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 5/2/2008 $36.25
[TAX] 12% State Surch 5/2/2008 $4.35
Phone : 503- 620 -4529 Total $40.60
Contractor:
BOB'S REEDVILLE PLUMBING
5976 SE ALEXANDER ST #C
HILLSBORO, OR 97123 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 356 -8832
FAX 503- 356 -5245
Reg #: LIC 168233
PLM 34 -342PB
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 / 1 P ermittee Signature:.." VP-or/ r te
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.
11111 y 01 08 11:04 Bobs Reedville Plumbing L 5033565245 P- 1 -
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Plumbin Permit A licati M - FOR' OFFICE USE ONLY t
Received .. Not I- A i Permit No.: i '�
City of Tigard
\./ ®� �(�-
Rcc01 e t
v 13125 SW Hall Blvd., Tigard, OR 97223 A PVan Review ether Permit No
i Pi = Phone: 503.639.4171 Fax: 503.598.1960 Date/By:
luriv. 1 55 See Page 2 for
Inspection Line: 503.639.4175 r`e a� g }Sy l� `- Date Ready/Hy guPplementat loformation
TIGARD CAI O , Eli lf'yh.4ot ifi e d/Method:
Internet: www.tigard or.gov FEE* SCHEDULE
l r, ' '
TYPE OF WOI j�t..
For special information use checklist.
❑ New construction El Demolition Description Total -
AAddition/alteration/rcplacement 1 ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
SFR (I) bath 249.20
CATEGORY OF CONSTRUCTION , _ 350.00
_
ICJ 1- and 2- family dwelling Commercial/industrial SFR (2) bath SFR (3) bath 399.00
❑ Accessory building ❑ Multi- family Each additional bath kitchen 45.00
❑ Master builder
❑ Other: Fire sprinkler (___ sq. ft.) Page 2
3013 SITE INFORMATION AND LOCATION Site utilities
/ /� Catch basin or area drain 16.60
Sob site address: i _( V 5y',/ f 1 i Az V �;��'� + 16.60
} 7 i Dryvell, leach line, or trench drain
CitylState/LIP� ( ��� �7t W �� G ``1 Footing drain (no. linear ft.: _) Page 2
Suite/bldgJapt. no.: 1 Project name: Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
SA j L
J / i V Rain drain connector 16.60
X Sanitary sewer (no- linear ft.: ___) _ Page 2
Storm sewer (no. linear ft.:
Page 2
�L� 7 Water service (no. Linear ft.: _) Page 2
Subdivision: Lot no.: Fixture or item
Tax map /parcel no.: Absorption valve
t 6.60 1
DESCRIPTION OF WORK Backflow prevcnter _
Page 2 3L( Z
j 1 7
/ 1_ Backwater valve
16.60
��( ����� C'(�l�
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
❑ PROPERTY OWNER ; ❑ TENANT Ejectors /sump 16.60
Name: K? Expansion tank 16.60
16.60
p� t . - ,4 C-71-- Fixture/sewer cap
Address: J 42 1 S t,,,., 91 I/l / � t/ 16.60
�._ 04 C_r -7ZL , J Floordrain/floor sink/hub City /State/ZIP: j � t "� Garbage disposal 16.60
Phone: f:-.7D-22) /n ��� 16.60
APPLICANT
U' � � Fax: ( ) Hose bib
❑ ❑ CONTACT PERSON Ice maker 16.60
Business name•
3 e , . 1 j u Q/L.4 rn . rd- L.L. CL-- Interceptor /grease trap 16.60
Medical gas (value: $ . ) Page 2
Contact name 16.60
.)tom 0-Le Le `/ Primer
Address: , Li , i �r� Roof drain (commercial) 16.60
City/State/ZIP: 1-4---MS [ l J Cy (71 w
/ I _ 5�� Sink/basin/lavatory 16.60
16.60
Phone: ' �l /- A'S:5 d ) ��1'�) Tub/shower/shower pan
I L t ) I F 0 pi t'nl 1 • Crl- Urinal 16.60
E-mail: /(�i k , �f'J 1 {3 C� i � !�7(7 f � �
CONTRACTOR Water closet 16.60
Water heater 16.60
Business name: Other:
Address: � ,,A ---' Subtotal
City /State/ZIP: . .. - Minimum permit fee: $72.50
Fax: ( ) Residential backflow minimum permit fee: $36.25 �it'• 25
Phone: ( ) _ Plan review (25% of permit fee)
CCB Lie.: (��� Plumbing Lie. no.:/ �jt ( {a 13 Plan
surcharge (12% of permit fee) ' 72S
Authorized signature: TOTAL PERMIT FEE q0 -(C
Date: j This permit application expires if a permit is not obtained within
LPrint name: K 1-7 r S�� j I L ('t �/� / - 180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
CITY OF TIGARD
I BUILDING DIVISION PERMIT #: i�LM2008 Ot 186
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/212008
Phone: (503) 639 -4171
An mii/r��,ll i ,I
Inspection Requests (24 Hrs.): (503) 639 -4175 -11.
INSPECTION WORKSHEET FOR DATE: �.00 W/2 8 TIME: 7:00AM PAGE: 29
5/
SITE ADDRESS: 15260 SW ALDERBROOK CT CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.7 LOT #: 403 TYPE OF USE:
PROJECT NAME: MOEN
DESCRIPTION: Installing backflow preventer.
OWNER: MOEN, MYRTLE PHONE #: 503 - 620.4529
CONTRACTOR: BOB'S REEDVILLE PLUMBING PHONE #: 503- 356 8832
Inspection Request Scheduled For: Date: 5/7/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 069491 -01 503.356 -8832 N
Corrections /Comments / Instructions:
Te /,
CU aL l tLecA
X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: V 1 ' `/VMwA \ .(\"— Date: Al 7 / -0? Phone #: (503) 718-
CITY OF TIGARD
1, BUILDING DIVISION
PERMIT #: PLM2008-00185
I 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 542/2008
Phone: (503) 639-4171 gardo i f,.
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 5/5/2008 TIME: 7:01AM PAGE: 50
SITE ADDRESS: 15260 SW ALDERBROOK CT CLASS OF WORK:
SUBDIVISION: SUMMERHELD NO.7 LOT #: 403 TYPE OF USE:
PROJECT NAME: MOEN
DESCRIPTION: Installing backflow preventer.
OWNER: MOEN, MYRTLE PHONE #: 503-620-4529
CONTRACTOR: BOB'S REEDVILLE PLUMBING PHONE #: 503-356-8832
Inspection Request Scheduled For: Date: 5/5/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
395 Misc. in sift/ ,4 069304-01 503-356-8832
Corrections/Comments/Instructions:
112 0 erd c ; Ac, C,, cra STA
n PASS [gt PARTIAL APPROVAL LI CANCEL I NO ACCESS
fl FAIL fl CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED
Inspector: (1 It) ra--4— Date: 5 Phone #: (503) 718-
_ -