Permit i b y {.•
CITY OF TIGARD PLUMBING PERMIT
17pg
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00166
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/26/2007
PARCEL: 1S134CB-13800
SITE ADDRESS: 12121 SW ANTON DR ZONING: R -7
SUBDIVISION: ANTON PARK NO. 2 LOT: 065 JURISDICTION: TIG
PROJECT: MEHEN
Project Description: New 60 ft water service
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: 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: 60 ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
MEHEN
12121 SW ANTON DR Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 4/26/2007 $72.50
[TAX] 8% State Surcha 4/26/2007 $5.80
Phone : 503- 330 -2892 Total $78.30
Contractor:
APOLLO DRAIN + ROOTER SERVICE
2208 NW BIRDSDALE #8
GRESHAM, OR 97030 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 239 -8801
FAX 503- 669 -9568
Reg #: LIC 49418
PLM 26 -533PB
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: �` Permittee Signatu „my) a7�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.
FROM •DOLLO DRAIN 503 - 669 -9568 (TUE)APR 24 2007 10:29/ST.10:28/No,6812889915 P 1
t :, 1.
Plumbing Pernut Appli t
Received Permit No .
City SW Fl rd A 2 4 201 Date/13y; PLIr(ac - OD /(�(ag
I31?S SW Fia}I Blvd.,'I'igard, OK 972 ^_3 Plan Review Other Permit No.:
Phone 503.639.4171 Fax: 503.598.1960 CITYOFTIGJ 1 j I •{ - Date/13 4- [lour Inspection Line: 503. 639.4175 ,_ca �i l /an
Internet; www.ci.tigard.or_us BUILDING DI •,- - "'. " :; " Not K dfM tiiy: Supplemental See Page for
- Notilied(Melhcrclr Supplemental l Infarmatlon
1
Ncw construction For .special information use checklist,
� ❑ Demolition Description I Qtv. I Ea. Total
, Addition/a11eratiorirep1acement ❑ Other New 1- 2 - family dwellings (includes 100 ft, for each utility connection)
;;; ''` ` CA`I_ECORY ". CON S TRUCTIONi' !', SFR(1)bath 240.20
'6 I • 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. ) Page
?;,', • JOB SITE.: INFORMATION'AND ?,LOCATION- ,'.,-'• - .-._
Job site address: I z1 a i G v..) A fl %O r) pr Catch basin or area drain 1 6.60
City /State/ZIP: "Ti ()�Lt'- C11 22 3 Diywell, leach line, or trench drain 16.60
` Footing drain (tto. linear ft.: ) Page 2
Suite /bldg. /apt, no.; Project name:
' Man 11fiiletu home utilities 110.00
Cross street /directions to job site:
Manholes 16-60
• Rain drtin connector 16.60
Sanitary sewer (no. linear IL: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Water service (no, linear fl.: AO )_.� 1 _ Page 2 b 67, CO
- Fixture or Item I
Tax map /parcel no„
. .. .. .....• ,...;..).: s , ' "'� ° +7 . I # : v ?s: Absorption valve 16.60
:.dti;�e l
"'A '.•,!'r.,i,a vwlj�: , 0* , 4 q11r4 •d O RI� sgta. ,S .tl k.` n, ' :4 A/' A v:I :
...��.....f�.�. alp ;..i.,� ,c,.,..tE�r. ,.,, -,,,., ",.,a „1.., .,,,.,, a ..,,.,.,�,,.,..,.,,,..� : - ,��.,,. �:. r Backflow pi'evcntcr Page 2
0tC' f GW leC) [ 1,004eA wryciCG - Backwater valve 16.60
t * Clothes wa sher' 16.60
r p. ICa.s- `C P roc l• -. w ht-in - 1 � S a a . 71-i ci n _S { Clo - -
• Dishwasher 16.60
'0:. ,ePR - ,6idi +Zi' ?4 IIV. :�:l r.Hi'ii 7t;�,�:' I ! 'iii?:; ; tic L'. •rr,,;. Drinking fountain 16.60 .
n
( n a lt,.•• ` -• "ii ti!; "r.�? ° Iw t..1 i.F:^;tP.`rtCkl;`•:i' Ejectors /st np 16.60
Name: Mchcn
Expansion tank 16.60
Address: Fixture/sewer cup 16,60
- _
City /State /LIP � Floor drain /floor sink/hub 16.60
Phone! (SO fi 2 '1 2 Fax: ( ) Garbage disposal 16.60
,.• t. ;PE o Ilose bib 16.60
-;: , APPLICArir'' • ';O.;;CO2VTAC RSOf1, :: ?
- - - Ice rnakty 16.60
Business name: hi
[ntcrccptor /gtLasc trap 16.60
Contact name: Medical g ag(value: S ) Page2
-- �.
Address: Primer - IE.i.b(1
City/Stec/ZIP: Roof drain (commercial) 16.60
Phone: ( ) Fax: : ( )
Sink/basin/lavatory 16.60
Tub /shower /showerpan __ 16,601
F- m,iil: Urinal 16.60
- •
CONTRACTOR; .... i W;ticrcloset 16.60 •
Business name: A 0 II
�` , 0 ._ 9 1uvv.bi'n ri Water heater
-- - 16,60
Address: 22.0IC 1,i6S410.1U Other: ` - - --
C'ity /Statc/LIP: C. "ba d-rr') q.--1O _ , . -__ St p Minimum $72.51) permit tcc: S72.50 �a �
Phone; (50s 2301 - ggQ ‘ Fax: (563 ) UL0 - q'3 1 � 0 Residential backllow minimum permit fcc: S36.25 'JO
CCL3 Lie,: 4 CiA t. Plumbing Lie. no.: Z-( 33 ?_.6 Plan ieview (25% ol permit t'ce) - - ,-
Al _tui,rvult State surcharge (11 %, of pcl,nit fee)
Authorized signature:
_ TOTAL PERM ITFEE 7 ? , ,
t [,
I Print name: , n G_Vu,C bn� I Date4 - _-e 1 This permit application expires if a permit is not obtalne within
- - ISO days after It has been accepted as complete.
"Fee methodology set by 1'1i- Count Buildin Industry Service Board.
, ri „dAinp Permits I'I,i .l'er*nil/1pp.dvc Oh 05 440-1011a( 1003 (115,1 v i:Hl
CITY OF TIGARD ,. .
BUILDING DIVISION .
PERMIT #:
PLM2007-00166
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
4126/2007
Phone: (503) 639-4171 ii*0
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
10117/2008 7:02AM 43
SITE ADDRESS: CLASS OF WORK:
•
12121 SW ANTON DR
SUBDIVISION: LOT #: TYPE OF USE:
ANTON PARK NO. 2 065
PROJECT NAME:
WHIM
DESCRIPTION:
New 60 ft water service
OWNER: PHONE #: 503-330-2892
WHIM, VONG & JENNIFER
CONTRACTOR: PHONE #: c03-239-8801
APOLLO DRAIN 4- ROOTER SERVICE
Inspection Request Scheduled For: Date: Pour Time:
10/17/2008
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 076712-01 503-239-8801 Y
Corrections/Comments/Instructions:
•
PASS 0 PARTIAL APPROVAL fl CANCEL I I NO ACCESS
0 FAIL El CALL FOR INSPECTION EI ADDITIONAL FEES ASSESSED
Inspector: (3111/v).A. \ \\'A-43- Date: 10 t \—) (O? Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639- 4171 M�i�u
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: �/ J S TIME: , � PAGE:
SITE ADDRESS: \ ?A A/An Or • CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
-,2 J •
Corrections /Comments /Instruc 'ons:
e o ►I C
®g , 1 L X ? i A. L-Ac) e_ a 11, 6- `i'lM c.-wo, c,t KJ LS
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Q. + - LVitt .a-' �J - L%1A
6 "C \A/"IP c< V C j'/ ON( RAAA o1/4_ 0-‘24 vv.,LA
F PASS g PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ' (,� V Lr Date: 6 Ae / 4 Phone #: (503) 718 -
CITY OF TIGARD a`:_ .`' --- eL C7., 601 ID to
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 A � n , eNi!�I 61 k . I
Inspection Requests (24 Hrs.): (503) 639 -4175 r'f .
INSPECTION WORKSHEET FOR DATE: C 17 / 3/O ' TIME: PAGE:
SITE ADDRESS: \ 7,1 _7j1 4 1 4ti 1) CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm #. Contact # Message
- V6 'L k �i -1,,, < Q
Corrections /Comments /Instructions:
4j C. kW 012 1 /176rYvtft . .-e,v1C-g-i O
\MAU C di- l__--, _ Li v L._ - o -I'.
V) uu2 1/4i-y-et. bef uu ; v--e K i i.-4
use I0vy ,
von .kt C cG Slr 1 r S . .
❑ PASS lei PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
❑ FAIL fl CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: VZ.A Date: q/ J #: (503) 718 - 14
1