Permit pr CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00228
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/4/2007
PARCEL: 2S 104C B -01600
SITE ADDRESS: 13083 SW ASCENSION DR ZONING: R -7
SUBDIVISION: HILLSHIRE WOODS LOT: 032 JURISDICTION: TIG
PROJECT: HANSEN
Project Description: New installation of valve and drain relocation.
CLASS OF WORK: ALT 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
DAVID & KA HANSEN
13083 SW ASCENSION DR Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 6/4/2007 $72.50
[TAX] 8% State Surcha 6/4/2007 $5.80
Phone : Total $78.30
Contractor:
BATHTUB SOLUTION
11747 NE SUMNER
PORTLAND, OR 97220 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 -595 -8827
FAX 503 -595 -6051
Reg #: LIC 165987
PLM PB -312
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: ki / Permittee Signature: 5: (Q,�
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.
1
FROM :BATH FITTEF "LAND FAX NO. :503 595 -6051 Jun. 01 2007 03:02PM P1
Plumbing Permit Applica on �"'
-- ��,��L� halt OFFtc;t? t!s1•: t>Nt.r •
City of Tigard 13125 SW Hall Blvd. c
71 u , Tigard, OR 97223' 0 1 2007 Date/By: � • Permit No.: P �a _ . ' 77p
' ' Phone: 503.639.4171 Fax: 503.59 0(,), Plan Review CL.O
TIGARD
Inspection Line: 503.639.4175 toll 11� �.-• ° ; IGARD
Date/By: Other Permit No.:
Internet: www.tigard- or,gov ! DIVISION Date Ready/By 62 See Page 2 for
K Notified/Method: 1 Supplemental
xille � " , } 1 9 s i in " itrum
iii ,. t
� ' � nl'- `� � . �rill � ������ . ` t '.1 E ❑ New construction
❑ Demolition For special information use checklist.
[ . Addition /alteration /replacement Description 1 Qty. Ea. Total
❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
jK1 iii ; , T n „�
ttti .. �' ,. 1 It 41 :1 SFR (t) bath 249.20
1 -and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
DO Accessory building ❑ Multi-family SFR (3) bath 399.00
❑ Master builder Other: Each additional bath /kitchen 45.00
t Aer
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� �� "�s� ag t �'�»st �� Aires sprinkler
liv .J � l ci, 3' it r : a ,. i s3 • st, I k q. } Page 2
rah.' ol, ' t ;31. Site utilities
Job site address: 1 Tjtit5 ( r` 7i , 1 ,� e_ Catch basin or area drain 16.60
City /State /ZIP.' ">1 ti' $ 1 t g cri gl. Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: 105- 1 Project name: . -L .1 -\ Footing drain (no. linear ft.: ) 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: 1 Lot no.: Water service (no. linear ft.: _ ) Page 2
Tax map /parcel no.: Fixture or item
Backflow preventer
1 per, s e , y r ., l I t t it t Absorption valve 16.60
� ar A.i.k i )> iti #.t�1.1,li _ I ' 6 41' t . � A.1 , 9 4 i'l 11 Page 2
,1� _ ( g
t`�'W 1 � }y � 6 1 4. d( 1 I wa g Backwater valve _ 16.60
Clothes washer 16.60
Dishwasher 16.60
mt 1°sa`g m Sr i h °i6 ` ' i , .- i Drinking fountain 16.60
2 v n 1 F t1Y` f y
.; e . lit �I A 3�' z , 1 11, . ,1 1i''
�� 1 / Ejectors /sump 16.60
Name: v, xa,V 1 r4. k Karein - 6,/\w)
Expansion tank 16.60
Address: ISO8 3 tZ (1 5 / IS 1 on Fixture /sewer cap 16.60
City /State/ZIP: k ; 4 �{- ) 0 / t1 -222 Floor drain /floor sink/hub 16.60
Phone: ( ) ` Fax: ( ) J Garbage disposal 16.60
1. y s � �nrx, e s a 9 b I t s 4: � a �uz� ; i • Hose bib 16.60
, s a , < , ma t t 3 1i;, i€ ul i4 . , , . , I , . ,, , 4si1a :111 ;It & Ice maker 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
Phone: ( ) I Fax:: ( ) Sink /basin /lavatory 16.60
E -mail
Tub /shower /shower pan t 16.60 11 --1.0,
E-mail:
�� Urinal 16.60
;. i ` °r• ,,tl ,: `il t �1 1 € E t °;'! ' ii) ■ 1i it {it
1 .a . . ,
11Yvr. ,,. J� lr tx P ��� � � is, �- s. =.�, � .;IEIt.�� Water closet 16.60
Business name: -BAIA 1 1 1 ) ` ,k Water heater 16.60
Address: w' . - w
? y - Other:
so
L�
City /State/ZIP: t �
�• b _ l
`t 9 Subtotal I��
Phone: (i+ I r c � Minimum permit fee: $72.50
r.. ) Y - r , a Fax: (tjhl &S- � ' / Residential backflow minimum permit fee: $36.25 ' 7 4.∎
CCB Lic.: % (6 e,. / ( Plumbing Lic. no.:' 3�� Plan review (25% of permit fee)
Authorized signature !mil 1 I i y State surcharge (8% of permit fee) 5. h,
t ! ` j TOTAL PERMIT FEE .q_%- 5
Date: Print name:
This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
1 :\ Building \Permits\PLM- PermitApp. 06/26/06 440.4d 16T(10/02/COM/WE8)
r ( ( r
'CITY-OF TIGARD
BUILDING DIVISION • ( PERMIT #: PLM2007- 00228
13125 SW Hall Blvd., Tigard, OR 97223 0 DATE ISSUED: 6/4/2007
Phone: (503) 639 -4171 £w ° � i I
Inspection Requests (24 Hrs.): (503) 639 -4175 j I Y
INSPECTION WORKSHEET FOR DATE: 6/7 /2007 TIME: 7:00AM PAGE: 62
SITE ADDRESS: 13083 SW ASCENSION DR CLASS OF WORK:
SUBDIVISION: HILLSHIRE WOODS LOT #: 032 TYPE OF USE:
PROJECT NAME: HANSEN
DESCRIPTION: New installation of valve and drain relocation.
OWNER: HANSEN, DAVID & KAREN PHONE #:
CONTRACTOR: BATHTUB SOLUTION PHONE #: 503 -6,95 -8827
W I)—'
Inspection Request Scheduled For: Date: 6/7/2007 Q Pour Time:
pA--/
Code # spection Description Confirm # Contact # Me :sage V _
3 Shower pan 049710-01 503-595-8827 Y
Correctio /Comments /Instructions:
V 1\ 11 7 , 1 ''
A 1
- - A) J4 -- I , , ( :
i i k #
u r
PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
\�
Inspector: -- - .. — Date: 61 Phone #: (503) 718 - 2 _ . � Z "�
CITY-OF TIGARD ‘.1
BUILDING DIVISION .- . :-. ,47.,
PERMIT #: PLMv12007 -00228
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/4/2007
Phone: (503) 639 -4171 0111110
Inspection Requests (24 Hrs.): (503) 639 -4175 s - !� - J..
INSPECTION WORKSHEET FOR DATE: 6/5/2007 TIME: 7 :01AM PAGE: 82
SITE ADDRESS: 13083 SW ASCENSION DR CLASS OF WORK:
SUBDIVISION: HILLSHIRE WOODS LOT #: 032 TYPE OF USE:
PROJECT NAME: HANSEN
DESCRIPTION: New installation of valve and drain relocation.
OWNER: HANSEN, DAVID & KAREN PHONE #:
CONTRACTOR: BATHTUB SOLUTION PHONE #: 503.595 -8827
Inspection Request Scheduled For: Date: 6/5/2007 Pour Time:
Code # Inspection Description Confirm # t Message
322 Shower pan 049545 -01 503-595-13827 Y
Corrections/Comments/Instructions:
•
_�� Z�
�: ' ASS r z. PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
FAIL / CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
ih
f
Inspector:: /� I •
Date: �JC 5 61 Phone #: (503) 718- ? / (/�
1 Y