Permit CITY OF TIGARD
PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2006 -00100
A' "�J �� 13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171 DATE ISSUED: 2/1712006
PARCEL: 2S 102CD -02708
SITE ADDRESS: 13560 SW ASH AVE ZONING: R -4.5
SUBDIVISION: FREWINGS ORCHARD TRACTS LOT: 026 JURISDICTION: TIG
Project Description: Sewer connection.
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: SEWER LINE: ft1
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
ROY F. THOMAS
13560 SW ASH AVE Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 2/17/2006 $72.50
[TAX] 8% State Surcha 2/17/2006 $5.80
Phone : Total $78.30
Contractor:
BRUNER PLUMBING
PO BOX 23985
TIGARD, OR 97281 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 624 -4880
FAX 503- 624 -2173
Reg #: LIC 81837
PLM 26 -445PB
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 Signature: S
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 : BRUNER 'PLUMB I NG FAX NO. : 6242173 Feb. 16 2006 04: 48PM P1
Btlilding Fixtui.. es
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City o f Tigurd f 4 .... c ... pamit N I) . ) \ /\‘,2006 7,00i e2
(3125 SW Hall Blvd., 'Tigard, OR 97221 ..1 r.
7f1116 • Plan R4.
Other Pennii No..
/4" 70.;' i .
Phol)C' 503.639.4171 Fax: 503.598,196FEB 1 0 ..-- y ., Date/By.
24- Hour Inspection line. 503.639,4175 U 1 Dais Ready/13y: ) ,""s i , (- VI See rage 2 fur
Internet: www.ei.tigard.orus Non ticcVMetho d: - 11( j' Supplemental lnformatim
, $I+0.F.natk . . ...
. :TYPE FeRMIOMSION . . , , . . . . . .. FEE* SCHEDULE
3 L _
For special information use checklist
Description
n New construction D Demolition
, LQ1. 'Total
--
A Addition/alteration/replacement 0 Other: New 1- 2 dwellings (includes 100 ft. for each utility col,neetion)
. ' . . ...CATEGORY OF CONSTRUCTION. . . - : . SFR (1) bath 249.20
.. . .. _... ....
--.-.....---
and 2-family dwelling 0 Commercial/industrial , SFR (2) bath 350.00
. „,... ..
D Accessory building - SFR (3) bath 399.00 D Multi-family -----
- --- - Each additional bath/kitchen 45.00
0 Muster builder Ei Other:
. , Fire sprinkler ( sq, 6,) Page 2 I
. . , '• 'JOB' SITE INFORMATION AND LOCATION .
- ' - - . - - • • - • • - - • - • • ; ' Site utilities
Job site address: 43:.S GO -SW A Ski Ale Catch basin or area drain 16.60
a.
City/State/ZIP: TLI1R i'd .t ( "w `-(1:7,I2 Drywell, leach line, or trench drain 16.60
Suite/bldg/apt. no.: Project name: - n 0-.),,yet_s Footing drain (no, linear ft,: ) Page 2
Manufactured home utilities 110,00
Cross street/directions to job Site:
Manholes 16.60_
Rain drain connector 16.60
- .
-
Sanitary sewer (no. linear ft: ) Page 2 ,257
_,.... _...___
Storm sewer (nu. linear ft.: ) Page 2
Water service (no. linear ti.: ) Page 2
SubdivisiOn: l ot no • - ___
- - ""'" - - - Fixture or ikin
Tax map/parcel n�.;
.
Absorption valve 16.60
• . ..... .. . ... . .„
" OF WORN . ' ..
' . • • ' liackflow preventer Page 2
.4. . !. - f Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
0 PROPERTY' OWNER':".• . ' ' ,• ' ,''' '' Drinking fountain 16.60 0 TENANT .
. . . . • • • . P.jectors/sump 16.60
Name:
It:xpansion tank 16.60
_
Address: Fixture/sewer cap 16.60
Cif y/State/ZIP: Floor drain/floor sink/hub 16,60
Phone: ( ) Fax: (. ) Garbage disposal 16.61)
16.60
0 APPLICANT • • . .0 CONTACT PERSON . . Hose bib ---
Ice maker 16.60
Business name:
loterceptodg,reaSe trap 16.60 _1
Conran name: Medical gas (value $ Page 2
Address: Primer 16 60
.-.1-.:-,...
City/State/ZIP. Roof drain (commercial) 16,60
' - - • ' ' - Sink/basin/lavatory i 6.60
l'hone: ( 3 Fax: :
'rub/shower/shower pan 16.60
1:,-rna il :
Urinal 16.60
....
. .
. .. . . . . .............- -
. • , Water closet 16.60
Business name: ,...)\(- VI j be . A.1--1 to ( &La,. LA71c..--- Water heater 16.60
• •
I Address: • ' P() n 6 ' . i 'e•---. Other:
Su btot2i , ..7).-. 1 7D
1 City/State/Z1R; r 4.a nd .‘ 0 Y C 4 7 0 ( Z - I _ .
Minimum permit fee: $72,50
Phone (S5TY) 6,7Z EA 3L T W Fax: i /e<7 -, 0 - Q 1 J 2"/ Residential backtlow minimum permit fee: $36.25 / .---.< ,
- - •
•-•-• - •
CCP, 1.1c - cz: 7, -,..- Plumbing Lie. no.: 0( --Lit4,s ip...) Plan review (25% of permit fee)
p
_ ,
Stale surcharge (8% of permit ice)
Autholized signature. 4'
--79,-
TOTAL PERMIT FEE
__.
12:,L
name ' af -, ....,,.- ,,,, km Date: c .... , i (. ote This permit applicatio II mtpirsiii poritiii iN not obtained within
ISO days after it has been accepted as complete.
"pee methodology act by 'Fri-County 13uilding Industry Servic, 13uard.
1 \ Bviltkg\Purrnits\PLMF-PerrnitApp.doc 06/05 44 0 61 (1( I oitii/COmfv1F,B)
CITY OF TIGARD Y /2L-r11
BUILDING DIVISION PERMIT #: 2_p616 —O a (a v
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 4mlll +l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: f 3 ,S v / 411) CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3- F - o . Pour Time: /C
Code # Inspecti n Description Confirm # Contact # Message
Corrections /Comments /Instructions:
P IA oi Pe 4Le-r
Ca- 1..`�— ...- Vv € Y Via!LL�.
•
PASS I 1 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL n CALL FOR INSPECTION ADDITIONAL FEES ASSESSED •
Inspector: (3111.4,,) Date: 317)06, Phone #: (503) 718-
CITY OF TIGARD , • ti.
BUILDING DIVISION PERMIT #: - ZD 4 ) 6 --00 L)6
1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 N�1�11i�dj�j�
Inspection Requests (24 Hrs.): (503) 639 -4175
' INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: l 3 S 0 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3-1 -0 G Pour Time
Code Inspection Description Confirm # Contact # Message
Seg- o3ocD
Corrections /Comments /Instructions: -e
/ // iii .--
,
AillieL%/440 ‘,.> _-_ -4 .,A0L-.
■
. / /
•
„
1# PASS 01 •ARTIAL APPROVAL ❑ CANCEL n NO ACCESS
• FAIL n CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED _
Inspector: /
M 47 Date: 3 / t O t Phone #: (503) 718 -