Permit II Il CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT
PE
COMMUNITY PLM2008 - 00273
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/18/2008
• PARCEL: 2S112CA
SITE ADDRESS: 07755 SW ASHFORD ST ZONING: R - 4.5
SUBDIVISION: RENAISSANCE WOODS LOT: 039 JURISDICTION: TIG
PROJECT: JENSON
Project Description: Replacing kitchen sink and disposal
CLASS OF WORK: ALT GARBAGE DISPOSALS: 1 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: 1 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
•
Owner: FEES
DARYL & BA JENSON
7755 SW ASHFORD ST Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 6/18/2008 $72.50
[TAX] 12% State Surch 6/18/2008 $8.70
Phone : 503- 639 -7241 Total $81.20
Contractor:
3 MOUNTAINS PLUMBING
20345 SW PACIFIC HWY STE 103
SHERWOOD, OR 97140 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 925 -1342
FAX 503- 925 -9104
Reg #: LIC 169499
PLM PB99
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 / . % // - /� Permittee Signature: / 2 ?4 - '
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.
06 -18 -2009 10 :03 3 MTNS PLUMBING 5039259104 PAGE1
. ..
Plumbing Permit App n
li l Building Fixtures \• , ciski4
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City of Tigard , OA 1 `, ... 1 III ii r,<,.. /fit �-C.�� 2
` ,i■ 1312.5 SW Hall Rlvd., Tigard, OR 97223 '� c ' • jT;S , , S � - �� • • �J
' II ' Phone: 503.639.4171 Fax; 503.598.1960 ('� , �; ``�' Other Permit No.:
Inspection Line: 503- 639.4175 C' " - "' _ �
IA (i n R I ) ■ „� R 1 I' y , luris: 63 se 1'uge 2 for • • Internet: www.tigard- or.gov B �� . +� � n i se ( Supplemental Information •
TYPE OF WORK VIN .
` FEE* SCHEDULE
El New constriction - � ❑ Demolition _� .... TM' Y MT~ T -.. For sped& in urination use cheekiist
Description I CjY. J Ed. I Total
2 Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 tl, for each utility connection)
-
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath - ... 350.00
0 Accessory building ❑ Multi-family SFR (3) bath 399.00
Each additional bath /kitchen 45.00
❑ Master builder 0 Other: -
Fire sprinkler (, sq. ft.) Page 2
JOB SfI'w: INFORMATION AND LOCATION Site utilities
Job . ` silo uddress. �' Catch bruin or area drain 16,60
City/State/ZIP: `7^`e, 4.14r( I 1 ?0V ii � . _ W_ Drywell. leach line, or trench drain 16.60
Suite/bldg. /apt. no.: r �/ / Projeel name; Footing drain (no. linear ft -: ) Page 2
���? L � O " Manufactured home utilities 110.00
Cross street/directions to job site: - - m - -
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear tt.: ) Page 2
Storm sewer (no. linear IL: ) Page 2
Subdivision: y- mm- ~ _m IA no.: Water service (no. linear ft.: ) Page 2
Fixture or item
'I'ux map /parcel no_:
--- - -- - Absorption valve 16.60
DESC:RIP'I'ION OF WORK Ragk(lvw preventer r Paget
-- / '} vL 5 %lt sir F o va' fa..r - _ -�,_, Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
0 PROPERTY OWNER 0 TENANT 1)rinkingfountain 16.60 •
„. �_, 1- jeckm /sump 16.60
Name: F.xponsion tank -- 16.60
Address; T_ - Fixture /sewer cap 16.60
City /State /LIP: Floor drain/floor sink/hub 16.60
Phone ( ) Fax: ( ) Garbage disposal .,...,._ P 1(,,60 /6/4:0
CI APPLICANT 0 CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name:
. Interceptor /grease trap 16.60
Contact name, - -,�, ___,.�, `� Medical gas (value: $ �-, ) Page 2 WM
Address: Primer 16.60
City/State /LIP: Roof drain (commercial) 16.60_
Sink/basin/lavatory I 16.60 / ' '
Phone; ( ) Fax::( )
- -- - - Tub/shower/shower pan 16,60
E -mail:
Urinal 16.6
CONTRACTOR Water closet 16.60
Business name; "�, • ( no 7/ ' Water heater 16.60
Address: Oel q 4a./ /7ilr 4.`C ,M-v 1(0J W
Other; - -
City/State/ZIP: [ / , Subtotal
S�i(� I�l1Jt:d ( �).!( p ' �() Minimum permit fee. $72.50 •) f �
Phone; (10'S ) 4 j. - / l4/ 9, Fax: (''t3) 95` - '%O f Residential hackflow minimum permit fee: $36.25
['C:fi l.io.: J 6' Plumbing Lie. no.: P I (! ! l l an re v i ew ( 25 % ofpermit fee)
Authorized signature
' �' / r
State surcharge (12% of permit fee) d,
r - ._. .. ! / /r /d�yvr`- TOTAL PERMIT 1:1 :4; F/ .
Print name: W I l � / ' r: ^+ �,� � � Date: d -- /8. • (. y This permit application expires if a permit is not obtained within
(1..C ISO days after It has been accepted as complete.
'Ter methndnlnav set tvv Iri .4'nnnty Rnitdinn Indusiry Service Anard
7
CITY OF TIGARD=
BUILDING DIVISION PERMIT #: PLM200B-00273
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/18/2008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 7/2/2008 TIME: 7:01AM PAGE: 46
SITE ADDRESS: 07756 SW ASHFORD ST CLASS OF WORK:
SUBDIVISION: RENAISSANCE WOODS LOT #: 039 TYPE OF USE:
PROJECT NAME: JENSON
DESCRIPTION: Replacing kitchen sink and disposal
OWNER: JENSON, DARYL & BARBARA PHONE #: 503-639-7241
CONTRACTOR: 3 MOUNTAINS PLUMBING PHONE #: 503-925-1342 .
Inspection Request Scheduled For: Date: 7/2/2008 _ Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 072107-01 503-925-1342
Corrections /Comments / Instructions:
C Ctft- f c $/t/-)
PASS El PARTIAL APPROVAL El CANCEL NO ACCESS
FAIL I] CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: CM 1 14-A-Ji t S mit-13-1 Date: - 121 0 R) Phone #: (503) 718-