Permit Mg CITY OF TIGARD'. PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00039
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/1/2008
PARCEL: 2 S 110 B D -07000
SITE ADDRESS: 11876 SW ASPEN RIDGE DR ZONING: R -4.5
SUBDIVISION: ASPEN RIDGE LOT: 042 JURISDICTION: TIG
PROJECT: TANG
Project Description: 50 ft. water service replacement
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: SEWER LINE: ft
WATER CLOSETS: WATER LINE: 50 ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
PENNY TANG D
11876 SW ASPEN RIDGE DR Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 2/1/2008 $72.50
[TAX] 12% State Surch 2/1/2008 $8.70
Phone : 503- 670 -831 1 Total $81.20
Contractor:
ARS LLC
PO BOX 20698
PORTLAND, OR 97294 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 -235 -8784
FAX 503 - 491 -2932
Reg #: LIC 127325
PLM 34 -168PB
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: �i ■1011. Permittee Signature:
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.
--.....- Plumbia Permit* • . I GE, eo '' .
FO u.Sit. ONLY . ...
. --- 1 Cit,y of Tigard 1 2-% p :7 i ,,„I 67
c..
1 - ) „, & r i y ‘ " I (.../ 6 7 - permit NC,
Oilier t)critiii Na
I 13125 SW Hall 3Ivd,. Tigard, OR 9722t - 0°
c2,
Phone: 503.639.4171 Fax: 501598.19(AT
1111 111 gkt) Drac/r3 in
nspeetion inc. 503.639.4175 L
nf IIG ,I■Ar IA, Et See Page 2 ror
TICARD I
14 N
Internet: www.tigard-or,gov cAINi Supplemental Intbrnoltion
TYPE OF WO) FEE* SCHEDULE
Fel. special informatinn use checklist,
ID New construction - CI Demo kina
- 2 I Qty. I Ea. I Total
.T.--- Addition/alteration/replacemcnt C] Other; New I. 2-family dwellings (includes 100 ft. for each utility connection)
' CATEGORY OF CONSTRUCTION . - SFR (1) bath 249.20
V 1- and 2-thrnily dwelling EI Commercial/industrial SFR (2) bath 350.110
. -
SFR (3) bath 399.00
ID Accessory building IEJ Multi-lamily
- - - Each additional bath/kitchen 45,00
0 Master builder EI Other: -
Fire sprinkler ( sq. 11.) Pap,c 2
JOB SITE INFORMATION AND LOCATION Site utilities
..
lob site address: Ir f) , II I i ' IV P- 0 0 ' Catch basin or arca drain ..,,, , ,. 16.60 --
--
.7=t{1..11='&74.:',._ 61:3 . ..-- •••••••- • --1•6 ....... - .
no.: Protect nurru.
: .. --- Footing drain (no. linear II.: ) Page 2
Suite/bldg./apt.
--- 0 Mnnufaciureil home utilities 110.00
Cross street/directions to job site; :C I I 'Li, , , ,
Manholes 16,60
-
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
_
Storm newer (nn. linear 6,: ) Page 2
Subdivision; Lot no,: Water service (no. linear ft.1. P Page
Fixture or item
..
Tax map/parcel no.;
Absorption valve 16.60
. . . ..
, DESCRIPTION OF WORK .. . .
. .,. .' • Briektlowarevenier Page 2
- _50 ( A)A. ii-E.L.:SS/2a-1.V_6_21911V-0-4EM Backwater valve 16.60
Clothes washer • I 6,60
- ' Dishwasher 16.60
PROPERTY OWNER TE • - Drinking fountain 16 60
D NANT .. : •:' ' ; :': • .
PZ i--
- 1jectors/sump 16.60
Name; P-EIVIVT 4 i
A. , , • i on Expaon tank
16.60
Address: I.175 A Ai S N ' 10 ' Fixture/sewer cap 16.60 -
City/State/ZIP; fl . Q Floor drain/floor sink/hub 16.60
Phone: - ( 571?..1 , Gi7,0. . ) 1 Fax: ( ) (lartiagc disposal 10,60
Hose bib 16.60
0 APPLICANT • 0 CONTACT PERSON: ' . • _. • -
- ' • - .•,-- rcc maker 16.60
Business name: A d JACK 14OWK PLUMBING & DRAIN
ey
Interceptor/grease trap -
16.60
. :
C of r.aw: /14A AS . 2iMle ____ Medical ' dical • , as (value. $ . --
)
Me Page 2
Address; P.O. BOX 20698 Prim 16.60
A , A
City/Slate/ZIP: PORTLAND, OREGON 97294 -- • A' te IT Cr ial) S - wolli 4 16,60
A 1 0%171 7 , t l' : Y
Phone: (503 ) 273 -'------------ ; (503) 491-2932 . 16.60
'
1 ,.4 .b/s1 1‘ 'flower pan 16.60
e
_.... mi ... l; ... Al . al 16.60
_ , CONTRACTOR
• k. ---
. c.r cot
.....
. 16.60
Business name: ARS dim JACK NOWT: PLUMBING & DRAIN 16.60
- - _
--
Address: P.O. BOX 20698 Other:
-
------ -
City/State/ZIP; PORTLAND,OBEGON 972698 . -. , . Subtotal -S--"-'
----
Phone; (503-) 235-8784 i : . . - A Fax: (503) 491-2932 Residential backflow p f 5 ; 1 3 2 612 5 5 0
- ,-
CCB Lie.: 127325 1 : :•• ,..: ' • Plumbing Lie. no.: 34 61 -168PB . . ,Plan review (25% of permit fee)
_ b", Vie
Anti,„,,zi,(1 si nature: . . • • (\k,C,,VLa ''', b 5 q _ State surcharge (12% of permit fee)
TOTAL, PF.RMIT FEE
Print mime: f 1 • ,S A, Vje9 Date()) /. i 0 li p 'his permit application expires if permit is not oinat cd atho.
, ISO days after it has been accepted as tntnplet t,_.,..------
Pee method set by. i- ny 13u d' Industry
I.0„ jidingw,i in irii 1 1 App. fin ' sk y 'TD e 6 � .
Service Board.
0 I an 9
CITY OF TIGARD . ..
,..
;A--
BUILDING DIVISION PERMIT #: PLM2008-00039
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/1/2008
Phone: (503) 639-4171 a\
Inspection Requests (24 Hrs.): (503) 639-4175 ...„ 1.J M
I
INSPECTION WORKSHEET FOR DATE: 2/4/2008 TIME: 7:18AM PAGE: 2
SITE ADDRESS: 11876 SW ASPEN RIDGE DR CLASS OF WORK:
SUBDIVISION: ASPEN RIDGE - LOT #: 042 TYPE OF USE:
PROJECT NAME: TANG
1 •
DESCRIPTION: 60 IT water service replacement
OWNER: TANG, PENNY PHONE #: 503-670-8311
CONTRACTOR: ARS LLC PHONE #: 603-3358784
Inspection Request Scheduled For: Date: 2/4/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 064430-01 50.3-235-8784 Y
F il).." - cvL
Corrections/Comments/Instructions:
p .e-L pi\pl t evc No,./tv\,1,4+...\;„. t.Jic_e...
14 PASS ri PARTIAL APPROVAL n CANCEL NO ACCESS
0 FAIL 0 CALL FOR INSPECTION pi ADDITIONAL FEES ASSESSED
Inspector: 0 Date: 2- 1 LA \ •071 Phone #: (503) 718-