Permit a CITY OF TIGARD PLUMBING PERMIT
.111 COMMUNITY DEVELOPMENT PERMIT #: PLM2006 -00555
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/14/2006
PARCEL: 1 S136DD -00900
SITE ADDRESS: 06830 SW ATLANTA ST 120 ZONING: MUE
SUBDIVISION: HAINES CROSSING II LOT: JURISDICTION: TIG
Project Description: (1) breakroom sink.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B 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
MALCOM ESLINGER
11575 SW PACIFIC HWY Description Date Amount
PMB 160 [PLUMB] Permit Fee 11/14/200E $72.50
TIGARD, OR 97223 [TAX] 8% State Surcha 111141200E $5.80
Phone : 503- 620 -9515 Total $78.30
Contractor:
UNIVERSAL PLUMBING
(DAVID RAY OAKLEY)
8811 SW SPRUCE STREET REQUIRED ITEMS AND REPORTS
TIGARD, OR 97223
Contact # : PRI 503- 452 -7480
FAX 503 -844 -9961
Reg #: LIC 111472
PLM 26 -589PB
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► /. Permittee Signat IF ' �!k
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.
Plumbing Permit Applicatio ECEll FOR OFFICE USE ONLY
p� Received /// D
IN •
Cit of Tigard NO O V 7 � Date 1 I ( 3 6 Pe rmit N . p 13125 SW Hall Blvd., Tigard, OR 97223 v Il 2006 t /!
-
Plan Review S {���
Phone: 503.639.4171 Fax: 503.59 Other Permit 1 � f �
TIGARD Inspection Line: 503 Date Ready /By: Jr
���� ®� � , ARD See PagC 2 for
V
Internet: www.tigard - or.gov ®IvIS Date /By: Notified/Method. J Supplemental Information
sa
:,e: TYPE OF: WORIC:�; e ' .'k °�;:£ : • ; €: Nei; ��.. ; ,f ,.,:,' F EE;,, S GHED1.iIE` >,''`E�hE,a -
r may.. ,. .
,. =� s ........ ed , s , .. . - ... _ :r te ,. .. �t ,� a„, ,_ „ _ ses� . . .. , ....._ -� . ,._a,,:<<<,1d • -
.New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. I Total
❑ Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
#,:; 1 v.: CATEGORY. F�_-_ SFR (1) bath 249.20
❑ 1- and 2- family dwelling Commercial /industrial SFR (2) bath 350.00
❑ Accessory building El Multi-family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
_ :
JOB. SITE INF..ORMATION AND'LOCATION
La.� .� ,..,:.�. •. , � 4. Site utilities
� Job site address: �. W .4110j,6�,'l`c cA . �fit�e.a / Catch basin or area drain 16.60
City /State /ZIP: lare( t CZ giv , a ..3 Drywell, leach line, or trench drain 16.60
Suite /bldg. /apt. no.: /2 l Project name: ` ✓ n s ; A 0 Footing drain (no. linear fr.: ) Page 2
r Manufactured home utilities 110.00
Cross street/directions to job site: Coif' A e� i4t �! f
Manholes 16.60
' PO 42-l6041 Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: _ ) Page 2
Subdivision: I Lot no.: Water service (no, linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
`;; 4 , DESCRIPTION ^. =1`. ? - -.. - ... Backflow preventer Page 2
13i' - . mom. S ,1_ Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
..E'' - Drinking fountain 16.60
,' ; :'- :: - « "r iD PR
PTY OWNER ' ®_ TEN
� x
"" "' W:ty.e.r• �' , Ejectors /sump 16.60
Name:/ WA 5V okror1 I 4 c. s1� e-'L . Expansion tank 16.60
Address: `1575 .g, ' ' j�� ` - e ... to) JF Fixture /sewer cap 16.60
City /State /ZIP: ...-----k i i/ CX_, 97L3 Floor drain/floor sink/hub 16.60
! 62161- ( ��)� Garbage disposal 16.60
Phone: �) ��- l'4-7c. Fax (5615 / `�i
s
Hose bib 16.60
,> : ® >APPIICANT ' 0 „CONTACT; PERSON
Ice maker 16.60
Business name: /L� 03 a e....
Interceptor /grease trap 16.60
Contact name: Medical gas (value: $ ) Page 2
Address: Printer 16.60
City /State /ZIP: Roof drain (commercial) 16.60
Phone: ( ) I Fax: : ( )
Sin - asin/lavatory 9 16.60
Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
„ at; , , ' CONTRACTOR`
R�F ,mac
.. _ . ._ _. r ...._ _ . _ ; ,2s,0 , Water closet 16.60
Business name: Universal Plumbing Company Water heater 16.60
Address: 8811 SW Spruce St Other:
City /State /ZIP: Tigard, OR 97223 Subtotal
Minimum permit fee: $72.50 7,,Q. Phone: (503) 452 - 7480 Fax: (503) 244 - 9961 Residential backflow minimum permit fee: $36.25
CCB Lie.: 111472 Plumbing Lic. no.: 26 - 589PB Plan review (25% of permit fee)
A , .' State surcharge (8% of permit fee) 5.�j
Authorized signature: " - ;, ( ;,� . 3D
r - . TOTAL PERMIT FEE !
Print name: David Oakley Date: 11/14/2006 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.doc 06/26/06 440- 4616T(10/02/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2006 00555,
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/14/2006
Phone: (503) 639 -4171 :nil V\
Inspection Requests (24 Hrs.): (503) 639 -4175 .J'
INSPECTION WORKSHEET FOR DATE 3/27/2007 TIME: 7:02AM PAGE: 20
SITE ADDRESS: 06830 SW ATLANTA ST 120 . CLASS OF WORK:
SUBDIVISION: HAINES CROSSING II LOT #: TYPE OF USE:
PROJECT NAME: SPEC SPACE
DESCRIPTION: (1) breakroom sink.
OWNER: MINCER. MALCCM PHONE #: 503 -620 -9515
CONTRACTOR: UNIVERSAL PLUMBING PHONE #: 503.452 -7480
Inspection Request Scheduled For: Date: 3/27/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 045492 -01 503-997-8478 N
Corrections/Comments/Instructions:
ill
K4LPASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
I I FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
� Inspector: Date: Phone #: (503) 718-
..
. ,
CITY OF TIGARD
BUILDING DIVISION
PERMIT #:- PLM200&00666
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/14/2006
Phone: (503) 639-4171 4 4/ 0 /1/10
Inspection Requests (24 Hrs.): (503) 639-4175 1
INSPECTION WORKSHEET FOR DATE: 11/15/2006 TIME: 7:07AM PAGE: 24
SITE ADDRESS: 06830 SW ATLANTA ST 120 • CLASS OF WORK:
SUBDIVISION: HAINES CROSSING II LOT #: TYPE OF USE:
PROJECT NAME: SPEC SPACE
DESCRIPTION: (1) breakroom sink.
OWNER: ESLINGER, MALCOM PHONE #: 503-620-9515
CONTRACTOR: UNIVERSAL PLUMBING PHONE #: 503-462-7480
Inspection Request Scheduled For: Date: 11/15/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough-in 039802-01 603-997-84M
Corrections/Comments/Instructions:
•
•
n PASS 0 PARTIAL APPROVAL n CANCEL 0 NO ACCESS
n FAIL 0 CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-
• • -