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Permit
,p?./ _ .-: .1' .t, e '6 6 " .: ' 1. ,,":1 :LA ;•‘;_----, ,a 7, : _ r' eg- , $( C3 CITY TIGARD PLUMBING PERMIT �' DEVELOPMENT SERVICES DATE PERMIT #: ISSUED: 1 %3/2004 00493 ?"" 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 12865 SW BEAGLE CT PARCEL: 2S104DA -10600 SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R -4.5 BLOCK: LOT: 092 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: 1 OTHER FIXTURES: TUB /SHOWERS: 1 SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Add bath tub. FEES Owner: Description Date Amount LYN PARROTT 12865 SW BEAGLE ST [PLUMB] Permit Fee 11/3/2004 $72.50 TIGARD, OR 97223 [TAX] 8% State Surchart 11/3/2004 $5.80 Total $78.30 Phone : 503 804 - 2084 Contractor: RAYBORN'S PLUMBING INC PO BOX 69 TUALATIN, OR 97062 REQUIRED INSPECTIONS Phone : 503 Rough -in Insp Final Inspection Reg #: LIC 87852 PLM 34- 166PB 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 ing (503) 246 -669q Iss ed By: , . /,i _,� ar ,_ Permittee Signature: �al S 6I (503) 639 -4175 by 7:00 P.M. for an inspection needed the next • • siness day CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #: PLM2004 -00493 I DATE ISSUED: 11/3/2004 ,,, .Il 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 12865 SW BEAGLE CT PARCEL: 2S104DA -10600 SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R -4.5 BLOCK: LOT: 092 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: 1 OTHER FIXTURES: TUB /SHOWERS: 1 SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Add bath tub. FEES Owner: Description Date Amount LYN PARROTT 12865 SW BEAGLE ST [PLUMB] Permit Fee 11/3/2004 $72.50 TIGARD, OR 97223 [TAX] 8% State Surcharl 11/3/2004 $5.80 Total $78.30 Phone : 503 804 - 2084 Contractor: OWNER REQUIRED INSPECTIONS Phone : Rough -in Insp Final Inspection Reg #: 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 -0100. You may obtain copies of these rules or direct questions to OUNC b calling (503) 24'6 -6699. AO 'OO ,f4,C' ue By: 4 Permittee Signature: l� �' Call (503) 639 -4175 by 7:00 P.M. for an inspection . needed the nextusiness day Building Fixtures ® Plunitiiiig Perm ig a >< n FOR OFFICE USE ONLY • 1 , City Of Tigard 10 Received Other Permit No.: /) p NoCv� � f�Ct �+ 2 Date/By: /0,2 ? G ( � _c 13125 SW Hall Blvd., Tigard, OR 9726 503.598. ?x u ® Plan Review Phone: 503.639.4171 Fax: 960 F / OR 10 y/9 Ilii n I ;``t D ateB 24- Hour Inspection Line: 503.639. 4 Y Q `v � s `® I t I y Internet: www.ci.tigard.or.us ^ ® ,I Date Ready/By: _ / LT,. , g I NAG Notified/Methodf� � 0 See Page 2 for Supplemental Information ,a,<.... , -a:. '.* .ra.' k'.�.a.;a -;.t'x;;;P-.z „,r "- nom,: zt.•cv, x <: E�. „? .stt. .z nrq. is" afxs, :« .::ras; - - <.- .nr «,. . -'"- ay tl , ;,"" .x 9 i s t " {.,� .. ` SCHEDU , -..•r ' . � � IRE OE�'a W O RI�" F°E ;s'- �.' ....r . .,�rn �:�.�.�rF:xw,..r �..�.:,��.tia;��:,, �_..�.. ..N.��,a�..- :.r'.'�.z � tt 'rA'a� 'r. ' €:vas;°��.:zs; �,�,::�,�,�. •^�r',. �. . ❑ New construction ❑ Demolition (( For special information use checklist. Description Qty. Ea. Total p • Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) ig S : , (A aOF C9ONSTRUCT O ,,, '. °��_ % SFR 1 bath 249.20 d ( ) ' : €.� .. � -�« ..� "��, ,.mom � ,. - .. �.,a�s .�s,..... �riT.�s, x... +.;= ,;��',aa ar�.�a 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ( ❑ Accessory building ❑ Multi- family SFR (3) bath 399.00 Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: :. : .> •. =r. < s r. w s i = r,l " r... Fire sprinkler ( sq. ft.) Page 2 a 4 _ "'JOBS INE OR LOONY " -,,. A44L. x; v . ...�„x 4 i- � i-Va:,gia -�. , - r 6. Site utilities Job site address: i 2,S( S S u...3 B 0. J IQ._ 0-. Catch basin or area drain 16.60 City/State /ZIP: i v 0..../- ° K y '2_2-3 Drywell, leach line, or trench drain 16.60 . t Suite/bldg. /apt. no.: Project name: Footing drain (no. linear ft.: ) Page 2 �, Manufactured home utilities 1 10.00 Cross street/directions to job site: G-ow cLe_e_ `f im. e.,v- 1 ;, P / Manholes 16.60 Rain drain connector 16.60 . Sanitary sewer (no. linear ft.: ) Page 2 , i Storm sewer (no. linear ft.: ) Page 2 Subdivision: &L a. j N O ) ( W Lot no.: Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no.: t,;; ,s x +' v:S'a ".} -:r .z v .:r: Absorption valve 16.60 ,�, � > ` � 1 DESCRIPTI j W " ORK h n "' i= "t' ' -.. "'-b . _ .... ,4 3 . �, ... N 25- A, , } ck S ". Backflow preventer Page 2 A/ICI b Ot)fre, tAJED _ $ 4. 6 t 1 Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 :t-,; itriTk W �,; 41 , , t Drinking fountain 16.60 �:" 3, =.�.:�,�,a };...x ,�� §���., �.z, P;. ... �E �� Ejectors /sump 16.60 Name: L yv p ro 66 Expansion tank 16.60 Address: 1 2A ( -.- 6..) 62ac ie CI. Fixture /sewer cap 16.60 City/State /ZIP: j 0 A 9'7 I.)-3 Floor drain/floor sink/hub 16.60 Phone: (a 3) ?- ...2 g Fax: ( ) 5 Z/ - Z ( Garbage disposal 16.60 �" . w rRPIIoANT;f 3 � "i.,a cl i ms ens Hose bib . 16.60 ® CONTAG ERSON ,�W=mua €»,. e� a�U 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: ( ) Fax: : ( ) Sink/basin/lavatory I 16.60 Tub /shower /shower pan l 16.60 • E -mail: Urinal 16.60 , ® e' te r , t : :- ' . Water closet 16.60 Business name: Water heater 16.60 . Address: Other: City/State/ZIP: Subtotal Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: Plumbing Lic. no.: Plan review (25% of permit fee) State surcharge (8% of permit fee) Authorized signature: TOTAL PERMIT FEE Print name: Date: 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. i\ Building \ Permits \PLMF- PermitApp.doc 12/03 440- 4616T(t0/02 /COM/WEB) t e Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression S stems: Site ` iiiities k .;� m _ Qt w t D :° Square Fgotage.. < .:_ , Perm><t Fee: Footing drain -1' 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 Sewer 1st 100' 55.00 3,601 to 7,200 $220.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas Systems: Water Service - each additional 100' 46.40 Storm & Rain Drain - 1st 100' 55.00 yalUatLon , $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each qt e e(ei) dotal additional $100.00 or fraction thereof, to and itureor �tem� x <� .' _.. �. :� � including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to (minimum permit fee $36.25) 27.55 1 and including $25,000.00. • , Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for Inspection of existing plumbing or each additional $100.00 or fraction thereof, to and including $50,000.00. specially requested inspections - per hour 72.50 Subtotal: $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. Fixture Work: . Are you capping, moving or replacing existing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees Fixture p £ 1 ,* kg 1a$ eN ` nroVea hr x g cp Comments regarding fixture work: Baptistry/Font Bath - Tub /Shower - Jacuzzi/Whirlpool Car Wash -Each Stall -Drive Thru Cuspidor /Water Aspirator Dishwasher - Commercial - Domestic Drinking Fountain Eye Wash Floor Drain /sink - 2" -3" -4 » Car Wash Drain Garbage - Domestic Disposal - Commercial *Note: If the fixture work under this permit results in an - Industrial Ice Mach. /Refrig. Drains increase of sewer EDUs, a sewer permit will be issued and Oil Separator (Gas Station) fees assessed for the sewer increase must be paid before the Rec. Vehicle Dump Station plumbing permit can be issued. Shower -Gang -Stall Sink - Bar /Lavatory Bradley Quantity Total Commercial Isometric or riser diagram is required if fixture quantity - Service total is >9. Swimming Pool Filter • Washer - Clothes Water Extractor Plan Review 1 Water Closet - Toilet Plan review is required if fixture quantity total is >9. Urinal Other Fixtures: • is \ Budding \PemdtsTLM- PermitApp.doe 3/03 1 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 - 4171 MST BUP Received Date Requested 2- 1 AM PM BUP Location / 2-$4 .c QQ-a - C Suite MEC Contact Person j— ^". Ph ( ) 3 ©(r - - DD CO 3 Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm ---- Susp'd Ceiling (/ Roof ,t Other: Final RT FAIL PLUMB' BI;Ti Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan • Other: 7 =%!" - F d PART FAIL CHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage Fire Alarm Anal Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE. ❑ Please call for reinspection RE: Unable to inspect — no access Fire Supply Line , Approach /Sidewalk Date /✓/ /J Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL