Permit is
CITY TIGARD PLUMBING PERMIT
�i� DEVELOPMENT SERVICES PERMIT #: PLM2005 -00389
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c — 13125 SW Hall Blvd., Tigard, OR 97223 503 -639 -4171 DATE ISSUED: 8/15/2005
PARCEL: 1 S136DC - 02800
SITE ADDRESS: 07100 SW BAYLOR ST ZONING:
SUBDIVISION: ELNOLA HEIGHTS LOT: 004 JURISDICTION: TIG
Project Description: Repair 40' water service.
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: ft
WATER CLOSETS: WATER LINE: 40 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
SALIMENA, JOHN A ET AL
7100 SW BAYLOR Description Date Amount
TIGARD, OR 97223 • [PLUMB] Permit Fee 8/15/2005 $72.50
[TAX] 8% State Surcha 8/15/2005 $5.80
Phone : 503- 620 -6007 Total $78.30
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Contractor:
LOVETT EXCAVATING INC
2925 SW HARTLEY DR
GRESHAM, OR 07080 REQUIRED ITEMS AND REPORTS
Phone : 503 -504 -2847
Reg #: LIC 125507
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: � r r 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.
_ 08/15/2005 10:43 5032881630 PAGE 02/03
08/16 /2005 10:14 FAX 6085981960
CITY OF TIGARD
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13125 SW Hall Blvd, Ti OR 97223 Men Re.iGw Olhert?anoettMo,t
Phone: 503.639,4171 Faun: 543.598."1960 , C � `t oo I 1 ,
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Internet www.ci,tilfltr'd.or.us - ,-, NotlSM/Me':laort•, _ IN
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t !� tD ai0lition For special information wecheck8a _
(] Nov/construction at 111_ ) Q Des u tion s Et . Total
Additivo /atteratirm/rcplacerncnt � Other: New 1- 24hmily dwa11In6s (inoInde3100 ft, for each utiOW connection)
li M, "�, i ' t ' 1 i t., i ,.� 1`fn�: i . r4W C] ,&i - L a �E , 1 .t �C
N� I f :l (1) Ep4th nu '29.20
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L 1- and 2 -featly dwelling ❑ Commercial/Mellish-Id S M C bath — 350,00
SFR (3) baPo 399.00
0 Accessory building ❑ Multi-Rudy
Bnch additional bath/kitchen 45.00
❑ Master builder ❑ Othml Fire sprinkler. ^ n9. ft.) PAga2 II
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t��, ,5 �. , • .►' � ss ' � •- . �, . a�(rtr�,^.a>irrx �= �',� ",.. � abs3: Gte tallies
site address: 0 10 , : I 0 Catch basin or area drift 16.60
City/St•9t&ZIP: Dtywe11, !eat line, or trench drain 111. 16.60 —
Suite/bldg./apt. too : Projt*et atone: Footing dada (PA, linear ft.: ^; _ ) � �
MenWaned home utilities 110.00
Cross atreet/direation9 to job Site: Manholcs 16,60 —
Rain drain connecter — 16.60
S a n i t a r y sewer (no linear ft: __ ) Mill Noe 2 -
Storm sewer (no. linear R:. ) — papa 2
Subdivision Lot no. Writer mice no. linear 1t: iA) WR
mitre or heal
Tax map/parcel no,: Abdotptioa valve 16.60
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IS SIR . I. - V,.... . vC . . Y ■ Backwater Alva WC/ ME
Clothes washer 16.60
DishWecher _ 18.60 IN
, , ,-z - , ... 777- � ' '' "er''''71= ., v .' Drinking >buntain 16.60
�'+� 51. au^'uAi r, i (af: " "•T� . t i r t ' ' t ' I
�+�Cdn.�f /� �r:�• '.� ;�w, au�J�i3, t�.,�'L�.tr�irs ;�n; Efodars/901nP 16.60
• o , A - Expansion tank 16.60
_ _
Address: Fixate /Kr:1 ' cap 16.60
City/State/ZIP: .. Floor drain/Door ainl/hub 16.60
Phone: ( ) • , 0' Fait: ( ) Garbage disposal 16.60
;,;a ax}� . a i re " : �Tt r •. = - .; ' . i Hose bib 16.60 Min
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Ir' .'4 .; AI., � _.4,,v:.'4 �� ; -: c'.12"/,r15" tiN Ice maker 16.60
Eua1'ie s name; ChY) * -r.,3 Interceptor/,grrcasebap 16,60 IN
Comma name: fet ' , 6 1 Medical u:: (value: $ _) MIN Page 2
FiTallillillIM 16,60
City/State/7J2: - 4 . 1 , ;I . ■ ' 1oofdrain(commercial) — 16.60
ti ° � ) it %3 —5 21 Si 16,60
Phone: —
( ♦ ) fi � Fax:: Talbisboverrishowur pen 16.60
)a ntatl: Urinal 16.60
, 'la' i'Vi " 6 .,0 %iliy'it t ' 2'`: y Watv'C109Ct
Bttsintss mans; rtit. IS .4.. �I Water heater 16.60 IMO
Address_ Other: -
Subtotal Min
1110 City/Sage/ZIP: , Minimum permit fi:e: $71,90
))\ Phone: ( 7) A - t'-, knx: ( j) at —1 6 '� 1 Residrntlal hackflow minimum • omit fee: 813625 _
4) 11 Plan review 9,5% of permit feo) —
CCB Lie.: ''66— Plumbing Lie. no,: „-• 'ior p g•.
State trunbarte (R% ofpermit fee) MOM
Authorized signature C TOTAL PERMIT P2E ?.
1 Frt t tome; a nry( O(,gc., Dn(te: - -- -"T] This permltapplietatien expires if s permit is net obtained within
180 days after it has been accepted as complete.
"'Fee methodology set by Tri -County Building Industry Service Board,
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CITY OF TIGARD
1
BUILDING DIVISION PERMIT #: PLM2005- 00389
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/15/2005
Phone: (503) 639 -4171 / � ' „,, miN ��� iigl�l�i��l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/17/2005 TIME: 7 :05AM PAGE: 3
SITE ADDRESS: 07100 SW BAYLOR ST CLASS OF WORK:
SUBDIVISION: ELNOLA HEIGHTS LOT #: 004 TYPE OF USE:
PROJECT NAME: SALIMENA
DESCRIPTION: Repair 40' water service.
- OWNER: SALIMENA, JOHN A ET AL, PHONE #: 503 - 620 - 6007
CONTRACTOR: LOVE I I EXCAVATING INC PHONE #: 503-504-2847
Inspection Request Scheduled For: Date: 8/17/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 013726-01 503. 442 -8611 N
Corrections/Comments/Instructions:
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V PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �G� /� Dat-. S 1 j Phone #: (503) 718-