Permit Il .-'1 'CITY OF TIGARD
PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/17/2007
PARCEL: 2 S 102 D B -0 0100
SITE ADDRESS: 08840 SW BURNHAM ST ZONING: CBD
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: VERIZON
Project Description: Replace water service to service bay, approx 200'.
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: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: 200 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
GTE NORTHWEST INC
GARY N WILLIAMS Description Date Amount
GTE TELEPHONE OPERATIONS [PLUMB] Permit Fee 5/17/2007 $101.40
IRVING, TX 75015 [TAX] 8% State Surcha 5/17/2007 $8.11
Phone : Total $109.51
Contractor:
POWER PLUMBING CO
PO BOX 19418
PORTLAND, OR 97280 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 244 -1900
FAX 503- 244 -8825
Reg #: LIC 52378
PLM 34 -150PB
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: w ie ` ... [ Permittee Signature: _AC— f/f f a J
f
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.
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May 17 2007 11:08F1M POWER PLUMBI-N,3 .CO. 503 244 8825 p.2
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Plumbing Permit Application 200 • FOIt oFI•IC:I: USE (.)1,11 {
• Ci o f Ti and ��[►�� ' r Recei
5/19-f0--- Permit No.:
N...i.r tt g+ Date/By: • p LM 2001-c02_09.-
a 13125 SW Hall Blvd., Tigard 5,14.5"9:8.19.66 1 .97.23) , i Plan Review Other Permit No : l7 U � -10024.
II Phone: 503.639.4171 F� i IA) ate/Sy:
Inspection Line: 503.639.4 7____'5 z y E, r, r „ � l'(' n1\ Date Ready m;. • • 611 See Page 2 for
'' ` tl� . , t' #, s �-
Internet: www tigard c3ga� 1 � g , � Notified/Method: , . Supplemental Information
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❑ New construction ❑ Demolition For special information use checklist,
• Description I Q 1
Total
A Additioaralteration /replacement ❑ Other: New I- 2-family dwellings (includes 100 ft. for each utilityconnec on)
si ,..,_.. y 4 i ;. _
:.. :2= 24920 life. & .7; a • p .' ll 5t P >x r ..0 :t , f4 • ;� y _ SFR (1) bath 249
❑ 1 - and 2 - family dwelling V Commercial/industrial SFR (2) bath 350.00
❑ Accessory building 0 Multi - family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder 0 Other: Fire sprinkler ( sq. ft.) Page 2
Y^!' : p.: t:.:7,,;;:,' a.K "L , , , .: ,, t#- 11 =, u :Wk ' - ::. :, ... . ,.. -.,... Site utilities
Job site address: : 8 58 l.. -- Catch basin or area drain • 16.60
City / State/ZIP: `'_'\ a • r Ocl , q- l 5 Drywell, leach line, or trench drain 16.60
Suite +�: apt. no.: t: l , , Project name: -' Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross streetidirections to job site: • Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft: ) Page 2
Storm sewer (no. linear ft.: 1 Page 2
Subdivision: Lot no.: Water service (no. linear ft.:aOO) Page 2 ) O 1 , 1 40
Fixture or item
Tax map/parcel no.: Absorption valve 16.60
3 _ • " Page 2
- `��r� =' � . -• 8ackflow preventer &
t ,\ . ■ .s' . . Backwater valve 16.60
tom% • ePoo r Clothes washer 16.60
Dishwasher 16.60
' s r Mw M1 ::: rs /sump 16.60
Name: ■ v e t - i Zan Expansion tank 16.60
Address: r'' 0 Fixture /sewer cap 16.60
City/State/ZIP: • QC (R q�� .2 3 Floor drain/floor sink/hub 16.60
! '
Phone: ( ) Fax: ( ) Garbage disposal 16.60
b ib 16 60
. _ .. w � �, a � H ose 1
i> - Im $'M.�g. ` $i r3.x„ P r .�: .'1.- -ti p 1 4t, to :)!_:-17-.-::4,6,
b n firs ti� - �s ,- • A ,7 , �--�; ._.. a _. r . 16.60
,,,, lee maker
Business name: p ■ - a & Interceptor /grease trap 16.60
Contact name: ,Mv ` V \ & e r n Medical gas (value: $ ) Page 2
Address: G� 11 ` �U.
St4� .\ tlfStYlt'), l t, 9, \u ! Primer 16.60
City / State/ZIP: prl r \C�IRr' o Q � hoof drain (commercial) 16.60
1 Sink/basiMavator 16.60
Phone: ( a3) a 9q- 19 00 Fax:: (5a3) a n y - A 9 „D S
Tub /shower /shower pan 16.60
E-mail: " Urinal 16.60
•+1 . a v r .. .. x� A , .. y- -;.; , 4' -.. :;ri -. .•s74: 7,'*1 =? -i" Water closet 16.60
Business name: + , 1 �� Y" Water heater 16.60
Address: ( 6 i \ 5L.SD 1\e, fYl[t,/1 9,1u4 Other: • Subtotal ' (0 1. 40
City/ State/ZIP: ph v_1c \e5 v.t1. ) b , q 3 Minimum permit fee: $72.50
Phone: (SOS eV LOA- 1 t (fir Fax: ( 503) ,, 44-R B 02 ‘ Residential backflow minimum permit fee: $36.25
CCB Lie.: 5 2 --- 7$ Plumbing Lic. no.: 3 i 50 p(3 Plan review (25% of permit fee)
State surcharge (8% of permit fee) B , (
Authorized signature: TOTAL PERMIT FEE ho el , 5
Print name: /ire 6,6_ r f" e.1 Date: 5 -/ 7- 0 7 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.
11 Building lPermileWLM- PermiiApp doe 0626/06 410- 4616T(10 102/COM/WEB)
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•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007 -00207
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/1712007
Phone: (503) 639 -4171 �
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/25/2007 TIME: 7:17AIMM PAGE: 50
SITE ADDRESS: 08840 SW BURNHAM ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: VERIZON
DESCRIPTION: Replace water service to service bay, approx 200'.
OWNER: GTE NORTHWEST INC, PHONE #:
CONTRACTOR: POWER PLUMBING CO PHONE #: 503 -244 -1900
Inspection Request Scheduled For: Date: 5/255/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 4. Pi I. 049075-01 971-998-5474 Y
Corrections /Comments /Instructions:
PASS I I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: Q Date: (51 211 J 7 Phone #: (503) 718-
•
CITY OF TIGARD � ,.
BUILDING DIVISION PERMIT #: PLM2007 -00207
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/17/2007
Phone: (503) 639- 41714
Inspection Requests (24 Hrs.): (503) 639 -4175 II..
INSPECTION WORKSHEET FOR DATE: 5/24/2007 TIME: 7:00AM PAGE: 46
SITE ADDRESS: 088340 SW BURNHAM ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: VERIZON
DESCRIPTION: Replace water service to service bay, approx 200',
OWNER: GTE NORTHWEST INC, PHONE #:
CONTRACTOR: POWER PLUMBING CO PHONE #: 503 - 2441900
Inspection Request Scheduled For: Date: 5/24 /2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 048980-01 5 971 -9
Corrections /Comments /Instructions:
? 9 i - ? 9?--s Li 2 y'
i --- ,1Co-- "N ''.7
..,. q <- '
6
/ - ej
9 :.4 17 .,- .,--___-..,) No,
I I PASS I PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
I
FAIL !1 ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
3 Inspector: t_ e" Date: - I Phone #: (503) 718- 2.