Permit IN I0 CITY OF TIGARD PLUMBING PERMIT
° . COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00508
TIGARD. 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/15/2007
PARCEL: 1 S 134 DC -06400
SITE ADDRESS: 11480 SW DAWN'S CT ZONING: R -4.5
SUBDIVISION: DAWNS INLET LOT: 001 JURISDICTION: TIG
PROJECT: ROOT
Project Description: Plumbing connection for water heater conversion
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: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
TERRY & SH I ROOT
11480 SW DAWN'S CT Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 11/15/2007 $72.50
[TAX] 8% State Surchart 11/15/2007 $5.80
Phone : 503- 624 -2704 Total $78.30
Contractor:
ANCTIL PLUMBING INC
16900 SWMERLO RD
BEAVERTON, OR 97008 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 642 -7323
FAX 503- 642 -7755
Reg #: LIC 24184
PLM 26 -162PB
This permit is issued subject to the regulations contained in the Tigard Muniapal 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 5 466699 or 1 8 332.2344. '-. __ 7- .
Issue By: v �,/�� C . Permittee Signatu : z��,lI /W
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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.
1,11 1.11
NOV-15-2007 01:49P FROM:RNCTIL PLUMBENG 5036427755 T0: 5035981960 P.2
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Plumbing Permit Applica i_on " I ()It 01.11(I 1'0 ONI.%
1 5 1J1. R e Received
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City of Tigard aawe lL•7lI)ii.�D�t� Permit No_ 1 � Ale AI 0
13125 SW Hall Blvd., Tigard, OR 97223 CITY OF au , t Plan Review
Phone: 503.639,4171 Fax: 503.598.196 ®g �q� t�� '4J�1�2i01VO® u jO
Internet: www.tigard � Date/By Other Penmit No: ii 24• Hour Inspection Line: 503.639.4175 :. Date Re�fY�Y t El Sec Page 2 for
Nod fi ed/M et hod. r t a Sepplemealallnfannatita
e ''' i `•i , r"' TYPE OR WORK ' ^ - w 4' ' a d: ?' FEE* SCHEDULE. r''", ,. "k^ " r '
❑ New construction ❑ Demolition For spedal Information use ctsecteliU.
Description I Qty. I Ea. I Total
Ij ddition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
• ' ' _. t ' '‘.! CATEGORY OF CONSTRUCTION - * `, SFR (1) bath 249.20
g and 2- family dwelling 0 Commercial/industrial SFR (2) bath 350.00
Accessory building ❑Molti- family SIR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder 0 Other: Fire sprinkler ( sq ft) Page 2
' • t ' !I 'JOB SITE INFORMATION AND LOCATION L'
Site otllllks
Job site address: l `LI g v SOU Y /kiwi$ C+ Catch basin or area drain 16.60
City /State/Z1P: Ihywell, leach line, or trench drain 16.60
Suite/bldg./apt. no.: I Project name: d _,�L Footing drain (no linear fl. • ) Page 2
� 4 2,
Manufactured home utilities 110.00
Cross street/directions to job site: Manholes 16 60
Rain drain connector 16.60
Sanitary sewer (no. linear R.. ) Page 2
Storm sewer (no. linear fl.: ) Page 2
Subdivision: I Lot no
Water service (no. linear R.: ) Page 2
Fixture or item
Tax map/parcel no.; Absorption valve 16.60
DESCRIPTION OF WORK Back flow preventer Page 2
-- LA/ K W- ( CrallA _QIN Backwater valve 16.60
--S � Clothes washer 16.60
- F` �.,,,. & 6, v✓�t-' C 1 o-
d Dishwasher 1 6.60
ROPERTY WNER I ❑ TENAN.I,T Drinking fountain 16.60
4- Ejectors/sump 16.60
Name: Expansion lank 16.60
Addre.ts: ebb ��Y Fixture/sewer cap 16.60
City /State/ZIP: Floor drain/floor sink/hub 16.60
Phone ( ) 1 Fax: ( ) Garbage disposal 16 60
' ❑ APPLICANT ❑ CONTACE PERSON Hose bib 16.60
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: ( ) I Fax: : ( )
Sink/basin/lavatory 16.60
E -mail: Tub/shower /shower pan 16.60
Urinal 16.60
CONTRACTOR Water closet 16 60
Ausiness name: �t, ji w ✓m �� Water heater i r 16.60 /,. l' el
Other: tk City/State/ZIP
Address: 6 (� [,ty Water
1 Subtotal
' ' L� C9 1r Ph
Minimum permit fee: 572.50
Phone (9)1, ' .- :} '7 Fax: (6)r) -4, R esidential back(low rfunimum permit f $3625
CCB Lic.: 24 t ti I ?. Plumbing Lic Co- Plan review (25% of permit fee)
'� lJ
Authorized signature .- State surcharge (8% of permit fee) 6.. (60 TOTAL PERMIT FEE 1 5;,:3 A
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Print name: !Zt 7( L J Date:// 1 This permit application expires If a permit Is not obtained within
180 days afte It has been accepted as complete.
. 1 0‘ 'Fee methodology set LT Fri - County Building Industry Service Board.
I\BuddmgWenniu'Pl.5t•Pe`mitApp cl0c 17/30/05 440.4616Te(W M/COM/WEBI
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CITY OF ' �--
�*w m m n�'n TIGARD
BUILDING DIVISION
PERMIT #: PLjN2O07-0U6O8
13125SVV Hall Blvd.. Tigard, OR07223 DATE ISSUED: 11/15/20OT
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): ( 639~1175
INSPECTION WORKSHEET FOR DATE: 11/27/2007 TIME: 7:01AM PAGE: 44
SITE ADDRESS: 114BOEW DAWN'S CT CLASS OF WORK:
SUBDIVISION: DAWNS INLET LOT #: 001 TYPE OF USE:
PROJECT NAME: ROOT
DESCRIPTION: Phmbing connection for water heater conversion.
OWNER: ROOT, TERRY & SHIRLEY PHONE #: 503-624'2704
CONTRACTOR: ANTIL PLUMBING INC PHONE #: 503
Inspection Request Scheduled For: Date: 11/27/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
359 Plumbing final 080286 503 Y
Corrections/Comments/Instructions:
r~\ � e �
v��
X PASS [1] PARTIAL APPROVAL CANCEL NO ACCESS
I I FAIL ' | CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: A Date: j O Phone #: (503) 718-
•
. . . .
CITY OF TIGARD 1
r4
BUILDING DIVISION
k,,,,,, PERMIT #: PLM2007- 00608
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: tin 5/2007
Phone: (503) 639-4171 At 1141,411 I\
Inspection Requests (24 Hrs.): (503) 639-4175 ,..1.4.INfr ...-...
INSPECTION WORKSHEET FOR DATE: 11/1612007 TIME: 7:01AM PAGE: 37
SITE ADDRESS: 11480 SW DAWN'S CT CLASS OF WORK:
SUBDIVISION: DAWNS INLET LOT #: 001 TYPE OF USE:
PROJECT NAME: ROOT
DESCRIPTION: Plumbing connection for water heater conversion,
OWNER: ROOT, TERRY & SHIRLEY PHONE #: 503-624-2704
CONTRACTOR: AICTIL PLUMBING INC PHONE #: 603-642-7323
Inspection Request Scheduled For: Date: 11/16/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 059817-01 503-642-7323 N
Corrections/Comments/Instructions:
/J
I PASS fl PARTIAL APPROVAL 0 CANCEL pi NO ACCESS
FAIL fl CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: CYDANK.A.J S l i \ i ‘i1 4 .---2_ Date: 1 1 1 t t(,„ , o'l Phone #: (503) 718-
■ .