Permit CITY TIGAR`C PLUMBING PERMIT
rr i , ( ( 6, DEVELOPMENT SERVICES PERMIT #: PLM2006 -00455
tAll DATE ISSUED: 10/5/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S103DA-01800
SITE ADDRESS: 10815 SW DERRY DELL CT ZONING: R -3.5
SUBDIVISION: DERRY DELL PLAT 2 LOT: 018 JURISDICTION: TIG
Project Description: SAWKINS remodel.
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: 1 OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
DOUG SAWKINS
10815 SW DERRY DELL CT Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 10/5/2006 $72.50
[TAX] 8% State Surcha 10/5/2006 $5.80
Phone : 503- 620 -5043 Total $78.30
Contractor:
MODERN PLUMBING
11120 SW INDUSTRIAL WAY
TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 691 -6166
FAX 503- 691 -6771
Reg #: LIC 87906
PLM 34 -250PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: - 7 7 2'�.(1_“ ; Permittee Signature: _7 T`
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
• r
Plumbin Permit Appleon , IN ED FOR OFFICE LSE ONLY
City of Tigard Received Permit No_
13125 SW Hall Blvd., Tigard, OR 97223 o C T ®ty 7 006 Dat - � - Q � X 91 A 6
Phone: 503.639.4171 Fax: 503598.1960 �,;� . r Plan Review
d I Other Permit No.:
24- Hour inspection Line: 503.639.4175 t I I `"` D a 1 e/By:
Internet: www.ci.tigard.or.us coy O F � -i `•f;, DateRendy/By: Tuns ®$ee 2 for
et ttt n1NG DN• - • - Notified/Method ) d $1.52.- for each additional
_ TYPE OF '.VORK ` FEE* SCHEDULE
❑ Nev, construction
IV Addition/alteration/rep
lacemeal D Demolition
❑Other I For specialInforrrrratfon use checklist
Description (qty. ' Ea Total
New 1- 2-family dwellings (includes 100 R for each utility connection)
CATEGORY OF CONSTRUCTION 5FR(1)bath j t 249.20
i- aiiu -C .... i;r uwcliuis 1 a �, ^^ I f
( LJ ommerci av industrial I L '- (2) vaui 3 jv.w
Accessory building SFR (3) bath -I I I I
ry g f0 Multi-family () II 399.00
Each additional bath/kitchen i 45 00
❑ Master builder Q Other Fite sprinkler ( . sq. ft.) 1 Page 2 L.�
JOB SITE LNFORhL4'rION AND LOCATION
Site utilities
Job site address: �, f1C 1 /'�1 t:l
. . Catch basin or area drain 16.60
City /State/ZIP: -Rowed a( n • I Drywell, leach line, or trench drain I 16.60
Suite/bldg. /apt no_: �J / Project name: S Footing drain (no. linear ft.: ) 1 I Page 2
Cross street/directions to job site: Manufactured home utilities ! I 1/0.00
114213 WIC° k a • (QSc Ds- d Manholes 16.60
Rain drain connector I 16.60
Sanitary sewer (no linear It: 1 Page 2 :
Storm sewer (no. linear ft.: ) Page 2
Subdivision I Lot no.: Water service (no. linear 8.: ) I Page 2
Tax map /parcel no.: Fixture or item
Absorption ion valve 16 60
DESCRIPTION OF WORK Backfiow preventer Page 2
orfLYi ei Backwater valve 16.60
Clothes washer 16.60
j Dishwasher 16.60
❑ PROPERTY OWNER ! I❑ TENANT Drinking fountain 16.60
Name: Ejectors/sump 16.60
' Expansion tank 16.60
Address: I ,
I Fixture/sewer cap 16.60
City/State/ZIP: 1 Floor drain /floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60
Business name: Ice maker 16.60
Jnterceptodgrease trap 16.60
Contact name: Medical gas (value: $ ) Pap 2
Address: Primer 16.60
City /State/ZJP: Roof drain (commercial) 16.60
Phone: ( ) I Fax:: ( Sink/basin/lavatory' 16.60 �t -�
E-mail: Tub /shower /showerpan 16.60
Urinal I6.60
CONTRACTOR Water closet 16.60
Business name: 1 o 8 e (r 'P‘ uYN's,‘P I f \9 I 0 Water heater 16.60
Address: j 1 \ 2 n S • 1 . r'\ fylt S� A ei 11 li`''R L _ Other.
City/State/ZIP: C .xOLk 2. q 1) c -1 CAL: . Subtotal
,JL ) /V r Fax Minimum permit fee: 572.50
3 1 I �e . (a Fax: ($1Z) nc: 1 Co �7 - 1 I Res backflow minimum permit fee: S36.25 -
Phone: ( -0,5D
CCB Lie.: i 34 Z _ 5 c_.. e Plan r eview
(� Plumb
utg Lic. o . . ^� (25% of permit fee) �y�
Authorized signature:7�- State surcharge (8% of permit fee) �' elf
TOTAL PERMIT FEE • 30
Print name: ‘ir■Gurrib-Nr‘ V ,M w t [ . Date: • 0/5/ I 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.
c l di cePermim PermitA7p doc 05/05 4404616T(10/021C0.41/WFBI
Z I•LL9 1.69 C09 ONIBWfild N2:18401A1 e9L'0L 90 90 PO
CITY OF TIGARD
BUILDING DIVISION / PERMIT #: PLM2005,04455
13125 SW Hall Blvd., Tigard, OR 97223 'ATE ISSUED: 10/5/2006 Phone: (503) 639 -4171 .and � l,+�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 12/21/2006 TIME: 7:00AM PAGE: 53
SITE ADDRESS: 10815 SW DERRY DELL CT CLASS OF WORK:
SUBDIVISION: DERRY DELL PLAT 2 LOT #: 0.18 TYPE OF USE:
PROJECT NAME:
SAWKINS
DESCRIPTION: SAWKINS remodel.
OWNER: SAWKINS, DOUG PHONE #: 5503.620 -51143
CONTRACTOR: MODERN PLUMBING PHONE #: 503-691 -6166
Inspection Request Scheduled For: Date: •12j2112006 Pour Time:
Code # Inspection Description Confirm # Contact # Me
399 Plumbing final 041402-01 503 - 631 -6166
Corrections /Comments /Instructions: l
I 6 * r ° . w
kr- -Q L S
1(1 ..). ...i_. i ..
x
DI
./
PASS ❑ PARTIAL APPROVAL n CANCEL NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
tt �f
Inspector: Date: 1 Zzi U ( 6 Phone #: (503) 718- 2�2 I
~
CITY OF
��nn m n�'n TIGARD
BUILDING DIVISION • PERMIT #: PLM3006-00155 '
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1050006
Phone: (503) 639-4171
Inspection Requests (24Hnoj:(603)63O'4175 w�
INSPECTION WORKSHEET FOR DATE: 10/9/2006 TIME: 7:01AkA PAGE: �6 �
SITE ADDRESS: 1O816GW DERRY DELL CT CLASS OF WORK:
SUBDIVISION: DERRY DELL PLAT 2 LOT #: 018 TYPE OF USE:
PROJECT NAME: SAVIIK/yVS
DESCRIPTION: SAMiNSrmmmd*\.
•
OWNER: SAWKINS, DOUG PHONE #: 603'620-5043 .
CONTRACTOR: MODERN PLUMBING PHONE #: 5O3'891'6166
Inspection Request Scheduled For: Date: 10/9/3006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough-in 037852-01 503-807'0166 Y
Corrections/Comments/Instructions:
tj f\
w
\
U \}\,
\
~
•
t r , irss � ��|ALAPP�� ����EL NOACCESS | | �� . ^ [ /
| | FAIL I | CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED
^*' ��
|nopector: Al ^Oate: I 1 Phone #: k5O3\ 718' -��-~�
-- ` -
CITY OF TIGARD r •
BUILDING DIVISION PERMIT #: PLM2006 -00156
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/52006
Phone: (503) 639 -4171 ii,,,,�IPiii'lil
Inspection Requests (24 Hrs.): (503) 639 -4175 :..:'!!+k -11.
INSPECTION WORKSHEET FOR DATE: 10/612006 TIME: 7 :03AM PAGE: 40
SITE ADDRESS: 10815 SW DERRY DELL CT CLASS OF WORK:
SUBDIVISION: DERRY DELL PLAT 2 LOT #: 0.8 TYPE OF USE:
PROJECT NAME: SAWKINS
DESCRIPTION: SAWKINS remodel.
•
OWNER: SAWKINS, DOUG PHONE #: 503. 620 -5043
CONTRACTOR: MODERN PLUMBING PHONE #: 503 -691 -6166
Inspection Request Scheduled For: Date: 101612006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 037791-01 503-691-6166 N
Corrections /Comments /Instructions:
r i 0 tgl
Atili Oir' _ ...fi _.....difaiK_Z.,. „.4
PASS ❑ PARTIAL APPROVAL n CANCEL I NO ACCESS
❑ FAIL CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: " 4 Date: Phone #: (503) 718 - 2 ii/ 3 1
_ ..