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Permit C ITY OF TIGARD PLUMBING PERMIT I DEVELOPMENT SERVICES PERMIT #: PLM2004 -00251 JII 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/4/2004 SITE ADDRESS: 07735 SW DURHAM RD PARCEL: 2S112CD -01000 SUBDIVISION: DURHAM ACRES ZONING: R -12 BLOCK: LOT: 2 -3 JURISDICTION: TIG CLASS OF WORK: NEW 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: 2,415 ft DISHWASHERS: RAIN DRAIN: ft Remarks: Site utilitiesm, 2,415 feet of water service. FEES Owner: Description Date Amount MATRIX DEVELOPMENT 12755 SW 69TH AVE #100 [PLUMB] Permit Fee 6/4/2004 $1,168.60 TIGARD, OR 97223 [PLMPLN] Plan Review 6/4/2004 $292.15 [TAX] 8% State Surchar1 6/4/2004 $93.49 Phone : 620 - 8080 Total $1,554.24 Contractor: WOLCOTT PLUMBING CONTRACTORS PO BOX 2007 GRESHAM, OR 97030 REQUIRED INSPECTIONS Phone : 667 Water Line Insp Final Inspection Reg #: LIC 23847 PLM 26 -208PB 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. Issued By: �r t � /f / ���� � Permittee Signature: T . ggitm Call ( 503) 639 -4175 by 7:00 P.M. for an inspection needed th . business day ft lA , !IIii.... 'f - ' ' - .' - fr7 1 ,,11 Plumbing Permit AppliegOtart Iii 0.itigii '2 FOR OFFICE USE ONLY Received i, o City of Tigard y ' ✓ /(�r� Permit 1 -N - 00 oh DateB z / , 13125 SW Hall Blvd., Tigard, OR 97223 Cn o �GA D Plan Revie / Phone: 503.639.4171 Fax: 503.598 1' ' o,r S,, l k r "; lz )a, .!'9,1:111•1# ' Date/By. - /1i 1 Other Permit No . _ g63--E-9 QS 24- Hour Inspection Line: 503.639.4175 - i, •,I! J Date Ready/By. v ®See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: /L_ Supplemental Information �� _� �., � art; �' ����,�F' °�;-= �. :'�:�w ,�t :�w ,�«� >° a a �� a� YPI'a ©F= �'OI Kl� ,�:a S I sl. New construction ❑ Demolition For special information use checklist. Description I Qty. I Ea. I Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft for each utility connection) .,, : Na of yag:;:;, r.•• ,',4-,:::',14,',3:[:2-41-1.1%,,,a, - 'rr S , ' CATEGORX �t v'` _ .. �� . •;`�� ,..,. �; -,.�„ �OF�CD��;ST,ItUGT.ION� SFR (1) bath I 249.20 14 1- and 2- family dwelling ❑ CommerctaUtndustrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi- family SFR (3) bath 399.00 _ Each additional bath/kitchen 45.00 ❑ f , Master builder ❑ Other: n -u, r. :: = r, i `' Fire sprinkler ( sq. ft.) Page 2 w r:�' `: > �: „_.. -FJOB z STTl2 =1N U I RMAT AI!1L ➢ OG O I , ', ! <`( ``_ ,._ -�• ' h�..,,�;�� � " <s.�� ���:.,„ ;• �<;�, �,,,« �.�,,: �. ,.�,- F,�'�:$ „ „.,* �_.,�y Site utilities - Job site addr'7'7 S W DochaM RUet d Catch basin or area drain 16.60 City/State /ZIP: 7 , (,qwA e1 722 . f Drywell, leach line, or trench drain 0 16.60 I Footing drain (no. linear ft.: ) C) Page 2 rP Suite/bldg. /apt. no.: Project name: If at. b de vii Dye,. 110. , 771 Manufactured home utilities 110.00 Cross street/directions to job site: g wee , 7 , Manholes 16 60 _ / 1 r q a Rain drain connector (, ) 16.60 J Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: - - Page 2 Subdivision: f-/ Umb a 4 - i I Lot no.: i 0, 0 0 Water service (no. linear ft.:'Z`/l� Page 2 i� 60 t ; Fixture or item Tax map /parcel no.: S fi v (ZC_O, I Z s, / i vv/ w.. M. szr -• ; �= ,,. a._� � ;��� ��,; ,�,,,,,,,� �;< ";�� ::..� ...:�. Absorption valve 16.60 DESCRII?T ON U 4 I t e `-' �;., .�.. ��' '3 �� Backflow preventer Page � <_ xa�,d ,.. - <,, ���.��. � ^�,u.,ee� �; ;�' - 3,. : -y -a ��. , ,„�%z'�; , e� 2 4 i),1 l/ 2pc,5e 3 g-, lot 5 r r+, lire .r r i t j s C'S,'dti-i.77 w-1 Backwater valve 16.60 6-2,1-1) d i ti,,. r c,iy Clothes washer 16.60 Dishwasher 16.60 �, - ,, ,,:„ ;�� : 14 , ,• Drinking fountain 16.60 & 4 - PROPE1tTTt°,OW14E .: - .y= � ti ' ° 7 � "' �` E /sump 16.60 Name: 1 1.4 et / l'Pi /©phi e, t {c7 - / %n • Expansion tank 16.60 Address: /2.755 S ktj [ e y 77/7A ✓.. , , L , L i f-e- I D 0 Fixture /sewer cap 16 60 City/State /ZIP: P -1 / a Ai d , 0A, q 72 Z - Floor drain/floor sink/hub 16.60 �,. Garbage disposal 16.60 Phone: (� 1,1N (aZG> -- .�Z3�U Fax:(5p5) `j- c a - s 0 0 ? : " s° ` s .. ,.<- ,_. -.,.. Hose bib 16.60 1'A p iCv4VT - 1 ;rr;:t u ❑ A iEiiSO1V: ,.. -� �� . -y , . � -, ,..- - �,_ , . � . � >6� ».�- ., � ,< <�,; �: , K., WO Ice maker 16.60 Business name: , 5 i 9-es j r'7 Ly;C; Interceptor /grease trap 16.60 Contact name: ,.... 5-1 - e ye. kopc',/' p Medical gas (value: $ ) Page 2 Address: 5/' i, , j W I-1-a 11 $r $ to Z Z_ Pnmer 16.60 City /State /ZIP: it t/c2 >�tU i'V, 0 L et drain (commercial) 16.60 Phone: ( jJn j ) L/ e -/ Z (3 I Fax: : ( j) qt i 5-3-5--3 Sink/basin/lavatory 16.60 Tub /shower /shower pan 16.60 E -mail: sie ve v -�t t le-- C o,c --(. Urinal 16.60 `.,. .. >> „a'� =w - ,.. `. _ _ , . "f . . €;,, , . h - Water closet 16.60 Business name: PJV Q L j --' 7 1_, , Water heater 16.60 Address: 0 Other: Subtotal T !/t 8, 60 City/State /L1Y: Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Residential backflow minimum permit fee $36.25 Plan review (25% of permit fee) a9a,/ S CCB Lic.: Plumbing Lic. no.: y State surcharge (8% of permit fee) 9 I , • X/ Authorized si gna ture: � . �, , ( �/ TOTAL PERMIT FEE t 93 i 651, 9 4 Print name: 7 4,-rn o -ct z- /fot e-d-7 Date: i / jam 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. • 1 \ Building \Permits\PLM- PermttApp.doc 12/03 440- 4616T(10/02 /COM/WEB) CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested C i — AM PM BUP Location Suite MEC Contact Person Ph ( ) a- 3 � r ( Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC 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 C`t Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In r Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: FL r PART FAIL ANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final 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 A ! � ADA • Approach /Sidewalk Date 77 4 - Inspector Ext Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL