Permit C ITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00024
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/29/2008
PARCEL: 25111 CD -00400
SITE ADDRESS: 09725 SW DURHAM RD ZONING: R -7
SUBDIVISION: ALDERBROOK FARM LOT: JURISDICTION: TIG
PROJECT: SOUTHWEST CHURCH OF CHRIST
Project Description: interior plumbing
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
• TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: UNK FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 2 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
SOUTHWEST CHURCH OF CHRIST
9725 SW DURHAM ROAD Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 1/29/2008 $72.50
[TAX] 12% State Surcha 1/29/2008 $8.70
Phone : Total $81.20
Contractor:
WESTERN PLUMBING
9460 SWTIGARD STREET
TIGARD, OR 97223 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 639 -5296
FAX 503- 684 -9015
Reg #: LIC 2439
PLM 34 -29PB
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 503 46.6699 or 1.800.332.2344.
Issue By: f (. I Permittee Signatu e: ` ! / �,
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.
WESTERN PLUMBING 603684901S 01/01/96 12:18am P. 001
a o 2'toC
Plumbing Permit Applicati ` � v FOR OFFICE USE ONLY
City of Tigard
R E: . ew ' eive
i W Permit No.: Cx y 1+Lj
n 13125 SW Hall Blvd., Tigard , R 97223
w\ 4��0� D e/By � Lt 0 j Other Permit No.' / Phone: 503.6394171 Fax: 503.598. �``> e /!3;
Date/By;
TIGARD Inspection Line: 503.639 J rs See f/I�f�CJ(J !� 3 "I
Internet: www.tigard- or.gov
PR Date Ready /By: ee Pa e 2 for
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Page �` ��j Notified /Method: Supplemental Information
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❑ New construction „ r t
lIA) olition For s el�cial information use checklist. •
tg Addition/alteration/replacement ❑ Description Qty. Ea. � � Total
m nt Other;
„ New 1 dwellings (includes 100 ft. for connection)
j,.`t.,•? ";'t1�'� ;a, s_ - ^,r° . =: +��,,. .,,, Y g (� or each utility c n )
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.,,,.4.:_�..at; �1: urn+ t�Sr�r��:" 7�nlV, i? j'} �! Fp: q�' �'? �! �' t: 4 .??rrstal!p },1hs9j'iC " -`I uk':t'tiii::,. �' SFR (1)bath 249.20
❑ 1- and 2- family dwelling X Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
•
❑ Master builder Each additional bath/kitchen 45.00
❑ Other':
; ; t5i': , 4 w a a +,;, '•p.:. :; ;,:: Fire sprinkler ( sy. tl.) Page 2
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t �1a"�aa.ti'.0 :,. +� n,bc.�. Site utilities
Job site address: �� itA ' ak>, aj � i `� Catch basin or area drain 16.60
City /State /ZIP: Ts, f ( � - _ / Drywell, leach line, or trench drain 16.60
Suite /bld g./apt. no.: Project name:Ct Footing drain no. linear ft.:
3 ► R llk (1 1 ( _) Page 2
Cross street /directions to job ste: UU � /1 U1 Manufactured home utilities 110.00
-
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
C I C6 sewer (no, linear ft.: ) Page 2
Subdivision: �b 1 1 1 Cr) ` co ! /C6 1 Lot n Water service (no, linear IL: ) Page 2
Tax map /parcel no.: "` fixture or item
:,'''t: :i':r; s;: ;al »N'' rr'i :rr; 'a Absorption valve
;•,, ?:�, li ::`?a'S €`li ``i' "t;>:.,: I. ;3,e..1. L�riiii�:Pc p 16.60
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e7 ± ,,..h a i ,, ,, r v„ ..4d.:H=1ii ,'t." :•.: : . $;ati::.;: ;!II it'fgn`:,!!:'=,us -(tir.
l �,,,. err t ' ° ,.a:,:ica i i i (r :. Vi ru s.:,n•.,.r.3 �.:__.. r.,.d,,. as ,: l� 3n: e: taa:!:!, $,, ,; : 1,1 ; 1 t:::; i a > 4 i' Backflow preventer Page e 2
#/�,, Backwater valve 16.60
�A , & 1 � Clothes washer 16.60
•
' °Si "''.:' „'. Dishwasher 16.60
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>m ni- n2j�S3''�.. '�9 �+. 1a } ?ilpp ri`�tiS� �;'' ^i;i ° s1iP:PS a ;;iir�'r:,�` �c' - ,t - Drinking fountain 16.60
1 .:4gtr tf4,,e tEr'�t ;liirH[:1�-_ •. 11 1 a he'd° h. Wiz c 1j `N-
u:rtt..tk -le4;r It rsr t,t, tw�r:•u ¢ ii}; : "t
t'* Ejectors/sump 16.60
Name: ,l) l'ki>, %I Oh l �� '
Expansion tank 16.60
Address:
�;
" Fixture /sewer cap 16.60
City/State /ZIP: fY\(�) Q_ G-a i i_,/ Floor drain /floor sink/hub
16.60
Phone: ( ) Fax: ( ) Garbage disposal 16,60
[,'' �1.,. `'C1 :P!! ::i ;. >':- ,:•,: Hose bib
l k •a " . e {, ;l. " i -.tun ,. Gi'`;i ?: 1;;' ; ; " 16.60
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ctan' .•r...,',^ : w1fn1; mge. me.;, ,.t� 1 . P(�t{ :,!d "k Ice maker 16.60
Business name: -
Interceptor /grease trap 16.60
Contact name: Medical gas (value: $ ___) Page 2
g
Address: Primer
. 16.60
City /State /ZIP: Roof drain (commercial) 16.60
Phone: ( ) 1 Fax: : ( ) Sink /basin /lavatory � 16.60 c� ).
E -mail:
Tub /shower /shower pan 16.60
?c}n,;n a1 :;l ::,, Urinal 16.60
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1 a. P�: t: rrts.: P�:= rriiatu�n' � ��t�rJ���! �iEI� •.fFx�6iufZd�;I�t;�?a:lp�:it�j; Water closet 16.60
Business name: Western Plumbing, Inc. Water heater 16.60
Address: 9460 SW Tigard Avenue, Suite 101 Other:
City /State /ZIP: Tigard, Oregon 97223 Subtotal ` a�
- Minimum permit fee: $72.50 10, F4)
Phone: (503) 639 -5296 Fax: (503) 684-9015 Residential backtlow minimum permit fee: $3625
CCB Lie.; 2439 Plumbing Lie- no.: 3429PB Plan review (25% of permit fee) -"'
� State surcharge (12% of permit fee)
Authorized signature ' j
�� , i rik _ }„ An ,I I r
"� l J
TOTAL PERMIT FEE )
Print name: Dana Jensen Dale: 6 This permit application expires if a permit is not obtained within
2 180 days after it has been accepted as complete.
°Fee methodology set by Tri -County Building Industry Service Board.
1 . 311uilding V \PLM- Per,nitApp doc 06/26/06 440 -46, ET(10 /02/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2008-00024
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/29120013
Phone: (503) 639-4171
2:11,
Inspection Requests (24 Hrs.): (503) 639-4175 1t
INSPECTION WORKSHEET FOR DATE: 2/22/2006 TIME: 7:00AM PAGE: 58
SITE ADDRESS: 09725 SW DURHAM RD CLASS OF WORK:
SUBDIVISION: ALDERF3ROOK FARM LOT #: TYPE OF USE:
PROJECT NAME: SOUTHWEST CHURCH OF CHRIST
DESCRIPTION: interior plumbing
•
OWNER: SOUTHWEST CHURCH OF CHRIST, PHONE #:
CONTRACTOR: WESTERN PLUMBING PHONE #: 503-6395296
Inspection Request Scheduled For: Date: 2/22/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 065439-01 503.639-5296
Corrections/Comments/Instructions:
CAtrt-'
PASS n PARTIAL APPROVAL 0 CANCEL n NO ACCESS
fl FAIL ( CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: (7.) Date: 2.1 92') #: (503) 718-
CITY OF TIGARD , •
BUILDING DIVISION PERMIT #: i�Ll ti 00O21
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/29/2008
Phone: (503) 639 -4171 /vv tmill j
Inspection Requests (24 Hrs.): (503) 639 -4175 .
INSPECTION WORKSHEET FOR DATE: 1/3()/2008 TIME: 7 : 02AM PAGE: 63
SITE ADDRESS: 09725 SW DURHAM RD CLASS OF WORK:
SUBDIVISION: ALDERBROOK FARM LOT #: TYPE OF USE:
PROJECT NAME: SOUTHWEST CHURCH OF CHRIST
DESCRIPTION: interior plumbing
OWNER: SOUTHWEST CHURCH OF CHRIST, PHONE #:
CONTRACTOR: WESTERN PLUMBING PHONE #: 503- 639 -52%
Inspection Request Scheduled For: Date: 1/3012008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in (b 064155-01 M3- 639.5296 N
Corrections /Comments /Instructions:
j g PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: /tw l �
(i d " il------' _ Date: / 1 c? "6 /-6T Phone #: (503) 718-