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Permit t. CITY TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #: PLM2005 -00026 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/24/2005 SITE ADDRESS: 10825 SW FAIRHAVEN WY PARCEL: 2S103DD -00420 SUBDIVISION: FAIRHAVEN COURT ZONING: R -3.5 BLOCK: LOT: 013 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: 1 MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: F2 FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 1 URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: 1 TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: 1 RAIN DRAIN: ft Remarks: Dishwasher, Garbage disposal, ice maker, sink. FEES Owner: Description Date Amount SAMPLE, SUE & AL VARNES 10825 SW FAIRHAVEN WAY [PLUMB] Permit Fee 1/24/2005 $72.50 TIGARD, OR 97223 [TAX] 8% State Surcharl 1/24/2005 $5.80 Total $78.30 Phone : 503 620 - 5231 Contractor: MODERN PLUMBING 11120 SW INDUSTRIAL WAY TUALATIN, OR 97062 REQUIRED INSPECTIONS Phone : 503 Rough -in Insp Top -out Insp Reg #: LIC 87906 Final Inspection 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. 4 #1" Issued By: Op. Permittee Signature: 2�2 t • Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day 01/21/2005 16:53 5036916771 MODERN PLUMBING PAGE 01 _ /0/12/.2004 L5 :34 FAX 5035981960 CITY OF TTGAD 11 003 _ 4 , RECEIVED Plumbhtsurprmit ,A,pplicatioo FOR OFFICE USE ONt.Y JAN 21 I'\ Receives Permit No.: j�� {'I� 5 ��Q � ' Ciiy of Tigard pa r :,B / _.. ,5 Pa 131 SW Ffail Blvd., Tigard, oR 972 FT 23 C O ' � f ; p Nn � odlarPorm+�N� -- • Phone: 50/639.4171 MI 503498.1960 • u :: , I D ardb r : 24- Hour Inspection Me: 503.639 4176 { aw l s : id see Page z for ages BUIL®INGa .11 � � � nti<idy/ay, [animation 1DtGmct 4/WW.C1.Llgffit1 Ntrruftled/1ti�Ietlpd: I /� s °pp leoleatal[o . I . 1 •, : T L''''.":516'.1:::. ; Pf n :,:2959 F:'''' y �R tiP ri :r , ':IJ`,ti ' i „' `� 4;'..11 , _ ' • ,. ,, .. ,;� * • 1 � ,� ,�;' ~ ;i �I ^' ' t.; .� ; - 'r;'1 - •Y' .1• :il � f y,! ' vilr,: 4W 1 :.n��vtd r• Demolition' • For a r�selal Information dst wNecWty' o New construction; Q . Description 1 ycv. 1 E s. 1 Toad 0..: Addition/alteration /replacement © Otheii New 1•24antily dwc111nga (inukudcc 100 % lbr nch Ylity ronnnrritm) 1 ' I' q'rI:C " • 1 �' X i1;"t i' �o � u, �y� •I: u tr ,' ;; SFR(1)bath 249.20 '! ':-f • � a, �i��!f. � ���'. yl.�, -, � Q . `. ..�„ ,Y� .,,, ,. ; :, .:a.: a•,. . , .�:i a;, ��' °' �:I',,� - ' :41 1.. and z.tamily dwelling CI CacaQaepaialN *a• 1 3FR (2) bath • 35100 SFR (3) bath 399-00 Q Agceg9olty building Q M Each additional bnth/Idiohon 45.00 Q Maser nunQer .; pp d ours Fite aptinkler (� sq, ft.) Pog 2 .4C a. -1.., 1 ' ;- gy m „ 1 '1 : � 7 i ! . n 1r.1"ii. d: :r1 " t1'i ' ' .1: !!., r t a ..l 1 , � rf a : , ! , I t ., , a' Betio ., ;41/ ' ti - ,. S utilities !,a j i ;rv,a' - 7a .4, m,ou _ Job CA:freee: i b i 2 r •t ` t 4r- U C Catch barrio or area drain 16.60 Drywe11,1eaclt l , or tench drain 16.60 - Suite/bldgJspt. no.: Pmieetuamt:t reN \ Footing drain (no. linter tt: _) Page 2 Manui:nunrl• borne utilielea 11.0 00 Cross t /desecdoffi to job site: Minho1 s I6.60 • T Rain that Conneetar 1 b - 60 Sanitary sewer (rio, linear ft: , ) Page 2 Storm sewer (no. iinomr ft.: __) Page 2 - 51111dt�11fii6rl: Lot II0,. Water wry (no. H1.063'114 ) Page 2 Fixture or item Tax map(pazoel to.: . Absorption v alve 16.60 1 .).` i :1I 'y :� • =ry :!'.:1 •1' .. 04101 lv ox i�l' •.c:..: I i:'6Ki k ; !" ++ B ACkflowprc yen I` ;,w, r. a H; ". r 1 ter P L ! fr Backwater valve 16,60 - 16.60 Clothe wpgtrer ,` Dishw*eher I 16.60 I ID, ID V • ; i -, -y , .� y 1' , ! :+' I --� .. -L' d`:a tb''V,:a � DfinlClt1f4 X 6.60 - 16 i )!'i: 1n 1Id11�9PIFPI � ' 1�11II '111'�'¢ !tjiyi,yr �! ,JI'1 1p, C 9 . 60 Na i t ti ; r �. . - ISG 1 • t ?, h + " 3 ptprs/ IIQI� - utc: •, -`� t ce - / ca 16.60 fixpannk Address: Flxtuerheatrr ea 16,60 __ Floor draizVile r slnklhub 16.60 cityist>uorz�: Garbage disposal t 16.60 . 1 , Co (� Attu ( '�) - �J / Fax: ( ) So, bib lI tI �rA i i•'. 1 : , ., -,: : :1.1 i ,lr"'; •I' I i k i o .,! i- I : �i - !',1 11 al ll 1 ', I `I , , d .7... 1, • , ill 1 , ,1 ' , ..: ;' l ' . c , !! Toenai , t 16.60 11D : b Sualoeas warm .4---4--. trap 16.60 Coilt t Battle: tvledreal gas (value: 5,,,_) Page x • Address: B runer 16.60 Reef damn (COt1t1 armei) 1 6.60 _ City /S tdZiP: - - - 4 18,60 ( _ sink/Daasn/lavatary I (L� 7 Phsmc: ( ) I : ( . ) _ Tub /shower /shower pan 1 6.60 !3 -mail: I Urinal 16.60 ii ; ,.t.,.:f�_c e ,. ' 1 . 47 " ".1.F:,'7.:':'- Q , fi ra F ' "1'I• -. 4 �:.,�r ii,4 ; ; , It'r wa g y i i I } , , ,.�' a :,�'v! ��:' :;,�;�t ill' 'F I;'.ii;i+ ��::Ild. I� :r!'l ': ,'d a- I t'•� . ' Si 1 0.40 ou ineSt flame: i ' ` , P r u 4, Ir - water heater _ 16.60 Address: _p Other: 1 r Y 1C .t \l , Subtotal City /State/ZIP: 4 4 ... d L Minimum permit Il'e $7250 - 7). - Phoae: (S 63) G9 1 - Cc+ 1 te te. Fat(: GS °s) l0 9 t - . Co j - Residential backfloW 1nlnimurr, permit f1rt: 536.25 Plan review (25% °fparnit fie) CC Lin.: ' 7 a Pturttb[ng Lie. r : ; J L 3 a t; State surcharge (8% of p earn 5 ' S C i Auth rtann t: ? - / - - TOTAL PEWIT FEE .30 FF7i; name r ..%; • j C - i' - e _ Bare ` 2 ' ij 'Th pe rn!d a�MGlatlan =ireful if a permit is net *mewed within tan days after It has been accepted as complete. "Fee Methodology sat by Ili-County Building ksdu'suy Service Board• kwwnsA gacrin.'tiM :Mp1I f« 1511:15 44046I6 (1642 /COMMEB1 CITY OF TIGARD BUILDING DIVISION ° PERMIT #: PLM2005 -00026 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/24/2005 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 _,ti INSPECTION WORKSHEET FOR DATE: 6/5/2005 TIME: 7:16AM PAGE: 60 SITE ADDRESS: 10825 SW FAIRHAVEN WY CLASS OF WORK: SUBDIVISION: FAIRHAVEN COURT LOT #: 013 TYPE OF USE: PROJECT NAME: SAMPLE ' DESCRIPTION: Dishwasher, Garbage disposal, ice maker, sink. OWNER: SAMPLE, SUE & AL VARNES, PHONE #: 503-620 -5231 CONTRACTOR: MODERN PLUMBING PHONE #: 503 - 691-6166 Inspection Request Scheduled For: Date: 5/5/2005 Pour Time: . Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 006168 -01 503- 691 -6166 N Corrections /Comments /Instructions: c (,/, . I l- / yl • PASS El PARTIAL APPROVAL El CANCEL Ti NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date / /� . Phone #: (503) 718-