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Permit
q CITY OF TIGARD PLUMBING PERMIT ° ' COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00150 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/19/2007 PARCEL: 2 S 104 CA - 06200 SITE ADDRESS: 13228 SW HILLSHIRE DR ZONING: R - SUBDIVISION: HILLSH IRE LOT: 062 JURISDICTION: TIG PROJECT: JIAO . Project Description: Install up to 80 feet of new water service. CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SFA WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: 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: 80 ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES LARSEN, TYLER L + DEBBIE A Description Date Amount 13228 SW HILLSHIRE DR TIGARD, OR 97223 [PLUMB] Permit Fee 4/19/2007 $72.50 [TAX] 8% State Surcha 4/19/2007 $5.80 Phone : Total $78.30 Contractor: MRP SERVICES PO BOX 33585 PORTLAND, OR 97292 REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 652 -2626 • FAX 503 -241 -6565 Reg #: LIC 106824 • PLM 3 -265PB This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. // � Issued By: I //l fL / Permittee Signature: c' � /Tfl � ef-th Call 503.639.4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. P1 G °tbing Permit Applica C 1 �` F ."-® FOR OFFICL 1.1SF. ONLY City of Tigard 7 Received ar� Permit No,: PLN12bb 001 41 13125 SW Halt t31vd., Tigard, OR 97223 1 Plan Review Phone: 503.639.4171 Fax: 503.59$.1960 d• � Ifl` l Dat&B : Other Penult No.: 24- Hour Inspection Line: 503.639.4175 CITY OF ,i��r . " L Date Reudy /6y: Jurir, 21 See Page 2 for Internet. www.Ci.tigard,or,us • , ■ 1 l N Notified/Method: �y� p supplemental Information �' �}pr' T w, w T x "' i � f �I; :Y tI 1 LR Y 'PYYS°1 p� . . ',1 � � lk" t r1 i.',9 ii ` rr,+ r M h "v'7 �v ` . o J J u t.., l a'u y � EilIr I a'( � O fGS�� .�t, Y: ' i !,�� k�, REF t + y . ] r ; >,1 _t .,.�rf U` P . d-'N S,Q3' it � .iC..a.. '1r54_.u- .wt z. .,.At N 0 New construction 12 Demolition For special injbrmariou use checklist Description I Qty. I Ea. 1 Total 1'S Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) Y.' 7'�{ � Yt t aml• craw n � -.a T"` "!"d� �' rl SFR (1) bath 249.20 �y i i, u r 15 r a e G- +� 4 /J t u '11'VyJ i, ERN at IN° F �f ,'AA Nr`ii,t!M` {r }u�„y.; ,r ;. ch e�ee.0 ,�,�^ lk $P � � , t 371. #..._•�_ SFR (2) bath 350,00 ►'■ 1- and 2-family dwelling [] Commercial/industrial _ CI Accessory building I:1 Multi-family SFR (3) bath 399.00 Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: '9„� K r . ; p Pile sprinklties er L� 54. 8.) Page 2 � r I r "7 �� `y s.- , „t�+ ' , .. , , i, ,, o t w. 4, .L Yi t " � ! ' Fit u tili Job site address: r WI1� Catch basin or area drain 16,60 City/State/ZIP; Jr Drywell, leach line, or trench drain 16.60 .___ Suite/bldg. /apt. no.: i Project name: 't" ! Footing drain (no. linear R.: ) Page 2 cJ Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 Rain drain connector 16,60 Sanitary sewer (no. linear ft.: Page 2 Storm sewer (nu, linear ft.: __) Page 2 Subdivision: Lot no.: Water service (no. linear tt.: J7 Page 2 5 �L1 , Fixture or item Tax map /parcel no.: — c' i',1 'i . k ,... � .. .'.. .M ttP`.4 1 N I a„ ' I . t . , • Absorption valve 16,60 } �` _ Z<? , . . . - ' 4. t 10 d; 4 L - . ' [ , u J , ' -t ' . r . .i i v . g, .' � .' ' . 'tk+ r . fe'l F � .., _0 f Pa e 2 -,,k ;r - � ..,��,� " :, x S� :L A�r . � ° , y Bacldlowprer�enter g 4 & #i 1_ � x, (a of ,_0 i ♦ Backwater valve 16,60 r/ Clothes washer 16.60 IBM i / Dishwasher 16,60 I m Yr + , D fountain 16.60 • ■ t?�j'iY : 5 7 7V. ti�1� r '+`' i 6 ' ! rr+ ' q ? 'CS�. . . El 1 ' 11) . t , +" '111'; + g F ti a' I a'., a >_': d• -.). i '' EjcctonJsump 16.60 Name: AA A .. ' . , Expansion tank 16.60 Address: ` % �T m�1 Ij�IT W i Fixture /sewer cap - 16.60 • _` A.I.I �i/ . `` Floor drain/floorsink/hub 16.60 �� �Z� Fax: ( ) Garbage disposal 16.60 E rnom °,��s „iK r f, ' 1 m , t _ N ©t1,4 Rose c bib 16,60 a �t e 'y ! �'! t '' J • Ice maker 16 Business name: rn P i� Interceptor /grease trap 16.60 Contact name: 1 l i B RI A] , T (l�c4/t/ Modica] gas (value: S ) Page 2 Address: P, .0k 3 G Primer 16.60 City /State/ZIP: Ill , , 1 l 7 J Roof drain (commercial) 16.60 �� `� Sink/basin/lavatory 16.60 Phone: 0 ' ) , .,. — i i . 0 - Fax:: ( 6 i li / le. Tub /shower/Shower pan 16.60 .r ,I l u a I . :I Urinal 16,60 4A 7" ,`�`, iJ tfS �q v l i i , Fy1�` 1i b� 7 1 i rJ ' tY 'S' ' N' fag .:. s JI >s� ••pier url tit _ , ;, o r „ , �.�,.t,0 `, ate.+ IVatcr close 16.60 u �� J 1 Water heater 16.60 • = i other: City /State✓ZIP: � , � 0 Subtotal / 6Q �� ��� �� � -�� Minimum permit fee: $72.50 4 Phone: ( ) a - #` • i� • + ' ' � , ��� Residential backflow minimum permit fee: $36,25 1�() CCB Lic.: 0 1p ire Plumbing L 3 a Q 4 S i Plan review (25% of permit tee) 1 State surcharge (8% of permit fee) 5 , cb Authorized signature: iv . qtdftA4)g49V-1' . ! A D TOTAL PERMIT FEE 1i Print name: 1 llate: V t/ 7 This permit application expires if a permit is not obtained within 180 days after It hos been.accepted as complete. "Fee methodology set by Tt'i -County Building Industry Service Board. i:l Building \Permiu\PLM•PermicApp.dac u u7 440.46 IiT(I0 /01/C0MAVEO) Z0 /Z0 3E d dZIW S9S9T1,ZEOS 90:ST LE Z /8t /tV0 , CITE 'OF TIGARD f BUILDING DIVISION PERMIT #: PLM2007 -00160 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/19/2007 Phone: (503) 639 -4171 al Inspection Requests (24 Hrs.): (503) 639 -4175 ...L. INSPECTION WORKSHEET FOR DATE: 4/24/2007 TIME: 7:01AM PAGE: 35 SITE ADDRESS: 13228 SW HILLSHIRE DR CLASS OF WORK: SUBDIVISION: HILLSHIRE LOT #: 062 TYPE OF USE: PROJECT NAME: JIAO . DESCRIPTION: Install up to 80 feet of new water service. OWNER: LARSEN, TYLER L + DEBBIE A, PHONE #: CONTRACTOR: MRP SERVICES PHONE #: 503.652-2626 Inspection Request Scheduled For: Date: 4/24/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message ' 330 Water service 047034 -01 503 - 843.6650 Y Correcti. s /Comments /Instructions: AV 4 , , lb I► - C Z A C 9 e .ititA/VV'2 "rt^/...---1.---Q‘ ..-- (rk----- ■ i/(Ai re' r. PASS n PARTIAL APPROVAL _ CANCEL I 1 NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ` C Date 1 I Z ` ) Phone #: (503) 718- ZL �' -1 �