Permit r
CITY TIGARD PLUMBING PERMIT
1 DEVELOPMENT SERVICES PERMIT #: P 3/2006 -00075
2.4411111 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/3/2005
SITE ADDRESS: 09303 SW HOME ST PARCEL: 2S111DB-14800
SUBDIVISION: KESSLER ESTATES ZONING: R -4.5
BLOCK: LOT: 005 JURISDICTION: TIG
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: OTHER FIXTURES: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Hose bibb install.
Owner: FEES
FROOM, ROB Description Date Amount
9303 SW HOME ST.
TIGARD, OR 97224 [PLUMB] Permit Fee 3/3/2005 $72.50
[TAX] 8% State Surcharl 3/3/2005 $5.80
Phone : 503 - 525 - 3615 Total $78.30
Contractor:
CROWN PLUMBING
5429 SE FRANCIS REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97206
Phone : 503 -771 -9449
Reg #: LIC 42671
PLM 34 -70PB
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) 24. x.99.
Issued By: « Permittee Signature: c7)—
Call (503) 639 -4175 by 7:00 P.M. for an inspection the next 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.
03/03/2005 10:50
CROWN PLUMB PAGE 02 • 41, n` 'Permit A lication • Citj o F'I igard 6�Hi� U Z ' ;` Foit ., i to • Ltsk ot;i:v
1312` St11JaH t31vd „Tig:'ud. fq`7:' •geceivcd +' r
Phone 5)3.639.4171 Fax: 9 F TI 1?soelS 3 / �”
1 'errrrirNo.{ _�
24- ti ur Inspection Line: $p b,,,dy, 'k nfafl Jicvrow ` p5�v�o ?S
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24- H' t: www.ei.ri ard, °tY3� 4�� DIVISIO a Ilpi'i�'
bateReady/By:
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DateBY: ot her P
8 onus a � errnit No.;
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r ..;!t'' : T" p .;;'a: '. i,1 ; 5 : ''' k?{ r .. l ti a,.r,,. Notified/M ec Page 2 for
v , t ' �y rM t
. rr I ' ;a?.,r' ,r •�. ,1 @ a a n i� "J ;%:%:: j ��r��������6$� �6h�� %f•,l{ "l` �*r Su
0 Neta ccnstructl x. 14 i. ,(�rt;1 tMwva+al ` ^� I f ; l t 1' . 4•. PPIemCnlnl 1nForinatloh
on "171916 t}� } 1°[+:�t.0 1 ' + � a'. F.': ?
CI ;molition to %:.y *I`;ll. >, <,r. l(r� S G' .: B r : r : y < ;fir:- 1 "tF';il :
Acce building
D Add o /alteration /replacement
For spesiaf fnfornrarLpn u3r checklist "rf
I '' ry" ',1-4 i ' .. �_- ❑ C. her: Description
New 1. 2-family dwellings
1: Ad �:I :r,,i! ";i( `:ffi +;;i,��� � i r `� @k' a o "e ::t a' �r 'e °C S tf 4 v s j Qty- Ea. Total
:..r,f � ,. r.i:,.; I 4< .- ,O r, z' g (includes 100 ft. for each utility connection)
rA I - ar. ,i 2 - family dwelling
Ytr'iti tin' SFR (1 ) bath
❑ C: m mercialjndustrial r 249 20
[' 350.00
[] Mast 'r f u
0 M rlti- family
ildrr n 399,00
•
h ; ,- „ ❑ Oti Ler; Each additipat bath/kitchen
� .:?.. J • ' : Jotitl.rCT p . - ^i a t IfI rc-
45,00 • � ' i ' e i ' a 4i. :f a tt}v k ( ,� Fire sprinkle �_ SR )
Job site a Idles; ' �� "r •"` xrst'r�1' "'t ft, —
" o-x Page z
__ Sc ....) n:. / " "'� °' �� • Site Il C'� l l [rC3
• C try /Stan "L. P J '' e, ..c.,, •
Catch basin or area drain 16.60
T �S.- C, 0 ~—
ui [ e/bldl Ian, no,: ___ .,.._____ ______ 1, Otywell, leach line, or trench drain 1111111111= — Project name;
Cross ctre ;Vt irec. ' Foatirlg (no. linear ft.: ) 1111111= duns to job site:
• Manholes Manufactured homy utilities MI 1 t0.D0
•
111111 16,60
—�- ._
Rain drain connector _
16.60 IIIIIIIIII
Subdivisio i~ ~� Storm Sewer (no. linear ft.: =�
Page
lax ma pip. rc, i nn,; _ Lot no Water service (no. linear ft.:
s'r l P,' P „ --,
Fixture or item ) Page 2
...:._ ;: � i , _- ` fis 7 Z7i jfi`51�1M 6 .4 7 ! NI I W `i { rtzm ,,, ,: '� , , ,.c n ' ., Absorption valve
. �. .. f....Jnl 'ra+41 it• ,. ; �ky,, ti ,: ,�,I7',_ ��, ��
�� / r c i.kidi i . r• " i1 16.617
L Backwater valve . v ` k ThillsESIIII 111111
16 60 =I
�?. 1Fq I�:. 4 R�� s 1M1:t,` ; ?�4� {s w 'i `" � t r�' ( I rlb A � ; 'i '`` r e " ;yet: c Drin kin fountain
1640
Name; , / � 1f {A ti , 3 l i /
e; i ` r�+u�. y3 tt u ' r i 6,60
✓ ° ..
J jectnrglsump
AddresS; �— �.. Expansion 16.60
�! P Sion tank
16,60 MEI
c: iry /Stater' / -1 t : Fixture/sewer cap 1111 — --•— ' ^� __ _ 16 . 60 MEM
Phone: (S P) S-2 l5 Floor drain /floor sink/huh
13 F ax ) G 1640 ME
i' 'r }} Ss � Y f� ,: . i lrll • :1 t: . :t (
Garbage disposal
,1`.'!, .f° PL t 1 4 :k�� ' r c 2t ,fih3t r 16,60
! ' f i r •. ; ,4. fb0ix't Ir ; { L� M rty f ti}s W . . e 1 sy , Hose bib
Business Warn s:',,' » " Y1 �M 16.60
�� -
Contact name _ Interceptor/grease trap
_ \ddress: —, .— 16.60
Page Z
+ n'iSlatelLlP l
Pin r 16.60
— • - -_ —_. Roof drain (commercial) 16.60
i'i (
—, . -- — ___ I Fax: ; ( ) 16.60
• E-mail:
Tub /shower /shower pan
;. a , t ,�. 16.60
"'f ;S „'I . -- :.r -,• ;h'oiY ..: �i ' `'" I ��w.r^ �yT•' Urinal
�_ . . "
. PLUMBING
k , ;'44 ( c tu t le ! "
f' .4 „ i'1 Wa tercloset 16,60
NG
Water heater
Business name CROWN f 6.60
_ 4ddress: 5= 29 SE FRANCIS STREET Other:
•
City /State /ZIP: iPCftTLAND, OR 97206 Subtotal
Phone. ('5(13) 7 1 - .: 443
Minim permit I'm 572.50
_ ._ _ - Fax: (SU3) 7 "1A454 Residential backflow minimum permit fee: 53 7 ,S-0
C'CEi Lic.: 426; I Plumbing Li,:- 4-70Pft Plan review (ZS %ol'pclznit fee)
A utliorized si f :ItU State surcharge ( 8 % permit fee) .5 TOTAL PERMIT FEE
[ Punt dame; Del nir Underwood Date:
- • '41) S –1 This Permit expires u pemit plet within
180 days application after i# hag been in acce is as not Complete_
1. liwidimr Fermhs , P1..f - P rnri,npp -,roc i ?'o? ' methodology set by Tri- County Building industry Service Board,
1 61(1 0/02i COM.nv E B )
CITY OF TIGARD - �
BUILDING DIVISION G`' PERMIT #: PLM2005-00075
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/3/2005
Phone: (503) 639-4171 ist >sy pi �� q � l j�l ? Inspection Requests (24 Hrs.): (503) 639 -4175 `:_... iP 3
INSPECTION WORKSHEET FOR DATE: 3/25/2005 TIME: 7 :07AM ,1 PAGE: 111
I
SITE ADDRESS: , 09303 SW HOME ST CLASS OF WORK:
SUBDIVISION: KESSLER ESTATES LOT #: 005 TYPE OF USE:
PROJECT NAME: FROOM
DESCRIPTION: Hose bibb install.
OWNER: FROOM, ROB, PHONE #: 503 - 525.3515
CONTRACTOR: CROWN PLUMBING PHONE #: 503- 771 -949
Inspection Request Scheduled For: Date: 3/25/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 002770 -01 503771 -9449 N
Co ctions /Comments /Instruc ions:
V - __.e,, , ,L sa A ,, /--
IA l y
7- (1 v ,,
A\\. „1 ...
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. , , /17 9'
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t � -5 r�. -y
•
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
=AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
r _
._A ` - Date: - 3 ) Phone #: (503) 718-
•