Permit C ITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 - 00367
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/9/2008
PARCEL: 25101 BC -02201
SITE ADDRESS: 08300 SW HUNZIKER RD ZONING: I -P
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: WPI
Project Description: Interior plumbing. Other fixtures: ice maker and sump.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 2 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 2
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
MICHAEL & ROACH
956 WEST POINT RD Description Date Amount
LAKE OSWEGO, OR 97034 [PLUMB] Permit Fee 9/9/2008 $72.50
[TAX] 12% State Surch 9/9/2008 $8.70
Phone : Total $81.20
Contractor:
MODERN PLUMBING
11120 SW INDUSTRIAL WAY
TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 691 -6166
FAX 503- 691 -6771
Reg #: LIC 87906
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 or 1.800.332.2344.
Issued By: Permittee Signature: i .€ 1 'C(/\J
p
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.
,
Se 8. -,2008 1:59PM Modern Plumb 1 ng ' No, 5126 P. 2
Plum Permit Appfieati CEJVED FOR OFi -ii :1c L Si: ONLY
City of Tigard RC6 - �
Pate Bs 'er'N,' Q ?
13125 SW Hall Blvd, Tigard, OR 97 '' Q 2008 t f ' r Lam? } �- f.0 J 6
$6 00 ' v 00 0 P P4 lct'itn'
Phone; 503.639.4171 Fax: 503.59 , i ;dhM p No >(,
I nspedlon Line: 503.639.4175 e > c �� cUJ l
" 1
T f .h i r lnteraK w et Pae 2 for
: wwtigard- or.gov CITY OF TIGARD Noti od: Sup e me g ntal Information
7 ' 1 .ry OF�
T Y)3 iNCI DIVIS' UN Xitiw. NC.m r t r L E
[E New consirrrclion ❑ Demolition For special issforrnafian we checklist
Description I Oh 1 Ea. I Total
Addition /alteration/replacement • El Other w ft for 1 Z tantlly SP ( or ea neat
dwellings elfin includes 100 each utility cou p
C 4 EC9R1' t71? C t)Tr 1Xt�TTO1 _ SFR (1 }bath 249.20 I
O I -and 2-family dwelling ' Commervial/industr al SFR (2) bath 350.00
Accessory building C Multi- family SFR (3) bath 399.00
L
Each additio
❑ Master builder ID Other
additional baUt/kitahen 45.00
alder ( it Page
J )1 5 . P nlA)'YOIV '+xl`nP `k 4TIO1V Fire spri s9• ) Pa 2
-- , � Site AtDitfes
Job site addncss: g ? -� U 1 k r �d Catch basin or area drain 16.60.
City/State/ZIP: 9 G7. r et ( , cry `7 2.23 Dryweu, leach line, or trench drain 16.60
`1\� .p Footing drain (no. linear ft: Page 2
Suite/bldgJapt. no.: I Project name:
Manufactured home utilities 110.00
Cross street/directions to job sift' (/JJSrtrfv 16 r Z/vS T L Manholes 16.60
_ Rain drain connector 16.60
Sanitary sewer (no. linear ft,; __3 Page 2
Storm sewer (no. linear it: _ ) Page 2
Subdivision: Lot Water service (no. linear ft.: ) Page 2
Tax map /parcel no.: )Fixture or item
T Absorption valve 16.60
��77 ,, t n : ;'' Deakflow preverder Page 2
Re tv- a t. e, (- 153 - 4- a 11 r ii -c! 4 Backwater valve 16.60
K, j e,r) Clothes washer . 16.60
- Dishwasher 16.60 -
�. � jW,', .'-r pROit d 6.0iiit11 ', , C1'.,./t . N 1 r Drnukin foaatoin 16.60
Name. Ejeetoralautrtp - - - / 16.60 l b, to o
`! 4 '4, , tt4 L Jul. _ Exile ns tank 16,60
Address: Mr V Tt. P
a Fixture/sewer cap 16.60
City/State.21P: G /� 7 Floor drain/floor ainkJhub 16.60
Phone: ( ) (( Fax: ( ) Garbage disposal 16.60
.' 0 ' ►ltl•l I FE N host bibb
Business name: Ice l 16.60 i F ep D
Interceptor /grease trap 16.60
Contact name: Medical gas (valet: S ) Page 2
Address: • Primer _ 16.60
City/Statr/ZIP: Roof drain (commercial) 16.60
Phone: ( ) F : ( ) Sink/basin/lavatory 16_60 3 3. Z0
-- - . Tub/shower/shower pan 16.60
E-mail:
Urinal 16.60
, 000: #CT�O 1 Water doses
16.60
Business name: 14loder» Plumbing CO. Water heater 16,60
Address: 11120 SW Industrial Way . Other;
City /State/ZIP: Tualatin, OR 97062 subtotal
--- Minimum permit fee: $72.50
Phone: (503) 6916166 Fax: (503 ) 691 6771 Residential baektlow minimum permit fee; $36.25 72 ..E
CCB Lic.: 87906 ' . - .'ng Lie. no,: 34 250PB Plan review (25% of permit fee)
Stale surcharge (12% of permit fee) 7 �
Authorized signature: A. / _ O l
TOTAL PERMIT FEE
Print name: to / a , . a • y A t ,. OP Date: • AV e ` This permit appllcatian expires if a permit is not obtained within
160 days after it has been accepted as complete.
*Fee methodology act by Tri- Cowrty Building Industry Service Board.
t: \BuildinglPermiLlPLM- PerinitApp.doc 06/26/06 400- 4616710/02/COMNJE9)
'
' '' , ' '
CITY OF �
��om n ��m TIGARD � '—„
.BUILDING DIVISION PERW1|T#: PLKH2OUB-00367
13125SVVHaUB�d.. Tigard, ORO7223 DATE ISSUED: 9/9/2008 Phono:(503)889'4171 A,
Inspection Requests (24 Hrs.): (503) 639~4175 -� hN� ^�J—
INSPECTION WORKSHEET FOR DATE: 9/15/2008 TIME: 7:00AM PAGE: 19
SITE ADDRESS: 013300 SW HUNZIKER RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: WESTERN PARTITIONS
DESCRIPTION: Interior plumbing. Other fixtures ice maker and sump.
OWNER: ROACH, MICHAEL & PAMELA PHONE #:
CONTRACTOR: MODERN PLUMBING PHONE #: 60�°691-
Inspection Request Scheduled For: Date: 9V15/20013 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Ph/mNng.rnuSh'in 075464'01 503-691'6100 N
Corrections/Comments/Instructions:
.
X PASS | ���ALAPP��L �� ��CEL � [�ACCES8
I �� / ,
FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
|napeotor� �0k Date: �� � (�� ��� Phone #: (503) 718-
�.~~ . ^^��",. � ` '
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2008-00367
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639-4171 /Ad
J
Inspection Requests (24 Hrs) 919/2008
: (503) 639-4175 ' —
•
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
10/1612008 7:01AM 19
SITE ADDRESS: CLASS OF WORK:
08300 SW HUNZIKER RD
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
WESTERN PARTmoNs
DESCRIPTION: •
Interior plumbing. Other fixtures: ice maker and sump.
OWNER: PHONE #:
ROACH, MICHAEL & PAMELA
CONTRACTOR: PHONE #:
MODERN PLUMBING 503-691-6166
Inspection Request Scheduled For: Date: Pour Time:
10/16/2008
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 076802-01 503-691-6166
Corrections /Comments/ Instructions:
C avt.
a PASS 0 PARTIAL APPROVAL CANCEL I I NO ACCESS
I I FAIL . 0 CALL FOR INSPECTION rj ADDITIONAL FEES ASSESSED
Inspector:CM LtvAn.,-/ 1I• Date: I 011 I 0?) Phone #: (503) 718-
. • •