Permit l
• 4, ' n CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00211
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/21/2007
PARCEL: 2S 111 AB -06700
SITE ADDRESS: 09255 SW INEZ ST ZONING: R -4.5
SUBDIVISION: PENROSE TERRACE LOT: 012 JURISDICTION: TIG
PROJECT: ALLAIRE
Project Description: Replace existing water pipe to 8 fixtures.
CLASS OF WORK: ALT 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:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: 50 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
PAT ALLAIRE
9255 SW INEZ Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 5/21/2007 $72.50
[TAX] 8% State Surcha 5/21/2007 $5.80
Phone : 503- 888 -2321 Total $78.30
Contractor:
3 MOUNTAINS PLUMBING
PO BOX 386
SHERWOOD, OR 97140 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 925 -1342
FAX 503- 925 -9104
Reg #: LIC 169499
PLM PB99
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 B � Permittee Signature: f\p codi
// % / L% l g j
C
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.
05- 2112007 12:03 3 MTNS PLUMBING 5039259104 PAGE2
Plumbing Permit Applicati u rti IV / i tale c)I h Ic l: 1st: l)N.I.1
g MAY 2 1 2007
City of Tigard Received
DatcBy: 5 Izt 1 0 4 ' Permit No.: • LM is - • Z
• 1 3125 SW Hall Blvd., Tigard, OR 97223 Plan Review
• _ Phone: 503.6W4 171 Fax: 503.591 '!�1� e fiQ' CF 1 �71`1�RD D ale ty y: other Permit No.: Ei.c.. = 0AZB.3
inspection Line: 503.639.4175
I ! t.: n,lt L) Ready /By: DIVISION D ate Read B Y: . .A RI See Pa e 2 for
�
Internet: www.tigard- or.gov Notificd/Metix,d: ' rj( r r g Supplemental lnformaeon
TYPE OF WORK FEE" SCHEDULE
El New construction ['Demolition For special it:forntation use checklist.
Description .. Ke1f� l;a, Total _
psj Addition/alteration/replacement ❑ Other: ' New I- 2- family dwellings (includes 100 ft. for each utility connection)
Y -!
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
I_ and 2 - family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
El Accessory building El Multi - family SFR (3) bath 399 -
.. - Hach additional bath /kitchen 45.00
❑ Master builder ❑ Other: __
Fire sprinkler ( sq. R.) Page 2
}
JOB sin; 1NFOI M.AI'1UN AND LOCATION Site utilities
Job site address: C2 . ,i��' ) J ,S, Catch basin or area drain 1 6.60
c City/State/TIT': r! Drywc11, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: rooting drain (no. linear 8.: ) Page 2
Manufactured home utilities 110.00
Cross strCCU _ dirCCtinus to job site: manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear R.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2 j '"S; r)--e
Subdivis Lot no.: Water service (no. linear ft.: ) 317 r Page 2
" Fixture or item
Tax map /parcel no.: Absorption valve 16,60
DESCRIPTION OF WORK Hackflow preventer Page 2
R k1) 19e._, ltZ0,�� J C„� y e*�\ , Backwater valve 16.60
P' j ��� - � Clothes washer 16.60
' Dishwasher 16.60
❑ PROPERTY OWNER ❑ TENANT
Drinking fountain 16.60
- I jectors /sump 16.60
• Name: aI ailaire2 Expansion tank - - 16.60
Address: 1. L . j j'^" -rile Z. „ ( /7 Fixture /sewer cap 16.60
City/State/ZIP: ii l f„" �� , h
� / % .71a2i -
flour drain/floor sink/hub 16.60
Phone: (503) D % ,)3 Fax: ( ) Garbage disposal 16.60
O
❑ APPLICANT ❑ CONTAC'r PERS ........ ~- Hose bib 16.60
SON .._..._
,-- • Ice maker 16.60
RnLyirte name_ - - Interceptor /grease trap 1 6,60 -
Contact name: Medical gas (value: $ ) Page 2
Address: Primer 16.60
--
t 5 ty /StrArJ7.iP: Roof drain (commercial) 16.60
-- .._..._.- ...... ..... ........_.__. Sink/basin /lavatory 16.60
Phone: ( ) I Fax:: ( )
'rub/shower/shower pan 16.60
E -mail: -
__ .. , , urinal 16.60
CONTRACTOR Water closet 16.60
Business name: . , nbi 2. . Water healer T 16.60
l�� v �/ /� v , (� / 1 lie `r` l
Address: �[.r✓ /e `� c) id ��Cf T/� �� 5:.2.��r r • /t� ()thee: -_. � �i�e � �t>\ ��, ?
�+ her WODd t 1)/-- ?7 / Sn 72.50
('its /S(jstr /7.1P
• `, Minimum permit fee: $72.50 �j so Phone: ( 3) ? /27 t+1 Fax: ( ) 9d5- ^ ,/ /Q Residential backflow minimum permit fee: $36.25 "l
CCB Lie.: /6 // y Plumbing I ,ic, no. pg yy Plan review (25% of permit fee)
Authorized signature: r,� .7.-i&-----, - ��,,// S tate surcharge (VA of permit fee) 6. So
, rv . jSII k� _ _ TOTAL PERMIT FEE ,
Print name: 4/ // lei" I Date: , „ f{) /`0 7 This p ermit application expires if a permit is not obtained within
/ Ye:v. y ft. t.. ! IRO days alter It has been accepted as complete.
*Fee mnthodnlovv art hv 'I'ri- ('nunfv Huitrtinn Indurlry Service Board
r f F
4
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007 -00211
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/2112007
Phone: (503) 639 -4171 A I
Inspection Requests (24 Hrs.): (503) 639 -4175 J.W'
INSPECTION WORKSHEET FOR DATE: 602007 TIME: 7:01AM PAGE: 43
SITE ADDRESS: 09265 SW I NEZ ST CLASS OF WORK:
SUBDIVISION: PENROSE TERRACE LOT #: 012 TYPE OF USE:
PROJECT NAME: ALLAIRE
DESCRIPTION: Replace existing water pipe to 8 fixtures.
OWNER: ALLAIRE, PAT PHONE #: 503-8N-2321
CONTRACTOR: 3 MOUNTAINS PLUMBING PHONE #: 503 - 915 - 1342
Inspection Request Scheduled For: Date: 6/5/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 049608 -02 503- 888 -2321 N
Corrections /Comments /Instructions:
s ad / 00
P AS S ❑ PARTIAL APPROVAL CANCEL ❑ NO ACCESS
❑ FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED '.‘ Inspector: Date: Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION o , r . , PERMIT #: PLM2007- 00211
13125 SW Hall Blvd., Tigard, OR 97223 1 ' DATE ISSUED: 5/21/2007
Phone: (503) 639 -4171 'tilt
Inspection Requests (24 Hrs.): (503) 639 -4175 =
INSPECTION WORKSHEET FOR DATE: 5/25/2007 TIME: 7:17AM PAGE: 41
SITE ADDRESS: 09255 SW INEZ ST CLASS OF WORK:
SUBDIVISION: PENROSE TERRACE LOT #: 012 TYPE OF USE:
PROJECT NAME: ALLAIRE
DESCRIPTION: Replace existing water pipe to 8 fixtures.
OWNER: ALL'AIRE, PAT PHONE #: 503 -B88 -2321
CONTRACTOR: 3 MOUNTAINS PLUMBING PHONE #: 503.92.5.1342
Inspection Request Scheduled For: Date: 5/25/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 04908801 503 -925 -1342 Y
Corrections /Comments /Instructions:
i '' 124-- \.r/t
PC— 0 pq-19/46? 1 0 4. i4 9
IL ti ' r�� ° L / ,C
Ii -'ASS PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL WALL FOR INSPECTION ❑ ADDITIO L FEE ASSESSED
Inspector: _ `o Date: C ' �' Phone #: (503) 718 -