Permit MI CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2006 -00596
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/19/2006
PARCEL: 1 S134AC -00100
SITE ADDRESS: 11388 SW IRONWOOD LP ZONING: R -4.5
SUBDIVISION: ENGLEWOOD LOT: 030 JURISDICTION: TIG
Project Description: Replace: kitchen faucet, sink & dishwasher, running ice maker line to fridge.
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: 1 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: 1 RAIN DRAIN: ft
Owner: FEES
MARTIN
11388 SW IRONWOOD LP Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 12/19/200E $72.50
[TAX] 8% State Surcha 12/19/200E $5.80
Phone : Total $78.30
Contractor:
SHAWNZ PLUMBING, LLC
PO BOX 341
GRESHAM, OR 97030 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 516 -1816
FAX 503- 669 -7143
Reg #: LIC 161 188
PLM 26 -767PB
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:• _! C /z'� Permittee Signature: • -L- .�
qe
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.
+e. • t-
Plumbing Permit Applicati pia, ECEIVED
FOR OFFICE l'Si: ONLY
II City of Tigard nn q � Received . f
+ 13125 SW Hall Blvd., Tigard, OR 97223 EC 1 9 2006 Bntel3YA,2 - 79 9 �t Permit No? I V �� A579
-
Phone: 503.639.4171 Fax: 003.591 ®F I plan Review �� % U
TIGARD Inspection Line: 503.639.4175 w+ I(a'�I�D Date/13y: Other Permit No.:
Internet: wwtv.tigard- or.gov BUILDING DIVISION Date Ready/By: furi� See e 2 for
Notified/Mettrod: I StapplemPagentallnformadoa
TYPE OF WORK
FEE* SCHEDULE
0 New construction ❑ Demolition For special information use checklist
TgA
ddition/alteration/replacement Description Qty. Ea. Total
0 er New 1- 2- family dwellings (includes 100 ft. for each utility connection;
CATEGORY OF CONSTRUCTION SFR (1) bath
( K - 1- and 2- family dwelling 0.00
❑ Commercial/industrial 35
ial /industrial SFR (2) bath 350.00
` [] Accessory building 0 Multi-family SFR ( bath 399.00
Each additional bath/kitchen 45.00
-
0 Master builder ❑ Other
JOB SITE INFORMATION AND LOCATION Fire sprinkler ( sq. R). Page 2
Job site address: ) ?L yL Site utilities
r
[ M �'�' �- x L i`v Catch basin or area drain
City/State/ZIP: % v �) Q 16.60
!Y C� UFO . ] 2 Drywell, leach line, or french drain 16.60
Suite/bldg./apt. no.: Project name: Footing drain (no. linear ft: , ) Page 2 ,
Cross street/directions to job site: 5 his Fe.,,,-7 Manufactured home utilities 1 I0.00
Al 7 Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft: _) Page 2 ,
Storm sewer (no. linear ft.: ) Page 2
Subdivision:
I Lot no.: Water service (no. linear ft.: 1 ,_ Page 2
Tax map /parcel no.: Fixture or item
DESCRIPTION OF WORK Absorption valve 16.60
S W J� �L, Backflow preventer Page 2
7p 7 ' --rtur � .e - 1 �'r. 1L Backwater valve 16.60
it 0 PI P) i t"' 9 i e -e. i✓t 4n. c -r it' 1.■ -y-s, P .4,, . Clothes washer
16.60
Dishwasher ,I 16.60 j, j 6 '2-
❑ PROPERTY OWNER ( ❑ TENANT Drinking fountain 16.60
Name: Ejectors /sump 16.60
Address:
Expansion tank 16.60
Fixtureisewer cap 16.60
City/State/ZIP: Floor drain./floor sink/hub
16.60
Phone: ( ) 1 Fax: ( ) Garbage disposal 16.60
❑ APPLICANT 1 ❑ CONTACT PERSON Hose bib 16.60
•
Business name: Ice maker l 16.60 I C '
Contact name:
Interceptor /grease trap 16.60
Medical gas (value: $ ) Page 2
Address:
Primer 16.60
City/Slate/ZIP: Roof drain (commercial) 16.60 •
Phone: ( ) I Fax: : ( ) Sink/basin/lavatory I 16.60 (� 6-%
E -mail: Tub /shower /shower pan 16.60 r
Urinal 16.60
CONTRACTOR
r Water closet 16.60
Business name: Sl�rzwyr 2 Q/ /
( / LC.Iyl�f j /�t� Water heater 16.60
Address: r O. g t _ Other:
City/State/ZIP: �'- c,r <Sk /�, i1 , r -7413E)
Subtotal l,/
Phone: ( S e Oic, Fax: (51) !) 6 Minimum permit fee: $72.50
, -7 j v 3 Residential backft , � 1 ow minimum permit fee: $36.25 `
CCB Lic.: 1 (? ([ o Lr Plumbing Lic. no.: �r �" P review 25 /° of
{jp- 7� �� ( ° permit fee)
Authorized signature: State surcharge (8% of permit fee) 5f.%
eY
TOTAL PERMIT FEE 73 j
Print name: a pThis P e
c>>n �s� I Date: l 0 / v t_ permit application expires if a penult is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
1 : \Pcmits'PLM- PermitApp.doc 0606'06 440 4616T(10/02/COM/WEBI
vd 9171-L Oil `6ulqu.lnld ZumeLIS d10 :00 90 61. deo
CITY OF TIGARD
BUILDING DIVISION . ' . :- - PERMIT #:
DATE ISSUED: P-121-)':A192/°2°06.6M696
13125 SW Hall Blvd., Tigard, OR 97223
Phone: (503) 639-4171 Atsdopol , 1 t\
Inspection Requests (24 Hrs.): (503) 639-4175 ..,41-' '-
INSPECTION WORKSHEET FOR DATE: 1121/2006 TIME: 7:00AM PAGE: 29
SITE ADDRESS: 11388 SW IRONWOOD LP CLASS OF WORK:
SUBDIVISION: ENGLEWOOD LOT #: 030 TYPE OF USE:
PROJECT NAME: MARTIN
DESCRIPTION: Replace: kitchen faucet, sink & dishwasher, running ice maker line to fridge.
OWNER: MARTIN, PHONE #:
CONTRACTOR: SHAWNZ PLUMBING, LLC PHONE #: 503-516-18'16
Inspection Request Scheduled For: ate: 12J2.1/2006 Pour Time:
Code # Inspection Description Confirm # t # Message
399 Plumbing final 041421-01 503-516-1816 - V V 3
Corrections/Comments/Instructions: ,' 11 e7& ate _, ,eDolv----
/ 74-_,052 4_4 ookiRe___ - 7 - 0
I - / 1 ili/e9.0 1.4.opt7/z- Wei:—
..." ( cz-5--009--i4/Af■r-- _______
,,,,.• 2 a - - x y reaMil Z . e / I 4 te. .5
l r al; Ashi9-C__ZI-(ND t , , /3-S- '' i t,,D1 C - . 7--
.=_ITL44/ F - It_ - PS■se 4 .e'r
— - ..i 'ern/ 77.046
<:s 7 PARTIAL APPRO 7 CANCEL p NO ACCESS
FAIL /ALL FOR :PE ION . i i D FIONA FEES ASSESSED
• ,17
Inspector: i igr Date: 27e edo-- hone #: (503) 7 8-
, ,