Permit df,
CI TY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00095
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/7/2007
PARCEL: 2S 104AA -90142
SITE ADDRESS: 12658 SW KAREN ST 14 ZONING: R -12
SUBDIVISION: BELLWOOD TERRACE CONDOMINIUMS LOT: 014 JURISDICTION: TIG
PROJECT: BELLWOOD TERRACE CONDOS
Project Description: Install clothes washers in units 14 & 15.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: MF WASHING MACH: 2 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: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
OREGON, STATE OF DEPT OF VETS
c/o ZAKOCS, EDWARD + MOZINSKI, Description Date Amount
PO BOX 336 [PLUMB] Permit Fee 3/7/2007 $72.50
YAMHILL, OR 97148 [TAX] 8% State Surcha 3/7/2007 $5.80
Phone : Total $78.30
Contractor:
R D PLUMBING INC
13900 NW SPRINGVILLE RD
PORTLAND, OR 97229 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 297 -7422
FAX 503- 297 -7344
Reg #: L1C 73913
PLM 26 -313pb
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: ___1.2,to
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.
r r/2014 17:59 FAX 5032977344 RD PLUMBING el 002./002
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Plumbing Permit A 0 0 firektun I't)R 6141( I. ['Si: O'si.1
City of Tigard MAR 0 6 2007 Received
City ' �7 / Permit o. / '
13125 SW Hall Blvd., 'lizard, OR 97223„,„, ( C' /,+ N �I ��4 ( r
®� T"3A�D Plan Review
Phone: 503,639.4171 Fax; 503.59R. 4�
" Other Permit No,:
24- Hour Inspection Line: 503.639.4 ILDINGDIVISIOI .I l i i Date/By:
Data ed / /y. NM S See Pngf 2 for
Internet: WWW.Ci.tigard.onus Notified/Method: Supplemental Information
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Ad'91 i9 i � 4 r e � it 4SNElSI�J d Java l,T74, to uu A, X4 411 iit ..v: 0, .,lf t h lal �7 .1,:',A tAfhl :a : ii,A4.y �lY, ?M1�hNrb { r{7r1.iali a{ INllat4 9 {W 'V kk 0, ' .. '' 9.Y." I'm
❑ Ne onstruction ❑ Demolition For special information use checklist
Descri.tion WW1, . Ea. Total
L' Addition /alteration/replacement ❑ Other: g p N New 1- 2- family dwellings (includes 100 ft. for each utility connection)
C1 r 7 , i . ,, .�41 9 v ..lCrlE LIii'VI1b'Vi a i ei1 {!�I $ Y.`C. 1 y 1 V1 y T',�s e11}/1.r 1N r.( � ' 4 53,4 f! 1l� + ` 1 ,11 1} } 141[[6 f 7/�l V N{ i' Y!
'''`', 4 l' " . 4,„ ,i,i4amma lit boaiYi r1Singi;L:22. : ,v;,:, ^4nr ,? :,;: r'1+4�' s. ' x1,2 �i!i SFR (1) bath 249.20
1: I - and 2- family dwelling ❑ Conunercial/industriai SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
- l ach additional bath /kitchen 45.00
❑ Master builder ❑ Other
4i" "" tr 7r' f rk hR}FY dr�� l? r S Y q t tr r 2 a` 6 r Fire sprinkler ( sq. ft Page 2
a
r y l q , , , • 44 ;? n , t , � t � '} { � t� IgNts rlY+ftfa IVASI >lil 6 3�' ru 11 Site utilities ,
- { , in " 1i{ 9Y r r
Job site address: Catch basin or area drain 16.60
U ell, leach line, or trench drain ■ 16.60
C ilylStele/ZIP: t ; O 9,727 3 ryN
ro jeet name: { Footing drain (no, linear ft,; ) Pane 2
Suite/bldg./apt. no.: Pr
SkA k j op( 1 r5:1 f �
Cross street/directions to job cite: Manufactured' home utilities 110.00
_ 0 vim/ ()-T Manholes I6.60
•.
Rain drain connector � 16.60
Sanitary sewer (no. linear ft.: ) ■ Page 2
Storm sewer (no. linear ft.: Page 2
Subdivision: f ,ot nn.: Water service (no. linear ft,: ) Page 2
Fixture nr item
Tax map /parcel no.: p y Absorption valve 16.60
trn ,' l ,Rr � {''' ;f � •,, r nr s „ n r( A 1NNU 7 S !m} 1, ' h b W k . a 4' p"i� {''t � {i`' } �,;rrl `�' 1 y� r�.. „1' Q II ; ° K ,q,1 � / Er 4 m
Rig
rr , t "41 h' {µ;rktta�v „„i.kc;Y t s .,.,,,,k. sa„,,„, tih 9;aaP, ,, l .x.1,8,tit tlg r ...Aril, Baokilow preventer Page 2
'''�1 , ..i■ •... mar AFL r - `l . ,0 ' 04 . Decimeter valve 16.60
Clothes washer 16.60 9
Dishwasher 16.60
l v
Pt nr i} rt m yA 1 Y r r ,,+,� wbrra arnz 11 � pi Drinking fountain 16,60 _'''`�
„ u r ,i : " d t; � ' f '9 N . ' M � � � wn 6 i dii. /' i t A , l ii , 4 k A • R .1 Ejectors/sump 16.60 _
Name; Expansion tank 16.60
Address; Fixture/sewer cap 16.60
City /State/ZIP! Floor drain/floor sink/hub 16.60
Phone: ( ) pax: fjt( ) Garbage disposal 16.60
gpv I r 7^ {l . f !I I 1 qI , q, d�' , hr y t al Wt � . C ro Itt '+aab .lad @ ' r
�r epb,Vg`oi Rm ; Hose bib 16.60
"°.c - c l t el :,.l1RIk� + i ,04 :0 {(v lr !: i.'� r ,,. . M�fc� (a0�y$Pn WG:.0, $1 /4;w,P1U "l,„:}J YL} #IQ1 ?. i t
. „r , lee maker 16.60
Business name: - (4,1141) )„t 1'"Y- Interceptor /grease trap 16.60
Contact name: t ,.. ..dl i ,5 C A Medical gas (value: $ ) Page 2
Address: - Jmi „ _ j/ Primer 16.60
City /State/ZIP: � �, � � Roof drain (commercial) 16.60
Phone: 4 ) IT) - 41ZZ_ Fax:: • ,
)2 Sink/basin/lavatory 16.60
� Tub /shower /shower pan 16.60 _
E -mail: a�V \L/`�"a�� Urinal 16.60
M +,t l' Irf "i4�2r th}i �fi r ( r �t v/ 1 1t l ] ¢ { t s1f g pr 1
o t�}'s,: !'d••Z, g e,,„, ; 4 ; I .. tr ` ka sit ke Y { 't ) � .[irk r � � 1 ?i tir g ∎, . afl!• W atcr closet 16.60
Business name: Marl t � 6 ,. Water heater 16.60
Address: 7 ��� I , >A T%W- Other
L .�Q I Minimum permit fee: $72.50
• Fax: (3 - Ski _ Si Residential backflow minimum permit fee: $36.25 -ID
CCB Lie.: r� Plumbing Lie. no.:21"- -3e �' Plan review (25% of permit fee) 0
` State surcharge (8% of permit fee)
Authorized signature: _ A A. /04 r ■LIIIII/ TOTAL PERMIT FEE lifago
Print name: Ili t i Date; This permit application expires if a permit Is not obtained within
-
180 days after it has been accepted as complete.
"Fee methodology set by Tri-County Building Industry Service Board.
440- 4b167(30/03/COM/WP.B)
i:\ Buildina \Penilts\tLM- PermitApp.doc obl03
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CITY 0������W�������� /
��mw m OF wm��a~unm�� :. .
BUILDING DIVISION PERMIT #: PLk4I007'00055
1312GSVV Hall B|vd.. Tigard, ORQ7223 DATE ISSUED: 3/7/2007
Phone: (503) 639-4171
Inspection Requests (24Hm.):(5O3) G80'417S --416 "Ail.
INSPECTION WORKSHEET FOR DATE: 31802007 TIME: 7:01AM PAGE: 35
SITE ADDRESS: '12658 SW KAREN ST 14 CLASS OF WORK:
SUBDIVISION: BELLW000 TERRACE CONDOMINIUM LOT #: 014 TYPE OF USE:
PROJECT NAME: BELLW000 TERRACE CONDOS
DESCRIPTION: Install clothes washers in units 14 & 16. • .
OWNER: OREGON, STATE OF DEPT OF VETS, PHONE #:
CONTRACTOR: R D PLUMBING INC PHONE #: 503-3977422
Inspection Request Scheduled For: Date: 3/8/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough-in 044606'01 503-2P-7422 N
Corrections/Comments/Instructions:
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|7:fr~-PASS I | PARTIAL APPROVAL El CANCEL NO ACCESS
FAIL El CALL FOR INSPECTION I | ADDITIONAL FEES ASSESSED
ri ' /� / .
/ r�� -�^ � ` _�_|nopeo�oc / ��^ �ate� �N� �y Phone #: (503) 718---~'�
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