Permit •
'CITY OF TIGARD
PLUMBING PERMIT
I DEVELOPMENT SERVICES PERMIT #: P 14/20% 6
-00080
I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 2/14/200
PARCEL: 2S 102CA -00931
SITE ADDRESS: 09380 SW LAKE ST ZONING: R -4.5
SUBDIVISION: VILLAGE GLENN LOT: 031 JURISDICTION: TIG
Project Description: Replace 60 ft. of water service and backflow preventer for irrigation.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
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: 60 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
STEURY, DONALD P Description Date Amount
PHYLLIS A
9380 SW LAKE ST [PLUMB] Permit Fee 2/14/2006 $82.55
TIGARD, OR 97223 [TAX] 8% State Surchan 2/14/2006 $6.60
Phone : Total $89.15
Contractor:
BRUNER PLUMBING
PO BOX 23985 REQUIRED ITEMS AND REPORTS
TIGARD, OR 97281
•
Contact # : PRI 503- 624 -4880
FAX 503- 624 -2173
Reg #: LIC 81837
PLM 26 - 445PB
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 -6.' or 1- 800 - 332 -2344.
Issued By: Apt � Permittee Signature: 4.1 A f
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.
Int
FROM : BRUNER1PLUMBING FAX NO. : 6242173 Feb. 14 2006 03:13PM P1
Building Ei,xtui'res
RECE WED . .... ........
Plumbin Application ..::::.,..-: : • . . . ..• .0 OFFICE USE ONL
TigardOR 97223 Y
sp
1 1 4 2006 Received ,-)
City of Tigard
Digviiir 0 Li !Do 6 Paviiii N4h .....0000
1.1 i 25 SW 11110 III vd., ', -
oita Review
' Mune. 501639 E n s : 503 OF TIGARD ,,
. _..1 V41 i .' ' Date/By: (.0 er permit No.:
24- Hoe, inSpeclion Line: 503.0" I MADING DR/Ivo:4M- 11.. Date Ready/By: InlI 21 See Page 2 tor
Internet: www.ci.tigarti.or.uR - Notifie&Maiinii 1111 Supplemental li m n
iforatle
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'TYPE OF WORK • •
. : . ,. : . - . . • • . , FEE*. SCHET)ULE • • ____.....
0 New construction I: Demolition - For special Wormation use checklist
- Dersipti on 1 Qtv. 1 Ea. - 1 Total
,Eff-,A,dd it ion/alteration/replacement 0 Other: New 1-2-family dwellings (includes 100 n. for each utility ecnineetion)
" . .. CATEGORY OF CONSTRUCTION. ' • SFR (1) bath 249.20
irat 1- and 2-family dwelling 0 Commercial/industrial SFR (2) haiti :350.00
- .
b 0 Accessory building 17] Multi-family SFR (3) th 399.00 _
- -, -
Each additional bath/kitchen 45.00
E Master builder 0 Other:
Fire sprinkler ( sq. ft.) • Page 2
. •
.. .
JC4 AND LOCATION • • •
. . ... , . ... • • Site utilities
Job site address: Gi? - L. --(-- Catch basin or area drain 16.607
.„.,.
City/State/ZIP: .---riq 4r-d „ Drywall, leach line, or trench drain 16,60
Sane/bldg./apt no.: Project name: ( &V Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
Rain drain connector 16.60
--..
■ Sanitary 5.ewer (no. linear ft.: ) Page 2
\.; Storm sewer (no. linear ft.: ) Page 2 _
UbtilVISIon: ot no
Water service (no, linear ft.: Ida) . J • Page 2
S r i.. .:
..., ,
Fixture or item
Fax map/parcel no.: -
Absorption valve 16.60
. .
. : " • - : DESCRiPTION . OF WORK • • • . , '
tack flow preventer i Page 2 ) . ,...
,_.
v ,-
. _
A . , 9 _AC' & i Cc , Back water valve )6.60
Clothes washer 16.60
Dishwasher 16.60
. Drinking fountain 16.60
'0:PROPERTY OWNER : ' in TENANt • • • • •
. . Ejectors/sump 16.60
-
Name;
- - Expansion tank 16.60
-
Address: Fixture/sewer cap 16.60
City/State/21P: Floor drain/floor sink/huh 16.60
._...
Phone: ( ) Fax: ( ) Garbage disposal
- 16.60 --1
. . .
0 APPLICANT : ' 0 CONTACT PERSON • .. .. Hose bib 16,60 ---
.
. . Ice maker 16.60
-
l2ii.n;irtess name,
Interceptor/grease trap 16.60
Contact name: Medical gas (value: $ ) Page 2
Address: Primer 16.60
City/State/ZIP: ' Roof drain (commercial) 16.60
Sink/basin/lavatury 16.60
l'horx: ( ) • .
Fax: : ( ) -
Tub/shower/shower pan 16.60
E-mail: " •
Urinal 16.60
. Water closet - 16,60
......_
Business name: ,..... i..--y / L4Ai-----., Al A ilg ./ j • . j c,,, Water heater 16.60
Address: 0 tt 7: - Other:
-......_ -
• 7 Subtotal ---.11
Ciry/State/Z1P1 ( - 1 an A -
I - L ._
Minimum permit fee: $72..50
Phorie: i 4 ..._ 7 a ) Fax: ( ....ro ' :.....,_ 4..., ci_p-i,...3 Residential back flow minimum permit fee: s36.25
..._, ....,. i
CC(-) Lie.: Plumbing Lie. no.: _ Plan review (25% of permit fee)
. . ..-••••••"'" State surcharge (8% of permit fee) (0. U;(
Authori signature: _. ,._
TOTAL PERMIT FEE. S .
... - , -
,----..,
Print name: VV;41.- ' , / 4 , Q t i , - This permit application expires if 2 perITI it i* not obtained within
180 days after it has been accepted sis coin pie ie.
*Fcc methodology set by Tri-County Building Industry Service Board
i.\Eluilding‘P.inins\l'UNIF-Pwaiii.App.doL 06/05 44 0-,is 1 eiT( inni/COmiwiiB)
CITY OF TIGARD r ' f L ril
BUILDING DIVISION PERMIT #: 021)66 _ n
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639-4171 " �N i�6l l � l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: 93 8t c"" CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 - I - 6 7 Pour Time:
Code # Inspection Description Confirm # Contact # Message
3 3 o 6 z fegO Corrections/Comments/Instructions:
wl-ct-lk) ; 4.6k.
SS ❑_ PARTIALAP_P_ROVAL ❑_CANCEL ❑_NO_ACCESS
n FAIL _ CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: �/ V � Date: 3 l (C Phone #: (503) 718-
6
CITY OF TIGARD
•
BUILDING: DIVISION !. . ' PERMIT #: PEN2006-09080
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/14/2006
Phone: (503) 639-4171 /, ollooti it
Inspection Requests (24 Hrs.): (503) 639-4175 ... 4g- '.- i 1.
•INSPECTION WORKSHEET FOR DATE: 2/2412006 TIME: 7:03Am •PAGE: 69
SITE ADDRESS: 09380 SW LAKE sr CLASS OF WORK:
SUBDIVISION VILLAGE GLENN LOT #: 031 TYPE OF USE:
PROJECT NAME: S TEURY
DESCRIPTION: Replace 60 ft. of water seivice and backflow preventer for irrigation,
OWNER: STEURY, DONALD p, PHONE #: NA
CONTRACTOR: BRUNER PLUMBING PHONE #: 503-624-4880
Inspection Request Scheduled For: Date: 2/24/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 027612-01 503 N
Corrections/Comments/Instructions:
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/
d or ...- .
._■.... Ar4 . , Allr....! -..aff __
•
i
2 C 7 e, 4 -f 2
0 PASS 1EARTIAL APPROVAL El CANCEL, 1—i_NO ACCESS
1 l FAIL 0 CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
Inspector: g2(1/1,'- Date: Phone #: (503) 718-
c .
CITY QE, TIGARD
BUILDING- DIVISION PERMIT #: PLIvi. 00 &
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: :i.0141'?4 0C;
Phone: (503) 639 -4171 /„iiidblruo1 i l l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: /17/2006 TIME: 7 :06Am PAGE: 03
SITE ADDRESS: 0900 SW LAKE ST CLASS OF WORK:
SUBDIVISION: VILLAGE GLENN LOT #: 031 TYPE OF USE:
PROJECT NAME: Sl-FURY
DESCRIPTION: Replace. GO ft_ of water s, nfice and hackflow t revonter for irrigation.
OWNER: ,TEURY, DONALD p, PHONE #: NA
CONTRACTOR: t3RUNER PLUMBING PHONE #: 503 -4880
Inspection Request Scheduled For: Date: 2117/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 027042-01 603 -624- 4884E ¥
Corrections /Comments /Instructions: r (h , `r D /J.. -S ,
• The plumbing Installation defects noted ��i /I
on this report she!! be Carrart{a
nn Inspection request made, within 30 ff-
calendar days per OAR 918 - 785 -0230
0 f--
L l G.-.L.. ` /.ice /L�h� d ,Ar __...0l.er
)-)-2, F ' f- - -2-. 67 r - I
£1 7 , 9'
.__. XP
f— 2-?0:3 d 1 Art , - t --- „,
ELPASS _ ►. PARTIAL_AP_P_ROVAL 0_ CANCEL E_N.O_AC
'df AIL ti' CALL FOR INSPECTION pi ADDITIONAL FEES ASSESSED
�I -�` / Inspector: / `� � k Date: � � � Phone #: (503) 718-