Permit , A
CITY OF TIGARD ` PLUMBING PERMIT
PERMIT #: PLM2005 -00695
'k' I i I � DEVELOPMENT SERVICES DATE ISSUED: 12/21/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S1 12 BA -05900
SITE ADDRESS: 14058 SW MILTON CT ZONING: I -L
SUBDIVISION: BONITA INDUSTRIAL PARK LOT: 007 JURISDICTION: TIG
Project Description: Replace breakroom sink w /laundry tub.
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:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft •
Owner: FEES
GOODHEAD, DAVID + JAN M
14058 SW M ILTON COURT Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 12/21/200f. $72.50
[TAX] 8% State Surcha 12/21/200f. $5.80
Phone : 503 -598 -8700 Total $78.30
Contractor:
POWER PLUMBING CO
PO BOX 19418
PORTLAND, OR 97280 •• REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 244 -1900
FAX 503- 244 -8825
Reg #: LIC 52378
PLM 34 -150PB
•
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: S O e 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.
Dec 21 2005 9:42AM POWER PLUMBING CO. 503 244 8825 p.2
Plumbing Permit 2 for
Internet: www.ci.tigard.or.us An 1.01( 1.n1t oFFirr�r t st•: or orr--
City of Tigard GIVE D Da / / Q,s�G� /I A6 95
13125 SW Hall Blvd., Tigard, OR 97223 F�nRrnew
Phone: 503.639 Fax: 503.598.19 %� "' . Other Permit No.:
p EC 21 1005_. `) A 'n.'' � DatelRy:
24- Hour Inspection Line: 503.639.4175 Date Ready/By: Page - Notified/Method: K 62 See S upplemental Information
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❑ New construction 0 Demo i • , For special Information use checklist
Description I Qty. I Ea. I Total
Addition/alteration /replacement ❑ Other:
e. �••,„-.. New 1- 2- family dwellings (includes 100 ft for each utility connection)
�•: i;:5 �I ' -ir. N.1rs1.',,
� ,rani. ii _ =k`i SFR(I)bath 249.20
❑ 1- and 2- family dwelling ka Commercial/industrial SFR (2) bath 350.00
❑ Accessary building ❑ Multi - family SFR (3) bath 399.00
❑Master builder ❑Other Each additional bath/kitchen 45.00
r , .. Fire sprinkler ( sq. ft.) I Page 2
- A•f;"�2��.�.._. Site utilities
Job site address: i H n 5e st,0 m i 1 ,6 in c ____-T- Catch basin or area drain 16.60
City/State/ZIP: - f &` O P. q - r a a Y Drywell, leach line, or trench drain 16.60
Footingrdrain (no. linear ft.: ) Page 2
Suite/bldg -/apt. no.: iyOS'$ I Project name: [ s4com T
Manufactured home utilities 110.00
_
Cross street/directions to job site: t p Manholes 16.60
;l�. Dr.)1 . t L1 0 a..� C-C-...- C Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: l Lot no.: Water service (no. linear ft.: Page 2
Fixture or Item
Tax map/parcel no.: Absorption valve 16.60
:B r,. * WO '. ' ;. ,':.. r,.:' Back flow preventer Page 2
r q . `1 ___c e_ Y e S.4-ii Backwater valve 16.60
b rer..�e'27D et- S m k ( s.i , - ;.•, Clothes washer l 16.60
Dishwasher 16.60
+i ,:: Drinking fountain 16.60
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: ( ) L Fax: ( ) Garbage disposal 16.60
r , t ` ; c Hose bib 16.60
( !ce maker 16.60
Business name: p or Y �(� Liar) 6i 4.Le. CO . Interceptor /grease trap 16.60
Contact name: 1 , ► i K L GoaL t-s-r n Medical gas (value: $ ) Page 2
Address:
66x1 scv mu.t +nht� l�l Primer 16.60
City/State/ZIP: P� ka „, 0 OR , q-i e 2 2 3
Roof drain (commercial) 16.60
a4tl - i goo Fax: : 603).249- A�2 5 T /shows \ 16.60 ` (�
Phone: ( o3)
Tublshower /shower pan 16.60
E -mail: VY1 l co eTi !'y 1 M C) .. (o m Urinal 16.60
Water closet 16.60
Business name: C' I•aC_k pi � Co , Water heater 16.60 -
Address: 6611 SW ryk L `V Aavint&Y, eAUrA Other:
City/State/ZIP: Subtotal 16, 60
Pr,C'�\ft_p O R . q ` Minimum permit fee: S72.50
Phone: (SDN) gilt, ' 1 9 Fax: ()3 )at/ 4/ -$ c- Residential backflow minimum permit fee: $36.25
g 3q - 1 5�
CCB Lic.: • 5 � 3 �� Plumbing Lic. n o.: ✓ Ps Plan review (25% of permit fee)
Authorized signature: State surcharge (8% of permit fee) 5,$o
_ i 1L TOTAL PERMIT FEE -7,A,3 Q
Print name: ; Ke.._ eig-rren Date: ( .2/ -dam 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.
i:\auitdiu \PermiIN'LM- Permi,App.dec I 3 --00-16 16T(I0/02 /COM,WEa)
l
CITY OF TIGARD
BUILDING DIVISION r - . PERMIT #: PLM2005.004%
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/21/)005
Phone: (503) 639 -4171 4 / NIii'
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1/26/2006 TIME: 7:03AM PAGE: 39
SITE ADDRESS: 140A SW MILTON CT CLASS OF WORK:.
SUBDIVISION: I3ONITA INDUSTRIAL PARK LOT #: 007 TYPE OF USE:
PROJECT NAME: WESTCON
DESCRIPTION: Replace breakroom sink Maundy tub.
OWNER: GOODHEAD, DAVID + JAN M, PHONE #: 603 - 9i3 0700
CONTRACTOR: POWER PLUMBING CO PHONE #: 503.244 -1900
Inspection Request Scheduled For: Date: 1/26/200G Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 02578001 503 -936 272.1 N
Corrections /Comments /Instructions:
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1 c,,,
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BASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION . ❑ ADDITIONAL FEES ASSESSED
Inspector: K e � Date:. - . e0 Phone #: (503) 718-