Permit t . ,.
71 v CITY OF TIGARD
PLUMBING PERMIT
: . .
COMMUNITY DEVELOPMENT PE
COMMUNITY PLM2008 -00346
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/22/2008
PARCEL: 2S 111 AC -02901
SITE ADDRESS: 09500 SW MURDOCK ST ZONING: R-4.5
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: TEMPLETON ELEMENTARY
Project Description: Repairing 8 ft. of storm drain.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: E1 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: 8 ft
Owner: FEES
WACO SCHOOL DISTRICT NO. 23
6960 SW SANDBURG ST Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 8/22/2008 $72.50
[TAX] 12% State Surch 8/22/2008 $8.70
Phone : Total $81.20
-
Contractor:
S&S SEARS INC
PO BOX 446
GLADSTONE, OR 97027 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 650 -8200
FAX 5023- 650 -8203
Reg #: LIC 156356
PLM PB132
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 . Permiftee Signature: . • /
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.
G • Plumbing Permit Application .
SiteNtilities ED FOR OFFIC► t. SE ONLY
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City of Tigard � CE1V DateB� , t3 L377 Permit No.: 7 c C
I
g -/, I
• 13125 SW Hall Blvd., Tigard, OR®7 E y
P hone: 5036394171 Fax: 5035981960 Plan Review
0 . . . . Other Permit No.:
Date
/By: ZOOS DtB y:
T i G A R D Inspection Line: 503.639.4175 AUG 2 Date Ready/By: Juris: El See Page 2 for
Internet: www.tigard- or.gov ah I Notified/Method: 7J I Supplemental Information
TYPE OF WOIrTY Or " FEE* SCHEDULE
❑ New construction For special information use checklist
Description 1 Qty. 1 Ea. I Total
dition/alteration/replacement ❑ Other: New 1 - 2 - family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 24920
❑ 1- and 2- family dwelling Co mmercial/industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: q S 0 0 pet oc K Catch basin or area drain 16.60
City/ State/ZIP: -- Q..� O � a I a` U' Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: ?� f ���� Footing drain (no. linear ft.: _) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: 611th
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.: ) Page 2
Tax map /parcel no.: CoGSE(0 Fixture or item
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
Ff+ 1:&e4[)1 x K � Backwater valve 16.60
a ~ on L�� � � Clothes washer 16.60
Dishwasher 16.60
p OWNER I ❑ TENANT Drinking fountain 16.60
,, (� pp 00 ,,, nr^ �^ I Ejectors/sump 16.60
Name:' ct -"Iu (,(l &'k �
1 1 1(� 10'I7' c Expansion tank 16.60
Address: t 61( O SIJ 5 U\ re _ Fixture/sewer cap 16.60
City/ State/ZIP: � q � C C FI 27— Floor drain/floor sink/hub 16.60
Phone: ( so '7
( r� l 31 ._ "' , t f ` � � I Fax: ( ) Garbage disposal 16.60
❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business 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
Phone: ( ) I Fax: : ( ) Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: G ' S 9 e t � ' , , r Water heater 16.60
�
Address: PD R (.4(1,(p Other.
City/State/ZIP:
(j)j A V T 1 1e O � ► o z i Subtotal
1 ^ A — Minimum permit fee: $72.50
Phone: 2 ( � j ) Fax: (CJ ( ) V� S0- 2-(J Residential backflow minimum permit fee: $36.25 - 7 6 ,/,5 - 7 6 ,/,57-) �
CCB Lic.: M(Q3 su Plumbing Lic. no.: j( 32_, Plan review (25% of permit fee)
State surcharge (12% of permit fee) T. 7c)
Authorized signature: TOTAL PERMIT FEE <' /,
Print name: S(1 CtKle, c I Date: pl `pal I This permit application expires if a permit is not obtained within
1 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:\Bui ding\Pmnits\PLM tJ- Permitnpp.doc 12/27/06 440-4616T(10ro2/COM/w8B)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM200B -00346
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8122/2008
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/26/2008 TIME: 7:00AM PAGE: 19
SITE ADDRESS: 09500 SW MURDOCK ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: TEMPLETON ELEMENTARY
DESCRIPTION: Repairing 8 ft. of storm drain.
OWNER: WACO SCHOOL DISTRICT NO. 23, PHONE #:
CONTRACTOR: S & S SEARS INC PHONE #: 50365003200
Inspection Request Scheduled For: Date: 8/26/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
340 Storm drain 074652 -01 503-901-1519 N
Corrections /Comments /Instructions:
E&A At- e
Care
V t PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector:C1 Date: I T \2J, ( D. Phone #: (503) 718-