Permit C ITY OF FIGARD PLUMBING PERMIT
PERMIT #: PLM2006 - 00487
���i DEVELOPMENT SERVICES DATE ISSUED: 10/18/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S136DB - 02602
SITE ADDRESS: 11596 SW PACIFIC HWY ZONING: C - G
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Replace water service.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: 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: 50 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
STEWART, PHYLLIS AND
STEWART, DONATA AND Description Date Amount
COHEN, NATHAN TRUSTEES [PLUMB] Permit Fee 10/18/200€ $72.50
LAKE OSWEGO, OR 97034 [TAX] 8% State Surcha 101181200E $5.80
Phone : Total $78.30
Contractor:
LITCH PLUMBING INC
PO BOX 2756
OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 657 -9006
FAX 503- 657 -2971
Reg #: LIC 156708
PLM 3 -498PB
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
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. •
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i 1
Plumbing Permit Application � �
. � .. t FOR OFFICE USE ONLY
OCT 18 2 0 06 D./By/7)77 e l l ( � mi l - o` �) 1 O C 'f 1
City of Tigard /�� Permit N ..
a 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
0 Phone: 503.639.4171 Fax: 503.598.1960 DateBy. Other Permit No.:
T G A IZ D Inspection Line: 503.639.4175 ,v I 'Li": ., tl'Li' i"s
Y ' nl- Thate Ready/By: tuns ® See Page 2 for
Internet: www.tigard-or.gov -1TTT 1":11,,,T,"' -- Iir�[r (�Vatified/Method: /� Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist
Description I Qty. I Ea. I Total
® Addition/alteration/replacement ❑ Other: New 1- 2 -family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
❑ 1- and 2- family dwelling ® Commercial/industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family
SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other: Fire sprinkler (_ sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: 11596 SW Pacific Hwy Catch basin or area drain 16.60
City /State/ZIP: Tigard, OR 97223 Drywell, leach line, or trench drain 16.60
Sui[e/bldg. /apt. no.: I Project name: Footing drain (no. linear ft.: _) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
72 °d Ave. 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.: 50) 50 Page 2 55.00
Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
new water service Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
® PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60
Ejectors /sump 16.60
Name: Phyllis Stewart Expansion tank 16.60
Address: Fixture/sewer cap 16.60
City /State/ZIP: Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
❑ APPLICANT ® CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: Litch Plumbing, Inc.
Interceptor /grease trap 16.60
Contact name: Ken Litch Medical gas (value: $ ) Page 2
Address: PO Box 2756 Primer 16.60
City /State/ZIP: Oregon City, OR 97045 Roof drain (commercial) 16.60
Phone: (971) 235 -4377 Fax: : (503) 657 -2971 Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail:
Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: Litch Plumbing, Inc. Water heater 16.60
Address: PO Box 2756 Other:
City /State/ZIP: Oregon City, OR 97045 Subtotal
Minimum permit fee: $72.50 72.50
Phone: (503) 657 -9006 Fax: (503) 657 -2971 Residential backflow minimum permit fee: $36.25
CCB Lic.: 156708 9" 15' U 1 Plumbin Lic, no.: 3 -498PB I -1i5A Plan review (25% of permit fee)
State surcharge (8% of permit fee) 5.80
Authorized signatltre: /J� TOTAL PERMIT FEE 78.30
Print name: Nona L. Litch Date: 10/18/06 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: Building \Permits\PLM- PermitApp.doc 0626/06 440.4616T(10/02/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION - , , PERMIT #: PLM200Er001187
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/18/2006
Phone: (503) 639 -4171 *u *f1lt
Inspection Requests (24 Hrs.): (503) 639 -4175 F
INSPECTION WORKSHEET FOR DATE: 10125/2006 TIME: 7:03AM PAGE: 22
SITE ADDRESS: 11596 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: STEWART
DESCRIPTION: Replace water service.
OWNER: STEWART, PHYLLIS AND, PHONE #:
CONTRACTOR: LITCH PLUMBING INC PHONE #: 503 - 557.9006
Inspection Request Scheduled For: Date: 10/25/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 038819-01 971- 235.43T/ N
Corrections/Comments/Instructions:
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❑ PASS 'PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Mi C / Dat e: Pho # : 503 p �� � c � 718 - -
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CITY OF TIGARD - ; 4 -
BUILDING DIVISION r • PERMIT #: PLM2006 -00487
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/18/20176
Phone: (503) 639 -4171 i� o I
Inspection Requests (24 Hrs.): (503) 639- 4175
INSPECTION WORKSHEET FOR DATE: 11/3/2006 TIME: 7:01AM PAGE: 75
SITE ADDRESS: 11596 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: STEWART
DESCRIPTION: Replace vier service.
OWNER: STEWART, PHYLLIS AND, PHONE #:
CONTRACTOR: LITCH PLUMBING INC PHONE #: 503 - 6579006
Inspection Request Scheduled For: Date: 11/3/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 039273 -01 971- 235 -4377 N
Corrections /Comments /Instructions:
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❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: IV 1. \X-44 ) Date: t ) J3/,f Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION ... PERM #: PLM20 06.00487
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/18/2006
Phone: (503) 639 -4171 1,, 11 "lit
Inspection Requests (24 Hrs.): (503) 639 -4175 . . -_—
INSPECTION WORKSHEET FOR DATE: 11/3/2006 TIME: 7:01AM PAGE: 26
SITE ADDRESS: 11596 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: STEINART
DESCRIPTION: Replace water service.
OWNER: STEWART, PHYLLIS AND, PHONE #:
CONTRACTOR: LITCH PLUMBING INC PHONE #: 503-657-9006
Inspection Request Scheduled For: Date: 11/312006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 039273-01 971 - 235 -4377 N
Corrections/Comments/Instructions:
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❑ PASS 10.PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
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Inspector: L V Date: I) _3 b Phone #: (503) 718 - ✓ l