Permit •
C ITY OF TIGARD PLUMBING PERMIT
�► PERMIT #: PLM2006 -00133
DEVELOPMENT SERVICES DATE ISSUED: 4/13/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S114BB - 05300
SITE ADDRESS: 10075 SW PICK'S CT ZONING: R -4.5
SUBDIVISION: PICKS LANDING NO.1 LOT: 015 JURISDICTION: TIG
Project Description: Tub change out.
CLASS OF WORK: ALT 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: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUBISHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
SIMMONS, RODNEY L AND
JUDY A Description Date Amount
10075 SW PICK'S COURT [TAX] 8% State Surcha 4/13/2006 $5.80
TIGARD, OR 97224 [PLUMB] Permit Fee 4/13/2006 $72.50
Phone : 503- 624 -0504 Total $78.30
Contractor:
RIGID PLUMBING INC
PO BOX 345
FOREST GROVE, OR 97116 REQUIRED ITEMS AND REPORTS
Contact # : PRI 357 -6897
Reg #: LIC 43140
PLM 34 -156PB
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: PA.- j Permittee Signature: . . b i
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.
Plumbing Permit Applic CE 'ED rOIt oil. - : ust: O,L.,-
City of Tigard APR 1 3 2 1 6 Received blob 216 Permit N / ; _. 3
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 ATf; .r;_;;� ; ; � •� D ate /B y: Other Permit No.:
24- Hour Inspection Line: 503.639.4175 CITY OF TI r , . �I 1 Date Ready/By: y: runs: See Page 2 for
w
Internet: ww.ci.tigard.or.us BUILDING I '- -• J Notified/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
0 125k- and 2- family dwelling ❑ Commercial[mdustrial 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: /V' -07 �� ; iC.E.. C /� � 7"- Catch basin or area drain 16.60
City/ State/%IP: � % Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: Footing drain (no. linear ft.: ) Page 2
/O Y/e 2 A.,_,4. Manufactured home utilities 110.00
Cross street/directions to job site:
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
Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
e e /&e. -e e ' T u $ Backwater valve 16.60
eV, 64 ti6 0 �� eweey / T / ! Clothes washer 16.60
L � Dishwasher 16.60
❑ PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60
C Ejectors/sump 16.60
Name: dl dA/.5 Expansion tank 16.60
Address: ...... L2: 5 , P c 4 ; CT Fixture/sewer cap 16.60
City/ State/ZIP: -r2.4 L�� 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: h2 Ceri (S J . Interceptor /grease trap 16.60
Contact name: £o6 & t.Jn,F Medical gas (value: $ ) Page 2
Address: / c Criz »,(e t Primer 16.60
• City/State/ZIP: ce , 70rl\l' C.9-R, Roof drain (commercial) 16.60
Fes.. Sink/basin/lavatory 16.60
Phone:
( ) 78Y - 8 S e 9 7 I ( ) Tub /shower /shower pan / 16.60
E-mail: Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: (.` ` P Water heater 16.60
Address: ) / 1 - Other:
City/ State/ZIP: m C Z ( C171/ Subtotal
Minimum permit fee: $72.50
Phone: 1 : 5 5 3 ) s C7 . . - 4 „ sq 7 Fax: ( ) Residential backflow minimum permit fee: $36.25 7a • sZ
()
CCB Lic.: 4'.� ( -V •'?/ 7 P . bing Lic. no.: 314_ L� Plan review (25% of permit fee) -
Li O State surcharge (8% of permit fee) s7 , 80
Authorized si : \store: ; ey,' - , -
-�' , - C� .� .
TOTAL PERMIT FEE
Print name: 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.
i:\ Building\Pmmits\P1M- PamitApp.doc 06/05 4404616T(10/02/COM/W®)
CITY OF TIGARD
BUILDING DIVISION • ,. ' PERMIT #: PLM200.i -00133
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/13/2006
Phone: (503) 639 -4171 /p
Inspection Requests (24 Hrs.): (503) 639 -4175 "__..
INSPECTION WORKSHEET FOR DATE: 5117/2006 TIME: 7:06AM PAGE: 13
SITE ADDRESS: 10075 SW PICK'S CT CLASS OF WORK:
SUBDIVISION: PICKS LANDING 140.1 LOT #: 015 TYPE OF USE:
PROJECT NAME: SIMMONS
• DESCRIPTION: Tub change out.
OWNER: SIMMONS, RODNEY L AND, PHONE #: 503 - 624 - 0504
CONTRACTOR: RIGID PLUMBING INC PHONE #: 357 - 6897
Inspection Request Scheduled For: Date: 5/17/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 0;300 -01 503.624.0504 N
Corrections /Comments/ Instructions:
C •
PASS ❑ PARTIAL APPROVAL El CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / Date: / /' Phone #: (503) 718- Z--al/171
CITY OF TIGARD
BUILDING DIVISION - PERMIT #: PI
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/13/200
Phone: (503) 639 -4171 �' �f
Inspection Requests (24 Hrs.): (503) 639 -4175 .- �- I ..
INSPECTION WORKSHEET FOR DATE: 4118/2006 TIME: 7:05AM PAGE: 5
7u ZNA•M 1 I o r'- '4 . 7 . 4 ;
SITE ADDRESS: 10075 SW PICK'S CT CLASS OF WORK:
SUBDIVISION: PICKS LANDING NO.1 LOT #: 015 TYPE OF USE:
PROJECT NAME: SIMMONS
DESCRIPTION: Tub change out
OWNER: SIMMONS, RZODNEY L AND, PHONE #: 503
CONTRACTOR: RIGID PLUMBING INC PHONE #: 357 -6097
Inspection Request Scheduled For: Date: 4/18/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
396 Misc:. inspection 028267 -01 503-704 -8497 V
Corrections /Comments /Instructions:
-I +rte ivy
, SS ❑ PARTIAL APPROVAL El CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: #7i: Date: y8' O 6 Phone #: (503) 718- Z b LP