Permit ee/ d lr (A
a CITY 6F TIGARD PLUMBING PERMIT'
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00234
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/6/2007
PARCEL: 2 S 104 DA -22300
SITE ADDRESS: 12938 SW PRINCETON LN ZONING: R -4.5
SUBDIVISION: QUAIL HOLLOW - SOUTH LOT: 049 JURISDICTION: TIG
PROJECT: RHODES
Project Description: Replace existing fiberglass shower insert with new tile shower. Construction of tile shower pan
and reseting drain if needed.
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: 0
TUB /SHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
STEPHEN RHODES
12938 SW PRINCETON LN Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 6/6/2007 $72.50
[TAX] 8% State Surcha 6/6/2007 $5.80
Phone : 503- 348 -8240 Total $78.30
Contractor:
OWNER
REQUIRED ITEMS AND REPORTS
Contact # :
Reg #:
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 or direct q -.•lions to OUNC by calling 503.246.6699 or 1.800.332.2344.
I ued By: 1/ I Permittee SignaturC4
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.
06/06/2007 06:29 5034946967 RADIATION ONCOLOGY PAGE 03/04
Plumbing Permit Application, FOR 01 I I USE O N I. V
Receives
City of Tigard i�. � r Date/13y: /� /UT Pencil No.: p LM a _ '.
lig 13125 SW Hall Blvd., Tiga . 2 t Plan Review
• Phone: 503,639.4171 Fax. 51 .598.19 Dare/13y; Other PermitNo.;
I' I C: n IZ i) Inspection Line: 503.639.4175 SUN I) 0 2.00 U�Dare/13y; Date Rc.dy /BY: hurh: See Page 2 for
Internet: www.tigard•or.gov • , r•_ 911 Notified/Mcthod: AI (,T Supplemental Information
fie Lam ¢, /� e . :%3,J1 DIiLlL';'. ' •, .
El New construction lib • D emolition For dal in ormation use chedWiss:
Description Qty. Ea. Total
® Addition /alteration /replacement U Other. New 1- 2- family dwellings (includes 100 ft, for each utility connection)
:1 r itarit O1 " COIQ UCTIti1N '• SFR (1) bath 24920
® I - and 2- family dwelling 0 Commercial /industrial SFR (2) bath 350.00
CI Accessory building El multi-family SFR. (3) bath 399.00
Each additional hath/kitchen 45.00
D Master builder ❑ Other. Page 2
Fire sprinkler ( sq. ft.) g
• :. MN '9 •Itft r',1NJkATifiP AND LDt tiliON ...
S ut
Job site address: 12938 SW Princeton LN Catch basin or arca drain 16.60
—
City /Statc/ZTP: Tigard, OR, 97223 Drywcll, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: _L Project name: ShoweerReplacement Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job sitc: SW Gaarde Street Manholes 16.60
Take SW Walnut ST to SW Gaarde St, turn left, proceed to SW Princeton Lane, _ Rain drain connector 16.60
turn right on Princeton bane. Sanitary sewer (no. linear ft.: ^ ) Page 2
Storm sewer (no. linear ft.: ) Page 2 •
Subdivision: Quail Hollow Sonth I Lot no.: Water service (no, linear ft.: ,) Page 2
Fixture or item
Tax map /parcel no.: Absorption valve 16.60
.. .. ac n ter Page 2
. ... :.. � �� :� Ogk '�1iF` � . .....,.
.. .., .,. .. .. .. 8 kfl wprcvctt
Replace cxlsltng fiberglass shower insert with new tile shower. Construction of Backwater valve 16.60 ,
die shower pan and resetting of drain needed. Clothes washer IMO
Dishwasher 16.60
**tit :::: untain -
Drinking fountain l
: . Cl,i��`: 16.60
... ... _; .:. .. - Ejectots/sump
Name: Stephen Rhodes Expansion tank 16,60
Address: 12938 SW Princeton Lane Fixturc/aewer cap 16.60
City/State/ZIP: Tigard, OR, 97223 Floor drain /floor sink /hub 16,60
Phone: (503)348-8240 Fax: (503)494-6967 Garbage disposal 16.60
H• ose bib 16.60
Ice maker 16.60
Business name: Interceptor /gresse trap 16,60
r Contact name: Stephen Rhodes Medical gas (value: $ ) Page 2
Address: 12938 SW Princeton LN Primer 16.60
City /StsteJZTP: Tigard, OR, 97223 Roof drain (commercial) 16.60
Sink/basin/lavatory 16.60
Phone: (503) 348 -8240 Fax: : (503) 4946967
Tub /shower /shower pan 1 16.60 16.60
E -mail: srhedca 25 @hotmnll.com Urinal 16.60
... ......:....:. >..:�i.;'.'::•; .��., W�tercloset
16.60
Business name: ck Howk Plum in n t) Al EA Water heater 16.60
Address: PO Box 20698 Other:
Subtotal
City /Statc/ZIP: Portland OR 97294
Minimum permit fcc: $72.50 72.50
Phone: (503) 235 -8784 Fax: ( ) Residential backflow minimum permit fee: $36.25
CCB Lie.: 23847 Plumbing Lie, no.: 4281 Plan review (25% of permit fee)
State surcharge (8% ofpermit fee) S, 70
Authorized signature: C/f c? e.— TOTAL PERMIT FEE 78.30
Print name: Stephen Rhdes Date: 06/05/2007 This permit application expires if a permit Is not obtained within
180 days after It bas been accepted as complete.
*Fee methodology set by Tti- County Building Industry Service Board.
i:\ nnlldhir6Pemha \P1.M•PcnnrApp.doc 06260 44O4616T(lO/02JCQM/WF.a)
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: PLM2007 -00234
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/6/2007
Phone: (503) 639 -4171 'I
Inspection Requests (24 Hrs.): (503) 639 - 4175 -' VIV I
INSPECTION WORKSHEET FOR DATE: 8/16/2007 TIME: 7:00AM PAGE: 12
SITE ADDRESS: 12938 SW PRINCETON LN CLASS OF WORK:
SUBDIVISION: QUAIL HOLLOW- SOUTH LOT #: 049 TYPE OF USE:
PROJECT NAME: RHODES
DESCRIPTION: Replace existing fiberglass shower insc-.t with new tile shower. Construction of tile shower pan and
reseting drain if needed.
OWNER: RHODES, STEPHEN PHONE #: 503.348.8240
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 8/16/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 054132 -01 503- 348 -8240 N
Corrections /Comments /Instructions:
Care, n txik 94,-)
K PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CP til-A- i 11 f`""z. Date: rf I C 1 o7 Phone #: (503) 718-
CITY OF TIGARD _
BUILDING DIVISION PERMIT #: PLM2007 -00234
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/6/2007
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/27/2007 TIME: 7:00AM PAGE: 29
SITE ADDRESS: 12938 SW PRINCETON LN CLASS OF WORK:
SUBDIVISION: QUAIL HOLLOW- SOUTH LOT #: 049 TYPE OF USE:
PROJECT NAME: RHODES
DESCRIPTION: Replace existing fiberglass shower insert with new tile shower. Construction of tile shower pan and
reseting drain if needed.
OWNER: RHODES, STEPHEN PHONE #: 503-348-8240
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 6/27/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
322 Shower pan 051032.01 503-348 -8240 N
Corrections /Comments/ Instructions:
I
�,; ' S ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Q � Date: #4 4 Phone #: (503) 718 -
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