Permit C ITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2005 - 00343
DATE ISSUED: 7/29/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 111 AD - 15200
SITE ADDRESS: 09059 SW REILING ST ZONING: R -4.5
SUBDIVISION: MALLARD LAKES LOT: 018 JURISDICTION: TIG
Project Description: Kitchen remodel.
CLASS OF WORK: OTR GARBAGE DISPOSALS: 1 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: 1 RAIN DRAIN: ft
Owner: FEES
BURR, NORMAN S /KATHLEEN E
9059 SW REILING Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 7/29/2005 $72.50
[TAX] 8% State Surcha 7/29/2005 $5.80
•
Phone : 503- 620 -4528 Total $78.30
Contractor:
BURFITT PLUMBING
6223 NE HASSALO ST
PORTLAND, OR 97213 REQUIRED ITEMS AND REPORTS
•
Phone : 503- 287 -1267
Reg #: LIC 00001076
PLM 26 -11PB
•
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
•
Issued By: J it Permittee Signature:
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day. `' 1
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
07/27/2005 15:00 FAX 503 3313933 BURFITT PLUMBING, INC. 0 002
Plumbing Permit A ApArgERF IV ED FOR oim is I .s l'. cr%l.\
City Of Tigard Received 29 d i l - Pennit1.204 W.,. .2 - • 5/g
13125 SW Hall Blvd, Tigard, OR 97223 worm
i 2:1 20I r cw
Phone: 503.639.4171 Far 503.59$.1960 .l Lark :l other l°amit
24 Hoar Inspection Line: 503.639.4175
Supplemental Internet www.ei.tigard.or.us __.• x� i
C O T I
lvt;t:
I.NG n � �� ple aaaa
❑ New construction ❑ Demolition For information J use cler
IF Addition/alteration/replacement ❑ Other: -
� . .., dwellings (includes 100 ft. eon
J Qty. I Ea_ I Total
New 1- 2-family d in 1 for each utility connection)
•. '.. :: + -Gt1 GORY :OP COIYS- EROCHHON' : ' SFR ( bath [ 24920
xi 1- and 20•Fansily dwelling ❑ Commereial/mdustrlal SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family
SFR (3) bath 399.00
❑ Master builder Each bathA�chen 45.00
0 other:
TQ11S1 3: : :li�T Fire sprinkler (___ _ s 9• R) Page 2
:..: • : : Yt kT 1ON :: AND:,' 3,9CAtiO1V• .: Site ut lines
Job site address: q D Gq 5 IA) ^^ 1, (match basin or area dram 16.60 i
City/Stare/ZIP: Ti nt a rd Ul-' 4 leach lint, or trench drain 16.60
Suite/bldgJapt nn_: 1 Project name: C/1L'cr un)iti t din Footing dram (no. linear ft.: ) Page 2
Cross street/directions Lions to job site: Manufactured home utilities 110.00
Manholes 16.60
Rain drain connector _ 16.60
Sanitary sewer (no. linear ft.: Page 2
Storm sewer (no. linear 8_: ) Page 2
Subdivision: Lot no: . Water service (no_ linear ft.: ) Page 2
Tax map/parcel no.: huture or item
h v at" 16.60
_ D"F C'Rli IOr1r OF' WORK an
,{ Backtlow preveotri Page 2
I ► ��n R 0 1 Backwater valve 16.60
Clothes washer 16.60
Dishwasher , I 16.60 i(p .100
:a ; ow1VEli;: J Dunking fountain 16.60 ,
N om; - Ejectors/sump 16.60
Address:
Expansion tank 16.60
•
Fixture/sewer cap 16.60
City/State/ZIP: Moor drain/floor sink/bub 16.60
Phone: ( ) Fax: ( ) Garbage disposal I 16.60 1 W ,(s0
ARI,I r 16.60
Business name: b 11A '' inc ice maker 16.60
r �+ 1 ` .' Intemeptor/greasc trap 16.60
Contact name: E fl i old Medical value: $
,� ! ( ) Page 2
Addrrse ' , l IN O. Primer
16.60
City/State/ZIP: 1 + _ . ' I / Roof drain (commercial) 16.60 r�
Phone: (G)$ 2 ' L'210.7 Fax : �j C 3 Sink/basin/lavatory _ I I6.60 [1 p. �Pv
Ehnen:
�� - t � `Sink/basin/lavatory Tub/shower/showerl� 16.60
0
Urinal 16.60
Water closes 1660
i Business name: i p ' t
1 d .fJ i � � l a . Water titmice 16.60
Address: i r . • Other L
• City/State/ZIP: - S ` / Sobtatai L) q ,go
City/State/ZIP: • •
A1'- ���� Minimum permit fee: $32.50 -y
Phone: ( 03 '� Fmc ( 5?)'I' Si Residential bact�aw minbrram permit fee $36.25 1 2 • �
CCB Lic.: 10'I # Plumbing Lic. no. , _ Plan review
(25% of permit Re)
Authorized signature: . l N I - State surcharge (896 of pmt fee) O
N
Print nom TOTAL PERMIT FEB Is, ?),
A ` f ■ ■ Q, i Date: 7 This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
w.._ ...-i -..a..t........... k.. T..: �......... Ta..11/ =.. t..4........ o..-. :-. nn.. -4
F
CITY OF TIGARD
BUILDING DIVISION PERMIT #: Pl_M2005 -003A3
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/29/2005
Phone: (503) 639- 4171gl to
Inspection Requests (24 Hrs.): (503) 639 -4175 `'I _
INSPECTION WORKSHEET FOR DATE: 9!7/2005 TIME: 7 :08AM PAGE: 3
SITE ADDRESS: 09059 SW REILING ST CLASS OF WORK:
SUBDIVISION: MALLARD LAKES LOT #: 018 TYPE OF USE:
PROJECT NAME: BURR
DESCRIPTION: Kitchen remodel.
OWNER: BURR, NORMAN S/KATHLEEN E, PHONE #: 503 -620 -4528
CONTRACTOR: BURFITT PLUMBING PHONE #: 503.287 -1267
Inspection Request Scheduled For: Date: 9/7/ ?005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 015080-01 503-888-9953 N
Corrections /Comments /Instructions:
, / ,
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: rir2— Date: A Phone #: (503) 718-