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Permit CITY TIGARD PLUMBING PERMIT P ERMIT #: PLM2004 -00534 r J l l � DEVELOPMENT SERVICES DATE ISSUED: 11/23/2004 13125 S W Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 14127 SW STARDUST LN PARCEL: 2S104BB -06300 SUBDIVISION: CASTLE HILL ZONING: R -25 BLOCK: LOT: 004 JURISDICTION: TIG CLASS OF WORK: OTR 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: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: 60 ft DISHWASHERS: RAIN DRAIN: ft Remarks: Line bore / replace water service. FEES Owner: Description Date Amount REYNOLDS, RICKY L 14127 SW STARDUST LN [PLUMB] Permit Fee 11/23/2004 $72.50 TIGARD, OR 97223 [TAX] 8% State Surcharl 11/23/2004 $5.80 Total $78.30 Phone : 503 - 590 - 0856 Contractor: BOB'S REEDVILLE PLUMBING 3028 SE 59TH CT. #600 HILLSBORO, OR 97123 REQUIRED INSPECTIONS Phone : 503 Water Line Insp Final Inspection Reg #: LIC 131619 PLM 34 -342PB 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. Issued By: � p� Permittee Signature: 4 Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next busines day FROM :BOBS FAX NO. : Nov. 23 2004 08:53AM P1 ,i: r��. j.VnrJ: 11 / 22/04 =3: P,r; ^ �J 5035061960 BcL Rr_civille Plumbing; Pal . 1 11/22/2004 15:27 FAX 5035981960 CITY OF TIGARD Z001 Plumbing Permit Appli CEIVE iOR OFFICE USE ONLY City of Tigard 2 ! 1 4 4 Gr-/ 47 AL__ i> ./ ' 13125 SW Hall Blvd., Tigard. OR 97223 NOV 2 3 plyn tie v i ea Phone: 503. 639.4171 FEW S03.593.1960 .6.0/2t;,,,;4,•, � ,,\ • nate/sy: °� Pemtit Wo.: i 2.4.; Hour Inspection Lime: 503.639.4175 CITY OF TI C `. " ., - lntemet WWW.Ci.tigand.or.us A ,.1 NotifiedtMethOd Supplemental Iofunnation Date Ready/By: •rlr' :I S'. •;;�••,: ,: J =r I :I �•r II:.; - : - ; .a• „ _:a� I '- :'i. i:6 `417^` .{ ':S ' .I .I r� f''a7, .I: is ∎I.'I: ' i '�.'.c' I .. : .!g g i-O . 11r:E. - '�F:; +:`�,, !:y��i. ��'::. �I,:!.: }} II �9•.' ^',71�'� '�,�'y_" (.�'N:�` `I ': :.I:,... s5k:... �„�•� .. ... ......_.... _ .. .. • • .... ,1 +' For special information use checklist ID Nee./ construction • ID Demolition _ � Desniptio Es 1 Total 1�tAdditioa/alteration /replacement ❑ Other: New 1- 2-family dwelling (includes 100 ft. for each utility connection) .. :..;... .......':•1'G1 ��eil_'5 ;' ( "':_ s;) , ... . : I•: SFR(1)bath 24920 - and 2- family dvsolling ❑ CommeroiaVindustri al SFR (2) bath • 350.00 ❑ Accessory building ❑ Multi- fanuly SFR (3) bath 399.00 CI Masterbudde ❑ Other additional bath/kitchen 45.00 % �0�'1' °' °,,''�,'ic. ; ii4L' I � r, �� ' "' ����,, •� E Ue Fire sprinkler L,.... sq. ft) Page 2 • 4S' y;111i • :ill ! j 'F .1 'I�` 1 *100 - Vf'rua`*I et. -:"' IOFT! ' ;.; . _ . _ ' :i . . Site utilties _ Job site addlrss: ' liy Z 7 �/ 4 Catch basin or area drabs 16.60 City /State/ZIP: i A / / •1 9 I Drywall. leach line, or trench drain 16.60 Suite/bidgJapt. no.: J Projecrname: Footin drain (no. linear stir: ) Page Z Menutltetured horse utilities 110.00 Cross Enrcuthdircctiona to job / - Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear rt.: _.) Page 2 _ Storm sewer (no. linear R.: ) Page Svbditi8i0n: Lot no.: Water Service (no. linear ft.: 412 Page 2 4i S66 Taxmap /pared no.: ..� Fixture or Item ,r:'IF'I :I'NII: +':. '1' 5�•I,:i. .:.,,. I , • . „a� 'y, ,,,.. : ; I ;;; q nbaetption valve 16.60 iCi : - ihT�' p ' i.r ii' I ri:i ... ':r r :;4 ::-. ; :• .I t ; p� :' 0 J I'::.:::i i I :: .. .. Baeldlow prevent= Page 2 ' 51-f• T1 .� /1/!7 . e _ _. /.Ill /. // Backwater valve 16.60 • VA) i C-E- Clothes washer 16.60 Dishwasher { 16.60 L.: J r:iF ,e 14! r. ;1 : nr, - r-r , r .:' - ■ r. e. • n r I • e,se r, v r I L4 • Drinkin � ;,. . .. :6:;:1' : i " ,..,. r;:�:I ... , am 16.60 f.,',. ' 'i -'_ja .ff :r � i 4 ` . .•r' :>�ii ,114 • .'.• •...f;[.I +, 9 1 . 1 ; , : :i.1 �'i.l''∎ :. • � � �� :P: � � .. ' �jectors/sulnp 16.60 � Name: ���` Expansion tank 16.60 Address: J . f Z 5. '- U 'B n i ✓. S -/� Fixbu'e/sewer cup 16.60 . City/State/ZIP: � av ,, K Floor drain/floor sink/hub 16.60 Phone: (• << . . pal: ( ) Garbage disposal _ - 16.60 p.i: • 3 1,1�., OP or q . _ Hose bib 16.60 g:c l �cll :I E: Lid l:.: .. � :' .. 1 . . , :I .... - '''f. Ice raker mess name * $us i I / 16.60 4 ! _ i / � (' ./ / J Interceptor/grease rap 16.60 Contact: name: p • I _ a a • L p Med(C0t gas (value: S ) • Page 2 , Address: I i ��� Primer 16.60 City/State/ZIP: .2, I A ���jf. Hoof drain (commercial) 16.60 • a, , tle / / % I Sink/train/lavatory a in/lavatory 16.60 • Phone:. fo. ip • Fax ::(L , Z Z ./_ Tub/shower /shower pan 16.60 E -mail: F h..: y Urinal 16.60 9 -� re:P� V''''';'.1 ;. }i �• IiPjli 2 1 �tb � Qlty y . 1 : ;j:f:3: "• • '' :: �:: � .� - ; :: ' as = • it :I - I:' , . il; I • :I : : ' ' ` °(� W nte� c 16,60 B • usiness name: We heater 16.60 . Address: Other: • city/ ate/z!p: - - -_. • • Subtotal 55,b© Minimum permit fee: $72.50 Phone: ( ) � ( ) Residential baekflow minimum permit fee: $36.25 7,1.5 CCB Lie.: Diir',k 'C�7 - Plan review (25% of permit fee) State surcharge (8% of fee) signature 4 �` / ) L ,fez 14• TOTAL PERMTI' FFE ':. 70 I Print name: ' nr � C , / em . y 1/ • This permit application c f, � �O �„v. D � �[„� d P PP expires If a permit is nn obtained within 180 days after it has been accepted as complete. • *Fee methodology set by Try - County Building Industry Service Board. f•.18uQtliog emsisaYLM- ParnikADFCOC 12/03 440.40107(10/O2/cotwvJEB) CITY OF TIGARD 24 -Hour BUILDING p Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST L` BUP Received Date Requested I" ° I AM PM BUP Location !; 1 � - _, • A Suite MEC Contact Person Ph ( ) , (o — R $ 3 > PLM Contractor Ph ( ) SWR BUILDING Tenant/a" ELC Footing 9 ' 3) -3s 01- (J ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: D SIT Post & Beam 4.f4/ Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In kektalerSUNic Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: _ PART FAIL CHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage Fire Alarm Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA - 77. - P Approach/Sidewalk Date , I _ - Inspector . Ext Other: Final ' O NOT REMOVE this Inspection record from the Job site. PASS PART FAIL