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Permit C ITY OF TIGARD PLUMBING PERMIT it DEVELOPMENT SERVICES PERMIT #: PLM2003 -00209 c � J II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/20/03 SITE ADDRESS: 10110 SW SUMMERFIELD DR PARCEL: 2S111CC -08800 SUBDIVISION: SUMMERFIELD NO.2 ZONING: R -12 BLOCK: LOT: 115 JURISDICTION: TIG 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: TUB /SHOWERS: 1 SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of custom shower to replace existing tub. FEES Owner: Description Date Amount ROBSON, JAMES A JR + GLORIA J 10110 SW SUMMERFIELD DR [PLUMB] Permit Fee 5/20/03 $72.50 TIGARD, OR 97224 [TAX] 8% State Tax 5/20/03 $5.80 Total $78.30 Phone : Contractor: PACIFIC PLUMBING & CONTRACTING P.O. BOX 19390 PORTLAND, OR 97280 REQUIRED INSPECTIONS Phone : 503 293 - 1818 Rough -in Insp Final Inspection Reg #: LIC 126627 PLM 26 -738PB 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 Issued By: ' / Permittee Signature: cx iO4/ C' 70 Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day S0nt By: Pacific Plumbing; 541 342 1842; May -16 -03 4:52PM; Page 1/3 -- -. ... ....:,00...,.., rat;ira.0 rl urnoi.ng; rage G d" 05/16/2003 15:56 FAX 5035981960 CITY OF TIGARD e002 ' . rsuitaxng r llccu .. �i Plumbing Pe i n . Received y. �� /O /Q3 Permit Tio."fo - Mg 0 9 City of Tigard MAY 16 2003 Planning Approval Sewer Date/By Permit No.: 13125 SW Hall Blvd Plan Review Other Tigard, Oregon 97223 t C ,' I f T� 1A O 'r FT n IGARD Dam. PermitNo.: Phone: 503-639-4171 Fax�Y03g98 -`L 1 2v Vlsl 6 Post Review Land Use ".' DatrJBy. Case No.: Internet: www.er.tigard.oLUS I II t:OntaCt µr e .. 24 -hour Inspection Request. 503 8' Name/Method: u See Page 2 for T/ CT Supplemental Info rmadon. '4,'!i' , c Yj! .•..o 'v • ,.... �.n , ;,.;._''.:!}vr' -' . - : •�I. • .'il y1.. Liiil �t .Vi CI New constriction 0 Demolition Desert non q • • Qty Fee(ca) Total �► i .Y; 3 0 wl , i I 1 ail 71T V1-i f 7 : : : , : : .. ►_ 1 Addition/alteration/r t lacement Other: tip � gyp �1 I j 7 �, 4i - 'i '.,::."4.4'..a..,;1!' .}� �1' C.i_1 .1 C�CF: CI I'" C EiI�: I �G lil O f',� ' • r'' iA •aJ �`L ' .S ,, ! t,1. 41 )'E lr7.7,.' 61 ; 'f7 :IfS� .:; I e r'1 '74 V� ,' � .E. :;:y'. "'` SFR : 1 bath 24920 Al & 2- Family dwelling ❑ ConamerciaVIndustrial SFR (2) bath 350.00 ❑Accessory Building ❑ Multi- Family SFR (3) bath 399.00 ❑ Master Builder • Other. Each additional bath/kitchen 45.00 . (' "Y' :u1,91 1C'dNall:!t '.i k .pl 0)1,Al.• ' e . rs. :y11,g)5611iP.V: q61 Fire 'rinider- • . ft.: Pa:e 2 �11� Job site address: JO //O S'W .51.463464e.<-(6,41) - . i r2. EILIL _''II 1G ' /f- `Ci t rl r 1' J � , _ L� J.:: 12-2, .;:m. Suite #: I Bldg. /Apt. #: Catch basin/area drain 16.60 Project Nance: Drywell/leach line/trench drain 16.60 job site: Footing drain (no. linear ft.) Page 2 Cross street/Directions to 7 Manufactured home utilities 110.00 Manholes 16.60 Rain drain connector 16"60 • Sanitary sewer (no. linear ft.) Page 2 Subdivision: Lot #: Storm sewer (no. linear ft.) Page 2 Tax ma ' areal #: Water service no. linear ft. _ Pa • e 2 "' �.' 9 rip :Z -11: f'I 71'(7 a •I.7(77 ii i i . 43; - :' I ally ITt'F�II�:.Ie 16:(�..I •l.'.,l 1 I`' " "' Absorption valve 16.60 AE/Wee &X/ 577A/G' 7u 14 /7774- Backflow preventer Page 2 &1 STO /1 .510 - w eg- / Backwater valve 16.60 _ Clothes washer 16.60 Dishwasher 16.60 Drinking fountain 16.60 Ejectors/sump 16.60 Name: Vim -f Q/dice ,e0,6 5-42 Expansion tank 16.60 Address: /0/ /e, Sur �i. 'rpm trt.,e..Ftfit4. A'C. Fixrure/sewercap 16"60 Ci /State/Z p .. -1-0e- q722r9 Floor drgin/floor sink/hub 16.60 Garbage disposal 16.60 Phone: Fax: Hose bib 16.60 G.` �ytsil 773 r,,,, '©G' _ _ 5 Ice maker 16.60 Name: Interceptor /grease trap 16.60 Address: Medical gas - value: $ Page 2 • • City/State /Z Primer Roof drain (commercial) rn 16.60 Phone: Ltax: Sink/basin/lavatory 16.60 E -mail: Tub/shower/shower. pan > V 16.60 ::`s 11:'�... i ' 1 :./"}i l'7:;r } i•`:S! Il ` t •C4: 51 M` ';:',7:I' . - Urinal 16.60 Business Name: i cr c ,teaftw'v /,' ' 47 4007 closet 16.60 itW Address: 0 . ,X.:0 Y3q p Other. heater 16.60 City /State/Zip: pv r'/,'re' Oie 91� o other: _ Phone:57)3. -3 - .3 . Fax: 9 ; - et> ,r iI,A ,. Y.. 'd.;:t ;: ::. • .hi i .• • - ;1 1` - . i a A:,. p 111 &-'a:. ., CCB Lic. #: / , - L Plumb. Lic. #: .0 6 - 7.81.= Subtotal $ e� Minimum Permit Fee $72-50 $ Authorized 044 O O I Residential Backfiow Minimum Fee $36.25 7 Z , ' .S Signs • Date:r /4s ° Plan Review (25% of Permit Fee) $ V /___ Stubs Surcharge (8% of Fee) $ S', 8 p• I � (Please print name) • TOTAL PERMIT FEE S 78. 3 O Notice: This permit application expires Ira permit is not obtained within All now commercial buildings require 2 sets of plans with isonsetric or 180 days after it has been accepted as complete. riser diagram for plan review. 'Fee methodology set by Tel -County Banding industry Service Board. i : \Dtis'.Permit Forms 1P1mPermitApp.doc 01/03 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested — M PM BUP Location 6 _ uite MEC a 9� O Contact Person iYyti Ph ( ) - �o / � PLM J — eDe) O ° l Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing –, Firewall / tgl i7//e - • r / r Fire Sprinkler v ` Fire Alarm / / iii. Susp'd Ceiling �� Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough-In Service Water Se Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: 41111 • PART FAIL HANICAL 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 Approach/Sidewalk Date r/65 Inspector � Ext Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL