Permit , 1-, T 4
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' CITY OF TIGARD
PLUMBING PERMIT
r ` 'r COMMUNITY DEVELOPMENT PERMIT #: PLM2006 - 00600
TIE GA W 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/29/2006
PARCEL: 1 S125DB -04400
SITE ADDRESS: 07160 SW TAYLORS FERRY RD ZONING: R - 4.5
SUBDIVISION: SHADY DELL NO.2 LOT: 018 JURISDICTION: TIG
Project Description: 50 ft of drain piping for 2 downspouts in rear of residence.
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: ft
DISHWASHERS: RAIN DRAIN: 50 ft
Owner: FEES
TOM BOYER
6905 SW VENTURA DR Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 12/29/200€ $72.50
[TAX] 8% State Surcha 12/29/200€ $5.80
Phone : 503- 245 -3530 Total $78.30
Contractor:
M LEON CONSTRUCTION LLC
315 NW 107TH AVE
PORTLAND, OR 97229 -6207 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 643 -6631
FAX 503- 644 -3110
Reg #: LIC 36771
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: // i"6h1�Ci -„ Permittee Signature: __ .e_ c
\\
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.
■
FROM :•'i I RTES INC FAX NO. :5032527806 Dec. 29 2006 11 : 13AP1 F'1 ' Et Plumbing Permit Applica e: y`' k , : r +olz c r ?I +IC Lq:I)St c N11 v , ,, , J ' -
City of Tigard Date/By/72 q A 1)8 Permit N8 lv, _/f 00 K
q 13125 SW Hall Blvd., Tigard, OR 97223 2 2006 , �
(��(` Plan Review
°.a;. Phone: 503.639.4171 Fax: 503.598.19161Y -t+ O therPetm i tNo,:
Date/By: Line; 503.639.4175 Date Read B Iuris: Ei Sec Page 2 for
TI�iAI D li • l
Ready /By:
_ Internet: www.tigard- or.gov 1 �� Not:fied/Method: Supplemen tnILntormntion
....... ....._.................. ....... . . .._ ............ ......,............ ... .:<:..;<.+ ..::.> . rr s ::: s1: .. :: : ::<•; :•.:;:::>::::::: c:: c;: c: o-: a: cs:.: o.: c:;:.:. :; :.:
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❑ 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 fl, for each utility connection)
:,:;irJ` >::: »::;, >i: >:;<: ? >: r >:;, :: >:<:>::«,z::> z ` :: >:a ::::: >E: >::i:i: >` »EE> f >:<:: ;:::'s:a'E> : <:
CTE k>it'4 CST CZIONSTIWC O p' ,,:;;;: SFR(1)bath 249.20
®. 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building El Multi-family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other:
Fire rinkler st . ft. e 2
Page
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TO FITJ..INFOR ATION l n LOC:a.TrO :;
' "' Site utilities
Job site address: 716(1 SW Taylors Ferry Road Catch basin or area drain 16.60
City /State /ZIP: TIgard Drywell, leach line, or trench drain 16.60
Suitc/b[dg. /apt, no.: [ Project name:
Footing drain (no. linear ft.: ) Page 2
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 tt .:, 5 )) Page 2
Subdivision: Lot no.: Water service (no. linear ft.: _) Page 2
Fixture or item
Tax map /parcel no.: Absorption valve 16.60
<. 1:) s �. ... :;:;w:. izlc %` ::'i:`i'3;::i::s:; :.::i;:s: <: , .. , > ii
nw venter Page a e 2
pre
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Install drain piping from two rear downspouts on approximately 20 year old mast- Backwater valve 16.60
et bedroom addition to connect with original storm water drain system of the Clothes washer 16.60
house which connects to the roadside drainage ditch Dishwasher 16.60
;.. ...: :::::
: , ..:::. , : , ...: :::,<: <.z:, :- ;:;: ::;:> : u.:• : :. .•, <., ::.;:;:: :;- >.. : :::<;;::..,::;-.•,.. :<.. ;.::r:;> s>:;: ;;.;. ou ta•n 16.60
PROPTGRd { OWN . 4j TENANT :: : nn or s n t
Drinking
.. -... ' Eject s/ ump 16,60
Name: Tom Boyer Expansion tank 16,60
Address: 6905 SW Ventura Dr. Fixture /sewer cap 16.60
City /State /ZIP: Tigard, OR 97223 Floor drain/floor sink/hub 16.60
Phone: (5113)245 -3530 Fax: (503)252 -7806 Garbage disposal 16.60
....,. Hose bib 16.60
❑: APir,. I K X1+1 7rf : l Ot.1
..., .. .,.:.... : ...:.. ice maker 1660
Business name:
Interceptor /grease trap 16.60
Contact name: Medical gas (value: $ ) Page 2
Address: Primer 16.60 .
City /State /ZIP: Roof drain (commercial) 16.60
Phone: ( ) I Fax: ; ( ) Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E-mail:
Urinal 16.60
:_ ' r'ONTR. .I >`:r.::.`'L ater close 16.60
Business name: /l / /� (!! 4 caw cD�f?.Di��/j� 60 Water heater 16.60
�/ �
Address: // ( Other:
N� /O�� � vf. Subtotal
City /State /ZIP: pa, r4,14/0 ,14/o oR 9 7z t
/ Minimum permit fee: $72.50 {^
Phone: (�03) 6,y?- ‘,73// Fax: (S-C1 ) ‘l d_3 //Q Residential hacktlow minimum permit fee: $36.25 72
COB Lie. 3677/ f Plumbing Lic, no.: Plan review (25% of permit fee)
Authorized signature:
State surcharge (8% of permit fee) r O
TOTAL PERMIT FEE 7 . 0
7
Print name: . egov Date: ( ,. ._ 2 This permit application expires if a permit Is not obtained wi hits
l ! 180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
t \Bitidvig \Permits \PL.M•PcrnatApp.doc 06/26/06 440.4616T(I 0/02/COM/WEB)
C ITY OF ��nn n ��*n mm���moa��
1 BUUUU ��U���� DIVISION - PERMIT #: PL1412006-00600
, 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12y29V2006
Phone: (503) 639-4171 AI i
Inspection Requests (24Hmj:(503 ) 639-4175 A - ,, T.L.
INSPECTION WORKSHEET FOR DATE: 1/3/2007 TIME: 7 PAGE: 16
SITE ADDRESS: 07160 5WTAyL0RSFERRY R[) CLASS OF WORK:
SUBDIVISION: SHADY DELL N0.2 LOT #: O1B TYPE OF USE:
PROJECT NAME: BOYER
DESCRIPTION: L50 flof'drain pipind fo, 2&mwnmpnu1: in real of residence.
OWNER: BOYER. TOM PHONE #: 503
CONTRACTOR: M LEON CONSTRUCTION LLC PHONE #: 603-8=-13'5631
Inspection Request Scheduled For: Date: 1/3/2007 Pour Time: ~�
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{�odo# Inspection Oe Confirm # Contact ti
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Inspector: ^~ � ' Oate� ~ ~� Phone #: (503) - 4- ( ______
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