Permit CITY TIGARD PLUMBING PERMIT
P ERMIT #: PLM2006 -00162
�l+ DEVELOPMENT H BM r SERVICES O -639 -4171 DATE ISSUED: 4/26/2006
PARCEL: 1S125DD-04500
SITE ADDRESS: 09795 SW VENTURA CT ZONING: R -4.5
SUBDIVISION: WASHINGTON SQUARE ESTATES NO.2 LOT: 053 JURISDICTION: TIG
Project Description: 40' of water service.
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: 40 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
BAHAR MOJDEH Description Date Amount
9795 SW VENTURA CT
TIGARD, OR 97223 [PLUMB] Permit Fee 4/26/2006 $72.50
[TAX] 8% State Surchari 4/26/2006 $5.80
Phone : Total $78.30
Contractor:
MR ROOTER OF PORTLAND
15033 SE MCLOUGHLIN BLVD #344 REQUIRED ITEMS AND REPORTS
MILWAUKIE, OR 97267
Contact # : PRI 503- 653 -5301
FAX 503- 653 -5376
Reg #: LIC 138941
PLM 3 -434PB
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 , • to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -0.01- 0010th • • • •AR 952 - 0001 -0100. You may obtain copies of these les or direct questions to OUNC by
calli 503- 246 -66• • • r : '0-332-2344.
Issue. By: 6_ , P I ELII/ Pe gnature: ��� � 4(l i > -(�
r -
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that 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.
RPR- 25- 2006(TUE) 09:58 MR ROOTER PLUMBING (FAX)503 653 5376 P. 002/002
I r
'r
'Plumbing Permit Applic .' FOR OFFICE USE ONLY
City and of Ti tas'N'd
�• taetrav: 25 eG J[ PemtftNo.: P( ft 0 - aor6
13123 SW Hall Blvd., Tigard, OR 97223 F�-
Phone: 503.639.4171 Fax 503.598.1960 APR 2 5 21. !
24. Hour Inepeedon Line: 503.639.4175 t , da other PermltNo.:
. ! i. �
'ntzrnct: www.ci,tigard.or.us Dale Nntl Reudyl0yt "r 8 t s m a stag In
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•( MI ! ,�, � '1 ',�� I " y u 'q' ' i-. �i.� 5 .1, 1 ; . ; ..-.Lr '.1„ f•i. ,• F , .. Tier'
r.in ` , � art 6.i. �, E�. �Twi��l.�yiv r wi���= :J��s:7' "*�' � ��J'�� Z:?l�� ?��i� 'J 1 ���-'� ti: • ., c.,� c' :.., - 1� ..' .. _
New construction CI Demolition D For dal in f or mation use eherl�tla.
escription Qty Ea. Total
�Addidon /alteration/replacc:tttent CI Other, New 1-2- family dwellings (includes 100 fL for each ut connection)
i ? �rL���`1' � ."�Irj`iljy" I't�lt:'�i��. W. �3' "�.
o Lt. 'w' tat. 'r. t7,- •1 i iiii .P "_ r 'i y'lA �;'I :74,-.11A : 1 � F.%.M , . �, . SFR (1) bath • - 249.20
. =' 1. and 2-taraily dwelling ❑ Commeralal/industrlal SFR (2) both • 350.00
El Accessory building ❑ Mold SFR (3) bath 399.00
Each additional buthAdtshen 45.00
❑ Mualzr budder ❑ Other
drain 16.60
or
N Fire sprialder L_. sq. It) Page 2
II�Rrp4� fi � t��� 1 < �1vtp�ti"� ±u.c Y� lu a ' jc� l� i •...., !! i i , � ,
y M1 t �t; 11 i , .p 'i �_ I Sn .. ,1 �... 2•! f !t1. �,,v1. g 1 7 ; 3 tint+ :... ! . i SItO ntlllilOS
Job trite address: a)C6 __ IA) 1 / i] � ,
Caleb bpbasin area
City /State/ZlP: �j r� 6 1 ' 7d - - Drywell. leach linker trench drain - 1640
Suite/bldg. /apt. no.: Project. Hume: (l� Faodng drain (no, Iincxr` R.: Puce 2 -
Munufuctured home ut 1 10.00
Cross srrt:et/direptians to job sits: Manholes 16.60
r ! L - Ygi ii ( Rain drain connector 16.60
Sanitary newer (no. linear ft.: Pop 2
Storm sewer (no. linear R.: _) Page 2
+ -
Subdivision: 1 Lot no.: Wuter >awwiee (no, linear 1L: 4D 1 1 h&c 2
Tax map/parcel no.: Mature ur item
i 11 ° I a�s °1 N X119 t x �� 1 G� �U� u � n 3 i ' • d.. ear. 1 .. , 9 , . A17parpdan valve
� llat � ? i j WIET� I r� N„ . �.: 103 A lt' . i t - I .. 16.60
a I n �I I .I ( '� I3 aek4aw pteve Page 2
Backwater valve 16,60
CI usher 16.60
�f�1��� �^ /+ + �','�, Dishwasher _ 16,60
M ri��� h leZ5 y,Ul1 7t ' . 1 �� l a l i is Ttl 'a��'7 � - F �V P I -4 9 7F DrindCntt ruuntanl 16.60
1.tnL S L1.l ) �. Ejectors/sump I 16,60
Name: r s ikMill '1,
CU) Expans tnt>>c 16.60
Address: St .1N�- • Cl I J l�X. . . FixnmJaewer cap 16.60
City/State/ZIP: Floor drain/floor sink/hub 16.60
PhD= ( ) Fox: ( ) Garbage dfupusal 16,60
a . r u rr�1 i h 14wAi 1 : +! .tj rr. i 1I' fi i. , I t;r `.-' -' Halle bib 16.60
I . -Trt q rri ,�. I�,ae� 1 a te r'. L'r��� i � °l sac !: ` 1 4... i 1' I .r t i
��� ice rrakcr 16,60
Business name: ' 6 �r �/�1.1>t'll'Aw J
interceptor/grease trap 16.60
Contact name: ' r . L ci is Medical gas (value: S ) Page 2
Address: , is . .40, 'SQ. C to .. \A, v a * 1 I Primer 16.60
City/State ZIP: 4 . ,L, , ' D112- Roof drain (cortuneteial) 16.60
OEM ...-1.-. 16.60
@�
Phone: •) 4 r A ...-1.-. - Tub /uhnwet /ithawcr 16.60
E-mail: y � Urinal 16.60
"1 I � .,� �„{ti b �F +� t ' ?tt5.' _, h ."'i :�,:" .�-''. Wales closet 16.60
- _ 1 `. R� . ~ U"n � Water homer 16,60
wer wiwom Other:
IFTIMM + `' i Subtotal
Minimum permit fee: $72.50
Phone: ( ) ,4-S it, Fax: ( A.► ) eAi "76 Residentlat backtlow minimum permit fee: $36
`CB Lie.: '2 Plumbing tic, no.: 3 ) 3 l 4 B - Plan review (225%orpermtt fee)
State surcharge (8% of permit fee)
Authorized nigrtutute: A :wt _ � y � , TOTAL PERMIT FEE
Print name: Date: i.4 Tbis permit application expires If a permit la not obtained within
a /1 180 days after It has been accepted as complete.
*Pee methodology set by Tri- County Building Industry Service Baud.
1.1bual4lnlPmntult•taa.P lutpp.doc ryas 4404e1011sniCotdrwElo
CITY OF TIGARD
A BUILDING DIVISION _ V PERMIT #: PLM2006- 00162
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/26/2006
Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 irli ,11111 ..
INSPECTION WORKSHEET FOR DATE: 4/27/2006 TIME: 7:04AM PAGE: 96
SITE ADDRESS: 09195 SW VENTURA CT CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE ESTATES NO LOT #: 053 TYPE OF USE:
PROJECT NAME: MOJIDEN
DESCRIPTION: 40' of water service.
OWNER: MOJDEH, BAHAR PHONE #:
CONTRACTOR: MR ROOTER OF PORTLAND PHONE #: 503 653 - 5301
Inspection Request Scheduled For: Date: 4/27/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water S ONIC 028806-01 503-653.5301 N
Corrections /Comments /Instructions:
' INFIFPW
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Y r - PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ,/7 k 6 Date: 0 7/6 Phone #: (503) 718 - ? :3`
t .