Permit w
CITY TIGARD PLUMBING PERMIT
i� DEVELOPMENT SERVICES PERMIT #: PLM2005 -00218
,� II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/27/2005
PARCEL: 1S125DD-03300
SITE ADDRESS: 06660 SW VENTURA DR ZONING: R - 4.5
SUBDIVISION: WASHINGTON SQUARE ESTATES NO.2 LOT: 041 JURISDICTION: TIG
Project Description: Installation of (2) hose bibs & supply line.
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: 0
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
TEMERLIN, JANE
6660 SW VENTURA DR Description Date Amount
PORTLAND, OR 97223 [PLUMB] Permit Fee 5/27/2005 $72.50
[TAX] 8% State Surcha 5/27/2005 $5.80
Phone : Total $78.30
Contractor:
CROWN PLUMBING
5429 SE FRANCIS
PORTLAND, OR 97206 REQUIRED ITEMS AND REPORTS
Phone : 503- 771 -9449
Reg #: LIC 42671
PLM 34 -70PB
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: �) Permittee Signature:
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.
05/26/2005 15:33 503 - 771 -9454 CROWN PLUMBING PAGE 02
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13125 SI .11- � � 0 Alk, a ll Blvd., Tigard, OR 97223 �� ��
Phone: _a '13.539.4171 Fax: SO3 598.1960 s. : :,.. PI10 Review Other Permit No.: i. r rya j `'` Date/bY
24- Hour I ns patron Line: 503 639 4175 CITY OF TI •h J
Internet' wv'W cr ttgttrd or us II p J� Nate Rc wt io U1 s See Page 2
�.7 J �,7 'Ir. r^^ to ,� `j • 1 Notied/Metlted. Supplemental Information
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❑ New c ins [ruction ❑ Deti Jolition For spacial information use checklist
® Amid m/ dteratron/replacemeot ❑ Oth, _Description qty l3a I Total
r New 1- 2- family dwellings (includes 100 ft. for each utility { ° f i ' t r 1 0 ' yt I 'a `I ;ir,'r' " rltr`�, t , j 1 r n\ r ' connection) fit ; Ibd .. . (.a J bii JF a tf;1 j I i lr lw" ' 'ri 4
tnr ... S ie .r • .y �r.�i.;,.sndhh r u . sr1 ' { *� iii .�G # ! 3Y ?4I l � r�;; SFR (l) bath 24920
g 1- and I'.f tinily dwelling ❑ Cor,:merciaUindustrial SFR (2) bath 350.00
❑ Acces: :Irk building ❑ Mu i- family SFR. (3) bath 399,00
❑ Master budder Each additional bath/kitchen 45.00
� Oth 1 r
r +tai jt , t Ft , 3� t i,t is a { t t a, r Fire sprinkler ( sq. ft.) I p 2
'11r,t I a it t`ri; ,!�', ^IIiI4 7 1 ^F k1 , °tf;' rf�1�1 t Y:�i 17 ' ' . ZI1{ { � { 1�r4"7iT Jr y ,p7)
L.L�.rI) U K�.• S p,4}jlalz.ti. c? L. tilx?;orJ,J�t� r,2 r4a. ;..I,,,L saw :Is F �ut.`,.. _i i....0 { Site utilities
Job site at ire sit: 6660 SW VENTURA DRIVE - Catch basin or area drain I I 16,60
City /Stater ! F.II': TIGARD, OR 97223 Drywall, leach lint, or trench drain 16,60
Suite/bldg. 'ap no.: ( Project name: TIMERJ, .IN _Footing drain (no. linear ft: ) Page 2
Cross stret Ud rectiorts to job site: Manufactured home utilities 1 10.00
Manholes 16.60
- Rain drain connector 16.60
- • Sanitary sewer (no. linear fL: ) Page 2
Storm sewer (no. linear ft: ) Page 2
Subdivisia : Lot no.: Witter service (no. linear ft.; ) Page 2
Tax maple roil no.: Fixture or item •
t V I jar }r t ^`.k'iR"i r} t'. i►j(Fl• s 1r '�t. Absorption valve
•ir el e I T ;.f PV:r,i7t zh yl l n J r; ' ' 4 ' L rlu ?1_�, �i.i +{ rili :y;p J Ib.60
t,1•swi4" . 'w'- :1 :u� +-. ' S,iiki �, in �, ra�kl.i "Jt h, * �' k.. Backtlow preveincr Page 2
INSTALL I 1 W HOSE BLEB AND SUPPLY LINE T(I SAME ) Z.., _Baekwatcr valve 16.60
Clothes washer 16.60
Dishwasher 16.60
,.- µ, r' 1 {f i }' t .5 1 { 1'T ,d -, ..i. I } 11 :'F'r r 0 t . TtV , , f y f rj a . T. Drinking fountain 16.60
l∎:.:iP k.tl_. aT 6z: -.!.. C li.Zcc1 3 Tii..s?. " 0.1 nXL: ±'� .ul. ra hc.1 , Lta. 9,1 L j ,S'sg1W2 4 �cr.
D trta s i LanI;f;:l EJeclnls/ 16.60
Name: MS Ji.NE TIMERLIN
Expansion tank 16.60
Address: S. IV ); Fixture/sewer cap 16.60
City/Stag [p Floor drain/floor sink/hub 16,60
Phone: (50 l2, 154110 Fax ( ) Garbage disposal
r �p {t I iir k7)' e j'�"� <r'4~" >hR }t i, t M { 1 T -r 16.60
' J ( r auY! I 1 ff rt fi S r 6 f j ', c A•tF r'M .5 ',4 t il,0 n, Dose bib
�1 ,_,El t6LL.:F.. igi ., J , 4 l(,� } � ) i .k. �1 t S i) e,-, , . .' :. 7 16.60 , ;�
.1f.. J.4�.j,la�• -1L�1 r1 1• 2 „f��,, ,.1f��� �.11�! ♦• Zl:tw ._Y...!, •. r.,i � • � �::Lf,tLrba� � 1� � �
Business ns roe Ice maker 16.60
• lntcrceptor /o case trap 16.60
Contact nag le:
- Medical gas (value: $ ) Page 2
Address:
_ Primer I6.60
City /State/2IP: Roof drain (commercial) 16,60
Phone: ( _ I Fax :: ( ) • Sink/basin/lavatory 16.60
E -mail. Tub/shower /shower pan I6.60 -
( �1 7 �� 11 Urinal. 16.60
yilli x i r Y�* t Zi, '+ ` i i P e r , ( : fi, ` ) K{7 t i" ' T ; ,r F ii + ^T ir4 I RFf 5 y `I w 1 r,
t .j .... :.11r.i .',Z11 :' li." d rc.:1,r I:A S:26:.i..11 i'ul a�Ji t'a. ilf:�w' ii;1 t 11 1.1 _ Watu closet 16.60
Business naj te: CROWN PLUMBING Water heater 16.60
Address: 5429 SE FRANCIS STREET Other:
City /State/Z .P: PORTLAND, OR 97206 Subtotal
Phone! (503 7; - 3443 Fax (503 . 771-9454 • Minimum permit fee: $72.50
Residential backflow minimum permit flee: $3625 '7"Z...573
CCB Lie.: 4; .671 Plumbing Lac. 34-70PB Plan review (25% of permit fee)
Authorized s gn sture: /` �` 1 - State surcharge (8% of permit fee) 40
TOTAL PERMIT FEE 7 S .?O
Print name: I het ids Underwood I Date: 05/26/05 I This permit application expires if a
p' permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by TTi -County Building Industry Service Board.
I:113w1dinatpc mii, I ?u 1- rcntitApp.eoc 12/03 4 a 0 d 61 6r00/02COMNEs) 1
J
CITY OF TIGAR •
•
BUILDING DIVISION PERMIT #: PLM2005- 00218
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/27 /2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 _.'!!d IL. • •
INSPECTION WORKSHEET FOR, DATE: 8 /5/2005 TIME: 7:02AM PAGE: 80
SITE ADDRESS: 06660 SW VENTURA DR CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE ESTATES NO LOT #: 041 TYPE OF USE:
PROJECT NAME: TEMERLIN
DESCRIPTION: Installation of (2) hose bibs & supply line.
OWNER: TEMERLIN, JANE, PHONE #:
CONTRACTOR: CROWN PLUMBING PHONE #: 503- 771 -9449
Inspection Request Scheduled For: Date: 8/5/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 012759.01 503- 771 -9449 N
•
Corrections /Comments /Instructions:
•
•
•
ASS ❑ PARTIAL APPROVAL ❑ CANCEL 111 NO ACCESS
✓ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: tIn L Date: i // Phone #: (503) 718-