Permit C ITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00232
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/23/2008
PARCEL: 25111 CC -09601
SITE ADDRESS: 15740 SW GREENS WAY ZONING: R -12
SUBDIVISION: SUMMERFIELD NO.2 LOT: 123 JURISDICTION: TIG
PROJECT: LEIPZIG
Project Description: Replacing 200 ft. of water service.
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: SEWER LINE: ft
WATER CLOSETS: WATER LINE: 200 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
JOE LEIPZIG
15740 SW GREENS WAY Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 5/23/2008 $101.40
[TAX] 12% State Surch 5/23/2008 $12.17
Phone : 503- 670 -4999 Total $113.57
Contractor:
BEAVERTON PLUMBING INC
13980 SW TUALATIN VALLEY HWY
BEAVERTON, OR 97005 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 643 - 7619
FAX 503 643 - 7620
Reg #: LIC 12889
PLM 34 -4PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By / i Permittee Signature: , G-J
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
May 22 08 03:19p Beaverton Plumbing Inc 5036437620 p.2
F!umbiln Permit A, iicatio C~
Building Fixtures
FOR OFFICE O!NL-
'USE
City of Tigard I,'.~ 2008 Received
1''3' ' Untc/Nv:_ ~~G~P~ v'nun \'o.:~H"r (.(J?C7oC
v 13 125 SW I•lull Illvd.,'I'igurd,OK 9722
Hall kevieW
0 Phonic; 503,639,4 171 I:;tx; 5(.13,$.48, ly ( OP Sr OILur Permit Mo.:
r)alc/1ty: '
Inspection Line: 503.639.4175 th,lc Kr.;td /l lSari,: rd 're P,„ ,
C DV iJ O Y Y' t_r 2 I'nr
Ini1Ct,tcl. „'WwJigard-pf,(!pV 1N Nnliricd1Mn6ud: Supplrmrntnl Information
TYPE OF RK FEE" SCIIEDULE
Fors rrirrl inJrrmafian urr ClmPkli.c!
NOW tx)astttlction ~ Demolition
Dc:cri tine (,)tv. F:a. Total
® Addition/;ttlt'.r;t(inn/rcplaccn,lnt ❑ otim" New I. 2-family (IwcllinRv (includes 100 II, lbr cash uiility ennncctinn)
CATEGORY Of CONSTRU(_TION SPR (1) huth 49.20
® 1- and 2-fancily dwelling ❑ CUrnrnerciul/industri:(I `I'R (2) ha(h 35(1.(10
❑ Accessary' building ❑ Muhi-lamily SFR (3) hath 199.00
Each additionalbutlYkitchen 4S.00
❑ Maslur huildcr ❑ Other;
.--..-.,.-,.,...,_._..WU Fitt: sprinkler sq, 1'L) I'n(;c 2
JOB SITE INFORMATION' AND LOCATION sitr utilities
.Inh silt address: 157JO GRF:h:NS WAY (;arch basin or area drain 10160
City/Statu/7,IP:TICARD,ORECON Diywcll. leach line. or irench dmin 16.60
$uitc/bldP„/apt. no,: I I rojcct nan)c: JOI; LIMIZIC Fnnrinp, drain (no, linear fl.: ) Pa ,c 2
MluwfacEUMILI home utilities 110.00
(:ra3R Sh'L'L'dllirCCtiens 10 Ittlt rile:
Manhulcs 16.60
Rain drain ennncetor 16,60
tianitaly scwgr (no. linear II.: Pagc 2
Storm sewer(no, linear [I,:_) Pave 2
Watcr service inn. linear Il.: 211111 200 N, c 2 Ql ,
Subdivision: 7Lul nu.: .
- - - Fixture or item
TINT IIl,'IP/paI-cCI nOj: Absorption valve. I 6.15U
DESCRIPTION OF WORK
_ Backfluw prcvcutcr I'a> c 2
Kit-PII'I: IMUSE IMckwmcr valve 1("(;0
('Inthes wai)icr 1 h.60
- DisIMMIL•r 16,60
- I)rinl inP
® raorl'aiTV OWNER ❑ TENANT -nintain I b. (A)
Ejedo cdsun lp 16,60
Name: JOE, LEIPZIG •°--f:'spansinn uutk 16.60
Addruss: 1,1740 C. RF,h,N` "'AV Fixlure/scwer crlp
City/Stole%%IP;'I'IGAKD,OKI."GO Him draittllluursink/hub 16,60 -
^Plume: (54).1)(P70.4999 Fax' ( ) (iurbage divpvs(d 16.60
I-lose bib 16.60
❑ CONTACT PERSON
Ice maker 16.60
Business mane: BEAVEICUON PLUMBINC, IN(' -
_ „ Inlc('CCplut/~tcasc+[lap , 16,60
Conlacl name.: MARK LOCRECO - Medical gars (value: $ Page 2
Address: 139M1 SNN' TIiALATIN VALLEY HWY Primer 16.60 - -
City/State/ZIP: HKAVI'XI-ON, ORL:CON 970115 Roofdrlin (cummercinl) 16.60
Phonic: (803) 670A999 I'arc:: ) tiink/basin/lav;t(ory 16.60
I'uh/shower/shower pan 16.60
P.-mail: IUt:rccomnrk(b%aol.cnm
I Irinal 16.61)
CONTRACI'OR WnICr clusct 16.60
Business manic: BEAVERTON PLIIMIIING, IN(:, Wakr header - 16.60
Address: 13980 SW TUALATIN VA1 LEA' IIWY Other:
0ty/SwtGZ1I1: BEAVERTON,OREGON 97005 - ~Irbrortd 101,40
- - - Minimum permit tee; $72.50
Phonic: (503) 643,7619 Fax: (803) 643.7620 Res idcnlial Nickllow miilaltu111 permit Ice: $36.2S
C CIl Lic.: 12889 I'lunnWrig Lic. no,: 34-4PR Man review (:250N.4irperolik foe.)
titale surchergC 112°r'v ufpCrrnil Ice) 1,--
Authurizutl signature; -
1L al~ ~"ciS~1 TOTAL ITRMIT ME 10.57
Print mane' SIISAN IWAN Dale: 5/21/2008 1111.4 pl'r mitaPplielttioa expires ira pernrll is not obtains-d within
180 days after it hii been accepted as CoIIIII1 lC.
•Fee methodology set by Tri-C(nmly Ruili imt Industry SCrvice Roard.
I:VhulrlingV'crn,itv',I'LM!~hcrmitApp Ant I:k'IAa, q~WIGIUT(IOIgZ/(:pMlW[fl)
l4.. ,
May 22 08 03:19p Beaverton Plumbing Inc 5036437620 P.2
.Plumbing Permit Applicati I , ciaNIVD
Building Fixtures + FOR OFFICE USE ONLY
City of Tigard . r 2 %?A% Received -
t f,'
, :. , ontut��: crtnit Nn.:
. o I3 125 SW Hall lilvd.,'I'igard, OR 97223 - j,'� - - -"
Man Review
i O • • I'honc: 503.639,4171 lax; 5(13.5 ( "vi, l�tltcr l't each Nu.:
v [ G tc� 1) ale TIGARD Inspection Line: $03.639.417$ GDN 1 1k" Dare Ready /Icy )urir. Q) tire Mgr 2 far
mlernel: uww,fi rd.or.CoV R OI EV Nan iricd,Mt1Ixat: I Supple mental Informnt inn
TYPE OF WORK FEI • SCHEDULE
El New construction ❑ Demolition
special infr,rmalion usr elrerLlitr,
1)cecription I Qty. I Ea. I 'Total
to Addition /alteration /replacement ❑ Other: New I.2•family dwellings (includes Inn 0, for each uiilily connection)
CATEGORY OF C.ONS1'RIICTION SFR (I) halt 249.20
® 1- and 2.ftimily dwelling ❑ Commercial /industrial SFR (2) lath 350.(x)
❑ Accessory building ❑ Multi - family SFR ( ?) bath 199.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
; ,.. -.- Fire Sprinkler ( sq. ft.) Page 2
- JOB SITE INFORMATION AND LOCATION
Site utilities
lob site address: 15740 GREENS WAY Catch hasin or area drain 16,60
City/Slate/7.1P: TIGARD, OREGON Drywell. leach line, or trench drain 16.60
Shine /bldL /a
„ (? t. no: , ---- - Project name: .IOU LEIPZIG
Footing drain (no. linear It.: _) Pace 2
-- - _... " " "" Manufactured home utilities 110.110
Cross street/directions lo job site:
Manholes 16.60
- _ Rain drain connector 1(1.60
Sanitary sewer (no. linear II.: -) Page 2 •
--
Sturm sewer (no, linear 0.; _) -- - ' :ig 2
Subdivlston: Lod nu.:
Water service (no. linear II.: 2110) 200 Page 2 /pi .40
Tux ma p /purCCl no.; - - Fixture or item
�- -' -- Absorption valve I b.bU
^•_ DESCRIPTION OF WORK Baeklluw picvcntcr ('age 2
RE -PIPE HOUSE Itackwatcr valve 16,6(I
Clothes washer 16.60
Dishwasher 1(,
I)rinkin' ti,unlain 1 6.61)
® PROPERTY OWNER -- I 0 TENANT Ejectors/sump - 16,60
Name: .101C I.F.I I' %IC: Expansion lank 16.60
Address: 15740 GREENS WAY - - Fixturc/sewerurp _ 1(,.60
(.'ily /Stole % /.I P; 'I'IGA KU, OREGO Floor drain /Inoue oiuk/Iwb ■ 16.60
Phone: (503)670.4999 Fax: ( ) Olt dispo,ti 16.60
® APPLICANT El coNTACr PERSON Hose hih . - 16110
Ice maker 16.60
Business name: BEAVERTON I'LIIMBIN(:, INC Intereeptur /gteax dap 16,60
Contact name: MARK LOC:RECO Medical {;us (value; $ ) Page 2
Address: 13980 SW'I'I;ALATIN VAI.I.EY HWY Primer I(,.(,0
City/State/7.1P: KM:AVI' ;1('I'ON, OREGON 97005 Rtwf drain (commercial) ■ 16.60
Sink/hasin /lavatory 1 6.60
Phone; (503) 670.4999 Fax: ( ) _
1'uh /shuwcr /shower pan 16.60
- nuril: IoCrccomark(u::wl.com I Irinal 16.60
CON'I'RAC I'OR Water closet If.60
Business name: BEAVER'I'ON P1.IIMRINC, INC. Water heater 16.60
Address: 13980 `W '1'IIALATIN VALLEY HWY Other:
City /Statc%/,II': I3EAVERTON, OREGON 97005. Subtotal
Minimum permit tee; $72,50
Phone: (503) 643.7619 Fax: (503) 643.7620 Residential hack minimum permit Iu: $36.25
Cell Tic.: 12889 Plumbing Lie. no.: 34 -4PII Plan review (75% of p rmit f e)_
Mime surcharge (12% of permit fee) ,
Authorized signature: hr j .., 0 cc(L WTh _ T O
;JJCC o0 111! TOTAL I'GRMfI' I til I I ?.57
l
Print name: SI ISAN DEAN J Date: 5/21/2008 ( This permit applientiun expires au permit is not nhtained within
180 days after it has been accepted nn complete.
•Fee methodology set by Tri•County Building Industry Service Board.
I: WwWinrV 'amitsTLMI-1•enni,Arr,anc rur,nx, 4•I{- 4414'fI1't21C0MIwCn)
CITY OF TIGARD
• A
BUILDING DIVISION PERMIT #: PLM2003- 00232
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/23/2008
Phone: (503) 639 - 4171 . 1
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/11/2008 TIME: 7:00AM PAGE: 21
SITE ADDRESS: 15740 SW GREENS WAY CLASS OF WORK:
SUBDIVISION: SUMMERFIL=LI) NO.2 LOT #: 123 TYPE OF USE:
PROJECT NAME: LEIPZIG
DESCRIPTION: Replacing 200 ft. of Water =Poise .
OWNER: , L.EIPZIG, JOE PHONE #: 503-670-4999
CONTRACTOR:' BEAVER (ON PLUMBING INC PHONE #: 503-643-7619
Inspection Request Scheduled For: Date: 6/11/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 0712/9-01 503. 670 -4999 Y
Corrections/Comments/Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CSVw t`V—v., Date: Co I I I ‘.0g) Phone #: (503) 718-
CITY OF TIGARD - • %
BUILDING DIVISION PERMIT #: PLM2000 -00232
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: J23/200S
Phone: (503) 639 -4171 A
Inspection Requests (24 Hrs.): (503) 639 -4175 ..' "'' �..
INSPECTION WORKSHEET FOR DATE: 6/10/2008 TIME: 7:01AM PAGE: 42
SITE ADDRESS: 15740 SW GREENS WAY CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.2 LOT #: 123 TYPE OF USE:
PROJECT NAME: LEIPZIG
DESCRIPTION: Replacing 200 ft. of water service.
OWNER: LEIPZIG, JOE PHONE #: 503
CONTRACTOR: BEAVERTON PLUMBING INC PHONE #: 503
Inspection Request Scheduled For: Date: 6/10/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 070968-01 503 - 670.4999 Y
iNv <
Corrections /Comments /Instructions: SZ)3 Sb2 `I IS;
LA-a P 1 o I v C--or,„, -dk Azipipot i ex, ,., u c-6,, -G., rw
1 2 � ( f (/ f v-ce 3e_ la' o'.
❑ PASS (4 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 41-4-- il\ — Date: 6, 110141 Phone #: (503) 718-