Permit „,_,, .16. ii 0 F
CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2006 -00512
' � I
AIPII°& 13125 SW Hall Blvd., Tigard, OR 972 503 -639 -4171 DATE ISSUED: 25/11 2006
PARCEL: 25111 DC -02600
SITE ADDRESS: 15725 SW ALDERBROOK CIR ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.8 LOT: 473 JURISDICTION: TIG
Project Description: Relocate tub to shower conversion.
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: 1 SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
FLORENCE WALBERT Description Date Amount
15725 SW ALDERBROOK CIR
TIGARD, OR 97224 [TAX] 8% State Surchari 10/25/200E $5.80
[PLUMB] Permit Fee 10/25/200E $72.50
Phone : 503 624 - 6494 Total $78.30
10
Contractor:
MRP SERVICES
PO BOX 33585 REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97292
I
Contact # : PRI 503-652-2626 0
FAX ,__� _ , __ �771 0
FAX 503-241-6565 ; , Iyr\.a - t.)J ,\ ,:; O
Reg #: LIC 106824 V I �/ VI
PLM 3 -265PB v
A9 7 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- 24fi-6699 1- 800 - 332 -2344.
Issudd By: \ ” ° . 'v` . .. Permittee Signature: .,= ? • /::„'----"-----
v •
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.
4 ' � IN! PE—V I'OR',S SIGNATURES ARE NOT
Inspections Required for: 6_ 06 5� 3 REQUIRED ON GREEN INSPECTION CARD.
✓ Code I Inspection Description I PASS Date I By ✓ Code I nspection Description PASS Date By
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground/slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing 120 Electrical rough -in
805 MFG - Structure grading/footing 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post/beam structural 150 Hot tub /spa/pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors 199 Electrical final
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls I 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG- Structure set -up MEC - Mechanical Permit
280 Insulation 605 Post/beam mechanical _
285 Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping
899 MFG- Structure final 625 Duct work
498 Grading final 630 Fire damper
299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection:
699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough -in _ 305 Plumbing underslab
915 Fire alarm rough -in 310 Crawl drain
920 Suppression trip test 315 Post/beam plumbing
995 Misc. inspection: S .320 Plumbing rough -in
998 Alarm final 322 Shower pan
999 Sprinkler final 330 Water service JJ�
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation _ 345 Culvert/catch basin
410 Fill _ _ 350 Septic tank
415 Grading 395 Misc. inspection: _
205 Footing 399 Plumbing final
210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 Final inspection
I: \8uilding\Inspection Cards \Forms\AOP- InspCard- Blank.doc 12/09/2005
i -
C ITY OF TIGARD PLUMBING PERMIT
�l DEVELOPMENT SERVICES PERMIT #: PLM2006 -00512
I � 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/25/2006 >,
PARCEL: 25111 DC -02600
SITE ADDRESS: 15725 SW ALDERBROOK CIR ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.8 LOT: 473 JURISDICTION: TIG
Project Description: Relocate tub to shower conversion.
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: 1 SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
FLORENCE WALBERT Description Date Amount
15725 SW ALDERBROOK CIR
TIGARD, OR 97224 [TAX] 8% State Surchaq 101251200E $5.80
[PLUMB] Permit Fee 101251200E $72.50
Phone : 503- 624 -6494 Total $78.30
Contractor:
MRP SERVICES
PO BOX 33585 REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97292
Contact # : PRI 503- 652 -2626
FAX 503- 241 -6565
Reg #: LIC 106824
PLM 3 -265PB
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
cal li ng,503 -246 =6699 1- 800 - 332 -2344.
Issued By: \ _ . 2 C.L.,. L .� 1 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.
R J 5/2006 10:04 5032416565 MRP PAGE 02/0
2
Plumbing Permit Application '" . OR OFFICE USE 01\11 City of Tigard
�eC ` " f Received
' V notes ; %o , - 0 � i Y �C -1i
] 3125 SW Hall Blvd., Tigard, OR 9722 Plan Review
Date/]3y: --41 Phone: 503.639,4171 Fax: 503.598.1960 2 2 e,, Other Permit No.:
�� 43 1 ' �
24- hour inspection Line: 503.639.4175 U t3�. , I i , Data Ready/By: J�t ® See Page 2 for
Internet: www,ci,tigard,or,us of TAG • Notified/Method: -7/ Supplemental Information
■
S .. S_Y ,.,�Ta ^ 41'17'r .��,r .' F A .1. " 4 1 •� O'��•' \ a rPJH .' ,
? 7,77W ���},! ro ro µt � ,� y � i YL y{^ ` �p , ` i .. .1•r , , QF 1 a �r4` �., ,�5�' a iJ '' � i l 7D Ill l�� 1 y 1`,«+ `+.,
t. � °�.p�??r� .t:�?IS'i i'. �u1�T�',�',"� {R �' '�1��� lY� F,`�n e'h�S, c � �-�t !� �r'�,�'E1Tx ° .��. �`T+�,1 �V. �
� a i; .�n! ^ fit ; ; r. a: _, .�, z �.�t: ,. ,.�; -c �..le" �. s _vr 'SZ.
❑ New construction El Demolition For special to armadon use checklist
Description ]Qty. I Ea. I Total
Addition /alteration /replacement 0 Other: New 1- 2.family dwellings (includes 100 it for each utility connection)
", f�'�l 7 0 S i• r Z, r .rW ri.rfi�L xr, r ,r[.,, , h" y , ; SFR (1) bath 249.20
l i * / :,' xt ', " 1r? , W,rF3K t{ w. .. .,' „i. . . r r f'-% i". �t.' :. t1Lr', y't,It ( )
► " .i 1 - and 2 - family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
CI Accessory building 0 Multi - family SFR (3) bath 399,00
Each additional bath/kitchen 45.00
Q Master builder ❑ Other Fire sprinkler ( sq. ft.) Page 2
s p
� Ct I , ', . ' M g '
.
r U � �
u 11 Kl r+-I 'it 4) - . . 6 .,.. rI �' :otrc e4. 1 ,.' ��� �° 6 Site Unities
d.nr: 4 .d ?. t2:��k �itf: s u�.;C'lre,: .3'��.. �.,, .�
Jab site address: w n ` . f� Catch basin or area drain 16.60
■ City /State/ZIP: 7 ok :111
O �. # Drywall, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: Project name: ,A j l[" ir7uk 1� � Footing drain (no, linear ]l.: ) 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 ft.: Page 2
Subdivision: Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or Item
Tax map /parcel no
p Absorption valve 16.60
. :1,. vY7� . , Yiri,.. yi � rU;;,.. r I Iti0�I :r. C C3'd wit- 7� 4Il'Orli 1'4 ° J t, t P� .
r - •a ,�i.�.,,klf. 411- i1LI ..,. _ n , im a AcY&71? t t4 _c ,. r . t,., .,.. Backflow pm venter Page 2
. Backwater valve 16.60
-a.?Ji_1PQ, n� _ J. Clothes washer 16.60
Dishwasher 16.60
r .r, . R w r , � o Drinking fountain 1
�� L� of ,lr „y - ,i
I � R�]�llfl��dl�an }y�.:� „ 1 •ar .r ��a�. a . �'
Ejectors/sump 16.60
Name: I It ' h Exp tank 16.60
Address:La��r�!la. 1 ►� J1�1ti , ! Fixture/sewer cap - 16.60
City/ State/ZIP: ` ,. / • Floor drain/floor sink/hub 16.60
Phone: yi illai��' Fax: ( ) Garbage disposal 16.60
r1r';-x�ai ti s ? r y � �� tt ,, H w mnPmr fi'1.�° Hose bib 16,60
' ' I i u 4 i'. c4,ko �h. . ' .,, Fi., , �J:wA D
.ii)bt�?9�.l .i!l..zPV i �'•+�.� •m�?� ±�f. ��ai�i trrw "a a,l I � ° . 16,60
/may ice maker
Ausiness name: pn K9 - . interceptor /grease trap 16.60
Contact name: ti g ( ' j4- �-1[f1J.J v Medical gas (value: $ ) Page 2
Address: °, , j . Primer 16.60
City /State /ZIP: C ~ ' elf_ a or- Roof drain (commercial) 16.60
Phone: yI 3) , -- , A F a x : d , Mall Sink/basin/lavatory 16.60
Tub /shower /shower pan 1 16,60 I tp • (0 t)
Email a S a f 1 V a I / V Urinal 16.60
71.7, it 7 'r 47 1 " ? I n� g N
:)''.�r^4,t c�, . "r ,,c..34 1 Ir"` , .. . , _ ,,,
, - 4 .:.., ,. s � ., ,.5 x "_.. T' • ,,." "+.,,,i.a; W ater closet 1E60
Business name: ` a • � ( Water heater 16.60
MIA Other:
Address: IA , 5 Subtotal
City / State/ZIP: / n1 � 0. _ 11.: 7A � - '--' ( �o 1 p
r/ � Minimum permit fee: $72.50
Phone ( 3 ) r a ^ ` , ■ ' , Fax: ( J ) 1P• r,57'!J Residential bacicflow minimum permit fee: $36.25 �,� 0
Plumbing Lic. no.: / , Plan review (25% of permit fcc)
CCB Lic.: 0, a g 3 a G S •
j State surcharge (8% of permit fcc) 5.5(C
Authorized signature: `: l % i If J ! TQTAI,. PERMIT FEE 3 C
J ,- This permit application expire, if a permit is not obtained within
Print name: • . k t Yr Ef'N SO 00
Date: �-, v ,) „.1 180 days after It has been accepted as complete.
*Fee methodology set by Tri- County Building industry Scrvicc Board.
i TuildinazPor rmIAPI-M- Perm; o6/o5 110- 46i6T(znm7dCOMAVFB)
CITY OFTIGARD 'ell 706- 00s- 0-
BUILDING DIVISION ' °'- i „ ,.. ,- PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 �1.�ji
Inspection Requests (24 Hrs.): (503) 639 -4175 - !.i __..
INSPECTION WORKSHEET FOR DATE: t t/< / (,, TIME: PAGE:
) SITE ADDRESS: 7.-- 1 A.`" 'A.,_rve CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message .....D
AA
1,,,,,,,./c7 a. rest,.- 52 - - 7--0 24,
Corrections /Comments / Instructiob :
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: r o
1 Date: i/f fr Phone #: (503) 718 - t
L