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7047 SW MAPLELEAF ST
CITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT M PLM2002-00307
13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 DATE ISSUED: 8f26/02
SITE ADDRESS: 07017 SW MAPLELEAF ST PARCEL: 1S136AA-07400
SUBDIVISION: PP1990-044 ZONING: R-4.5
BLOCK: LOT: 003 JURISDICTION: TIG
CLASS OF WORK: NEW 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: 50 ft
WATER CLOSETS: WATER LINE: 110 ft
DISHWASHERS: RAIN DRAIN: 75 ft
Remarks: Utilities lines serving three lots _
Owner: FEES ____
------
Type By Date Amount Receipt
ESLINGER BUILDERS, INC. PLCK CTR 8/5/02 i $25.35 27200200000
11575 SW PACIFIC HWY. PRMT CTR 8/26/02 $147.80 27200200000
PMB #160 5PCT CTR 8/26/02 $11.82 27200200000
TIGARD, OR 97223 PLC2 CTR 8126/02 $11.60 27200200000
Phone 1: 503-620-9515 -- '—)
Total $196.5'
Contractor:
ROME PLUMBING INC
17295 SW EDY RD
SHERWOOD, ON 97140-8709 REQUIRED INSPECTIO`,1IS
Phone 1: 625-1452 Sewer Inspection
Reg#: LIC 96346 Sewer Inspection
PLM 34-265PB Water Line Insp
Wa`.er Line Insp
Rain Drain Insp
Rain Drain Insp
Final Inspection
This permit is issued subject to the regulations contained in the Tigard Muni,;ipal Code, State of OR.
o Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans.
U 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 952-0001-0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503)X46-1987.
Issued By: _. ' , � � . .[_� Permittee Signature: _ -
Call (503) 6394175 by 7:00 P.M.for an Inspection needed the next buslne 4 day
� ►�z a is / T7f_�,
Plumbing Permit Applicatiom
rDaterecelTved Pcrm((no. _ .Zoll co
City of 'Tignr� — �� �Addrecs: 13125 SW I Inll Blvd,'t igard,OR 9722; werPermit no.: Building Permit no.:
c'iry n/Tignr`I I'hone: (503) 639.4171 P►ojeclAppl.no.: 13rpirednic:
Fax: (503) 598-1960 Dale issued: _ Ily: Peccip(no
I-nid use approval: Case rile no.: Payment type:
U I &2 fnntily dwelling or accessory ^0inunercial/industrial U Multi-family O Tenant in ro�e/jtsn
J New construction U A(Idilion/nileratiot✓re..pincement U food service W Other:
Job address: 7011 St,) Descri llon
QIL. fee ea. Total
BI(lg. no.: - --� Suile no.: — New I-and l-faro lydwellings only:
Tax nial0ax Io/account(no.: '1 (pgg -�'�x 'O+ ! -� (Includes 10o0,foreechrrlllhycannccllnn)
�— SFR(1)bath
I.ot: Block: — Subdi"'.on: SFR(2)
Project nnntc:_ �5��1 - •p,^ _ S(�R(J) ►alit
City/county: 71 P; lv- Each additional batli/kilchen
Description an( ocalion of work on premises: fiheulllhles:
2"`'�l - of R_Q�►• • f{� (o Catch basin/atea drniu
Est.date of coin tletion/inspection: )rywells/Ieaefflin
eJUench drain
rooting drain(no. lin. ft.)
Business name: MAnuftictured ome utilities
C�(�C'. ILSfit�,�J, � an o ea
Addregs: 11•L y E t Rain rain connector
City: State:[ ZIP:eI_1lgU Sanitarysewcno.lin. ft.)
Phone: ' r - 4 rax:bZS IgSz E.-mall:-mall: - r(Stonn sewer(no. lin.ft.)
-CCB no.: q(G,' 1(o Plumb.bus.reg.no: ( _ ater service no. lin.ft.
City/metro tic.no.: OtJ(j0'v Fixture or Item:
Contractor's representative signature: Abso tion valve
hint name: p otjRck flow prevenler
1111,1111101 all 0 M�- DAIe: S 2 BAckwa(er valve-
Bn.41ns/IAval0ry
Name: C kadClothes washer
Addrrss: 11S-IS- 5 W c 1 M _16 p _15isltwasltcr —
brincin fountain a
City: �' a _ �latc: �(L 7,IP: 57223 Cs'cctors/sum -
Phone: -4 S- I rnx:G 20-jq7 d E-mail: -- Expansion lank
�i --rxtu sewer cap
Name(grin!): ; u (7CP-(S r drnins/floor sinks/hub _
Mailing address: I(S"7 ,� p4c 1k Garbage disposal --
�_—._L� AA f2
IIOSC 1bb
City:I p State: o - ZIP: 47223 --
Ice maker
rL Phone: , - SI rax: i0-tiy lS E-mail: Vn! or/ fosse—trap
Owner ins(allatiorr/rcaidcntinl maintenance only: 711c Actual installation )
N will be unadc,by me or the maintenance and repair made by my regulnr in(commrrcial)
employeeon the property 1 own as per ORS Chapter 447. basin(s),lays(s)
Owncr'-, signnlurc: Date: um
mTubs/shower/s ower pan
L7 Narnc: 4s r
Urinal
W � - -- Water c ose�l ---�
J Address: q p W (� l O t7 Water heater
City: State: o ZIP: �'/1 H O Other: i'
r.
Phone:`(2s-5199 rax: ZS_S E-mail:_ otel F
NM ell,hntrdicoam accept credit cosh,pimw call)mlwk(ton rm mere Infermalion. Minimum fee................ 1y� fL--
Nolice:This permit application
U Visa U MasterCard expires if a permit is not obtained Plan review(at ^_ 96) 015.35
credit cord mrmbn: a fee — within I80 days oiler it has been State surcharge(11%)
Now c l ,r a shown en crr+du e — accepted a complete. TOTAL.......................$ r 3 4 .$6
CauxlMolder t 6nalure— n�ioallr K V $r3-S•3 5
11416I6(elearC'OAr)
CITY OF TIGARD PLUMBING PERMIT
~' DEVELOPMENT SERVICES PERMIT#: PLM2002-00386
13125 SW Hall Blvd.,Tigard, OR 97223 (503)639-4171 DATE ISSUED: 9/30/02
SITE ADDRESS: 07017 SW MAPLELEAF ST PARCEL: 1S136AA-JP003
SUBDIVISION: ZONING:
BLOCK: LOT: JURISDICTION:
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF US_ SF WASHING MACH: 1 BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
_ FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES:
TUBISHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Install 1 lav, 1 clothes washer, 2 hose bibbs and 1 kitchen sink. Plumbing is not aware of any structural
construction.
FEES
Owner: ---
Description Date Amount
NANCY WILSON -
6306 SE 44 f PLUMBI Permit Fee 9/27/02 $83.00
PORTLAND, OR 97206 IPLUMBI Permit Fee 9/30/02 $0.00
[TAX]8%State Tax 9/27/02 $6.64
[TAX]8%State Tax 9/30/02 $0.00
Phone 1: 503-771-3770 —
Total $89.64
Contractor: �—
IVO SKORA PLUMBING
1820 SW WYNWOOD
PORTLAND,OR 97225 REQUIRED INSPECTIONS
Phone 1: 503-6.14-7173 Rough-in Insp
Top-out Insp
Reg#: I.I( 104945 Final Inspection
PLM 34-297PB
i
i 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
, Permittee nature:Si
Issued By:�'�������c',I�LCG 9
Call(503)6394175 by 7:00 P.M.for an Inspection needed t e next business day
Building Fixtures
Plumbing Permit ApplicationNINNEEM
Date received:q130 y Permit na�,�p��� b
Cit of Tigard City b Sewer permit no.: Building permit no.:
Address: 13125 SW Ifall Blvd,Tigard,OR 97223
City gfTigard phone: (503) 639-4171 ProjecUappl. no.: Expire date:
Fax: (503) 598-1960 Date issued: By: Receipt no.:
Case file no.: Payment type:
Land use approval: __�___-_ __
Ib 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
U New construction U Addition/alteration/replacement U Food service U Other:
1
Job address: 7� -_ 6)escription 01y. Fee(ea.) Total]
S U' �/�LL of �F cw I-nn aarnll-y dwellings only:
Bldg. no.: �_-- Suite no.: (includes 100 ft.for each tit lilt y connection)
Tax map/tax lot/account no.: SF- 't)bath
Lot: Block: Subdivision: _ S, )bath __
Project name: _ SFR(3)bath
City/county: j,q _ ZIP: Each additionst bath/kiti hen
Descr ption and location of work on premises: �1� r't6�P siteutilities:
_ V,0h 71;11L_& k ✓%)'t . ����� _�°i�'� Catch basin/area drain
Est.date of completion/inspection T— Drywellsileach line/trench drain
Footing drain(no.lin. R.)
Manufactured home utilities
Business Warne:_—ILL V=/ �_/ y is _ Manholes
�( � _ -- -- —
, ddress: /Vol. u jSjt
Rain drain connectorCity: !'l��lrgR ate: Sanitary sewer(no.lin.fl.)
Phone: 11414 Fax: E-mail: Storm sewer(no.lin.R^) _
CCB no.: % Plumb bus.reg.no: ,34-c?y)T P6
Water service no.lin.fl.)
City/metro lic.no.: ,$•
3J-; A)_�),�1 Fixture or Item:
Absorption valve
Contractor's representative signature: Back now preventer
Print name: /4( (f_i/' Date: f95'L._ Backwater valve
Basins/lavatory
Name: Clothes washer
Dishwasher _
Address: Drinking fountain(s)
City: State: ZIP:_ Ejectors/sur..p
Phone: Fax: E-mail: Expansion tznk _
Fixture/sewer cap
Name(print): A /f!'P�i'a�l t _ Floor drains/floor sinks/hub
Garbage disposal _
Mailing address: s• E Hose bibb
City:Phone: "�, State: ZIP: ?G Ice maker _
/,>' Fax: E-mail interceptor/grease trap _
2 Owner installation/residential maintenance only: The actual installation Primer(s)
will be made by me or the maintenance and repair made by my regular Roof drain(commercial)
employee on the property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s)
Owner's si mature: Date: Sump
Tubs/shower/shower pan _
Urinal _
Name: Water closet
U Address: Water heater
—_ _ _
City: State: ZIP: _ Other.
Phone: Fax: Total
- Minimum fee................ $
too
F('j"
t all jurisdictions accept credit cards,please call juri:diction for more information. Notice: This permit applicationvisa U MasterCard Plan review(at — %) $
expires if a permit is not obtained State surcharge(8%). ..$
Credit card number _ -a_— - — / within I89 days after it has been
Expires
Name of cardholder as shown on credit card —
p accepted as complete. TOTAL..................... ..
S
Cardholder signature Amount J 4404616(&WCOM)
f
PLUMBING PERMIT FEES:
PRICE TOTAL New 1 and 24amlly dwelling's only:
FIXTURES individual QTY sa AMOUNT (Includes all{dumbing fixtures In PRICE TOTAL
Sink 16.60 the dwelling and the firatlo0 It. QTY (sa) AMOUNT
Lavatory 16.60 for each utilityconnection
1Ja_ v One 1 bath _ _ $249.20
Tub or Tub/Shower Comb. 16.60 Two(2)bath 5350.00
Shower Only 16.60 Three-(3)bath $399.00
Water Closet 16.60 SUBTOTAL _
FJ -al 16.80 8%STATE SURCHARGE
Dishwasher _ 16.60 PLAN REVIEW 25%OF SUBTOTAL
Garbage Disposal 18,60
Laundry Tray 16.60
Washing Machine 16.60 j
FloorOrain/Floor Sink 2" 16.60 PLEASE COMPLETE:
3" 16.60
q^ 16.60
Water Healer O conversion J like kind 16.60 J Ounntit b Work Performed
Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/
permit
MFG Home New Water Service 46.40 SinkLav
to
MFG Home New San/Storm Sewer 46, Tub
T
40 or
Tub or Tub/Shower
Hose Bibs 16.60 7 9 Combination
Roof Drains 16.60 ShowerOnly
Drinking Fountain 16.60 Water Closet _
Urinal
Other Fixtures(Specify) 16.60
Dishwasher
-- Garbage Disposal !_
Laundry R?om Tra
--
Washing Machine
Floor Drain/Sink: 2"
Sewer-1 st 100' __35_00 3" _
Sewer-each additional 100' 46.40 04"
Water Service-1st 100' 55.00 Water Heater
Other Fixtures
Water Service-each additional 200' 48,40 —
(Specify)
_
Storm 8 Rain Drain-1st 100' 55.00 _
Storm 6 Rain Drain-each additional 100' 46.40
Commercial Back Flow Prevention Device 46.40 -—
Residential Backflow Prevention Devine' .'7.55 -"
Catch Basin 10.60
Inspection of Existing Plumbing or Specially 627—
'0
Requested Inspections _ er/fir COMMENTS REGARDING ABOVE:
Rain Drain,single family dwelling 6525
Grease Traps 16.60 -- ---
QUANTITY TOTAL
Q. Isometric or riser diagram is required if
Quantitj Total is >9
"SUBTOTAL —
tA _
8%STATE SURCHARGE — - -
J _"_PLAN REVIEW 25%OF SUBTOTAL
(� Re ulred onl If flxtura t .total Is>9 _
(g TOTAL a
W
_j —
I
*Minimum permit fee Is$72.50+8%state surcharge,except Residential Backflow
Prevention Device,which Is$36 25-8%state surcharge
**All New Commercial Buildings require 2 sets of plans with Isometric or riser
Lldiagram for plan review.
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