Permit C ITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 - 00379
DATE ISSUED: 9/25/2008
TrcM 1 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S111 DC - 07300
SITE ADDRESS: 09400 SW BRENTWOOD PL ZONING: R - 7
SUBDIVISION: SUMMERFIELD NO.9 LOT: 491 JURISDICTION: TIG
PROJECT: BAUER
Project Description: Tub to shower conversion.
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: 1 SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
ARLENE BAUER
9400 SW BRENTWOOD PL Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 9/25/2008 $72.50
[TAX] 12% State Surcha 9/25/2008 $8.70
Phone : 503- 639 -3550 Total $81.20
Contractor:
BATHTUB SOLUTION
11747 NE SUMNER
PORTLAND, OR 97220 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 -595 -8827
FAX 503 -595 -6051
Reg #: LIC 165987
PLM PB - 312
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. • • - ru - :reset forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of these rules or dired questions
to O. C by calling 503.24.6.6699 or 1.800.332.2344.
Is- ed By: 1 _ _ ` j i L I �r i Permittee Sig
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.
.
;-. -Plumbing PermitApplication
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17V11, City of Tigard Rok p As a f ' y Pcinit No.; ° C r/Aft, tr'00g77 ■
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r .. -..,,, 11125 SW Hall Blvd , Tigard. OR 97223
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Phone: 503.639,4171 Fax: 503.5 5 98.1960 SO k)
„Nmy: Other Pornill
Inspection Linc; 503.639.4175
,n I . Date Rcuiy/Ry.
Ju • • • 21 See Page 2 for
i. Internet: www.tigard-or.gov
Iv ' _ ,,,A: licd/Meiht.id: IC. Supplemental Information
OIL 41111/11111,CL").'1;i:VI;14,:)t1'1; altlitl!11.1i,',1141:igiVrAl&Alran i Ikeletaltirini ErsiEr, amignalam
: . ,- - . - , -
For special information use checklist
O New construction ['Der ) Mon
- - Description - Q. 1 P,a, 1 Total
%Addition/alteration/replacement 0 Other:
New 1- 2-family dwellings (includes 100 ft, for each utility connection)
it c. TritimVr., !ii . 711;; r A',1, i 3477 ,4),; ...InFtV , • --
■•, t
..nliC i,1, ,,.144.1akilataawg,ii - mi ' - woitl S FR ( bath 249,20
9-4 1- and 2-family dwelling lif Conamercial/industrial SFR (2) bath
._
SFR (3) bath .„, 350.00
399.00
0 Accessory building 0 Multi-family
. ------.
Each additional bath/kitchen 45.00
0 Muster builder 0 Olher;
. ., Fire sprinkler ( sq. ft) Page 2
:IN 1 311% Cialg:T",.071W1022111711: , ..s '. MILO sit, „times
Job sitc address; et 00 31pJ f e Catch basin ur urea drain 16.60
Ci ty/Statc/Z1P: UT:L C .1 0 l- cil-L-4 Drysvell. leach line, or trench drain 16,60
„ .....
Footing drain (no. linear fl.: ) Page 2
Suite/bldg./apt. no.: Project nume:
•
• 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
Storni sewer (no. linear ft.: ) Page 2
, Water service (no. linear tt.: , ) Page 2
Subdivision: T.ot no,:
Fixture or item
Tax mup/pareel no.:
. Absorption valve 16.60
,, . Li t . ,i i ".1 ., ,„. li, • 11 one x,e, Lug ...rkt 11( ' a . . ., i, . ,..,„ . t ■ aLkflow preventer
‘ i f PERO ' ril I KIt . l it ' f ' Al 13 • Page 2
+U .1 , tr Cd,t10 0 A Backwater valve 16.60
..._
Clothes washer 16.60
- • - • '"' Dishwasher 16.60
9
) , Drinking fountain
■ firm ili Mrilimatilifi LI 1-41111 litiligiVRA ofilit 16.60
, ,i,i11. 'o )..tei .. A (I, :V r . ... I I- .. i So7s , 0 '.1, h13 ! ' ", 1 • Ejectorsisurn„ 16.60
. V
Name: 14 irj e A..e r2 c;, ( 2, cr
Expa,Bion tank 16.60
_..,
(..0A1,...it 1 61 i-ixturcIscwer cap 16.60
....
City/Stato/Z1P: (, 1 ‘c eA (..)(6. cr?.. 4 . Floor drain/floor sink/hub 16.60
- • . -
Phone: (11)0 . 3 ‘? ..._ e 5--- e) Fax: ( ) Garbage disposal 16.60
. _
, k 11 VP '4 11 ' ! Il l r i ' VniNe ''‘' 1 5 t° ' IPI't14' i'::1 ' 1 r i .24118e blb .. 16.60
. ..._
16.60
Business name; 6 o-t, ccif r
,
• Interceptor/grease trap 16.60
._
- .
Contact name:
_ E („..; 5 6,.c..EA-e, • . Medical gas (value .
: $ ) Page 2
.,
Address: I /R Primer _ • 16,60
.
city/sta./zip: .- . Roof drain (commercial) 16.60
- -
Sink/basin/lavatory 16.60
Phone: (1752, ) .....5 el 5 - ...- 6 7_1 I Fax: : (Its ) 5 5 - ) c.. ) 5 1 - ( -
. TIM/showcr/showcr pan 16.60
' Q 1.44, _
E-tnuil: .
44 n r,,,, I , , . , e , .. . % 1 C , ) ,.. L , , Urinal 16.60
•• .
1 FLIMPAUSEN , AN 1114E0 Lt . ' 4 '1 ,1 ; ; 1 1, 4 Water closet .
____
Business nume: .A.1.4 '
Water b . eater 16.60
1 16.60
Address: 0 /-* ) L. S./ nAngf Other:
_
_ . -
City/State/Z1?: e r..-Vi ()(L ot.1--4 J.) ' • _.
' Subtotal ,.. a • Minimum permit fee •
: $72.50
Phone; ( 51) 515 - )1, Z Fax: (1 5 • - L,D-.: 1 Residential hacktlow minimum permit fee: $36.25
.
-
CCB Lie,: 1 t 5 9 1- Plumbing Lie. no,: p 2 _piail rvvicw (25% of permit fee)
State surcharge (12% of pennit fee)
Authorized signature:
1-2f)--- AU - ,
• VOTAL PER MIT FEE
,
(Print name: / N) Date: - -7- Z,-5' ..-Dx this penult application expires if a permit is not'obtnined within
- 180 days after it has been accepted ilN complete.
* Fee methodology set by Tri-Counly Building Industry Service Board,
laulidii0Permitsftxtr-rernatAap.ilor. 12/27/0(, 44n 0/02/CUMAVF.11)
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CITY OF TIGARD - s�
BUILDING DIVISION PERMIT #: PLM2008 Qt? :i79
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: ,9126/2008
Phone: (503) 639 -4171 afsrn Orlil ;
Inspection Requests (24 Hrs.): (503) 639 - 4175 _4
INSPECTION WORKSHEET FOR DATE: 9/29/2008 TIME: 7:02AM PAGE: 46
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION: 41900 SW BRENTWOOD PL
L OT #: TYPE OF USE:
,'�Ul+etl�l�.l�FII.:.LI� Nt�.!� X19'!
PROJECT NAME: BAUER
DESCRIPTION: Tun to sl"tower conversion.
OWNER: BAUER, ARI.ENE PHONE #: 50 639.3550
CONTRACTOR: BATHTUB SOLUTION PHONE #: 503-5955 -0827
Inspection Request Scheduled For: Date: 9/7912008 Pour Time:
Code.# Inspection Description Confirm # Contact # Message
320 Plumbing rough-in 075998-01 503 -595 -8527 Y
Corrections /Comments / Instructions:
_ FiOciLt G, 568 I.
-I -;C) 9
, ---„,..._____
14 PASS ❑ PARTIAL APPROVAL ❑ CANCEL . ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
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Inspector: C j∎\\\ Date: CI \25((\ - Phone #: (503) 718-