Permit 4 CITY OF TIGARD
PLUMBING PERMIT
i '; DEVELOPMENT SERVICES PERMIT #: PLM2006 - 10057
i I �j _ 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/16/2006
PARCEL: 1 S 125DD -05301
SITE ADDRESS: 09810 SW VENTURA CT ZONING: R -4.5
SUBDIVISION: WASHINGTON SQUARE ESTATES NO.2 LOT: 061 JURISDICTION: TIG
Project Description: New fixtures no rough.
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: 2 OTHER FIXTURES:
TUB /SHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
ALLEN, JAMES + KATHLEEN
9810 SW VENTURA CT Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 6/14/2006 $72.50
[TAX] 8% State Surcha 6/14/2006 $5.80
Phone : Total $78.30
Contractor:
D & F PLUMBING
4636 N ALBINA AVE
PORTLAND, OR 97217 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 282 -0993
FAX 503- 288 -0604
Reg #: LIC 465
PLM 26 -23PB
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: /d /t �i _ , .‘ ` ...:_a / /
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.
,Jun- 12 -06 1O:34A P.O1
Plumbing Permit Application FOR OFFICE USE ()NIX
f Received Plumb' _
Date/13 : Permit No _IA ....4:e/ - 1O „ 7
C� of Tigard Planning Approval Sewer
g ' , �, Date/13 : Permit No.:
13125 SW Hall II1vd. • ' ,v. • � J Plan Review Other
Tigard, Oregon 97223 ° ' 3s' Dated : Permit No.:
Phone: 503 - 639 -4171 Fax: 503 - 598 -1960 : • • , Past- Review [and Use
use; a .�, I + Dal / : C -e No.:
Internet: www.ci.tigard.or.us �j r'. I I Contact g See Page 2 for
24 -hour inspection Request: 503- 639 -4175 . , Name/Method: ' Su lemental Information.
`,: tea.
• ... ,'i . . 7•TYFE1O i :CDRK i:`�;:' . � ::: 4 • • IEE!' Sg# iEDULE '�fti>�gficclsil'inlofiiiatllon uie'chiekliit = .
New onstructio c ,`
construction ❑Demolition De scrl trot[ Qty. � Fee(ea.) � Total
Addition/alteration / re laccmerit I Other: "' ,. 1 c,# •ti'4b' �19!' _ 1 , . .. , �}�i
' CATE O , SF . bath u a11 ( a " hlu Illy . ec[ton)
1; � �. �.;;�i .'q;ty n`l:"1 "dtb." � 0 .t:�f
RY�.'.OI�TSTRIIOIii; i.;,, R U I bat 249.20 .
0-1 & 2 -Famil dwellin Commercial /Industrial SFR (2) bath 350.00
-9 Accessory Building Multi- Family SFR (3) bath 399.00
Master Builder Other: Each additional bath/kitchen 45.00
.. ''Id�sY nS1FORWATION:ana; O ATIO : jY: Fire sprinkler - sq. ft Page 2
Job site address: 7.9 ve,e) ?4 Cr h':,`,':�s N,,;,.,:Ati ° °i .. :i h_itles'.' 1 .. ?; i w, Tf ,.. : , , • _'' '. . 1
Suite #: Bldg. /Apt. #: Catch basin /area drain 16.60
- Pro pct Name: D ell/leach line/trench drain 1640
,_...., - -. -. G- d �t/
Footing drain (no. linear ft.) _ Pap 2
Cross street/Directions to job site: Manufactured home utilities 110,00
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear R.) Page 2
Subdivision: Lot #: Storm sewer no. linear ft. Pa e 2
Tax ma /P areal #: "' "" Water service (no. linear ft. Pa ire 2
p . ; a i :�; t NP gwtrt vt, i'i ^ iii t , ( ` ' t`'.:.: "
.. '
_ .. . ..D , O d. F .... ? _ �, : �a. a 11 F . ,. .: ., .
_ Absorption valve 1 16.60
f v2 S 4 ti Backflow preventer Page 2
4/9 e0/4‘-ii --- Backwater valve 16.60
/ S ✓ - 2 L Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
]Jectors/sump _ IG_GO
Arne: � 5 7 L6- Expansion tank 16.60
Address: 9, /0 / 5.2r'U C 7.-7 Fixture/sewer cap 16.60
City /Sta_te /Zip: J�� - Floor drain /floor sink/hub 16.60
Garbage disposal 16.60
Phone: i3) 204 - (l pe) Fax: Hose bib 16.60
"E M EMAN ;!? 7 I .Wa•' e; i:. Ice maker 16.60
Name: Interceptor /grease trap 16.60
Address: Medical gas - value: $ Page 2
Primer 16.60
City/State/Zip:
Roof drain (commercial) 16.60 ,
Phone: Fax: .--_, Sink/basin/lavatory _ . 16.60
E -mail: Tub /shower /shower. pan / 16.60
, , E ,, , iP: : Urinal 16.60
"..'MP" :.: � � �!�QI?IY�'LDRw� €��ar.�� i;' .i, ^ -� -;• � ` . . - - - - ,
Business Name: Water closet , 16.60
r L - � � Water heater 16 -60
Address: c ,¢� / ' �y,- Other: - -
City /State /Zip: eei?ri4✓e) 9'72(7 of Permit Fee) $ Other:
- o �' 3 Z` d6f t`.W' C� y .. • .. :lixla':" `.��i ° ! kl'Iii iibinl; ire :ri taFi ' K : :.F: . a 1;
Phone: � Fax: � •� . :.�
CCB Lic. #: tf 65 d Plumb. Lic. #: 26 _.23,20,-.3 subtotal $ O
�1, Minimum Permit Fee 572.50 $ 7 2. �'
Authorized xe 1J . Date: / ^ " 1- O: Residential 13 Plan Review (25 ackflow Minimum Fee $36.25 • y
/o
��,,re. _ -- _..._• -- -- - -. - - - • State Surcharge (8% of Permit Fee) $ �. ev
°� � ' � I (Please print namo) TOTAL PERMIT FEE $ 7 ' . -5 t27
Notice: This permit application expires if a permit is not obtained within All new commercial buildings require 2 sets of plans with isometric or
180 days after It has been accepted as complete. riser diagram for plan review.
*Fee methodology set by Tri- County Building Industry Service Board.
i:\Dsis\Perrnit Forms\PlmPermitApp.doc 01/03
OF TIGARD S � - �, ,,�-
! TY
LDING DIVSION PERMIT 5 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: � _ /005 e: (503) 639 -4171 ction Requests (24 Hrs.): (503) 639 -4175 4 ECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: Ci 8 / () i 244 CLASS OF WORK:
SUBDIVISION: OT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: (, 44-0(e, Pour Time:
Code # Inspection Descri tion Confirm # Contact # Message , ::: 32 0,,,„,„
Corrections /Comments /Instr tions:
9 .. ,..){.2
(P) ic44/ (/) r s-7,0-c_
I1►1 PASS I 1 PARTIAL APPROVAL n CANCEL n NO ACCESS
FAIL ❑ CALL FOR INSPECTION _ ADDITIONAL FEES ASSESSED
Inspector: _ `✓ `____-- Date: (04 ` Phone #: (503) 718- -(2.-y