Permit ., CITY OF TIGARD PLUMBING PERMIT
= t COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00285
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/7/2008
PARCEL: 1S133DC-18500
SITE ADDRESS: 13143 SW LAURMONT DR ZONING: R - 12
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK LOT: 040 JURISDICTION: TIG
PROJECT: PIERCE
Project Description: Installing backflow preventer.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
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: ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
CHRISTOPHE PIERCE
13143 SW LAURAMONT Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 7/7/2008 $36.25
[TAX] 12% State Surch 7/7/2008 $4.35
Phone : Total $40.60
Contractor:
D & F PLUMBING
4636 N ALBINA AVE
PORTLAND, OR 97217 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 282 -0993
FAX 503- 288 -0604
Reg #: LIC 465
PLM 26 -23PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952- 0001 -0010 through OAR 952- 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
•
Issued By: j Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Jul 03 08 04:46p D & F PLUMBING 503 -288 -0604 p.1
rtuiltuan rermit Application 0 ��`)
- 't�,uilt.ing Fixtures
F OR OFFICE USE,O �l n f l_s . ..r 't
City of Tigard ` 1`` ® t�� Re
E7
'r 13125 SW
Hall Blvd., Tigard, OR 97223 U4 p�sya-, n gy Date.rBy: 'J ? (78 Perr. it No.: f�i�i����
Phone: 503.639.4171 Fax: 503.59$.1960 c ,,..ri n Reciew J f
1 1 t e; By
Other Permit r o.:
I IGARD Inspection Line: 03.639.417 ` v1S
Internet www. ig 03 1C 1 ' `(y�? Date Read} %B y: � u 121 Sec Page 2 far
0 5 )10. V Notified/Method. Supplemental Inform uti
TYPE OF WORK FEE* SCHEDULE
❑ New constructionEl De olition For special ia/ormatiun use checkiiyr.
Add (riot; /alCCrati on/re pine cm eut l Description Qty. i Ea. i Total
El New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)badu
_ 249.20
I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
ill Accessory building El Multi-family SFR (3) bath 399.00
❑ Master builder Each additional bath /kitchen
❑ Other: 45.00
JOB SITE INFORMATION AND LOCATION Fire sprinkler ( sq. ft.) p abe 2
Site utilities
Job site address: ?�! [1 . i / _
7/6-;:,-_,W49 7 y t �� 4_ Catch basin or area drain 16.60,
City /State /ZIP: �.,
f 3 Drvwell, leach line, or trench drain 16.60
Footing drain (no. linear ft,: ) Page 2
Suiterbldg. /apt, no.: I Project name:
Cross street/directions to job site: Manufactured home utilities 1 10.00
Manholes 1E60
—
, Rain drain connector 16.60
-
Sanitary sewer (no. ling ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: Lot no.: Water service (no. lin ear ft.: _) Page 2
Tax maplparceI no,: Fixture or item
DESCRIPTION OF WORK Absorption valve 16.60
_ Back llow proven ter / Page 2 ".y�
i isi` 1 .e : : , GfTr Z 7 / ) /;giL' jT C- Backwater valve :6.60
12f1 ' .`'U , Clothes washer 16.60
Dishwasher 16 60
El PROPERTY OWNER - Drinking fountain 16.60
❑ TENANT
Name: ,. % /y � l / - �C�
16.60 Ejectors /sump 16.60
—
Address:
/ / - Expansion tank
— Fixture/sewer cap 16.60
City /State /ZIP: Floor drain /F :oor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
❑'APPLICANT 0 CONTACT PERSON I Hose bib 16.60
t
i_
Business name: Ice maker 16.60
• Interceptor /grease trap 16.617
Contact name:
Medical gas (value: 5 ) Page 2
Address: 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
Urinal 16.60
CONTRACTOR
J � r Water closet 16.60
Business name: %V,r /7/47(1,/,/W1?"' /r Water heater
C, _ 16.60
Address: (//% ',- d /774-I. Other:
City/State/ZIP: jL �� Gf+ 72/7
Subtotal
or Phone: (" ) y'
�y Fax: ( ) '� Minimum permit fee: 572,50
j -� 07 Residential backtlow minimutn permit fee: $36.25 0,1-7
CCB Lie.: ` Plumbing Lie. no.: Plan review (25% or permit feet .---
Authorized signature: f (� Stale surcharge (12% of fee)
7 �� /
me:. -1�ill
TOTAL p-
OT- 1LPERh41TFGC - l�(rr'
Print n
— / > - - - t - Date: -- - -- - - - " - - - - - nispermit application expires if a permit is not obtaine no
180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Bu'.lding Industry Service Board.
IiOttL lIn ,l'crntiiOOPLMn.- Pcrmithp:r.doc 12/77,tiG »0 iGICT(Is..'lo.coM1i \L'8n)
INSPECTOR'S SIGNATURES ARE NQT,
Inspections Required for: �Li'7 w- p( ,0, 8'S REQUIRED ON GREEN INSPECTION CARD.
I ✓ Code I Inspection Description 1 PASS Date 1 By 1 ✓ Code Inspection Description PASS Date 1 By
BUP - Building Permit ELC - Electrical Permit
405 Excavation • 105 Underground /slab cover
•
410 Fill 110 • Temporary electrical service
415 trading 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 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
915 Fire alarm rough -in • 305 Plumbing underslab
310 Crawl drain
920 Suppression trip test 315 Post /beam plumbing
995 Misc. inspection:
998 Alarm final 320 Plumbing rough -in
999 Sprinkler final 322 Shower pan
. 330 Water service
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:\ Building \Forms \InspCard- AOP- Blankdoc 02/02/07