Permit CITY OF TIGARD
PLUMBING PERMIT
. COMMUNITY DEVELOPMENT ` PERMIT #: PLM2009 - 00009
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/14/2009
PARCEL: 2 S 110 B D -00901
SITE ADDRESS: 12035 SW BULL MOUNTAIN RD ZONING: R -2
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: WHITNEY
Project Description: Replace drain line for (2) clothes washers, (1) dishwasher, and (1) sink.1/21/2009 ADDED (1)
backwater- .Laivo ae other -
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF • WASHING MACH: 2 BACKFLOW PREVNTRS: •
OCCUPANCY GRP: FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: C1
TUB /SHOWERS: SEWER LINE: -- f
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: 1 RAIN DRAIN: ft
Owner:
FEES
PAUL & DIA WHITNEY
12035 SW BULL MTN RD Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 1/14/2009 $72.50
[TAX] 12% State Surch 1/14/2009 $8.70
Phone : 503-620-3502 [PLUMB] Addl Permit 1/21/2009 $16.60
[TAX] 12% State Surch 1/21/2009 $1.99
Contractor: Total $99.79
ARS RESCUE ROOTER
PO BOX 2830
CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 235 -8784
FAX 503- 491 -2932
Reg #: LIC 127325
PLM 34 -168PB
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: Q 1`.V-\ s L Permittee Signature: SO 0 . CN 1 (J.
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.
s , t , ail-24-2004 19:35 .. • - a .. of d b occe P 001
. ` Plumbing Permit Application �` �� U�'��
Building Fixtures RECEIVE
Building FOR OFFICE USE ONLY
City of Tigard JAN 2.1 2009 Received
IN 0 . a 1312: SW Hall Blvd._ Tigard, OR 97223 Date/B ii �r /
Phone: 103.639. t 171 Fax: 503.598.1 n� Plan Re • aO,4+'_
1.1 l 1 OF TIGARD Da�c.•B, �i ' rli
rtr:nK►� Inspection Line: 503.639.4175 �ateRead .
I nternet: www. tigard- or, BUILDING DIVISII otified.'Method �
TYPE OF WORK �/�a �► / "
❑ New construction 9 Demolition For special information use checklist,
Descri non ( t '. Ea. Total
P Addition /alteration /replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR ( 1) path EMII
12 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) hush 399.00
❑ Mastcr builder ❑ Other: Euch additional bath/kitchen 45.00
Fire sprinkler ( _ sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION
Job site address: / / 6 p.. ,04 1 Catch basin or area drain 16.60
M / A MI Drywell, leach line, or trench drain 16.60 —
Suite/bldg. /apt. no.: Project name: �,� Footing drain (no. linear ft.: ) Page 2
Cross street directions to job site:
Manufactured home utilities 1 10.00
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linrur ft.; ) Page 2
Storm sewer (no. linear ft.: _ ) Page 2
Subdivision; Lot no.: Water service (no. linear ft.:. ) EMI
Tax map /parcel no.: Fixture or item
Absorption valve 16.60
DESCRIPTION OP WORK BackOow preventer Page 2
'. 131111g K "'..4— j , L X Backwater valve
MEI 16. rf/j,►
�.�i :i/4 J r Clothes washer 16.60
Dishwasher 16.60 MIN
li PROPERTY OWNER ❑ TENANT Dunking fountain 16.60
/, / Ejectors /sump MI 16.60
Expansion tank MIMOriliMil
Address: tr Q,.? ..4M1 14/ ap r MV7 : r
City /State /ZIP: /• /'
/1.Y /J
Floor d • .
' it ��� -I xLx• ( ) Garbage disposal 16.60 -
V ❑ CONTACT PERSON Hose bill � �
lee maker _ 16,60 r
Business name: ARS dba JACK ROWK (Rescue Rooter
interceptor /grease trap 16.60
Contact name: JOYCE DENNIS Medical gas (value. $ �) Page 2
Address: P.O. BOX 2830 ____ Primer 16,60
City /State /ZIP: CLACKAMAS, OR 97015 Roof drain (commercial) 16.60
Phone: (503) 235 -8784 Fax: : (503) 491 -2932 Sink/basin/lavatory 16.60
Tub /shower /shower pan 1 6,60
E -mail: JOYCEiaJACKHOWK.COM
Urinal 16.60
• CONTRACTOR Water closet 16,60
Business name: ARS dba JACK HOWK /Rescue ROOter Water heater 16.
Address; P.O. BOX 2830 Other:
City /State/G1?: C.LACKAMAS, OR 97015 Subtotal w 4
Phone: (503) 235-8784 Fax: (503) 491-2932 Minimum permit fcc: $72.50
_ Residential buck0ow minimum permit fee: $36.25
CCB Lie.: 127325 Am. P umbing Lic. no.: 34 - 168 P Plan review (25% of permit fcc)
State surcharge (12% of permit fee) 1�/
Authorized signature: , � , / m �.....�
t/J . i � ! TOTAL PERMIT FEF` �
il. i g /
/ EIS Mg. i. This permit application expires if a permit Is not n ix ` "
180 days after it has been accepted as co • etc.
Fee methodology set by Tri -County Building Industry Service Boa
i -P. Please FAX BACK t • 03- 491 -29321 q
_....,_
/0
CITY OF TIGARD
PLUMBING PERMIT
n
COMMUNITY DEVELOPMENT PERMIT #: PLM2009 -00009
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/14/2009
PARCEL: 2S110BD -00901
SITE ADDRESS: 12035 SW BULL MOUNTAIN RD ZONING: R -2
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: WHITNEY
Project Description: Replace drain line for (2) clothes washers, (1) dishwasher, and (1) sink.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: 2 BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: 1 RAIN DRAIN: ft
Owner:
FEES
PAUL & DIA WHITNEY
12035 SW BULL MTN RD Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 1/14/2009 $72.50
[TAX] 12% State Surch 1/14/2009 $8.70
Phone : 503- 620 -3502 Total $81.20
Contractor:
ARS RESCUE ROOTER
PO BOX 2830
CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 235 -8784
FAX 503 -491 -2932
Reg #: LIC 127325
PLM 34 -168PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: \\( J1 J ` " " A fl ( lit AN Permittee Signature: Q1 a tiu •
Call 503639.4175 by 7:00 a.m. for an inspection that business day. �/
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
JUN -17 -2004 17:32 P.001
- Plumbing Permit An licatio l E EIVE
. 11 ,
Building Fixtures FOR OFFICE USE ONLY .
City of Tigard JAN 14 2009 Received
n 1 312 S W Halt Blvd,. Tigard. OR 97223 Dsle/$y. l • I • ■ '• Permit No . ea rn cei . r • ti, L
s Phone: 503.639.4I7I Fax: 503.598. 9f TY OF TIGAR !i Other Permit No.. • Inspectio Line: 503.639,41 1 p� /1
7' It I l g BPJI.L�IING mist to Read la See Pa
Internet: uww.ti ardor. vv 6r ae 2 for
utit Sun .lemental Information
TYPE OF WORK FEE* SCHEDULE
El New construction ❑Demolition - Far special lufirmation use checklist
tif Description Qty Ea Total
Addition/alteration/replacement Q Other,
New (_ 2- family dwellings ( includes 190 ft for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I I bath 249.20
Nr1- and 2- family dwelling ❑ Commercial /industrial SFR (21 bath 350.00
IM
❑ Accessory building ❑ Multi - family SFR 131 bath 399,00
El Master builder ❑ Other Each additional bath/krtchen 45.00 -
Fire sprinkler (_ s>. R.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address R.o y1ZIMvjE Catch basin or area dram 16.60
City /State /ZIP: / lr,L_ , Drvwell, leach line, or trench drain 1060 -
Suite/bidg. /apt, no.: Project name: �,m� ! Footing drain (no. linear It: ..) � 1
Cross street/directions to job site: ��•�•' Manufactured home utilities 110.00
Manholes 16.60 =
Rain drain connector M 16,60
Sanitary sewer (no. linear ft.: 1 Km
Storm sewer (no, linear fl.; _) - Page 2
Subdivision; Lot no.: Water service (no. linear ft.: �) Page 2
Tax map/parcel no.; Fixture or Item
Absorption valve 16,60
'DESCRIPTION OF WORK Inn
,�/L. zr✓i91 � r ` Back proven ter
� , 1 ,� • ; Backwater valve 16.60 0
Mill,
1 f�� �W ff f - Clothes washer 10211111 16 60 %� /�t
Drn ngfo ME 16 IT ..4...
Pi PROPERTY OWNER ❑TENANT Drinking fiuniain 16.60
Ejectors/sump 1E21
�,tL ' Expansion tank 16,60
A . G.r� 1 1 ki I F /sewer cap In 16.60
City/State /ZIP: ` -% ,t.!/ ll71 / Floor drain/floor sink/hub MI 16.60
Phone: ( I _...../ �� �� ) Garbage disposal NMI 16,60 ,
-1 Q CONTACT PERSON Hose bib ME 16.60
Ice maker 16,60 i
Business name: ARS dha JACK HOWK /Rescue Rooter
-
interceptor/grease trap
Contact name: JOYCE DENNIS _ Medical gas (value; $ )
Address: P.O. BOX 2830 Primer M 16 60 .
City /State/7[P: CLACKAMAS, OR 97015 Roof drain (commercial) 16.60 NM
Phone: (503) 235 -8784 Fax: : (503) 491 -2932 Sink/basin/lavatory 16.60 worm
pan Tub /Shower /shower
E -mail: JOYCE JACKHOR'K.COM P 16.60
t
Urinal 16.60
CONTRACTOR Water closet
• 16,60
Rosiness name: ARS dbe JACK HOWK /Rescue Rooter Water heater 16.60
Address: P.O. BOX 2830 Other: 1.1.11.1
City /State /LIP: CLACKAMAS, OR 97015 Subtotal M
Phone: (503) Fax: (503) 491
235 -8784 491-2932 Minimum permit fee: 572.50 1/J 4
-293_ Residential backtlow minimum permit tee $36,25 G "
CCB Lie.: 127325 ,_ Plumbing Lie. no.; 34 -168 P Plan review (25% of permit fec)
Authorized signature: \'`A , State surcharge (12 "i" of permit tee) IOWA
f TOTAL PERMIT FEE Iran
,o rrrioni Date/4 i r Thin permit application expirca if a permit is not own Ile* n -
1St) days after it has been accepted as compic e,
t!2uilding \Permits \I't. MF -e. Please FAX BA _ - .to: 503 -491 -2932'
"Fee methodology set by Tri -County Building Industry Service Board.
...
CITY OF TIGARD .. .. .
1.1 a. Arce-
BUILDING DIVISION ,, .. PERMIT #: PLM2009-00009
13125 SW Hall Blvd., Tigard, OR 97223 A ,Do (A DATE ISSUED: ' /14/2(109
Phone: (503) 639-4171 h011i teit r , ,,6
Inspection Requests (24 Hrs.): (503) 639-4175 ....44 r''..-- V I 653 /d
- I
INSPECTION WORKSHEET FOR DATE: 1/20/2009 TIME: 7 PAGE: 3
SITE ADDRESS: i2036 SW BULL MOUNTAIN RD CLASS OF WORK:
SUBDIVISION: LOT #: .......-- TYPE OF USE:
PROJECT NAME: w
DESCRIPTION: Replace drain line for (2) clothes washers, (1) dishwasher, and (1) sink.
OWNER: WHITNEY, PAUL & DIANE PHONE #: 503-620-3502
CONTRACTOR: ARS RESCUE ROOTER PHONE #: 503-235-8184
Inspection Request Scheduled For: Date: 1/20/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 07986'2-01 503-860-3122 N
Corrections/Comm nts/Instructions:
1\1 1141 --- T U/0140 Ci\A Ct 4\A OA — ,e'N
1
P
, ,- , , , , _ . ( A o.s Arvi
. `74/(■4_ k 2
0
fl PASS pi PARTIAL APPROVAL CANCEL El NO ACCESS
n FAIL fl CALL FOR INSPECTION I ] ADDITIONAL FEES ASSESSED
Inspector: Date: ) t Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2009 -00009
13125 SW Hall Blvd., Tigard, OR 97223 DATE - D: 1, 14/ 3009
Phone: (503) 639 -4171 N �r��n a
Inspection Requests (24 Hrs.): (503) 639 -4175 �!+ , 1 i.. /
INSPECTION WORKSHEET FOR DATE: 1/22/2009 TIME: 7.00A: PAGE:
SITE ADDRESS: 1e°t136 SW BULL. MOUNTAIN pr, CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: WHITNEY
DESCRIPTION: Replace drain line for (2) clothes washers, (1) dishwasher, and (1) sink.1 /21/2009 ADDED (1)
haclorater valve as other.
OWNER: WHITNEY, PAUL & DIANE PHONE #: 503 - 520~3502
CONTRACTOR: ARS RESCUE ROOTER PHONE #: 503 .B7F4
Inspection Request Scheduled For: Date: 1/22/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 079932-01 W3-850-3422 422 N
Corrections /Commen s /Instructions:
p 1.--1.-__ t It_ /6 ---- a -1(1---- --
1 —y■./ 'T i" 1Zc S C .
ff 4. cIr •6C-;,--
C 4-� ' ii•e I1L.-S 1
n
rn4 L s4
vii:j I Z
v
. •/ - i pez1/4."! - -b TIL.e. ALA/L1Z. Corv%---odtc_K..".„,‘
,/I PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
1 , 4% Inspector: Date: Phone #: (503) 718-