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Permit C ITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT PERMIT #: PLM2009 - 00028 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/17/2009 PARCEL: 2S 109AD - 02100 SITE ADDRESS: 14550 SW 130TH AVE ZONING: R -7 SUBDIVISION: WOODFORD ESTATES LOT: 013 JURISDICTION: TIG PROJECT: VALLEREUX Project Description: Replace 60 ft. of water service. CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: 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: 100 ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES JERRY & SH VALLEREUX 14550 SW 130TH AVE Description Date Amount TIGARD, OR 97224 [PLUMB] Permit Fee 2/17/2009 $72.50 [TAX] 12% State Surch 2/17/2009 $8.70 Phone : 503- 481 -6147 Total $81.20 Contractor: APOLLO DRAIN & ROOTER SERVICE 2208 NW BIRDSDALE #8 GRESHAM, OR 97030 REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 239 -8801 FAX 503- 669 -9568 Reg #: LIC 49418 PLM 26 -533PB 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: — �' /�( ,�� p 0 Q Q Permittee Signature: 04 ) Q (bh �=` -� 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. - - "Fro'. 17. 2009 7:57AM No. 8389 P. 1 • Plumbing Permit Ap .L' . 1 lE, Building Fixtures . FOR OFFICE USE; UNIX . __ City of Tigard E Received _ ZC']b� 000 8 g� fElk 12 7 2009 I58lem • O • _ • 46 Permit No,: IYI 13125 SW Hall Blvd., Ti �r , 9 2 Plan Review l Phone; 503,639,4171 Far; 503,598,1960 Orher Permit No.: - . Uale/�y: TIGARD Inspection Line: 503,639 OF TIGARD Date Reedy/fly ' tarts: l See Pate 2 for Internet: wrrw.tignrd- :WILDING Sopptonrentolllnformolroo 9tLDi�1G DIVISION, rx'P1✓. WORK ' rrC* SCIII I • - '' ❑ New construction � ~ ❑Demolition Fors aka! hi ormalon use checklist, • Dcscri Ilion « E•a. Total Addition /ollernliori/repineement ❑ Other: New 1- 2- family dwellings (includes 100 (t for each utility connection) ' •., CATEGORY: OF CONSTR(IC"I ION - . SFR (1) bath 249.20 • K l • and 2- Iamily dwelling ❑ Commcrcial/induslrinl SFR (2) bath 350.00 El Accessory building ❑ Multi - family SFR (3) bath 399.00 Each additional bath /kitchen 45.00 ❑ Mosier builder ❑ Other: . .., „ Fire sprinkler ( sq. It,) Page . 2 JOB . . . .• . Site utilities SITE l 1, lV A 1 I N _r1ND LO('AT ►ON. Job site address; r� + 1 th f V Catch basin or area drain 16.60 City /Slate /ZIP: T e r -d ( )/ 9-12-24, Drywell, Leach line, or trench drain 16.60 Suite/bldg. /apt. no,: Project name: Footing drain (no. linear (1.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job sift: --- Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear R.: ) Page 2 Storm sewer (no. linear II.: ) Page 2 Subdivision: I Lot no.: Water service (no. linear II.: f Page 2 • 00 Fixture or item Tax map /parcel no,: -. . ..- Absorption valve 16.60 DESCRIPTION,' O.(' VVnlzl:' • .. f1 D tckflow prcvcnta Page 2 • 11 / I D . .. / pry D 13itekwalervalve - 16.60 2 Clothes washer • 16.60 W0. ti Dishwasher 16.60 - T--�." Drinking fountain 16.60 ❑ PROPERTY- OWNER' . ( f ❑ TENANT r�/ . Cjeclors /suritp 16.60: Name: vt 1 ' r ! �` /Jr _ - ^µ Expansion tank 16.60 Address; '+ . . Future/sewer cap . 16.60 City /State/ZIP: Floor drnin/floorsinldhub • 16.60 Phone: ( fax: (. ) Garbage disposal 16.60 ~� • ❑ CQNTA.CT:.hEttSON`::; ::,,. Hose bib • 16.60 p nrr>,ICANT . ..... ... ranker . ',lee • ' 16,60 • Business name: . lnlerccptor /grease trop . 16.60 Contact name: • Medical gas (Value: S' `) .. • . • Paget' . • Address; . Primer ' 16.60 City /Slate /ZIP: ' Roof drain (commercial) 16.60 • • Sink/basin /Invrltory 16.60 Phone: ( ) . • f fox:: ( ) • . • . Tub /shower /shower pan 16 60 E- mail: w :'.- rum t) t 16.60 r ' , . ,. ;• '`CONTRAc- 'QIt, ... Water close) 16.60 • Business name: r dIr / M, 0 r • .. .. • , r • gp • , . c Water treater 16.60 • Address: © 1/L) j l'`r� � ,' / • ' -' ,.,J U O tlicr . : _ . . City /State /ZIP: / .___41.0 V I 0 0170"),-)O ti J Ivlinnnti pernii(.Rc: •572 : 50 Phone: ( i • no Fax: ( j Lpw 9 • 9 5`1' -M Resid backIloty ntirliffti111r.pennit fee; 536,255 72 CCI3 Lic.: ! 4 iv •Plumbing Lic, no.: / � . Plan review (25% of permit fee) Id Authorized signature: / L ` : St ate surc harge (12% of permit fcc) °o'7 0 _� TOTAL PERMIT FEE Print name: ^�L I Emffp This permlt application expires if a permit is not obtained within . • • 180 days after it has been accepted As complcle "Fee methodology set by Tri- Counly Building Industry Service Board, :U duildinglP ermirs\PI.MF.PermitApp ,doe 12/21/06 '-1- 10- 1616T(lo /O2/COTUWFe),. 1 A N If's CITY OF TIGARD ,_, .;..- , 1 it 3 BUILDING DIVISION 1577 PERMIT #: PLM2009-00028 13125 SW Hall Blvd., Tigard, OR 97223 DATE I SUED: 2/170 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 212W2009 TIME: 7: JAM PAGE: 5 SITE ADDRESS: 14650 SW 130TH AVE CLASS OF WORK: SUBDIVISION: WOODFORD ESTA I ES LOT #: 013 TYPE OF USE: PROJECT NAME: VALLEREUX DESCRIPTION: Replace 60 ft. of water service. OWNER: VALLEREUX, JERRY & SHELLEY PHONE #: 603-481-6147 CONTRACTOR: APOLLO DRAIN & ROOTER SERVICE .i PHONE #: 503-239-8801 . kyv- \4,4 6 Inspection Request Scheduled For: Date: 2120/2009 Pour Time: 01/fr Code # Inspection Description Confirm # Contact # Mes Q 399 Plumbing final 080685-01 503-239-8801 ents Corrections/Co auctigns: t f o _..e i ' \ 4 ■ i \,.- C \? ‘ /---)u- u ,,Q.,4 \9) P IF_L) • , ( 3-36) uuv___c _ir-_ut qt. PASS 1 PARTIAL APPROVAL fl CANCEL , NO ACCESS FFAIL CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED Inspector: K1 (.1 Date: 2 71D/ Phone #: (503) 718- 7 4 2-11