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Permit ,o 7 ° CITY OF TIGARD COMMUNITY DEVELOPMENT PLUMBING PERMIT PLUMBING PLM2007 -00561 TIGAR DATE ISSUED: 12/18/2007 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S112AC -01700 SITE ADDRESS: 15065 SW 74TH AVE ZONING: I -P SUBDIVISION: FANNO CREEK ACRE TRACTS LOT: 016 JURISDICTION: TIG PROJECT: INTERSTATE ROOFING Project Description: Repair 75' of stormline. CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM 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: ft DISHWASHERS: RAIN DRAIN: 75 ft Owner: FEES INTERSTATE DEVELOPMENT LLC 15065 SW 74TH AVE Description Date Amount PORTLAND, OR 97224 [PLUMB] Permit Fee 12/18/2007 $72.50 [TAX] 8% State Surcharl 12/18/2007 $5.80 Phone : Total $78.30 Contractor: MIKE PATTERSON PLUMBING 15028 S MITCHELL LANE OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS Contact # : PRI 503 632 - 7374 FAX 503- 632 -5647 Reg #: LIC 81746 PLM 3 -359PB 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 9 or 1.800.332.2344. Issue By: _> �=,(�A Permittee Sign. ure: ,I � • , I ---- 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. ti Plumbing Permit Ap licati c�� p rOtt o ric[: rsv ()Ni City of Tigard DEC 1. b 2001 Received / /._ 0 7 .. • 13125 SW �© � oDS(o/ Hall Blvd., Tigard, OR 97223 Date /By: a- S Permit No. L// d7- Phone: 503.639.4171 Fax: 503.598 V OF. 7,�191i7 Plan Review Ins ectionLine: 503.639.4175 p���ppdd�g6ppA(� Notified/Method: �;¢��q pp Date/By: OiherPermitNo.: f I G ,� F n Internet: wp IC1tU�C.1J1tMV11.11 N ISPO�`� Date Ready/By: H Sec Page o ww.6gard - or.gov ,t2.91721.1 Supplemental 2 lo formation TYPE OF WORK FEE* SCHEDULE ❑ New construction ❑ Demolition For special information use checklist. g Addition /alteration/replacement ❑ Other: Description 1 Qty. Ea. Total New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath , 249.20 ❑ 1- and 2- family dwelling lid Commercial/industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi - family SFR (3) bath 399.00 Each additional baetlkitchen 45.00 ❑ Master builder ❑ Other: JOB SITE INFORMATION AND LOCATION Fire sprinkler ( sq. ft) Page 2 L-1 1 Site utilities , Job site address: 1 , S I --'j vl -t-- • v .., ' Catch basin or area drain ` p 16.60 City/State/ZIP: IP' I , rt 1 l4. i G a 722 Dtywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Project name: 1 e( 1 - it.re ' ■-ye Footing drain (no. linear ft.: ) Page 2 Cross street/directions to job site: I Manufactured home utilities 1 10.00 Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear fl.: 1' i) , Page 2 55 0 0 Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2 Tax map /parcel no.: Fixture or item Absorption valve 16.60 1 DESCRIPTION OF WORK Baclflow preventer Page 2 i - V tc Li Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 Al PROPERTY Drinking fountain ❑ TENANT 16.60 ROPERTY OWNE' Name: r t Ejectors /sump 16.60 Address: `_ `.• ' - -tom i. .. • 14. Expansion tank 16.60 Fixture /sewer cap 16.60 City,'State /ZlP: Floor drain/floor sink/hub 16.60 Phone: ( ) Fax: ( ) Garbage disposal 16.60 ❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60 Business name: Ice maker L6.60 Contact name: Interceptor /grease trap 16.60 Medical gas (value: $ ) Page 2 Address: Primer 16.60 City /StatefZIP: Roof drain (commercial) 16.60 Phone: ( ) Fax:: ( ) Sink/basin / lavatory 16.60 E-mail: Tub/shower/shower pan 16.60 Urinal 1660 CONTRACTOR Water closet 16.60 Business name: VI, I a. u � ( W ater h 16.60 Address: 1 50 2 U. } l Other: City/State /ZIP: () Yel oyl CA {'(.� Fax: U p II S Subtotal 35 - Phone: ( ) L032- �I �� es : �C�3 Minimum permit fee: $72.50 1 L052-- 5 (p t-1 -7 Residential back - flow minimum permit fee: $36.25 CCB Lie.: 0 , 7 q w Plumbing Lie. no.: 3.3 p E Plan review (25% of permit fee) Authorized signature: -Ia. State surcharge (8 %of permit fee) CD.S0 p � TOTAL PERMIT FEE '�, I Print name' \jr 11 i -"r,I� -Be 1 (t'} Date: (.2/ l g f o 7 1 This permit application expires if a permit is not obtained within J 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. Z'd L1799 - £09 6u!gwnld uosaa)ind amW dZ6 Z0 LO 86 oeo CITY OF TIGARD BUILDING DIVISION PERMIT #: PLIVI2007-00561 , 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 121 Phone: (503) 639-4171 hs41901?' Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 12/28/2007 TIME: 7 PAGE: 71 SITE ADDRESS: 16065 SW 74TH AVE CLASS OF WORK: SUBDIVISION: FANNO CREEK ACRE TRACTS LOT #: 016 TYPE OF USE: PROJECT NAME: INTERSTATE ROOFING DESCRIPTION: Repair 75' of stormline. • OWNER: INTERSTATE DEVELOPMENT LLC, PHONE #: CONTRACTOR: MIKE PATTERSON PLUMBING PHONE #: 503-632-7374 Inspection Request Scheduled For: Date: 12/2812007 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 062233-01 503-632-7374 Corrections/Comments/ Instructions: Co v r-e--A A-13 C 9 a PASS fl PARTIAL APPROVAL D CANCEL n NO ACCESS n FAIL CALL FOR INSPECTION E ADDITIONAL FEES ASSESSED Inspector: (n) Date: 1 2-1 2,q - 1 Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION' PERMIT #: pt_M7807 00561 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/18/2007 Phone: (503) 639 -4171 /�min��NUi��flh Inspection Requests (24 Hrs.): (503) 639- 4175 __� INSPECTION WORKSHEET FOR DATE: 17119/2007 TIME: 7:00AM PAGE: 39 SITE ADDRESS: 15065 SW 74TH AVE CLASS OF WORK: SUBDIVISION: FANNO CREEK ACRE TRACTS LOT #: 015 TYPE OF USE: PROJECT NAME: INTERSTATE ROOFING DESCRIPTION: Repair 75' of storrnline. OWNER: INTERSTATE DEVELOPMENT LLC, PHONE #: CONTRACTOR: MIKE PATTERSON PLUMBING PHONE #: 503-632-7374 Inspection Request Scheduled For: Date: 12/19/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 340 Storm drain 061820 -011 503- 632 -7374 Y Corrections /Comments /Instructions: V `e`r 5 7 q I 07 -z 4A- L.-- R 60 N.-) Ov R co ' 6- I C �i° lam,- �e v - `:)". 4 -. i 1 c -o s J PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: ( - D Date: v1\ \c\:01 Phone #: (503) 718-