Permit n CITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2006-00450
44- 13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171 DATE ISSUED: 10/2/2006
PARCEL: 25111 AC -02200
SITE ADDRESS: 14725 SW 92ND AVE ZONING: R -4.5
SUBDIVISION: PINEBROOK TERRACE LOT: 063 JURISDICTION: TIG
Project Description: Upsize washing machine standpipe.
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: OTHER FIXTURES: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
DELORIS WOMACK
14725 SW 91ST. ST. Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 10/2/2006 $72.50
[TAX] 8% State Surcha 10/2/2006 $5.80
Phone : 503 -639 -5448 Total $78.30
Contractor:
CROWN PLUMBING
5429 SE FRANCIS
PORTLAND, OR 97206 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 771 -9449
FAX 503- 771 -9454
Reg #: LIC 42671
PLM 34 -70PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 -0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: Permittee Signature: r —
Call 503-639-4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
10/02/2006 09:42 5037719454 CROWN PLUMBING PAGE 02
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Plumb Permit Application rt t + •
1.1.)R (11••1'1cE vsE oNI.I
City of Tigard tt1 Recd
13125 SW Hall Blvd.. Tigard, OR 97223 -! 2�r 1 Dnteive /0 GG ,dam PcumitN , I�b�D 0
Phone; 503.639,4171 Fax 503,598.1960 y� „, v
24- Hour Inspection Line: 503.639.417$ o ' , R�" 711 ')] ( ihhcr Permit No.;
Internet! www.ci.tigard,or.us ), „ � 9 1 --
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.-� YC' pl7
. o r .. ,. . � .7... Supplemental ,- � o
can information
0 New construction � r ' ; ` ; ;” "`
❑ D emolition For special iniormaiion use checklist
►.� Addition/alteration/replacement Desaru�tion Qty. Fa Total
❑ Other,
Ncw I - 2 family dwellings (includes 100 ft, for each utility connection)
i, • . ,.,. CAT OF CONSTRV `Iblir ",. - :., .• • . SFR (I) bath
249.20
0 1 - and 2-family dwelling El Commercial/industrial SFR (2) bath
350.00 `
El Accessory building
■ SFR (3) bath 39900
■ ■
Each additional bath kitchen 45.00
a ; 0 , 0 0 0 Fire sprinkler ( sq. ft,) Pagc 2
Jbb site Site utilities
address: Catch hasin or area drain
1
drain 16,60
Suite/bldg./apt. no.; Project s Footing
lvlanufactured home utilities 110,00
Cross street/directions to job site:
Manholes .1
connector .Rain drain al
Sanitary sewer (no. linear ft.! _ ) Page 2
Storm scwer (no. linear ft.: 1 Page 2
• Water service (no. linear ft.: ) . Page 2
Fixture or item
Tax map/parcel no.:
DEsCrtreirmiv •
Absorption valve 16.60
REPLACE WASHING i'IACHUNE STANDPIPE WITH UPSIZED ,
+1
Clothes washer I Dishwasher 16.60 -
ir_ 0 16,60 •
i 1 ] 6.60
.Expansion tank Address: 14725 SW 92" A VF,NUE
.1
Fixture/sewer cap 16.60
City/State/ZIP: TIGARD, OR 97224 Floor drain/floor sink/hub 16.60
Phone: (503)639 -5448 Garbage disposal 16.60
k e 1.6.60
13usincss name: CROWN PLUMBING
16,60
Contact name DENNIS UN, 1 ' 0 1 1 " = .16.60
Page 2
Address: 5479 SE FRANCIS STREET Primer 16.60
97206 Roof drain (commercial) 16.60
Phone: I I . I J
pan 16.60
Urinal 16.60
CONTRACTOR
closet Water ♦1
Business neme: CROWN PLITMBING Water heater 16.60 .
Addre,ss; 5479 SE FRANCIS STREET Other:
Subtotal
City/State/ZIP: PORTLAND, OR 97206
I I 1
_ . . •
CCB Lie,: 42671 I �1F Plan review (25% of permit fce)
ill
Authorized signature: A Pr 1 r State surcharge (8% of permit fee) e,
TOTAL PERMIT FEE 7 te.2(9
Print name; Dennis Underwood Date: 10/2/2006 This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
"Fee methodology set by Tri- County Building Industry Service Board,
i:\ Buifdlna \Permitx\PLM- POrmithoodoc 12/03 4 10 - 1616T(10 /02 /COM/W1 m)
CITY OF TICARD
BUILDING DIVISION PERMIT #: PLM200&00450
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/2/2006
Phone: (503) 639 -4171 , ' ("
Inspection Requests (24 Hrs.): (503) 639 -4175 J `'I �..
INSPECTION WORKSHEET FOR DATE: 10/612006 TIME: 7 :03AM PAGE: 39
SITE ADDRESS: 14725 SW 92ND AVE CLASS OF WORK:
SUBDIVISION: PINEBROOK TERRACE LOT #: 003 TYPE OF USE:
PROJECT NAME: WOMACK
DESCRIPTION: Upsize washing machine standpipe,
OWNER: WOMACK, DELORI S PHONE #: 503 - 639 - 5448
CONTRACTOR: CROWN PLUMBING PHONE #: 503- 771 -9449
Inspection Request Scheduled For: Date: 10/642006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 037792-01 503-771-9449 N
Corrections /Comments /Instructs s: • ----
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1
/ 7 /
V T / PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: PI v (-- Date: / / Phone #: (503) 718 ?�
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