Permit l ON
• "\\ � � CITY OF TIGARD PLUMBING PERMIT
° . COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00065
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/15/2007
PARCEL: 25111 BA -04000
SITE ADDRESS: 14100 SW 98TH AVE ZONING: R -4.5
SUBDIVISION: MCDONALD ACRES LOT: 015 JURISDICTION: TIG
PROJECT: BLACK
Project Description: Relocate drain for tub to tub conversion.
CLASS OF WORK: OTR 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:
TUB /SHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
DICK BLACK
14100 SW 98TH AVE Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 2/15/2007 $72.50
[TAX] 8% State Surcha 2/15/2007 $5.80
Phone : 503- 722 -3510 Total $78.30
Contractor:
MRP SERVICES
PO BOX 33585
PORTLAND, OR 97292 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 -652 -2626
FAX 503- 241 -6565
Reg #: LIC 106824
PLM 3 -265PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature: .,4-e c : ) ,
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
02/1512007 16:00 5032416565 MRP PAGE 02/02
Plumbing Permit Applica '__ � � FoR OFFl: i� tISis ONL.
City of Tigard Fkt Rec „ Y •
I u Permit No. �- / / CT itIL
13125 SW Hall Blvd_, Tigard, OR 97223 C 2��� Plan Rovew D ate /B • - 7
Phone: 503,639.4171 Fax: 503.598,1960 /_!•++ yh11 - / {l' Plany:
r: k 'I', \ Other Permi
24.. Hour Inspection Line: 503.639,4 175 ; 1
Internet www.ci,tigard.or.us CITY fir 1 ttil� t - . tote Rcad} " /By furls: 0 Sao f for
t n vl 1 t Ne iflmvMetbod melt suppleental I information
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❑ New construction ❑ Demolition For special information use checklist
'A Addition /Alteration/replacement El Other: New 1 p 2_fam y wells (includes 10 ft. for u 1 connection)
Total
it dwellings utility n
h1 j , y : .'�"�' 'c „4 ~?y ';I�fiy :y ' : a. "?x'I.�111.$� 1 , w. : .+ „ ;^vl,"'i" -•�:a: �fM . :rlj,7 ,;�„ t3: ^^..;bT ..�' 0 :ft each ry CO On)
,I tt Stht1111 U 1\ � IIr t r-� i a \+rtt v' t t k 41 .P.! SFR (1) bath 249,20
nl . •<re r, alitrt,.iif' i':6 iM1... :Yxc tP7,, j� r 1C- r:"w^.0 ].. a t. ,..Y,t 1Jiti : lii+�+ 111st;kt. :..; ,1114
►. 1 -and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building El Multi-family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other: —
I 1 ,�,, Fire sprinkler ( sq, ft.) Page 2
\ �1n t J. r a' i�` j4 1' l arl i .z0h , . I I�r C 0 ",I 9t, . l r 1 L C �f r 4 II 1('t n ' ir r; p
tih>;.(.aw:p <'l fi'a+r�,tFxt+. .rxs !.;• o I .i .a�awxM.., �r�: G1 t u �kr i ril r = q+i1.e -Ydt
Site lltilitle8
Job site address: if��� eft � ,d 1/`t Catch Catch basin or area drain 16.60
City /State /ZiP; • _e. ) _� 1� ;O I?r leach line, or trench drain 16.60
Suite/bldg. /apt. no.: , Project name: Jr IF Footing drain (no. linear ft.: ) Page 2
Cross street/directions to job site:
�` -al � Manufactured home utilities 110.00
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.; ) Page 2
Subdivision: ^ Lot no.: Water service (Ito. linear it.: ) Page 2
Fixture nr item
Tai; map/parcel no.:
:; rl '�� l i +� :, °'1!`it l+ I �� , •+•^ r� �py C �'r; G' :.'� "I. Absorption valve 16,60
6. w;. 1 � Vi 4 ," M1,.."' 0 r . : ∎ '. ' ,... ,, . tj Y .'�' 'Gr r t,�` itWA 3w ° ''� P !' % 6 i 5 , h
' A 1 ,
CM � - ■-' Jt�� a i:.E:.r. Backflow preventer Page 2
r `'w l 7 1 r i= � 4 r>jl ra 1!�/��1v�� Backwater valve 16.60
W
NIA IA At
Clothes washer 16.60
Dishwasher 16.60
\; ax r . - k 1 E ` ;, 1 , Drinking fountain 16.60
�1 �' itri`af7i .d 14 I r p il .1 . •+G' l , ' �eY�2t1.'i' „is r P•� r �i''1M " R. i i t
. " 7SM Ejectors /sump 16.60
MJL _� - Expansion tank 16,60 I
Address: � it► r I Fixture/sewer cap 16.60 I
City /State /ZIP; A A 1111 os,M Floor drain /floor sink/hub 16.60
Phone: s) 0 iimmigi F.„( ) Garbage disposal 16.60
1,s :1 us�cf„ , ;r .,��R,.a. )n,,.>E n i,,; Hose bib 16,60
r u.�, A` ii t t t. ►' r 1 y ap i " }'j� Art i m i r e cc maim pp ,,� p 1r� .. ,
u ?`tlA� . 1. 1Y� Yi!: el�i�: n; WC. ia�,#�fi�b•f�+� rt
' 16.60
Business name; lA " _ .0.4.....
` / Interceptor/grease trap 16,60
Contact name: c A-f3ia! N ‘4- T Nso Medical gas (value; S ) Page 2
Address: •, .;, x • lam- Primer 16.60
jM 1 -a.., c)--. Rootdrain (commercial) 16 -60
Phone: bI 3) , - ,` I , 1111111 Fax: : ( 6 , Sinkshasinllav 16.60
Tub /shower /shower pan 16.60 k (pQ
E-mail: (t d I J./ 11
/ ►/ Urinal 16.60 ' i ` F ' '34 : u :"' fTM i' w�r; : �1,_" i :,y,7 e a MIA, r , a ,. ' �
h:! t! df fiiX 'tIP'?t'7C,`Jt9�7�i4tfi'a ?4�e1' t •p lPI.1 f P) Y'i )r11,< . tl .'11�, oqif. R.'n'-'
r �.: MI ° Water closet 16.60
SIMI Water heater • 16.60
Address; /I , t o 4 , 04 Other: `�
City/State/ZIP: ►
Subtotal l
i1 �� —/ '4 Minimum permit fee: $72.50 `
Phone; (513 • A Mk i /A , gga1 Residential hackflow minimum permit fee; 53625 i r}x S
/ QQ Plan review (25 °/n of permit fcc)
.C13 Lie.: a Plumbing Lic, no.. 3 -6)6c l! (�
State surcharge (8 °/n of permit fee) CO
Authorized signature: -i a ' A
, AP / : • TOTAL PERMIT FEE
c�?-
Print name: SOLIDI t �k 37 ) #- SQ i t� Date: I e, .-. rf This permit application expires if a permit is not obtaine withi
1 drays after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
I: \aultains \Permits \Pt.Lr- ParmitApp dm. 06 /0S 446.401Gr(I0/02 /COMJWE13)
CITY OF TIGARD .. _ - • ti
l BUILDING DIVISION PERMIT #:
DATE PLM2007 00066
13125 SW Hall Blvd., Tigard, OR 97223 E ISSUED: 2J15/2007
Phone: (503) 639 -4171 4'0 4p.41
Inspection Requests (24 Hrs.): (503) 639-4175 -.4.0%11L
INSPECTION WORKSHEET FOR DATE: 3/23/2007 TIME: 7:03AM PAGE: 23
SITE ADDRESS: 14100 SW 98TH AVE CLASS OF WORK:
SUBDIVISION: MCDONALD ACRES LOT #: 015 TYPE OF USE:
PROJECT NAME: BLACK
DESCRIPTION: Relocate drain for tub to shower conversion.
OWNER: BLACK, DICK PHONE #: 503- 722 -3510
CONTRACTOR: IMP SERVICES PHONE #: 503-652 -2626
Inspection Request Scheduled For: Date: 3/23/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 045307 -01 503-.652-2626 Y
•
Corrections /Comments/ Instructions:
,q ft �
- / .4/ 1
ex /ft" ,
n.
1 PASS n PARTIAL APPROVAL III CANCEL n NO ACCESS
F IL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: n \_./... Date: , ). Ii Phone #: (503) 718-
' V
CITY OF TIG 1 ' -' A
s
BUILDING DIVISION ' PERMIT #: PLIv12007
13125 SW Hall Blvd., Tigard, OR 97223 t ''t . , DATE ISSUED: 2115/
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 - .... .,
INSPECTION WORKSHEET FOR DATE: 2/22 TIME: 7:02AIvi PAGE: 53
SITE ADDRESS: 14100 SW 98TH AVE CLASS OF WORK:
SUBDIVISION: MCDONALD ACRES LOT #: 015 TYPE OF USE:
PROJECT NAME: BLACK
DESCRIPTION: Relocate drain for tub to tub conversion.
OWNER: BLACK, DICK PHONE #: 50-722-3510
CONTRACTOR: MRP SERVICES 7 ?4",e6--- .5 2 __._. 0 L 7 43HONE #: 503-652-2626
f \
Inspection Request Scheduled For: Date: 2/2212007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough-in . 043669-01 503-652-2626 Y
Corrections/Comments/Instructions:
r
i
ril -ASS PARTIAL APPROVAL 7 CANCEL I I NO ACCESS
_
n FAIL pi CALL INSPECTION 7 ADDITIONAL FEES ASSESSED
ref
0 l
4 „c, ,
Inspector: " Date #: (503) 718-2-- 3/
. .