Permit `' CITY OF T IGARD PLUMBING PERMIT
'", IA DEVELOPMENT SERVICES PERMIT #: PLM2006 -10011
�J I 13125 SW Hall Blv Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 3/2/2006
PARCEL: 25111 BB -01501
SITE ADDRESS: 14135 SW 103RD AVE ZONING: R -12
SUBDIVISION: TIGARDVILLE HEIGHTS LOT: 001 JURISDICTION: TIG
Project Description: Replace water heater.
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: 1 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: ft
Owner: FEES
ANDREW MARZAHL Description Date Amount
14135 SW 103RD AVE
TIGARD, OR 97224 [PLUMB] Permit Fee 3/31/2006 $72.50
[TAX] 8% State Surcharp 3/31/2006 $5.80
Phone : 425 445 - 1509 Total $78.30
Contractor:
OWNER
REQUIRED ITEMS AND REPORTS
Contact # :
Reg #:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -00 -0010 through OAR 952 - 0001 -0100. You may obtain copies of these - : s or direct questions to OUNC by
calling 03- 246 -669 • or 14i 0- 332 -2344.
Issued _ ' Permittee Signat AM' ' �.��
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans am required on the job site at the time of each inspection.
Mar 02 OG 04:23p p.1
03/02/2000 13:01 FAX 5035981980 CITY OF TIGARD Wool
Plnmbine_Permit Application �"
City Tigard a ( o X PeaaitN0.: ,?�62.r lee r'
Review
13125 SW 1-1.11 Hlvd., Tiyrd, OR 97223 Phu
S
Phone: 503.639.4171 Fax: 503398. &960 Omer Nnsr NC.: r
44 Hour inspection Liner: 503:639.6175
Internet www.tigard or.gov Natifi �J.J_ •1 1 � Diec Ready/fir i ds J 1 s„ s 2 for
d kilted
'l w u,r veal r re • .::: •:. •.... . _ ..l 7FTtOtE'O!E.S*Rt[. ` , . - y :c6EE •
❑ New construction 0 Demolition For wtcidisforrnaaiew ax checklist.
C Mditioo/altcratio /r lacanent Other: New I Or I >?a I Taal
ep New 1 -?rfa� duelling. (includes 100 R for each Milky connection)
''.: _; 4TF4CA$Y`OF.:«. tl1C77014 : ;5. ::,. . ':. ::-' SPR(1)bat 24920
and 2 - family dwelling 0 Commercial/Industrial SFR (2) bath 330.00
0 Accessory building 0 Multi - family SPA (3) herd! 394.00
D Master budder ❑ Other:
Each additional batb&Mchm 45.00 ,
Fite sprinkler (_ sq. tL) Page 2
. . e•VotMA11OIV AND.•PockTION...
_ ... ., _. Sire :utrTAiea
Job site a ddress: ! S L. j 1 a> r n 4J 6 catch Cosi% or Ism drain 16
City/State/ZIP: ) ie I D r r- - e "7 2 1 k LI Drrwe lute. or trench drain 16.60
Suite/bldgJapt m_: Project name: Footing drain (no. finer 8: 1 Page 2.
MrmtScnrred home uoIities 110.00
Crass stroet/directioos to job site: Mraboles 16.60
1 03 +'Z'Y: X- f ic O0/eAL .h _ win connector drain contor 16.60
■ Swaney servo (no. linear ft.: _) Pagel
f Sturm sewer (ao_ linear li.: ) Page 2
Subdivision: /✓ //l I Lot tam � w� service (■o Home 11.: ) Pagc2
ff ' Beare or item
Tax map/pared no.:
At sorption naive 1
._ ; OF Wp� Beddow preventa Pagre2
��PI�, f-- al � . �s.�_ /4 Ar( Rarkenter valve 16.60
Cl+,thes washer 16.60
Di :Invasher 16.60
n
. rug 16.60
' t 1�) ��t'e w /4 r '� rF L E x curs i on tan _ 16.60
Name:
ri z � Excursion teak 16.60
Adams: 1 / 3 5 5 -J 1 O 7 AU ( - Firesur/sevier cap 16.60
City/Staie/Zfl : ->`) / r3 / r 9 CI - 7 - L. Z L1 Fkwr drain/floor sink/hub 1.6.60
Phone ( 1 / SO 1 Fax ( ) Gadrege disposal 16.60
�lcse brTs 16.6
ice maker 16.60
Business name: Iatsaplor/srasetrap 16.60
Contact name: Medical gas (vat S ) Page 2 ,
Address: Primer 16.60
City/Start/ZIP: Roof dnim (commercial) 16.60 ,
Phone (5 -,,(:)<_ / i Fox: : �S / C7 L Siek/basindsvatory 16.60
v Ttn/sbower/sbowa pm 16.60
E-mail: Ur ml 16.60
. • :. . - ' -.% .: Ctr Weser closet 16.60
Business name: OK) U f Wrier heater / 16.60 7‘ 1O
Address: Odic;
City/Star/ZIP: Sab
Minim manic um snic foe: 572.50
Phone ( ) Fax: ( ) Residential badcnon mielmum -aunt foe: 53625 7 2.5 0
CCB Lie.: plumbing Lic. no.: Plan review (25%ofpcimitfa)
State swamp (8% of permit fee) 3„g0
Authorized signature; �-
��•`_ � ] me �� JJ TOTAL PERMIT FEE --77-2 ( j
I Flint norm: ��� i L L ( - e I Ili: ' ` / y f ni. pmt applieatiae expire' if a permit net obtaiwsd within
111 / ` f 1g/ days after it ran been accepted as raarpkte.
'Fee methodology set by 'hi-Canary Building ladusny Service Hoard.
cwiu:yiamsi nteS- resmio veers ivscrns uaasurylienCenrM'm)
CITY OF TIGARD _ /�
BUILDING DIVISIO
B I v — / D of l
�
13125 SW Hall Blvd., Tigard, OR 97223 ; DATE PERMIT ISSUED: #: ZO
Phone: (503) 639- 4171 w`r a p�o�y�i'i�i���l �
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
V`j
SITE ADDRESS: 14 1 bs A CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 — /0 a LP Pour Time:
Code # Inspection Description Confirm # Contact # Message
vee\Ct�e L l -� -c am, b Anl ; a ,, 6 2 ,
Sa(i.../
Corrections /Comments /Instructions: "771.011
/ -
$3:11/4 j vv, # i — '. •4 �L
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1
qt.
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4 —pAs - s ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: \IL t J "`� Date: t r b Ph #: (503) 718- 2;.1 2-( P � )