Permit C ITY O F I OA R D PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00092
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/6/2008
PARCEL: 2S103CA -00106
SITE ADDRESS: 13475 SW 115TH AVE ZONING: R -4.5
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: MORGENTHALER
Project Description: Replacing 50 ft. of water service and replacing (1) double check valve.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
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: SEWER LINE: ft
WATER CLOSETS: WATER LINE: 50 ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
CASS MOGENTHALER
13475 SW 115TH AVE Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 3/6/2008 $82.55
[TAX] 12% State Surch 3/6/2008 $9.91
Phone : 503- 209 -2630 Total $92.46
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 • � �- Permittee Signature: ��
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.
FFsOM APOLLO DRAIN 503 - 669 -9568 (WED) MAR 5 2008 15:02/ST. 15:01 /No. 6812889024 P 1
numbing. k'errnit Application RECEIV
-Hu: j'I I I 1 -I ('.I., •
Re- ved
City of Tigard MAR — 200'1 , Nte/B : , a, v/I ?midi No.: /x11 , . f -- ciw)
.1 13125 SW Hall Blvd.. Tigard.OR 9722: Plan keview
Phone; 503.6;'9...1171 Fax; 5.11 ;.595'.1960 0ae.l4: other Permit no.:
1 r.; ,, . i 7
inspection Lira. 503.639.1175 CITY OF TIGA Is 1 o Rcndy/Ay' turic, III See Page 3 for
Internet www.upard- or.gov • 1 , a • , ed/Metltod Su plemeatal1nfarmati on
TYPE OF WORK _ _ Frt. SCFIEDUI
[] \c„ cnnhr- action 1 ❑Demolition For special iinform:Mon km cheat&
— . .• Descri.bon It . E. Total
1ition /alteration /replacement I ❑ Other: New 1- 2- family dwellings (includes 100 ft for each utility connection)
' CATEGORY OF CONSTRUCTION Silt (I) bath 2
I and 2- Family dwell inc ❑ COmMercial /industrial SFR (2) both 350.00
❑ Accessory huiidius ❑ Multi- family SFR (3) bath 399.00
. _• - Each additional bath/kitchen 45.00
❑ M --
ncier builder 0 Other:
Fire sprinkler L sq, ft.) Page 2
_
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: 2-)1--ri _ �a } ` " ("t/J2 Catch basin or area drain 16.60
L Citvi5tntc /Z1i': ,� a I� 1 22 Drywall, leach lint. or trench drain 16.60
Suite/bldg. /apt. no rujcar mc: Mor5 ales Footingdr>,in (no. linear ft_,__) P ag e 2
l -- ----- Manufactured home utilities 110.00
Cross strcct/dircainns to job site: Manholes 16.60
Rain drain connector i 16.60
Sanitary sewer (no. linear ft.: ) Page 2
SM1+11 +ewer (no. linear ft 1 Page 2
: uladi•vision I of no. Water soviet (no. linear 112 I Page 2 .5-f,
----- -' rnrture nr item
Tax map /parcel no.:
Absorption valve 16.60
DESCRIPTION OF WORK l3acicflow preventer a • Page 2 -z
�'�'Q�1� t r It. I • �-� /�' _ 1� Backwater valve 16,60
f - - ^ -� , �. f A lf. i 40 > r • f n Clotht■ washer 16.60
R, Dishwasher j 16.60
U f - Drinking fountain 16.60
a. PROPERTY OWNER ❑ TENANT -
Ejectors /sump 16.60
Name: IA S r re .A 1.1 / MUM= Expansion tank 16.60
Address: - _ Fixture /sewer cap IRO
City /State /ZIP: Floor drain/floor side/hub 16.60 MI
Phone: ( • �D� • Z. CA Fax: ( )
Garbage disposal 16,60
0 APPLiCANf Hose bib 16.60
• [] CONTACT PERSON Ice maker 16,60
Business name: Interceptor /grease trap 16 -60
Contact name: Medical at (value: X) Page 2
-
Address; Primer 16.60
City /Stare /ZIP: Roof drain (commercial) 16.60
Phone: ( ) Fax: : ( ) Sink/basin/lavatory 16.60
---- - Tub /shower /shower pus 16.60
E -mail;
:)tins: I 16.60
CONTRACTOR Water close 16.60
Busine9a Home: ' Water h.coatr 16.611 AI
Address: 2,2„61 p f /_ <, .- Other I
Subtotal _
Ciry/StatelZIP; C r .. a I vv\ - # li.P
• .. w Minimum permit fee: 572.50 t y� -
Phanr ( Yom 7 F ax; ( t ) r r . / / I R es i dent i a l backflow minimum permit fee: S)6.25 _ ?
COI Li c.: ' Plumbinfi Lic. 6\ 0.124p .e j 2/6 Plan rcwiaw (25% of permit fee
1 Site surcharge (12% of permit foe) 9 • Cf I
Authorized signature: ( TOTAL PERMIT FEE _(L 1
I _ . rya. �.= ta. '
Print name: G1, 9 _ Date: g M A I This permit application expires if a permit is not obtained within
-- -- 18n days alter it hag hecn accepted its eampiere.
- 'Fee methodology set by Tri.Counry Building Industry Service Board.
I WmldiniPcrm -T IIApp,enc 1a:lroo lno- t,516T(10;tarCUM/wTR)
CITY OF TIGARD „.
BUILDING DIVISION
PERMIT #: PLM2008-00092
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 31612008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 3/11/2008 TIME: 7:00AM PAGE: 62
SITE ADDRESS: 13475 SW 115TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: MORGENTHALER
DESCRIPTION: Replacing 50 ft. of water service and replacing (1) double check valve.
OWNER: MOGENTHALER, CASS PHONE #: 503-209-2630
CONTRACTOR: APOLLO DRAIN + ROOTER SERVICE PHONE #: 503-239-8801
Inspection Request Scheduled For: Date: 3/11/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 066416-01 503-969-6964
'Pis/0c I
Corrections/Comments/Instructions:
94,}
•
•
%PASS Ei PARTIAL APPROVAL fl CANCEL 11] NO ACCESS
I I FAIL n CALL FOR INSPECTION ri ADDITIONAL FEES ASSESSED
Inspector: ( � Date: 2111 I O Phone #: (503) 718-
CITY OF TIGARD
• BUILDING DIVISION PERMIT #: PLM2008.00 )2
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 316/2008
Phone: (503) 639 -4171 I mr1���0le
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 317/2008 TIME: 7:00AM PAGE: 61
SITE ADDRESS: 13475 SW 115TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: MORGEN T HALER
• DESCRIPTION: Replacing 50 ft. of water service and replacing (1) double check valve.
OWNER: MOGENTH-HALER, CASS PHONE #: 603 -209 -2630
CONTRACTOR: APOLLO DRAIN .1. ROOTER SERVICE PHONE #: 503 - 236.8801
Inspection Request Scheduled For: Date: 317/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 066230-01 503 -238 -8801 Y
Corrections /Comments /Instructions:
e r' *-- 0 t w ib 6c, c ,c.,Vi, U A w S i \v,d) f va-,ft C6
A S ck., Lie l ov ■.
I I PASS k PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
T i FAIL n CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: Cr6 w�„�✓�l \�`"'" Date: (11-2 j DT) Phone #: (503) 718-