Permit . I` 0.
4 �+ CITY OF TIGARD PLUMBING PERMIT
"' ° COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00395
TIG 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: $/29/2007
PARCEL: 2S 104AD -01800
SITE ADDRESS: 12655 SW 128TH AVE ZONING: R -4.5
SUBDIVISION: BELLWOOD LOT: 045 JURISDICTION: TIG
PROJECT: CONNOR
Project Description: Replace water service.
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: SEWER LINE: ft
WATER CLOSETS: WATER LINE: 50 ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
CATHLEEN CONNOR tion Date Amount Description 12655 SW 128TH p
TIGARD OR 97223 [PLUMB] Permit Fee 8/29/2007 $72.50
[TAX] 8% State Surcha 8/29/2007 $5.80
Phone : 503 -579 -8693 Total $78.30
Contractor:
CRAIG ANDERSON PLUMBING INC
2730 SE 15TH AVE
PORTLAND, OR 97202 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 232 -1060
FAX 503- 232 -5263
Reg #: LIC 100658
PLM 26 -524PB
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.
1_, Issued � JJj j iL 1 i/ Permittee Signature: S
App ) Moil
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.
08/29/2007 10:15 FAX 5035981960 CITY OF TIGARD cui u "`
RECEIVED OFFICE I.' :Fl o�zti
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'TYPE (3F WORK . • • .. • F we deride.' 1.. Ea Tai
❑ Demolition IMO a -n i a lles ti ' Nearl- 7,- te*silydweUinC,Ceuludesl00IL for each utilityennnoetionl
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Address r _ L Float dratNfloorsitlkJtrue 16.60
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Phone: ( tie ) Fn'c ( ) Hose bib 15.60 rer. e �� (7pNT[T ta
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Waal 16.60
' Water Water met 16.60
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Water henna 16,60
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Address:
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CITY OF TIGARD ,
BUILDING DIVISION PERMIT #: PLM2007- 00395
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8129/2001
Phone: (503) 639 -4171 u> 'ii
Inspection Requests (24 Hrs.): (503) 639 -4175 =��
INSPECTION WORKSHEET FOR DATE: 9113/2007 TIME: 7:01AM PAGE: 53
SITE ADDRESS: 12655 SW 128TH AVE CLASS OF WORK:
SUBDIVISION: BELLWOOD LOT #: 045 TYPE OF USE:
PROJECT NAME: CONNOR
DESCRIPTION: Replace water service_
OWNER: CONNOR, CATHLEEN PHONE #: 503-579-8693
CONTRACTOR: CRAIG ANDERSON PLUMBING INC PHONE #: 503. 232 - 1060
Inspection Request Scheduled For: Date: 9/1312007 a Pour Tim -• . (p p.,
1 /
Code # Inspection Description Confirm # Contact # Ms -.ge ift
330 Water service - 055622 -01 • 503-522 -2283
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Corrections /Comments /Instructions: 0-'1Z—
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PASS n PARTIAL APPROVAL H CANCEL I I NO ACCESS
FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
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4 Inspector: V(�( Date: A l ) Phone #: (503) 718 -� 7 Z`r