Permit CITY TIGARD PLUMBING PERMIT
T�NI DEVELOPMENT SERVICES PERMIT #: PLM2005 -00115
erll DATE ISSUED: 3/22/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S111DB-01500
SITE ADDRESS: 15480 SW ALDERBROOK CIR ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.8 LOT: 443 JURISDICTION: TIG
Project Description: Installing water lines & 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
STEVENS, JACK L + ARDUS J
15480 SW ALDERBROOK CIR Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 3/22/2005 $72.50
[TAX] 8% State Surcha 3/22/2005 $5.80
Phone : 503- 968 -5268 Total $78.30
Contractor:
GEORGE MORLAN PLUMBING
2222 NW RALEIGH
PORTLAND, OR 97210 REQUIRED ITEMS AND REPORTS
Phone : 503- 274 -1444
Reg #: LIC 2734
PLM 26 -60PB
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: . 2,/ , � Permittee Signature: c) \ ��n
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.
MAR -21 -2005 17 55 GEO MORLAN PLMG SVC 503 265 0538 P.02
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City of Tigard 00 Datatly:
13125 SW Hall Blvd., Tigard, Olt 97223 �� � ' i 1 "` it tdo, D `� ��6/ - 0(5//,c
Plan Other permit Na.:
Phone: 503.639.4171 Fax: 503.598.1960 MPR . .,.. , ,
2e. Hour Inspection Line: 503.639.4175 ,-171. __ .d;,: bete Aeady/By: . lufaIf /7 671 Sac pose a tar
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❑ New construction Q Demolition Description HILitgl Ea. Total
j i ddition/altcatiort/replacement 0 Other: New 1- 2- family dwellings (includes 100 Et. for each utility connection)
! '1".1.‘ T -' � 5FR 1 bath
! :., fi: :r,ls�;- '_'}I ?tCi:,•1)s,l,tr. �. ���.T -' r.�;;ti; �- i., ij:•ry + 1... ZQ�.ZI)
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►:LI and 2-family dwelling CI Conunercial/industtial SFR(2)bath 350.00
Q Accessory building ❑ Mule.fxmily ssx {3) bath 399,00
Each additional bath/latchea 45.00
0 Master builder ❑ Other: 2
. ,-� -r '-T - ` - �- -r . . ---•- - • _______ Fire sprinkler ( eq. L) Page
1 l '� f; 1J .ill N , + J•1 •1.O/y tiilifn ! r y r '....Y4.1 .. r
Job site addtcss: S ` . 71 i . ta r Catch basin or arcs drain ME 1640
City/State/ZIP: C ( ' V C Z Z ci Drywell, teach line, or trench drain NM 16.60
Sniteibldg. /apt. no.: 1 Project aatae: � ).....ei11 Footin drain (no. linear it.:, Page 2
Manufactured home utilities 110.00
Cross Steeer/directions to job site! 16,60
Manholes .
Rain drain connector 1640
. • • ^ Sanitary sewer (4o. linear ft.: „__/ f �
Storm sewer (no. linear ft.: Page 2
Subdivision: J) Lot tie.: Water service (no. linear R,: ___) Page 2
Fixture or 'item
.I :. r,.,•. •..; -,• -- ; ". , -• rT.r.- ,.,it';oA.
Absorption valve
16.60
Tax to areel no.:
' � / , {a ` ! "�� ' ` a ,• Hacktlawpreventer
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VAS • 1 ' 1(l r ' 1 el f : 'lQ 3 aeekwater valve 16;60 MA
J1k) as � + �� Clothes washer 16.60
Dishwasher III 16.60
-,r.;. .� r; ':- •:!,I �'ti':c• 7-1-77 "- f: - R - ?rl 7t i ; : ice - "T Vii D(irilatrg founsain 16.60 •
4,Lia.2.L.L.__r. =' •6 . _t - -- �._..,.._, _...~ : ; .....t71: :- ._..27 , z _ ;.!.. :. Eicctoralautrmp 16.60
Name: S ci -- eA-)' ) % C k Expansion, mile 16.60
Address: Fixture/sewer cap 16.60
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City/State/2 : Floor d!aitviloor sinlrlhub 16.60
Phone: (.ia 7) 96ck .51 6 IMICSIMMIIIIIMMIll Garbagc disposal 16.60
- ._ ,� - Hose bib 16,60
L.' , '1'.11.7.:41.1,:,11'..; ` 1 .. _ r... - if: -' . 'i ,r.,• ,�: i "1 "
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I _���; . !.. r _ ,. . - I I _.__ .... - ;ic''�=:1-- .... .. a maker 16.60 MOM
lausinesa name: , . -12-0 -
r interceptor/grease trap 16.60
Contact name: N ! , iu Medical gas (value: 3 ) Page 2
Address: C .J i'� 16.60 IIIII
City /Scut /ZIP: ' -n- Roof drain (commercial) 16.60
Phone. ( ) Fat: : ( ) . Sink/basin/lavatory - 16.60
Tub /shower /shower pan 16,60
E -mail:
Urinal 16 -60
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� :.. , � F ' I ': _ . IJI . W � 1 1' • " �.. , ■G y :•: � ;.: ='` ' .FI ( I: •. •. r t't.. -' A Y • • � I Water closet 16,60 • '; �. ,r .i,__ , •�.. __ _'L:I.i�. 11�i .�..'_., M. x,9.... :,�.1''�.f':
Business name: r r 'rl /l \ r \ y Water heater E , 16.60
Addrats: ..„ ( ,. (N w Q__CL-Q e r Other: 1 e,-- i r12S Ell
Qty/5tatd2lP: er _.. . r u m� "( j� Subtotal
_ M inimum pernliL lee: 572.30
Phone., (Spy 14 .H
1 14 y ' Fax: ( Q -QS r , fiendencal backflow trommum pernat Fee: 536.25 2
Plan rcy(ew (25% of permit fee) CC8 Lie.: �� t- plumbiag Lie. 1,,O.: -)C) State surcharge (g% of permit fee)
Autbari2td signature: IJL, / TOTAL PERMIT PEE
Print rimier 1 -4Q 1 N1-- Date: 5 /Jas 1 ) �}� This permit application expltee if a pfarrttlt is not obtained v' ,
11 1S0 days attar le has been accepted as ' comptctt'
*Pet methodology set by Tri- County Building budustry Se
I; t84116 .1■1 1tl01 s<d.46181'(10/0vC061l'eI tl)
CITY OF TIGARD , -
BUILDING DIVISION PERMIT #: PLM2005.00115
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/22/2005
Phone: (503) 639 -4171 "u�fim�i i iitliI I i\
Inspection Requests (24 Hrs.): (503) 639 -4175 _�� `_...
INSPECTION WORKSHEET FOR DATE: 414/2005 TIME: 7:11AM PAGE: 84
SITE ADDRESS: 16480 SW ALDERBROOK CIR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.8 LOT #: 443 TYPE OF USE:
PROJECT NAME: STEVENS
DESCRIPTION: Installing water lines & water heater.
OWNER: STEVENS, JACK L + ARDUS J, PHONE #: 503 - 968 -5208
CONTRACTOR: MORLAN PLUMBING, GEORGE PHONE #: 503 - 2741444
Inspection Request Scheduled For: Date: 4/4/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 00351 9-01 603 - 968-5268 Y
Corrections /Comments /Instructions:
/ yy r
la i r
c . :6„... ___",„„,„
PASS ❑ PARTIAL APPROVAL ❑ CANCEL _ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ' Date: / 4/ "-- Phone #: (503) 718-