Permit CITY TIGARD PLUMBING PERMIT
Aro ,,,I DEVELOPMENT SERVICES PERMIT #: PLM2005 -00189
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/4/2005
PARCEL: 2S111DB-05200
SITE ADDRESS: 15271 SW ALDERBROOK PL ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.7 LOT: 408 JURISDICTION: TIG
Project Description: Replace tub /shower.
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
LYLE KEENAN Description Date Amount
15271 SW ALDERBROOK PL
TIGARD, OR 97224 [PLUMB] Permit Fee 5/4/2005 $72.50
[TAX] 8% State Surchari 5/4/2005 $5.80
Phone : 503 670 - 0336 Total $78.30
Contractor:
CRAFT RITE PLUMBING INC
4812 SE MELDRUM AVE REQUIRED ITEMS AND REPORTS
MILWAUKIE, OR 97267
Phone : 503 327 - 4975
Reg #: LIC 162040
PLM 3 - 526PB
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 -2499 r 1 -800- 332 -2344.
. Issued y: � Q j Permittee Signature: a / Pt
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.
May 04 05 ll:lla Bryan Nelson 5036573622 p.1
Plumbing Permit Application FOR OFFICE l SE ONI.\
City of Tigard Rece
ei J II `) ' , Permit No.: ` , , �.., 0O •S .
13125 SW Hall Blvd., Tigard, OR 97223 y '
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 l 41iiloy,p1!�( It ' ;‘ Date/By: O Permit No.:
.-a_41; 24- Hour Inspection Line: 503.639.4175 .-a_41; ^ `�.. Datc Ready/By: iP� H See Page 2 for
Internet: www.ci.tigard.OLUS Notified/Method: / t(g.. Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist
Description 1 Qty. I Ea. I Total
Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
X11- and 2- family dwelling ❑ Conunercialindustrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi-family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. It) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: 15 " 7 I l ?Y V A I d e r b y0Q Catch basin or area drain 16.60 ' i
City /State/ZIP: --r-- I °arc\ i 7�v� J q.---r r Z Drywell, leach line, or trench drain 16.60 .
Suite/bldg. /apt. no.: " ✓ Project name: Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: l Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.: -
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 3 6.60
PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60
Ejectors/sump 16.60
Name; l l ).e. a_ r Expansion tank 16.60
o Address: Fixture/sewer cap 16.60
City / State/ZIP: Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
❑ APPLICANT [ CONTACT PERSON Hose bib 16
Business name: \� 1 ,^ j,
Ice maker 16.60
Y T� �m�'� t `V Interceptor /grease trap 16.60
Contact name: C^. A c. \ J Medical gas (value: $ ) Page 2
Address: Primer 16.60
City /State /ZIP: Roof drain (commercial) 16.60
Phone: (C-43- .. 7 ... :7--:7..-\ an I Fax: : ( ) - Sink/basin/lavatory 16.60
E -mail: Tub /shower /shower pan l 16.60 ( ( ,(0 b
Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: p .. ' , p I u n i i f 1 C L or Water heater 16.60
Address: \ ' ('(b , c�U ,Ay-e. Other:
City / State/ZIP: l �1
I I �t 1�t �.lf .1 P Z Z �J Sub tota l
Mi nimum permit fee: $72.50 s ,�
Phone: (Sj 3 2�. Lig --- Fax: ( <) (0S - 3 (..2-L Residential backflow minimum permit fee: $36.25 �)
CCB Lie.: ' (2204+0 Plumbing Lie. no.: 3_ 52J.J0 P re) Plan review (25% of permit fee)
�
Y State surcharge (8% of permit fee) �,g0
Authorized signature: y l , n ,1 „k..Q + TOTAL PERMIT FEE , ?�()
�� �
Print name: .��yP i So '�/1 Date: 5/C, /�5 This permit application expires if a permit is not obtained within
//{ 180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
CITY OF TIGARD _
BUILDING DIVISION- QL PER MIT #: PLM200S.00189
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/4/2005
Phone: (503) 639 - 4171 " ` ° °�N "N
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/12/2005 TIME: 7:08AM PAGE: 27
SITE ADDRESS: 15271 SW ALDERBROOK PL CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.7 LOT #: 408 TYPE OF USE:
PROJECT NAME: KEENAN
DESCRIPTION: Replace tub/shower.
OWNER: KEENAN, LYLE PHONE #: 603 - 670 -0336
CONTRACTOR: CRAFT RITE PLUMBING INC PHONE #: 503 - 327 -4976
Inspection Request Scheduled For: Date: 5/12/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 006707 -01 503- 327 -4975 N
Corrections /Comments / Instructions:
-- - 1 , --- /A&,S,c - 52_,, t _ , C) , A 2:7 .g
5 -0 , -z-vv .r "\ 11� q °
li i .,
Y -.' ‘ ...
``: PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
/J i �—
Inspector:. �✓ C� Date C/� 2 w Phone #: (503) 718-