Permit C ITY OF TIGARD PLUMBING PERMIT
,d I DEVELOPMENT SERVICES PERMIT #: PLM2006 - 00125
J�I DATE ISSUED: 4/7/2006
'` �� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S112CA-08100
SITE ADDRESS: 07598 SW ASHFORD ST ZONING: R -4.5
SUBDIVISION: RENAISSANCE WOODS LOT: 007 JURISDICTION: TIG
Project Description: WATER SERVICE REPLACEMENT
CLASS OF WORK: 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: 60 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
VANDEHEY, MARK ALLEN /PAULA RAE
7598 SW ASHFORD ST Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 4/7/2006 $72.50
[TAX] 8% State Surcha 4/7/2006 $5.80
Phone : Total $78.30
Contractor:
ANCTIL PLUMBING INC
16900 SW MERLO RD
BEAVERTON, OR 97008 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 642 -7323
FAX 503- 642 -7755
Reg #: LIC 24184
PLM 26 -162PB
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 B Permittee Signature: /77.
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.
APR -7 -2066 09:35A FROM :ANCTIL PLUMBING 5036427755 TO: 5035981960 P.2
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City of Tigard ROOC1e"ed i I Dpi /?U Permit Ho. Pl,,M �
13125 SW Hall Blvd., Tigard, OR 97223 �`�
Phone: 503.639.4,171 Fax SO3.S Date/By. P8.196"oPR ® 2006 Ptael'tehDate/By. Other Permit No
24- Hour Inspection Line: 503.639.4175 I
p !. � . I_� . bate Ready/By. Iris: III See Patel fir
Internet: www.tigard- or.gov CITY OF .I I (j f-k ' ms 's Notif ied/Method f I G Supp lement f
CITY V In orsatiaa
! . ;l,. '�3Y 1 *�t `, . - . . . � ;!'' r;� °��� "�' 1 ;'' ' .:', ' ' FEE °CSCNEDUL
� L►�.t' °AJly1'�x�a,' "s�'�`;,`•
❑ New construction ❑ Demolition For spedal Information use tkeekl s&
Description I Qty. I Ea. I Total
.ddition /alteration/replacement ❑ Other: Newt- 2- family dwellings (includes 1001L for each utility connection)
Y' f. . ` . ` '" 1 ;i''' CATEGORY OleCONSTRUCTION' e `o�'i« ' ''''' e ', i SFR (I) bath 24920
_ and 2-family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
' ❑ Accessory building ❑ Multi- family SFR(3)bath 399.00
❑ Master builder ❑ Other Each additional bath/kitchen 45.00
Fire sprinkler - (r_ sq, fl.) Page 2
It'" '$ _ .;., y ., - ''� - JOB SITE'INFORMATION M APiD- IACATION i;'3l '' �- ' site utilities -
Job site address: j // / / ; ' - " -
5� s( - Catch basin or area drain 16.60
City/State/ZIP: p a 6 t •P-0 6-1-; Drywell, leach line, or trench drain 16.60
-
F ooting drain (no. linear R.: ) Page 2
Suitelbldg /apt. no.: Project name: Y�m y g
/ 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 It: ) Page 2
Subdivision: l Lot no.: , Water service (no. linear It: (q O) l Page 2 53-1.-
F1eeeee or Item
Tax map /parcel no.: _ Absorption valve 16.60
DESCRIPTION OF,WORK ..1:•r I ' , Badtflowprevents Paget
� Al' C, '16 Ar 6 Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
❑ PROPERTY OWNER 1 , ': . ,, , ,❑ TENANT
Name: ( /4.) 1 l� u/ xpan on tan om" a'/ c 6 tGr r Expansion tank 16.60
Address: 5 Fixture/sewer cap 16.60
City/Stale/7_1P: Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( . ) Garbage disposal 16.60
❑ APPLICANT ' ` ' ❑ CONTACT PERSON ` ` '
Hose bib 16.60
Ice maker 16.60
Business name: Interceptor/grease trap 16.60
Contact name: Medical gas (value: S ) Page 2
Address: Primer 16.60
City /State/ZIP: Roof drain (commercial) 16.60
Phone: ( ) i Fax: : ( )
Sink/basin/lavatory 16.60
Tub/shower /shower pan 16.60
E-mail: Urinal 16.60
CONTRACTOR Water closet 16.60
m Business name: 111-10e « L ti9 l iJ'W (S s - d --/`�' V Water heater 16.60
Address: 1 61 Op .Sw r Y l F(Z-(- Ii u) . Other:
�i o 9 �-no co Subtotal City /State/ZIP: �.
{0�2 3 23 ( ( �T J `, Minimum it fee: 572.30 ��Sd
Phone: ( ) F ax: ) Residential backflow minimum permit fee; 536.23
CCB Lic.: Zit l (� Plum • Lic. no.: 2-r et 62186 Plan review (25%ofpermit fee) Ir
State surcharge (Wo of permit fee) 5 $O
Authorized signature: ie.� - _ /+ 2- G - 1 C.2. PB - TOTAL PERMIT FEE -- 4A•30.
Print name: Z,[�(_ ! t . , _ f ''T 7-1040 Date: Thls permit application mires If a permit is sot obtained Maim //✓✓ " "�� �� 180 days after It has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
I: \Building\Purniu\PLAM- PenniIAppdoe II/30/0S 440-4616T( I0002/COM/WED)
CITY OF TIGARD
BUILDING DIVISION
PERMIT #: PLM200600126
13125 SW Hall Blvd., Tigard, OR 97223
(- DATE ISSUED: 4/7/2006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 4/1212006 TIME: 7:04Aivi PAGE: 66
SITE ADDRESS: 07598 SW ASHFORD ST CLASS OF WORK:
SUBDIVISION: RENAISSANCE WOODS LOT #: 007 TYPE OF USE:
PROJECT NAME: VANDEHEY
DESCRIPTION: WATER SERVICE REPLACEMENT
OWNER: VANDEHEY, MARK ALLEN/PAULA RAE, PHONE #:
CONTRACTOR: ANCTIL PLUMBING INC PHONE #: 503-642-7323
Inspection Request Scheduled For: Date: 4/12/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Watof service. 027830-01 503-642-7323
Corrections/Comments/Instructions:
)
fl PARTIAL APPROVAL Ei CANCEL n NO ACCESS
FAIL fl CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: MAr
Date: 49- — Phone #: (503) 718-