Permit I. 'rty
CITY TIGARD PLUMBING PERMIT
4 I DEVELOPMENT SERVICES PERMIT #: PLM2006 00201
`,i 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/11/2006
PARCEL: 1S133CA-02000
SITE ADDRESS: 13910 SW BARROWS RD ZONING: R - 25
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Line work to relocate sewer connection. Original connection made in 1992, see permit
#SWR92 -00162 for details. No sewer connection permit required per Mike White.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: 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: 40 ft
. WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
VERIZON
PO BOX 1100 Description Date Amount
BEAVERTON, OR 97075 [PLUMB] Permit Fee 5/11/2006 $72.50
[TAX] 8% State Surcha 5/11/2006 $5.80
Phone : Total $78.30
Contractor:
LOVETT EXCAVATING INC
2925 SW HARTLEY DR
GRESHAM, OR 97080 REQUIRED ITEMS AND REPORTS
Contact # : FAX 503- 288 -1630
PRI •503 -504 -2847
Reg #: LIC 125507
PLM 26 -773PB
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: 6
_Zzlh
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.
0
1 2006 08:58 5 PAGE 1 / 02
032881630
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—Numbing Permit Applicatiit\ ..H ii. p'
. _ 1 OFFICE USE. ONLY
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City of Tigard t 0.„-,■-,--q - - Received,.
Dm/By:Via/Dip 36 Permit NoTaVap& Idp
13125 SW Hall Blvd., Tigard, OR 97223
Pt rm Rcvi IN
Phone! 503.639.4171 Fax: 503.598. I 96„0 A v (•, t-' MEI i llNO , II Illil# Daleilly;
291cr Pormit No5 0
24 - 1 inspection Line: 503.639.4175 MAI ''.- L •Aillo• 1 / Date Rencly/fiy:
Ilk 63 Set PngC 7 for 1
Internet: www.ci.tigard.orus
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Notified/Method: Supplemental information
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tir- 6P VbRik,.--1-;;110.(M• • rrx- SCHEDULF
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ANEW construction ITAT , ;E
1 / ' ' II Demolition For special beforruation use checklist.
Description 1 QtY 1 Ea• fi Th fIlli
. • . Addition/alteration/replacement LI Other:
New 1-2-family dwellings (includes 100 ft, for each u(ility', connection)
. .. .
•
' .. .
CATEGORY OF CONSTRUCTION ..
. • .
. SFR (1) bath 0
• .
- 249,2
•:- and 2-family dwelling Commerci al/industrial SFR (2) bath 350.00
SFR (3) bath 399.00
LI Accessory building 71 Multi-family
P:ach additional bath/kitchen 45,00
0 Master builder 0 Other:
„_ Fire sprinkler ( sq, ft) Page 2 I
• • 10.13 SITE INFORMATION AND LOCATION • .
Site utilities
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Job site address: (3ctfo .,(0..___21acrocti.S___S-1- Catch basin or area drain 16,60
—
city/Statc/Z1P: 1 ic i 0
___9_74),-q_s_________ Dr ic.hlinc. or trench drain 16,60
Footing drain (no. linear ft ; ) Page 2
Suite/bIdg./apt, no.: Co' Project nume: Ver I 20 ri .
• Manufactured home utilities 110,00
Cross sireet/dircctions to job site;
Manholes 16.60 I j
2 16.60
Rain drain connector
.11,-111)." Sanitary sewer (no. linear ft..A Page 2 I 43?)
-
Storm sewer (no. linear ft.,: ) Page 2
Subdivision; n w y Lot no,: fiis Water service (nn, linear fl.: ) Page 2
Fixtur or item
Tax map/parcel no.: \ •JI life t tAk • e
_.„ .,., , Absorption valve 16.60
IP
DESCRTION OF WORK 5 \'`,":•• e Back (low preventer Page 2
Tha fi...; \ENV, .., Backwater valve 16,60
n ao_s_L er si, ?,, „Li_ - Clothes washer 16.60 I
Dishwasher 16,60
• • 0 PROPIJITY OWNER : 0 TENANT Drinking fountain 16,60
' -- Ejectors/sump 16.60
Name:
Expansion tank 16,60
Address!
Fixture/sewer cap 16.60 I
City/State/Z1P: Floor drain/floor sink/hub 16,60
.
Phone: ( ) Fax: ( ) Garbage disposal 16.60 I
— ,—
:• I• , . ' 0 APPLICANT 0 CONTACT P , .
ERSON. . • i
- • . Hose bib 16 60
• Ice maker 16.60 I
-.L.
Business name:
Interceptor/grease trap 16,60
Contact name:
, Medical gas (value: g ) Page 2
Address:
Primer 16.60 , I
_.._
City/State/ZIP: Roof drain (commercial) 16.60 I
Sink/basin/lavatory 16 60
Phone: ( ) Fax: : ( ) ' _L
- 'rub/shower/showcr pan 16.60
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E-mail;
Urinal 16.60
CONTRACTOR
•
• . • . Water closet 16.60
..._
Business naL - water heater 16.60
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City/StlItclZTP: G r es ckm - BR sllbtotal 111■1°
Minimum permit fee; 572.50
Phone; (g)3) 664 __50.42 Fax: 5631 - 14,3n Residential hackllow minimum Ea-tit •fec: $36,25 Fv....g)
CCB Lie,: Plumbing Lie, no.: Plan review (25% of permit fcc) [
4 i ' State surcharfte (8% of permit fee) 16 19
Authorized s ignature: • -
'0 . I '
- .■ 6 TOT PERMIT FEE
.
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[Print name: . pi . ..... rib Date: (---..... _._., This permit application expires if a permit' iS not ntitaine'd within
- •• . 180 days after it has been accepted as earorleted
*Pcc methodology set by Tri-County Building Industry Service Board,
I:\ 1.41;lein*Wcrrnits\ PIN-enema Anp.dna cr,,ns 1.10.46 I 6' l'( I 0/02./C.ONI/W12r3) I
•
CITY OF TIGARD
BUILDING DIVISION . , PERMIT #: PLM2006-00201
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: EV1112006
Phone: (503) 639-4171 4, 21014
Inspection Requests (24 Hrs.): (503) 639-4175 scAl- 112.
INSPECTION WORKSHEET FOR DATE: 5/12/2006 TIME: 7:03AM PAGE:
SITE ADDRESS: 13910 SW BARROWS RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: VERIZON
DESCRIPTION: Line work to relocate sewer connection. Original connection made in 1992, see permit
inA/R92-00162 for details. No sower connection permit required per Mike White.
OWNER: VERIZON, PHONE #:
CONTRACTOR: LOVETT EXCAVATING INC PHONE #: 503-604-W147
Inspection Request Scheduled For: Date: 5112/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 029803-01 503-38-0300
Corrections/Comments/Instructions:
r.
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• .1P
N X,pASS I I PARTIAL APPROVAL EI CANCEL fl NO ACCESS
I FAIL I CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED
Inspector: Yti Date: .•) Phone #: (503) 718-