Permit CITY TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 - 00313
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/23/2008
PARCEL: 2S 104 DC -01100
SITE ADDRESS: 13798 SW BENCHVIEW PL ZONING: R -4.5
SUBDIVISION: BENCHVIEW ESTATES LOT: 011 JURISDICTION: TIG
PROJECT: LLOYD
Project Description: 40 ft water service
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF 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: ft
WATER CLOSETS: WATER LINE: 40 ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
LEYNDA LLOYD
13798 SW BENCHVIEW PL Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 7/23/2008 $72.50
[TAX] 12% State Surch 7/23/2008 $8.70
Phone : 503 -579 -2670 Total $81.20
Contractor:
ARS RESCUE ROOTER
PO BOX 2830
CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 235 -8784
FAX 503- 491 -2932
Reg #: LIC 127325
PLM 34 -168PB
•
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: A.1
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.
r` JUL -21- 2008 11:51 P.001
t PIOmbing Permit Application
Building Fixtures RECEIVED ' FOR OFFICE USE. 'ONI Y ' b,d
n
City of Tigard Received � *' xc a t 1114
Deters Permit No 2008 —
13125 SW Ilan Blvd., Tigard, OR 972 063/3
Phone: 503.639.4171 Fax: 503.598. 1
7 Q Plan B
200 DatelB Other Permit No..
Inspection Line: 503.639.4175 ®See Pap 2 for
Ti t; AR 17 Date Iteady/Bv: tur* —
Internet: www.tigard- or.gov CITY , Nohded /Method:
. � \. Su i lementul Information
TYPE OF�' �� �t >v INGD1 V1 IpN FEE* SCHEDULE
❑ New construction ❑ Demolition Fora eclal1 armadorr use checklist
A i Desert lion tjIMI Ea MEM
Addition /alteration/replacement ❑ Other: New 1.2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath _ 249,20
ELl- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building El Multi-family SFR (3) bath 399,00
❑ Master builder 0 Other: Each additional bath/kitchen — 45 00
Fire sprinkler ( sq. R.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: 'W wi /
��� 5 �!��`�[.lry � �
� fit, Catch basin or area drain L6.60
City /State/Z1P: :irk' 9Z R. Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: Project name: /7.0 — Footing drain (no. linear ft.: _) Page 2
t..
Cross street/directions to, job site:
Manufactured home utilities 110.00
(f �� — Manholes 16,60
El
' Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2 ...
Storm sewer (no, linear ft.: _) Page 2
Subdivision: Lot no,: IMMEZEMEINTA Page 2 ��
Tax map /parcel no.:
Fixture or item
Absorption valve 16.60 El
DESCRIPTION OR WORK Duckflow preventer Page 2
i 41 7 — bl 't`! ea" i aiel4Ce Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16 60
,,te�rr� " , D 'TENANT . Drinking fountain 16,60 • Iii PRO.PEb1'I Y1'1lER` • •
�
, / . Ejectors /sump 16,60
Name: ' Vl? Expansion tank 16.60 —
Address: 1 i 7M8 5- Vim Fixture/sewer cap 16,60 r
City /State /ZIP: 1I`T/l 4 , 7 Floor drain /floor sink/hub .
_ _ 16.60
Phone: ( 17 ,9,__ j 7 0Fax: ( ) Garbage disposal 16,60
• : ,APPL1CA)`T. ' . 1 ' , F--r _COIlSTAC'x PERSON Hosc bib _ 16.60
Ice maker 16.60
Business name: ARS dba JACK HOWK /Rescue RootehC
- Interceptor /grease trap 16.60
Contact name: JOYCE DENNIS Medical gas (value, $ ) Page 2
Address: P.O. BOX 2830 Primer 16,60
City /State/ZIP: CLACKAMAS, OR 97015 Roof drain (commercial) 16.60
Phone; (503) 235 -8784 ilex :: (503) 491 -2932 5ink/basin/lavurory 16.60
E -mail: JOYCE @JACKlIOWK.COM
Tub /shower /shower pan 16.60 —
Urinal 16.6 MI
CONTRACTOR Water closet 16.60
Business name: ARS dbn JACK HOWK /g,e8C11$ Roote>~ Water heater 16.60
Address: P.O. BOX 2830 Other IlltIll
-
City /State /ZIP: CLACI AMAS, OR 97015 Subtotal �i'Lii
Minimum pemrit fee: $72.50
Phone: (503) 235 -8784 Fax: (503) 491 -2932 Residential backflow minimum permit fee: $36.25
CC13 Lie.: 127325 Plumbing Lie. no.: 34 -168 P Plan review (25% of permit fee) �`
1 State surcharge (12% of permit fee) Sri %, 5. ,
Authorized signature: 0.7 .
.. �� TOTAL PERMIT F -a
Print name: /1 41# 1 1 This permil application expires if a permit is not oh arMlfillifr
_....._ _ _ _ �.__. , __ -- _ _ __ 180 days after it has been accepted as complete.
M- _ eu "" - ~ - �g� -Z�32 t rodulnal ITiy Iii= C IySuilditiriaistry i cc Board,
t, iiId�ng\Permhe \Pratt -P. Please FAX BACK to:
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PL i�1200003'i3
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7123/2000 Phone: (503) 639 -4171 �n� �u�dpv i l '�i , I
Inspection Requests (24 Hrs.): (503) 639 -4175 ��!
INSPECTION WORKSHEET FOR DATE: 7125/2008 TIME: 7 :00AM PAGE: 19
SITE ADDRESS: 13798 SW BENCIIVIDA1 PL CLASS OF WORK:
SUBDIVISION: BENCI - IVIE / ESTATES LOT #: gi 1 TYPE OF USE:
PROJECT NAME: LLOYD
DESCRIPTION: 40 ft water service
OWNER: LEYNDA LLOYD, PHONE #: 503-579-2670
CONTRACTOR: ARS RESCUE ROOTER PHONE #: 503- 235 -8784
Inspection Request Scheduled For: Date: 7/2512008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 073218 -01 503-236-8784 Y
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Corrections /Comm nts /Instructions:
p , 1 , . „,,-4- i , P `rp C t 1,.1 .-c,/S e . -v ( ee 1 ,-(, is PVC, Lk-A,' Sv ili C ‘_c_
Cokre. chr4,t-<--A p
PASS I I PARTIAL APPROVAL _ CANCEL I I NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: CFO Gl'is-A-- JA `\)` -4- Date: "7'.),,slo ) Phone #: (503) 718-