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Permit CITY TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #: PLM2005 -00505 Jil 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 11/7/2005 PARCEL: 2S 110BC -00900 SITE ADDRESS: 12475 SW BULL MOUNTAIN RD ZONING: R -1 SUBDIVISION: LOT: JURISDICTION: TIG Project Description: Site Utilities Only. CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: U2 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: 60 ft WATER CLOSETS: WATER LINE: 40 ft DISHWASHERS: RAIN DRAIN: 100 ft Owner: FEES TIGARD WATER DEPT. Description Date Amount 8777 SW BURNHAM ST TIGARD, OR 97223 [PLUMB] Permit Fee 11/7/2005 $165.00 [TAX] 8% State Surchart 11/7/2005 $13.20 Phone : 639 - 4171 395 Total $178.20 Contractor: HAMPTON PLUMBING CO. 411 S COLLEGE ST REQUIRED ITEMS AND REPORTS NEWBERG, OR 97132 Phone : 503 -538 -5629 Reg #: LIC 160927 PLM 36 -102PB 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 -.699 or 1- 800 - 332 -2 4 4. Issued By: , � / / Permittee Signature: p}-yN 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. SEP -29 -2005 07:51-AM CHNIEDER QUIPMENT 503 633 2668 P.02 1 ? ( (I . 7 , cc(.-.) .+ 1 1 c ... v _A, 3 \ AT-4-c u \ \> . ..., ia,C--„ I°t Plumbing Permit Apph _ ' ,21] t '' t' NJ �_. 1r►1 hI lc f • t t. tivl.l Received , - r Permit N it City of Tigard �a Date/B : f ,fi L 1 �� �� dj �-� 13125 SW Hall Blvd., Tigard, OR 97223 t , , ii,-ii-- = Plan Review Phone: 503.619.4 171 Fax; 503,598.1960 + �' „ 1 11 I Other Permit No.: 24 - Hour Inspection Line: 503,639,4175 a.l `' ' I Date Reed /13 c (' �1 See Pa c 2 fat' r " _ .� . +, ��� Y Y \, Supplemental Informaden Internet: www.ci J' � e ., 9 r Notifed /Method; I iI i 1 TOT!' I i f 1;:lu I ii Wi i ` I fl) a �l�I' t 4rlt 9iligi f[ �i�(ii lllllull��lll II I� '(llli�11l�llll k"�1;�i �'^ � r i 1, 1 ; , ! i � !f � l l l � ` ![fiBc 1E New construction Demolition For special Information use checklist: Description I Qty. I Ea. I Total 0 Addition /alteration/replacement ❑ Other; New 1 dwellings (includes 100 ft for each utility connection) I ' t;;►; "'t giE ,;line � a l iK lli i�li11'lijIlillllll llllf 1 ll!Iil111 SFR (I) bath 249,20 1- and 2- family dwelling ® Commercial /industrial SFR (2) bath 350,00 0 Accessory building ❑ Multi- family ! SFR (3) bath 399.00 Each additional bath /kitchen 45.00 0 Master builder �� 0 Other: f II Fire sprinkler ( sq. 1't.) Page 2 1 �� t "'rr t riilPlln�lll ii�Itlli�Irl fl �I i,I�QUUt1 ll�all l ± Il l unrl� it :1 Ii.: i HI 9 site utllltfes 1. Job site address: 12475 S.W. Bull Mountain Road Catch basin or area drain I 16.60 City /State /ZIP: Tigard, OR 97224 Drywell, leach line, or trench drain 1 ! 16.60 . Suite /bldg. /apt, no.: J Project name: Tigard ASR 2 Well House Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross str•eet/directions to job site: 125 Avenue /Bull Mountain Road Manholes 16.60 Rain drain connector 16.60 \O Sanitary sewer (nn. linear ft.: t) Page 2 55.00 Storm sewer (no, linear ft.: 1l;) Page 2 55.00 \ Subdivision: Lot no.; Water service (no. linear ft.: t0) Page 2 55.OQ , O n Fixture or Item V Tax map /parcel no.: } ( I III Absorption valve I 16,60 i is i' ,:i ' i ! ;ii i i11 I t I t l i I r t i , �i1�Et� Ii tilr ilrf Iii J il i n iIIIIl111 �I I :1 �'` !1f1I11II1I1�1�U1 13ockflow pr ©venter Page 2 r Construction of well house over existing well Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 . ; - • i• ., ••• , s m • '. • ■ • t ; . � ilrt1l Ill 's l' i • • ' ! r i mil 1 f .i l 't , i:i Drinking fountain 16.60 sial,i is ,isi 81 1 . , li. 11 1 ► t il l► ,,,, u�il a e`>ll1f1�11111i111111.1 '.. Ejectors /sump 16,60 Name: City of Tigard _ Expansion tank 16.60 Address: 13125 S.W. Hall Blvd. Fixture/sewer cap 1 6.60 _ City /State /ZiP: Tigard, OR 97223 Floor drain /floor sink/hub 16.60 Phone: (503)639 -4171 II Fax:: (503)624-0752 Garbage disposal 16.60 52 I II . l i ; ( !. i !,{ !: i: 4Iq t ft t 1 if M 1 111NIIIIfllII1111A1 iii illllu V t j II/ iil ii i11 Hose bib 16.60 i Ice maker ■ 16,60 El M Business name: Schneider Equipment, Inc, Interceptor /grease trap 16.60 Contact name: Stan Schneider Medical gas (value: $ ) Page 2 • Address: 21881 River Road N.E. Primer . 16.60 , City /State /ZIP: St. Paul, OR 97137 Roof drain (commercial) 16.60 Sink/basin/lavatory 16.60 Phone; (503) 633 -2666 I Fax: ; (503) 633-2668 I - - Tub /shower /shower pan 16.60 sa,l h -mail: stanseldc.com Urinal 16.60 ' . ', r' ;' ii;iil i' l ', i ' Ili M�1Ii! ilNilllll�$]� rill llyilt �li iit�6lnlil I�llli 1 NA1 #iiEt1NNIII 1I1 H Water closet . • 16,60 W Business name: Hampton Plumbing Co. Water heater 16.60 Address: 411 S. College • Other: City /Statc/ZiP: Newberg, OR 97132 Subtotal 113.E 06 Minimum permit fee: $72,50 Phone: (503) 538 - 5629 Fax: (503) 538 - 5629 Residential backflow minimum permit fcc: $36,25 4 CCB i.ic.: 160927 Plumbing Li . no.: 36 - 102PB _ Plan review (25% of permit fee) • Authorized signature:. - / / -4 State surcharge (8% of permit fee) / . .2 1,0 r TOTAL PERMIT FEE r T.,2.0 Print name: Bob Hampton I Dam: 9/28/05 This permit application expires It a permit is not obtained w thin . 180 days after it has been accepted as complete. •Fee methodology set by Tri- County Bull • g Industry Service Board. , :lauil dmg \Permits \PLM.PcrmitApp.doc 06)05 440.46I611 /COM/was) CITY OF TIGARD iv -1 BUILDING DIVISION g PERMIT #: �`i 41 a C J d S " C20,5 13125 SW Hall Blvd., Tigard, OR 97223 - C i ,l ° DATE ISSUED: Phone: (503) 639 -4171 ://111 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 1 ' ,k0 ,k0/6 6 TIME: PAGE: SITE ADDRESS: 0,14 7 5 S to 5J( Me w n'1l'w ,v. K) CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: C4y b I :e) Cf r d 1 DESCRIPTION: C ons - 4ruc4 'um aT tile II 'hots e. OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message R fit wimcr 3 7 1 674 c_ -7, .:.:r._ , AN 7 in et Corrections /Comments /Instructions: O,?, 6( 'L-e 6a /AI& ( 7a ,(i....c...;; A--r-ez. /vv I /i 4 r .,, ) ,S ' . ,y 1,A, , tik_ PASS I I PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS n FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: `� l�t� Date: q/ 61 Phone #: (503) 718- 2— 1/4'D` CITY OF TIGARD f rn BUILDING DIVISION 494 PERMIT #:�S — QO.DO SD ' 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: S Phone: (503) 639 -4171 : A 1 11A 4p���iitill�i Inspection Requests (24 Hrs.): (503) 639 -4175 � -_.. INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: ( ) (--( —7 �" � V I V'L, Rot' CLASS OF WORK: SUBDIVISION: J LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 3 `f -6 Pour Time: Code # Ins "ection Description Confirm # Contact # Message Corrections /Comments /Instructio s: ) - k- -- ( - 1;1, - \Xt.& - �j . ( Tro U ( 1 rwt" O � s -- e-7-i_ i-e- -5' 4- L o iao\P c — .- X-i•-1S Z -A AAdv‘_...ge---U0 - 1.__ : 4-7 _..0j.-c)--6 CL-t_ - k) e. .-_) ‹-: c4e_,_, - k..:.,4:-- Le,A,„„)_„-1_, r ' H a. f :111I1 / ,/ 7 .. ii/.../e1SS • ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED Inspector: v Date: / , Phone #: (503) 718 - L - - - CITY OF TIGARD `� BUILDING DIVISION - PERMIT #: ICI Ii°4'ltfr C0' • 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/7/2006 Phone: (503) 639 -4171 ho g" oviAlli Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: ://24/2006 TIME: 7 :g; A t PAGE: 10,9 SITE ADDRESS: 1247 ; SW BULK. MOUNTAIN IUD CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: CITY OF TIGARD DESCRIPTION: Site Utilities Only. OWNER: TIGARD WATER DEPT., PHONE #: -,g CONTRACTOR: P HONE # : 503,638..5629 0 $ r .z HAMPTON PLUMBING CO. • Inspection Request Scheduled For: Date: 2124 006 Pour Time: Code # Inspection Description ' Confirm # Contact # Message 396 Misr.. inv.:pection 027441 - 01 603 - 3069786 N Corrections /Comments /Instructions: I ` 7Z ./65-7 . 71/ (--- P—.... ( ---- -'. PASS n PARTIAL APPROVAL n CANCEL 1 I NO ACCESS I I FAIL CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: 0 / ) v Date: . / " l Phone #: (503) 718-