Permit 4 CITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2006 -00447
'�' II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/29/2006
PARCEL: 25111 CC - 01600
SITE ADDRESS: 10275 SW CENTURY OAK DR ZONING: R -7
SUBDIVISION: SUMMERFIELD LOT: 013 JURISDICTION: TIG
Project Description: Kitchen remodel: DW, GB, WH all relocates, sink.
CLASS OF WORK: ADD GARBAGE DISPOSALS: 1 MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: 1 BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: 1 RAIN DRAIN: ft
Owner: FEES
DAN /MARY COUGHLIN
10275 SW CENTURY OAK DR Description Date Amount
PORTLAND, OR 97224 [PLUMB] Permit Fee 9/29/2006 $83.00
[TAX] 8% State Surcha 9/29/2006 $6.64
Phone : 503- 620 -2629 Total $89.64
Contractor:
JAY JAY'S PLUMBING
19447 E. BURNSIDE
PORTLAND, OR 97233 REQUIRED ITEMS AND REPORTS
Contact # : PRI 667 -8420
FAX 503- 492 -3863
Reg #: LIC 14332
PLM 26 -177PB
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. le/
Issued By: Permit Signature: /��
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.
Plumbing Permit APPI >�on� � ® „ FOR OFFICE USE ONLY s
��
City Of Tigard Received P ermit N
13125 SW Hall Blvd., Tigard, OR 97223 S E P 2 9 2006 Date /By: 4/49b �� �— a� — 7
Plan Revi w
Phone: 503.639.4171 Fax: 503.598.1960h�' I y , Other Permit No.:
+
24- Hour Inspection Line: 503.639.4175 CITY OF TIGAF ,. . E•' Date/By: Date Ready /By: 1urs: EI See Page 2 for
Internet: www.ci.tigard.or.us BUILDING DIVISIVI`. Notified/Method: Supplemental Information
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,. .., .., <. ..`.�,c .z. .....�,* -..<. :. :. .... fa�,�•. `,�a .; .;� '€:.;.3 t °. %:is�' .iy � :.�. ,.,o•,..R;.�c -`�� i��.?;;''si�' *,
I New construction ❑ Demolition '' ' use checkhst.
Descrigtion et . Ea. Total
S• Addition/al teration/replacement ❑ Other: dwellings (includes 11 ft. for . ,
r
:CA'T iVri O 4.01` 1STRUC'r'IG1N ` V"V''' '' ..
1- and 2- family dwelling ❑ Commercial industrial 350.00
SFR (3) bath
❑ Accessory building 111 Multi-family " 399.00
Each additional . 11
❑ Master builder ❑ Other:
"tip;': ::qtr = `::�, r"c,:. =; +';: �;�..:_ <.a £ ::'•k., -ir ,,-,,i••it; . , _
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Job site address: /00/.75 .-30.-) • Ce./)luieY Oh Dg or area drain 1
City/State /ZIP: rqm1 OR 97 a ( . drain . 61
Suite/bldg. /apt. no.: "--� I Project name: �` 1g/el)
Footing ' ' Page 2
C Manufactured home utilities 110.00
Cross street/directions to job site: VVV
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Pap 2
Water service (no. linear ft.: ) Page 2
Subdivision: l Lot no.:
Fixture item
Tax map /parcel no.: or
Absorption valve 16.60
c ` ; ,' :•: �.\• DESCRIPTION OBz:_'VORK>ry ..,.,,_,;.
i +: , :.'".a':°.< ": „ra:. < -..... _,.. .,..,:sue \:�:. W, µa > `'`: �.:'' Backflow prey enter Page 2
f twvrta s A Ots -W c i ac.•4 . -✓ /)/.p /0/„sp Backwater valve 16.60
) e Loa-740 ( 16.60 b.�O
iPON =TX: OWN `` i.:' � .' TE I�I AN
, T
Name: n _ \ /� n t �:� Ejectors/sump
�I i'. el � j � _ 1 .. . 16.60
Address: [Oa75 3t3 eel � y ,,N-As OA • Fixture/sewer
City/State /ZIP: �nf� d 4;',7,,2'(/ „ drain/floor , . ■ 661
Phone: Vim' Garbage 16.60
�3) Fax: ( ) - '
F' '
4
43
�: ” =CONTACT '.E . �t,...
Ice maker 16.60
Business name: ( � 1 PP Cpl!���i t �.TC '/ . • 16.60
Contact name: (n .1 R1,n� , c frS .e.,D Medical Page 2
Address: Cfaaa s� ltiaDn S ,:kis 6Lua Primer 16.60
City/State /ZIP: c- cyR ? 7 ?& Roof ' 16.60
1 ' ., 16.60
Phone: (5�)- f`f( -tilcU Fax: :( 603)77I - l8 7/
Tub/shower/shower 16.60
E- mai1:644 ) egr &co_60 -
" a
4 ..1
a, 3 CONTRAGTOR '> ..;. ,; - _ :,. s:,.. >.,, <..,
`
Business name: ' --- Z -- , -
•' 5 91 ,gyp � — 1 - 5 16.60 jCokav
Address: /W e77 ait/S /D 6, Other:
City/State /ZIP: � en 97 53 Subtotal " 4 °•,
Minimum permit fee: $72.50 2
Phone: (j22 ) 4,6,7 EL 2 Fax: (. j) 4/9 -3 86,3 Residential backflow minimum permit fee: $36.25 ' j
CCB Lie.: lip.: /../ 3 Plumbing Lic. no.:.. / 77 T p� Plan review (25% of pennit fee)
State surcharge (8% of permit fee) . (p; o
Authorized signature: /
TOTAL PERMIT FEEj J
Print name: Date: This permit application expires if a permit is not obtained witlti .
180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
is \Building\Permits\PLM - Permit pp.doc 0 /05 440 -461 T 10/02 /COM/WEB)
Y 7 — 1 i / 08
CITY OF TIGARD n _
13125 S.W. HALL BLVD. U 1) c� ( ` �� � � L �
TIGARD, OR 97223 l�J
OCT 3 20%
M PORTANT PERMIT NOTICE eU D Div oN
JAY JAY'S PLUMBING
19447 E. BURNSIDE
PORTLAND, OR 97233
Plumbing Signature Form
Permit #: PLM2006- 00447
Date Issued:
Parcel: 2S111 CC -01600
Site Address: 10275 SW CENTURY OAK DR
Subdivision: SUMMERFIELD
Block: Lot: 013
Jurisdiction: R -
Zoning: TIG
Remarks: Kitchen remodel: DW, GB, WH all relocates, sink.
'our company has been indicated as the plumbing contractor for the permit indicated above. In order for the plumbing
■ermit to be valid, please have the appropriate individual from your company sign below and return this Plumbing
Signature Form prior to the start of the work to the address above, ATTN: Building Division.
lo plumbing inspections will be authorized until this completed form is received
OWNER: PLUMBING CONTRACTOR:
DAN /MARY COUGHLIN JAY JAY'S PLUMBING
10275 SW CENTURY OAK DR 19447 E. BURNSIDE
PORTLAND, OR 97224 PORTLAND, OR 97233
Phone #:503- 620 -2629 Phone #: 667 -8420
Reg #: LIC 14332
PLM 26 -177PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Signa re of Authorize /;'' mber
F you have any questions, please call 503.718.2433.
L'd 999C - 909 y}iwg ue>i d99:90 90 CO PO
CITY OF TIGARD
BUILDING DIVISION PERMIT #: P , 206-
LI 0 00447
13125 SW Hall Blvd., Tigard, OR 97223 . DATE ISSUED: 9/29/2006
Phone: (503) 639 -4171 � l+
Inspection Requests (24 Hrs.): (503) 639 -4175 J
INSPECTION WORKSHEET FOR DATE: 212812007 TIME: 7 :02AM PAGE: 23
SITE ADDRESS: 10275 SW CENTURY OAK DR CLASS OF WORK:
SUBDIVISION: SUMM'ERFIELD LOT #: 013 TYPE OF USE:
PROJECT NAME: COUGHLIN
DESCRIPTION: Kitchen remodel: DW, GB, YOH all relocates, sink.
OWNER: COUGHLIN, DAN /IMIARY PHONE #: 503 -620- 1628
CONTRACTOR: JAY JAY'S PLUMBING PHONE #: 667 -8420
Inspection Request Scheduled For: Date: 2/28/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 044086 -01 503- 771 -9606 N
Corrections /Comments/ Instructions:
KP ASS P' 'TIAL APPROVAL n CANCEL ❑ NO ACCESS
I FAIL . , /FOR INSPECTION I i ADDITIONAL EES ASSESSED
Inspector: _ Date: Z 6 G Phone #: (503) 718- ....v■• A/
CITY OF TIGARD
BUILDING DIVISION PERMIT #: pLM2006-00447 •
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/79/2006
Phone: (503) 639-4171 ,l
Inspection Requests (24 Hrs.): (503) 639-4175 a lit
INSPECTION WORKSHEET FOR DATE: 10/9/2006 TIME: 7:01AM PAGE: 46
SITE ADDRESS: 10275 SW CENTURY OAK DR CLASS OF WORK: i
SUBDIVISION: SUMMERFIELD LOT #: 013 TYPE OF USE: ,
PROJECT NAME: COUGHLIN
DESCRIPTION: Kitchen remodel: DW, GB, WI-I all relocates, sink. f
OWNER: COUGHLIN, DAN/MARY PHONE #: 503-620-2629
CONTRACTOR: JAY JAY'S PLUMBING PHONE #: 667-8420
Inspection Request Scheduled For: Date: 10/9/2006 Pour Time: ;
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough-in 037849-01 603-667-8420 Y
Corrections/Comments/Instructions: .
,
-"# A --- ,/•it.■.-_e .... ./.•__A.... , -
•
•
a -
SS EI PARTIAL APPROVAL [ CANCEL NO ACCESS
El FAIL El CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: f
.-
Date: : Phone #: (503) 718- —7"--