Permit CI TY OF TIGARD GARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00257
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/19/2007
PARCEL: 2 S 102 D B -03500
SITE ADDRESS: 13391 SW CHELSEA LP ZONING: R -12
SUBDIVISION: CHELSEA HILL LOT: 012 JURISDICTION: TIG
PROJECT: ISOM
Project Description: Remove and replace tub.
CLASS OF WORK: ALT 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: 1 SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
ISOM, DAVID BRYAN AND
BARBARA JO Description Date Amount
13391 SW CHELSEA LOOP [PLUMB] Permit Fee 6/19/2007 $72.50
TIGARD, OR 97223 [TAX] 8% State Surcha 6/19/2007 $5.80
Phone : Total $78.30
Contractor:
TERRY MASSEY PLUMBING
PO BOX 2407
CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 997 -0324
FAX 503- 655 -7065
Reg #: L1C 151756
PLM 3 -480PB
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 Permittee Signature: S 49,/irAcli
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.
FROM :Terry Massey P 1 umb i ng FAX NO. : 5036557065 Jun. 19 2007 06: 08AM P2
v -- -
Plumbing Permit ABEca •
City of Tigard JUN 19 /0l1/ Received /
DaciRY: bag 69 S Permit No,:
PLN12-C63
13125 SW Hall Blvd.. Tigard, OR 97223
Phone: 503.639.4 Fax: 501598.16bTY O TIGARD /40,,,,,,,. . Plan Review
Date/By: Other Permit No.;
24- Hour Inspection Lint: 503.639,41BU I WI NG DI VISI 0 ,,,44,1-. .11 Date Ready/By: .. ,., ..-- et See Pagel for
Internet: www.ci.tigard,or, cs Notified/Method: (or Supplemental Information
-.. : • ' .: , , : : :
TYPE 4 i;..::::).: .:„,-..,.:-. : .:::::::,,:.-:',.:.:,:,,:-.,.:::•.:,:;::;:,,..,:: y±:::,:
...v..• , • . ,A-4 i:„„ ,„. ,;,,, „4 .
For s , :- Olin , relation use cherkfle
0 N,v construction 0 Demolition
Description Qty. Ea. Total
0Addition/alteration/replacement El Other: New 5-2 dwellings (includes 100 It for each utility connection)
, ,:l •;;! ,F ..:,'' SFR (1) bath 24920
Ig‘and 2-family dwelling CI Commercial/industrial SFR - (2.) bath 350.00
...
- .
,
0 Accessory building CI Multi-family SFR (3) bath . 399.00
Each adi1itinaI bath/kitchen 451)0
_
-
ICI Master builder 0 Other: -
Fire sprinkler ( sq. ft.) Page 2
:''' . ,. ' : '.: ;: :elijr.i*Skt000:46':,t,00*110#:''.. .; ,..; , ,,••• _ .. •
lob site address: / --- " C / 5 (,)CELLS4_42...., LP , ,., Catch basin or area drain 16.60
4
City/State/ZIP: -- i- 2 64: 4-8 011 --) Drywell, leach line, or trench drain 16.60
Suit bIdgJapt. no.: Prnicct name:
Footing drain (no. linear ft.: ) Page 2
c/ "
Manufactured home utilities 110,00
tr
Cross street/directions to job Site: opma. Y
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no, linear ft.: ___3 Page 2
Storm sewer (no. linear II.: ) Page 2
Subdivision: Lot no.:
Water service (no. linear It:, ) 1. Page 2
I - -
;Ware or item
TeX map/pnrcel no.:
Absorption valve 16.60
;..•.',:.;.:;-:‘'.:`,:'!::::,";•:: , •• -...'• ., *,:l'''' ‘ 1WS.....IMQ 1 ?.;'''9f".1•Y9W : :: , 'j:i,',. Backllow preventer Page 2
( 1.1.tert.e ,e_ ci,,, ca. 12-(2.-fte,---..4ta__ Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16_60
- . • . . Drinking fountain 16.60
:,. •.ILYP.Ittik0;4",0,:, tri ' : :: 1. •'' ' ':: ''s '. ,' :, -: lill:T,F.';N:Xt•Fi,%•;1 !'';:' ',
jcctoiWsump 16.60
Name:
Expansion lank 16.60
Address: • Fixture/sewer cap 16.60
City/State/ZIP: Floor drain/floor sink/hub 16.60
Phone ( ) Fax: ( ) Garbage disposal 16.60
: Hosc bib 1660
_ .
:', :!, ..'cl.: ?....,.:: ' i" '::,:,:: .. :::•: ..'. ,.::':',:H: - : ,, T'T, , ,,„i:;,P. , , ,, ;, ,,,:.:.,. 7• ice maker 16.60
Business name:
Interceptor/ trap 16.60
Contact name: Medical gas (value: S ) Page 2
Address: Primer 16.60
City/State/ZIP: Roof drain (commercial) . 16.60
Sink/basialavatoty 16.60
Phone: ( ) -. Fto.:(___
„ Tub/shower/shower pan I 16.60 / C _ ..?i
E-mail: -
Urinal 16.60
16.60
Business name: -- r e. „ ( < Li 1 gt..../ P I (.4.1/1•110 - 1\11 c:\ Water heater 16.60
Address: CV , 6 i ---- . -j. 9.„ , , 6 , - ) 1 Other:
Subtotal
City/State/ZIP: ( 3 1/4 f cAc,_ QA cte , c, 7 .74 i S. Minimum perrnit fee; $72.50
Phone: f>3) jq 7- O 3 a '`-/ Fax: (50 ) a S5 .27 0(
- Residential backflow minimum permit fee: $36.25 IL 5 6
003 Lie.: / , .L=7 -5 C Plumbing Lie. no.: 3 - -47 to f--I• Plan review (25% of permit fcc)
State surcharge (8% of permit fee) ,131:3
Authorized signature: ''"' ,... , A / Air 4. 1 TOTAL PERMIT FEE .7 9 3J
Print name: e .- , %L I, .- / •
Date: 40- 4 1Pb This permit application expires if a permit is not obtained within
• 180 days after it has been accepted as complete.
*Fee methodolocv set by Tri-County Buildine Industry Service Board
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007 -00257
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/19/2007
Phone: (503) 639 -4171
ile Inspection Requests (24 Hrs.): (503) 639 -4175 L
INSPECTION WORKSHEET FOR DATE: 6/29/2007 TIME: 7:00AM PAGE: 64
SITE ADDRESS: 13391 SW CHELSEA LP CLASS OF WORK:
SUBDIVISION: CHELSEA HILL LOT #: 012 TYPE OF USE:
PROJECT NAME: ISOM
DESCRIPTION: Remove and replace tub.
OWNER: ISOM, DAVID BRYAN AND, PHONE #:
CONTRACTOR: TERRY MASSEY PLUMBING PHONE #: 503-997-0324
Inspection Request Scheduled For: Date: 6/29/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 051127 -01 503- 997 -0324 N
Corrections /Comments /Instructions:
I (9
SASS I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: IL / q Phone #: (503) 718- -9-21 �✓
/ 6
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007 -00257
13125 SW Hall Blvd., Tigard, OR 97223 „ _ - DATE ISSUED: 6119/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/20/2007 TIME: 7:04AM PAGE: 54
SITE ADDRESS: 13391 SW CHELSEA LP CLASS OF WORK:
SUBDIVISION: CHELSEA HILL LOT #: 012 TYPE OF USE:
PROJECT NAME: ISOM
DESCRIPTION: Remove and replace tub.
OWNER: ISOM, DAVID BRYAN AND, PHONE #:
CONTRACTOR: TERRY MASSEY PLUMBING PHONE #: 503-997.0324
Inspection Request Scheduled For: Date: 6/20/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 050545.01 503-997-0324 Y
Corrections /Comments /Instructions:
ri AO?
/ r
II " SS ❑ PARTIAL APPROVAL n CANCEL I I NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: M / ( Date: / / iD Phone #: (503) 718 -
.