Permit I^
CITY TIGARD PLUMBING PERMIT
i DEVELOPMENT SERVICES PERMIT #: PLM2006 -00347
'�I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 7/17/2006
PARCEL: 1S133DD-07600
SITE ADDRESS: 12755 SW DANBUSH CT ZONING: R -4.5
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 3 LOT: 115 JURISDICTION: TIG
Project Description: Relocate drain for tub to shower conversion.
•
CLASS OF WORK: OTR 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
THOI NGUYEN
12755 SW DANBUSH CT Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 7/17/2006 $72.50
[TAX] 8% State Surcha 7/17/2006 $5.80
Phone : 503 -524 -9361 Total $78.30
Contractor:
MRP SERVICES •
PO BOX 33585
PORTLAND, OR 97292 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 652 -2626
FAX 503- 241 -6565
Reg #: LIC 106824
PLM 3 -265PB
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: .i7 J( en, .& Permittee Signature: S j
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.
• - t•
Pin'lmiiine- Permit Appal i ulc {)hal Ii I ONLY
of Tigarci �I � ,► ' R odoivea Permit No.:
13125 SW Hall Blvd.. Tigard, OR 97223 Date/13y: / � ?et % i Air
Flan, Anviuw
Phone: 503,639,4171 Fax: 503,593,1960 JUL 1 < "rr p� it Dute
� � By: Other Permit No.!
24- Hour Inspection Line: 503.639.4175 l .,, . Data �
p a ,� � Ltex<ly /By: Iuria: � See P age for
Internet: www.ci.tigard.or.us Notified/Morhod: )/ G Supplemental ►nfurmatiun ■
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CI New construction Demolition ' For speciallr{formarion use checklist
Description 1 Qty. ( Ea, 1 'total
i + Additio (n/allterra,tyiit" on/replacement �t � j T El Other New :t- 7- family dwellings (includes 100 ft. for each utility connection)
1260 � Y� :rS , ?.1'a� j lr4 u: ! ' : ., rc "'"�1 .. . i t 1"'�e'
..., _ f � � ,.., :. � d�!��� 1 j + ` "1r n4�M t' o , � i�r ' P,�, 1 t,s' SFR (I) bath 249.20
0 and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
Accessot building SFR (3) hash 399.00
❑ y g ❑ Multi- family
Each additional bath/kitchen 45.00
❑ Master builder j ❑ Other: • -• -
� ° 4y if iaU ' �'It 71 q 161. b 0. O ��Q , �6 Site -
utilities
Job site address: � 1 �. Catch basin or area drain - 16.60
City/State/ZIP: e „ " ' 1 • Of-) g?3 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: 1 Project name: (f 1 Footing drain (no. linear 13,; ) Page 2
• IIVJ/���sss b� Manufactured home utilities 110,00
Cross street/directions to job site: • Manholes 16.60
A 1 Rain drain connector 16.60
NERIMM . , 1 . l /L 1 a, . Sanitary sewer (no. linear ft.: Page 2
>' Storm sewer (no. linear ft.: ) Page 2
-
Subdivision: ,m great Water service (no. linear t1.: Page 2
Tax map /parcel no.: Fixture fir item
S ix t r ��, �. v "x r: ,La .W „ir c5 ...ti... •.a: . Absorption valve 16.60
n
��yy "1 Y i i • f , t , $ }- ��..11i° iii ;.F '., vni�''t
w' t ` S' Nk1 i ' IA . , x,, yes, l ,.,kiri (r' Aij� Backllowprevenler Page 2
111:411MO ` M fit) WMA LM Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
"° t') ran. ; ° "re" t, hR „ - Dnuking - in 16.60
v I t``�y� c L 1 glp� o J�` . , � + k g.1 . �!��,tiJJ
fountain
r w,rl "r7f rN ntt� .... hi . i:u 7f- r' ,,'�, '7 �5'•,�`'I`l�, n' -�.�
` � �jectorsJs`ump 16.60
FI, Lri_ /. { ��` Expansion tank - 16.60
Address: 1 PM, 1 : ! ��� Fixture/sewer cap 16,60
City /State/ZIP: f 111 F :' Floor drain/floor sink/hub 16.60
al i ) � .. pi � Garbage disposal 16,60
,r ,,T ;ltf+ E k ,,m w y )1 „} ic i rs; A c x +, °i ; , Hose bib 16.60
Ice maker 16.60
M. ° Ln . .1 __I-..4 interceptor /grease trap 16.60
Contact name: • y • Or 1 I Pt/ Medical gas (value; $ ) Page 2
Address: Pi r 141. Pruner 16.60
City /State /ZIP: 1 ' i t O' t r '- Roof drain (commercial) 16.60
Phone.5) r r _ 01 Fax:: ( Q • - Sink/basin / lavatory - 16,60
r f ` r ` 111 Tub /shovaer /shower pan 1 16.60 1(0 , (
1r mail
�� " Pnu !li" v� 7 ( iP mr' " v t Uri nal
t �� 16,60
: i � E r' t t ' l kl it `� t,l y G(,t 9�i 1 u tj�`:Y. t+ i e • " ,) �'" Sx ;„t i �'!+1 1 °�'' i•�:rko +. '_ � 16.60
>,� r rit:.:tt�+ �.�.Ry.,. «i:3!RtatL.t; „�•:1v ��., t i �pr�1 ' ��:�l .h rt��,tia' ri��a;. ;d'r „ M , Wal'er c;lbset
V WIM Water heater 16.60
Address: ° ` ea ax 3 L Other:
City /State/ZIP: / r1 .� .�_ i� ?. Subtotal I (Pt (o
Phone: �n A permit permit tee: 572.50
`W 3 )(Q6) - r� r .,�. r mg-
( Fax: ( I ) d' - Residential backtlow minimum peit fee: $36.25 •
CCB Lie.; ! i 0 d j A Plumbing Lie, no.: 3 --d , $' / ' _ Plan review (25% of permit fee)
Authorized signature: ��f +'ti 1 State surcharge (S% of permit tee) , Vt C � , TOTAL PERMIT FEE
Print name: - brl A Al . 37) ( s Date: r 7 1 -el This permit application expires if a permit is not obtained within
Y 180 days after it has been accepted as comptctc,
i°Fee methodology set by Tri- County Building Industry Service Board.
istnuildiii mita\PLM- ParmitAppdoe 06/05 49040IGT(I 0/02/CDMIwJm)
ZB /tB 3917d dHlhJ 9S STIZEBS 9Z :ZT 9902 /LT /L0
CITY OF TIGARD -- .
BUILDING DIVISION , - PERMIT #: PLM2(106.00347
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Itlii2006
Phone: (503) 639 -4171 11,��, Fill
. Inspection Requests (24 Hrs.): (503) 639 -4175 _ •
INSPECTION WORKSHEET FOR DATE: 7/28/2006 TIME: 7 : 01AM PAGE: 55
SITE ADDRESS: 12755 SW DANBUSH CT CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 3 LOT #: 115 TYPE OF USE:
PROJECT NAME: NGUYEN
DESCRIPTION: Relocate drain for tub to shower conversion.
OWNER: NGUYEN, THOI PHONE #: 503-524 -9361
CONTRACTOR: !ARP SERVICES PHONE #: 603
Inspection Request Scheduled For: Date: 7/20/2006 Pour Time: _
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 033949 -01 603.652 -2626 Y
Corrections /Comments/ Instructions:
fi___ /LA�
•
/ Il
(7- a ' ' ' ' -e----- ; '7
/■ 'ASS I I PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
I I FAIL I I CALL FOR INSPECTION F ADDITIONAL FEES ASSESSED
Inspector: V X J t/ Date: 2 / "7 i Phone #: (503) 718-
, CITY OF TI.GARD - --
BUILDING DIVISION _ PERMIT #: PLM200G -00347
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7f17/7006
Phone: (503) 639 -4171 4011 `�I
Inspection Requests (24 Hrs.): (503) 639 -4175 1 I
INSPECTION WORKSHEET FOR DATE: 7/26/2006 TIME: 7 :07AM PAGE: Of
SITE ADDRESS: 12755 SW DANBUSH CT CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 3 LOT #: 115 TYPE OF USE:
PROJECT NAME: NGUYEN
DESCRIPTION: Relocate drain for tub to shower conversion.
OWNER: NGUYEN, THOI PHONE #: 6603 -624 -3361
CONTRACTOR: MRP SERVICES PHONE #: 603- 6512626
Inspection Request Scheduled For: Date: 7/26/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 033710-01 503 -652 -2626 Y
Corrections /Comments /Instructions: 5 / 2 '3
{) NtN"-- CA/61
•
" likPASS _ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
I I FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED •
Inspector: U" /. Date: .1 25 i0i Phone #: (503) 718- .2' */