Permit C ITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00241
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/3/2008
PARCEL: 1S134AC-02646
SITE ADDRESS: 11040 SW COTTONWOOD LN ZONING: R -4.5
SUBDIVISION: ENGLEWOOD NO.3 LOT: 212 JURISDICTION: TIG
PROJECT: SWEARINGEN
Project Description: Interior plumbing for kitchen and dining room remodel. Other fixture: (1) hose bib.
CLASS OF WORK: ALT GARBAGE DISPOSALS: 1 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: 1 OTHER FIXTURES: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: 1 RAIN DRAIN: ft
Owner: FEES
LARRY & RO SWEARINGEN
ROBERTA Description Date Amount
11040 SW COTTONWOOD LN [PLUMB] Permit Fee 6/3/2008 $72.50
TIGARD, OR 97223
[TAX] 12% State Surch 6/3/2008 $8.70
Phone : 503 -590 -3655 Total $81.20
Contractor:
ACCURATE PLUMBING
3021 NE 72ND AVE
#924 REQUIRED ITEMS AND REPORTS
VANCOUVER, WA 98661
Contact # : PRI 360 - 944 -8952
FAX 360 - 896 -4870
Reg #: LIC 85333
PLM 37 -309PB
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 ": f—r �� Permittee Signature: /� .1,0115f .
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.
V
May -29 -2008 10:59 AM Walker Interior Remodeling 503 -244 -4667 3/4
8 ; ‘ )
Plumbing Permit Application. I FOR OFFICE USE ONLY t c. , r
� r �eeived
City of Tigard c l, ��" , • ' Pcrnait No. /`IT t�/v ' 6
M illi r1 13125 SW Hall Blvd., Tigard, OR 97223 Mpy �". 1 , , -:;.
Phone: 503.639.4171 Fax: 503.598.1960 ` • et
`, y : Other Permit No. ic4p ar,F3� 00/901_
'T Inspection Line: 503.639.4175 `� ® '0 " Date Ready /fly: luris El See Page 2 for
Internet: www.tigard- or.gov 1J\ ,���C Notified /Method: Supplemental lnrormation
I TYPE OF WORK v \ ' ��V ) FEE* SCIIEDULE
ti New construction ❑ Demolition For valid information use checklist.
Description I Qty. I Ea 1 Total
❑ Addition/alteration/replacement ❑ Other: New I- 2- family dwellings (includes 100 II. for each utility connection)
• CATEGORY OF CONSTRUCTION SFR (l) bath 249.20
11] I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
JOB . ..SITE E INFORMATION .f(NI);:LOCA'T'ION;:: ,' . • • Site utilities
lob site address: (\ Oy O S03 C k4 ( cv,n.e Catch basin or area drain 16.60
City /State /ZIP: Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt, no.: Project name:
Footing drain (no. linear It.: _) Page 2
kAyear1 1 )'ti Manufactured home utilities 110.00
Cross street/directions to job site: �' P,f, - .A0eCt, Nr - i UP...
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: � ) Page 2
Subdivision: Lot no.: Water service (no. linear R.: ___) Page 2
Fixture or item
Tax map /parcel no,:
Absorption valve 16.60
DESCRIPTION OF WORK Backflow premier Page 2
K i -1i ve.►-N / i h' v fV •NArne>ck RA Backwater valve 16.60
Clothes washer 16.60
Dishwasher I 16.60 ((p , (.00
Drinking fountain 16.60
01011 Y "OW{ CR ' ' ®'i:l'p : .
n ' f Ejectors /sump 16.60
Name: 1� 17In• es �a l V'Y" - StAY-e.Rv ( 4.t1 Expansion tank 16.60
Address: ' w �� cOnn Fixture/sewer cap 16.60
City /State /ZIP: Floor drain /floor sink /hub 16.60
Phone: ( ) Fax: ( ) None Garbage disposal ( 16.60 Ito, 60
CONTACT Hose bib •( t6.60 Us.40
[ APPLICANT ❑ CON
Ice maker 16.60
Business name: Walker Interior Remodeling, Inc. °
Intcrccptor /�rt:asc trap 16.60
Contact name: -"-pc)Lvy, i._ �'�t0ctid Medical gas (value:$ Paget
Address: 6775 SW 111th Avenue, Suite 201 Primer 16.60
City /State/ZIP: Portland, Oregon 97008 Roof drain (commercial) 16.60
Phone: ( 503) 452 -1383 Fax:: ( 503) 244 -4667 Sink /basin/lavatory 16.60 Ile lei
Tub /shower /shower pan 16.60
E -mail: None Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: Accurate Plumbing Water heater 16.60
Address: 3021 NE 72nd Avenue # 924 Other
City /State /Zit': Vancouver, Washington 98661 Subtotal lrt°•
(vlinimum permit lee: $72.50 ��
Phone: ( 360' "944 -8952 Fax: (360) 896 -4870 Residential backllow minimum permit lce: $36.25
CCB Lie.: 85333 Plumbing Lie. no.: 717 8 Jp Plan review (25% of permit fee)
State surcharge ("$% of permit fee) S.1-D
Authorized signature: r
TOTAL PERMIT FEE Y4 I , 0
Print name: Pay,,.., C , C Date: r j I iR This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by 'Fri- County Building Industry Service Board.
Luluitding'I'orn itsU'LM- PcrmitApp.don o° 20 /oo 440- oinT(le/02 /(oNvwen)
i 1
CITY OF TIGARD
• .-.
BUILDING DIVISION PERMIT #: PLM2008-00241
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: En/200
Phone: (503) 639-4171 7
Inspection Requests (24 Hrs.): (503) 639-4175 ...„..„.. '...L.
INSPECTION WORKSHEET FOR DATE: 6/5/2009 TIME: 7:00AM . PAGE: 28
SITE ADDRESS: 11040 SW COTTONWOOD LN CLASS OF WORK:
SUBDIVISION: ENGLEWOOD NO.3 LOT #: 212 TYPE OF USE:
PROJECT NAME: SWEARINGEN
DESCRIPTION: Interior plumbing for kitchen- and dining room remodel. Other fixture: (1) hose bib.
OWNER: SWEARINGEN, LARRY & ROBERTA ' PHONE #: 503-590-3655
CONTRACTOR: ACCURATE PLUMBING • ' PHONE #: 360-9448952
, : • .
Inspection Request Scheduled For: Date: 6/512006 ,.• ; Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough-in 070933-01 503-1340.2292 Y
Corrections/Comments/Instructions:
[kAS S n PARTIAL APPROVAL 0 CANCEL I I NO ACCESS
I FAIL I I CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
Inspector: (5611-A-.A \ \i Date: 4 1 q () Phone #: (503) 718-
. .
CITY OF TIGARD
(.)
BUILDING DIVISION ' () .0 DATE 6 P / 1:1 7 : 0 ,M 0 ( 8 )8 00241
13125 SW Hall Blvd., Tigard, OR 97223
Phone: (503) 639-4171 1 ; 1441 Mtit - 0 E‘
° (R fr_.-- - •
Inspection Requests (24 Hrs.): (503) 639-4175 ..,-4,W '
INSPECTION WORKSHEET FOR DATE: 6/412008 TIME: 7:01AM PAGE: 9
SITE ADDRESS: 11040 SW COTTONWOOD LN CLASS OF WORK:
SUBDIVISION: ENGLEWOOD N0.3 LOT #: 212 TYPE OF USE:
PROJECT NAME: SWEARINGEN
DESCRIPTION: Interior plumbing for kitchen and dining room remodel. Other fixture: (1) hose bib.
OWNER: SWEARINGEN, LARRY & ROBERTA PHONE #: 503-590-3656
CONTRACTOR: ACCURATE PLUMBING PHONE #: 360-944-8952
Inspection Request Scheduled For: Date: 6/4/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Mes :ge
320 Plumbing rough-in 070644-01 503-840-2292 N
Corrections/Comments/Instructions:
7 --- 7) --
I I PASS fl PARTIAL APPROVAL El CANCEL NO ACCESS
ra AIL ZSALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
\ZZ).
Inspector: Date: Vc__
l e/ V( C( Phone #: (503) 718-
CITY OF T.IGARD
BUILDING DIVISION PERMIT #: PLM2008 -00241
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6i3/2008 Phone: (503) 639 -4171 /tzni!r �iii�' .
` ^
Inspection Requests (24 Hrs.): (503) 639 -4175 ' ' - -.
INSPECTION WORKSHEET FOR DATE: 8/8/2008 TIME: 7:00AM PAGE: 39
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION: 10140 COTTONWOOD LN LOT #: TYPE OF USE:
PROJECT NAME: ENGLEWOOD NO.3 212
SWEARINGEN
DESCRIPTION: Interior plumbing for kitchen and dining room remodel. Other fixture: (1) hose bib.
OWNER: SWEARINGEN, LARRY & RO ERTA PHONE #: 6 03 - 5901 -3565
CONTRACTOR: ACCURATE PLUMBING PHONE #: 360-944-8952
Inspection Request Scheduled For: Date: 8/8/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 073890 -01 50:452.1383 N
Corrections /Comments /Instructions:
ccrtcsL fr
X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector( \ \S\ Date: I •Z Phone #: (503) 718-