Permit r .� CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00062
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/21/2008
PARCEL: 25111 CC -11300
SITE ADDRESS: 15910 SW GREENS WAY ZONING: R -12
SUBDIVISION: SUMMERFIELD NO.2 LOT: 140 JURISDICTION: TIG
PROJECT: GILLILAND
Project Description: Re - pipe all internal water pipe.
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: SEWER LINE: ft
WATER CLOSETS: WATER LINE: 300 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
SEDIA GILLILAND
15910 SW GREENS WAY Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 2/21/2008 $147.80
[TAX] 12% State Surch 2/21/2008 $17.74
Phone : 503 -639 -4152 Total $165.54
Contractor:
BOB'S REEDVILLE PLUMBING
5976 SE ALEXANDER ST #C
HILLSBORO, OR 97123 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 -356 -8832
FAX 503- 356 -5245
Reg #: LIC 168233
PLM 34 -342PB
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 callin. 503.246.6699 or 1.800.332.2344.
Issued By: ! d r Per 'ittee Signature: ///` //G/./
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.
21 08 08:44a Bobs Reedville Plumbing L 5033565245 p.l
RECEIVE.
Plumbing Permit Application FOR OFFICE USE ONLY
FEB 212008 R eceived
City of Tigard /
IN q 13125 SW HagBlvd -, Tigard O Date/By: y: , A= PPermit No.: /1 due g ` . TIGAR Plan Review
Phone: 503.639.4171 Fax: 50 5 196 ®F
Date/By: Other Permit No.:
TIGARD Inspection Line: 503.639.41 1 DIVISI D at eReed B lads: 9J See Page 2 for
^� Y
Internet: www.tigaid or,gov N Notified Metho d: Supplemental Information
• TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist
Description I Qty. I Ea. I Total
Addition/alterationfreplacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
- 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 INFORMATION AND LOCATION _ Site utilities
Job site address: 'C' _3 , (C,' ,'. (-/S -i .. L.% Catch b asin or area drain 16.60
�.> �/l . 1. -
City/State/ZIP r ' 9 f� 3 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: Project name: Footing drain (no. linear ft.: ) - Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
I / 2 r - /- f\ Manholes 16.60
X ‘.5 r.(ff?/ igr i r }"--- Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2 ' I
Subdivision: I Lot no.:
Water service (no. linear ft.: ) / Page 2 l iy 7,
Fixture or item
Tax map /parcel no.: Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
7 7',./ "' ,r) < 2 /" .- C t -7, Backwater valve 16.60
/-J -I-e- Clothes washer 16.60
Dishwasher 16.60
,-PROPERTY OWNER El TENANT Drinking fountain 16.60
Ejectors /sump 16.60
Name: C- / - �"' /l' /7 Expansion tank 16.60
Address: / < < C �/(- /� J �.(, C /
,_) ��� � C �.: � %� '. _ .� -� � Fixture/sewer cap 16.60
U" Floor drain /floor sink/hub 16 -60
City/State /ZIP: /, <� �;•�G/ (..::/<, �' -��� t
Garbage disposal 16.60
Phone: (.rx b �,_ t //5 Fax: ( ) Hose bib 16 -60
APPLICANT ❑ CONTACT PERSON -
1 _I // / Ice maker 16.60
Business name: ; - S /F :,c,' 6,4. pX (/; (.4 1� l { . Cr Interceptor /grease trap 16.60
Contact name: t7 A a' i7 f c (1R't'r. //U //i 1. , �,. zi -/ - fc',•; y '�./ iy / / - / 7 Medical gas (value: S _) Page 2
Address: 5 /�' .5E A�tr- it�a71(,- 1e,t -S / -g(1... / Primer 16.60
City /State /ZIP: // 9: �7/"?_ Roof drain (commercial) 16.60
�7 / �Sl / �� 1 C Sink/basin /lavatory 16.60
Phone: ( _ 7 ) J� - S / j 2 Fax:: (,,- ), jJ� >:.) y-.J C Tub /shower /shower pan 16.60
E-mail: ." 74: h6f. i/j / I f8'7.?L%'f '4iz/,7KY/ /,?/ . )/i/'t'F.'JG -- ce L. Urinal 16.60
/ . CONTRACTOR :7-
/ Water closet 16.60
Business name: ' J�. L ', Water heater 16.60
Address: Other: Subtotal j it ?,ci
City /State /ZIP; Minimum permit fee: $72.50
Phone: ( ) Fax: ( ) - L / 9 v Residential backflow minimum permit fee: $36.25
CCB Lie.: / &', / YIBM Plumbing Lic. no.: y,7 Plan review (25% of permit fee)
State surcharge (12% of permit fee) 1 7, 7 /
Authorized signature: / ✓ !, / TOTAL PERMIT FEE 5
Print name: x'� r it . ?h , '21 ` - Dater This permit application expires if a permit is not obtained within
pg 180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
P\ Building \Permits\PLM- PcrmltApp.doc 06/26/06 440- 4616T (10102JCOM0NEB)
CITY OF TIGARD
BUILDING DIVISION
PERMIT #: PLM2008-00062
I 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/2112008
Phone: (503) 639-4171 p
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 2/2&20O TIME: 7:00A1v1 PAGE: 69
SITE ADDRESS: 15910 SW GREENS WAY CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.2 LOT #: 1210 TYPE OF USE:
PROJECT NAME: GILLILAND
DESCRIPTION: Fte-pipe all internal water pipe.
OWNER: GILLILAND, SEDI A PHONE #: 503-639-4152
CONTRACTOR: DOB'S REEDVILLE PLUMBING PHONE #: 503-356-0832
Inspection Request Scheduled For: Date: 2/26/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 065600-01 503-848-2876
Corrections /Comments/ Instructions:
Gait ci
X PASS PARTIAL APPROVAL EI CANCEL fl NO ACCESS
I FAIL [ CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
Inspector: C -6\1 / ---4 - - ' -\( \t" --e Date: D tit] ( Phone #: (503) 718-