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Permit , mi 1 , tiTY OF TIGARD PLUMBING PERMIT ° ` COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00487 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/1/2007 PARCEL: 2S 102 DB -07000 SITE ADDRESS: 09173 SW HILL ST ZONING: R -4.5 SUBDIVISION: CHELSEA HILL NO.2 LOT: 047 JURISDICTION: TIG PROJECT: NELSON Project Description: Bathroom remodel. 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: 2 OTHER FIXTURES: TUB /SHOWERS: 1 SEWER LINE: ft WATER CLOSETS: 1 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES CINDY NELSON 9173 SW HILL ST Description Date Amount TIGARD, OR 97223 [PLUMB] Permit Fee 11/1/2007 $72.50 [TAX] 8% State Surcha 11/1/2007 $5.80 Phone : 503- 746 -4370 Total $78.30 Contractor: EXCELLANCE PLUMBING LLC 7520 SW 140TH AVE BEAVERTON, OR 97008 REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 643 -3459 Reg #: LIC 175678 PLM PB344 • • 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. Issue By: ./ Permittee Signature: ,•aa 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 • • oject. Approved plans are required on the job site at the time of each inspection. Plumbing Permit Application Pui97_cd J u risd ictioil name' ,,, r .17- TYPE OF WORK FEE SCHEDULE ❑ New construction ❑ Demolition For special information, use checklist. Description I Qty. I Ea. I Total . Addition/alteration/replacement ❑ Other: New I- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath Al- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath ❑ Accessory building ❑ Multi - family SFR (3) bath ❑ Master builder Each additional bath/kitchen ❑ Other: Fire sprinkler ( sq. ft.) JOB SITE INFORMATION AND LOCATION Site utilities Job site address: q-7-7 -73 lJ 55/4/ , l) sr Catch basin or area drain City/State /ZIP: yar d, . 0 le 97223 Drywell, leach line, or trench drain Suite/bldg. /apt. no.: / l Project name: Manufactured home utilities Cross street/directions to job site: Manholes Rain drain Sanitary sewer (no. linear ft.: ) Storm sewer (no. linear ft.: ) Subdivision: I Lot no.: Water service (no. linear ft.: ) Tax map /parcel no.: Fixture or item DESCRIPTION OF WORK Backflow preventer A Backwater valve RI A //, f/4 ` ' © d .,` ,, Clothes washer i _ _ • £ / - ,1 r _ /_, �+/ Dishwasher � p� 1�ce de ,Y 2 57ie Drinking fountain , Ejectors/sump PROPERTY OWNER I 0 TENANT Expansion tank G //(, f n / vC L..50 Fixture /sewer cap Name: 1 7./ 5 'e / // 9 Garbage drain/floor disposal sink /hub Address: 1'l� Garbage disposal City/State/ZIP: T 9a jrd 0e 9722 3 Hose bibb Phone: 9 3) 7 �( 0 ' 7o Fax: ( ) Ice maker ❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap L Medical gas (value: $ ) Business name: 0 i /4, 1 ��/ ./..e 2. Contact name: "'Scar u"t'7 b /)7/�.f�L�.., , I Roof drain (commercial) Address: 79 S� l f • �1 ..ye Sink/basin/lavatory 2.. /t ' 5.6 • Vv City/State/ZIP: L aver-to/7 0P- ?7007 Tub /shower /shower pan / /( 40 /0.6 lt /_ y/ _ y5 q ( ) Urinal Phone: 4 � ( 5 J (!/ T J / / Fax: : /' E -mail: eu{Je/2 o am/f y -on7 Water closet Ile. 6t) /� 4" — `//"� Water heater COTRACT R' Other: • Business name: a C QDue, Other: • Address: / Subtotal City/State /ZIP: Minimum permit fee 7a . 5 Plan review ( % of permit fee) -$^ Phone: ( ) Fax: ( ) State surcharge (8% of permit fee) E -mail: Plumbing. lic.: P/ 3f TOTAL PERMIT FEE 7 c', 30 CCB lic.: 175 76 9' �j3� // ^ City or metro lic. no.: 93 / This permit application expires if a permit is not obtained within 1 / Y 14 180 days after it has been accepted as complete. Authorized Q Q f signature: Z� 440 -4616T (E /OS /COM/WEB) Print name: J ,4 e / ellen 1 0 Date: /WO 7 CITY OF TIGARD - -- . BUILDING DIVISION PERMIT #: Pl,.M2007- 1)04117 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/1f Phone: (503) 639 -4171 / A �i;� * Inspection Requests (24 Hrs.): (503) 639 -4175 i . ' t ,I L i INSPECTION WORKSHEET FOR DATE: 12/27/2007 TIME: 7 : 00AM PAGE: 45 SITE ADDRESS: 09173 SW HILL ST CLASS OF WORK: SUBDIVISION: CHELSEA HILL NO.2 LOT #: no TYPE OF USE: PROJECT NAME: NELSON DESCRIPTION: Bathroom remodel. OWNER: NELSON, CINDY PHONE #: 503-746 -4370 CONTRACTOR: EXCE.LLANCE PLUMBING LLC PHONE #: 503-643-M59 Inspection Request Scheduled For: Date: 12/27/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 062175 -01 503- 267 -2238 N Corrections /Comments/ Instructions: C'a PC/ C s ■,r,. L---1 ii \PASS _PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL — CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Q L1JN-. -v Date: k' -) 10 Phone #: (503) 718 -, CITY OF TIGARD - .. BUILDING DIVISION PERMIT #: PLM2007 -004L 7 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/1/2007 Phone: (503) 639 -4171 u , y e� Inspection Requests (24 Hrs.): (503) 639 -4175 ...' W L. INSPECTION WORKSHEET FOR DATE: '11/7/2007 TIME: 7 :00AM PAGE: 47 SITE ADDRESS: 09173 SW HILL ST CLASS OF WORK: SUBDIVISION: CHELSEA HILL NO.2 LOT #: 047 TYPE OF USE: PROJECT NAME: NELSON DESCRIPTION: Bathroom remodel. OWNER: NELSON, CINDY PHONE #: 503 - 746 -4370 CONTRACTOR: EXCELLANCE PLUMBING LLC PHONE #: 503 - 643 - 3459 Inspection Request Scheduled For: Date: 11/7/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough -in 059148-01 503.643-3459 N Corrections /Comments/ Instructions: • Dgt PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: CTIAN) 1 \� n^^— Date: 11 NO Phone #: (503) 718-