Permit O Y OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00195
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/8/2008
PARCEL: 2S104CD -02200
SITE ADDRESS: 13714 SW HILLSHIRE DR ZONING: R -7
SUBDIVISION: HILLSHIRE ESTATES LOT: 022 JURISDICTION: TIG
PROJECT: LOOP
Project Description: Replacing 50 ft. of water service
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: 50 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
CURTIS & C LOOP
13714 SW HILLSLURE DR Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 5/8/2008 $72.50
[TAX] 12% State Surch 5/8/2008 $8.70
Phone : Total $81.20
Contractor:
CROWN PLUMBING
5429 SE FRANCIS
PORTLAND, OR 97206 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 -771 -9449
FAX 503 -771 -9454
Reg #: LIC 42671
PLM 34 -70PB
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 Permittee Signature: �- . � /261)75
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.
05/07/2008 ! 07:42 5037719454 CROWN PLUMBING PAGE 01/02
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A RECEI
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13 SW Tigard C D VISA n"111". J
13125 SW Mall Blvd., Tigard, , OR 97223 p1NG 1 Aex w r; (� 4 • an Review other Pe
I Date /By; B{ Sec Par 2 f or
Phone: : ill - }l r Inspection Fax; 503.639. 175 1 ' ' { ^ • Date Ready/! y
S ap pt rm c o r al information
our Ins!
rcelion Line: 503.(139,4175 Notified/Method; ' lye ;(r,' :"'�'Ik,;r1 s °�
rd.Ar.1 N;.�L�4; 'd :7i''�i�� "�'r(i lrY��l�l�.�i ,r`; };�; ti,Ser�; J!�� •�{lati'J17or+W� .,��! J+ .,
Internet: www.Cl.tiga ,, ir l.4c 11q“. rStt �, r �l 'ly r. ii i(. n •r
a t14r '1. e r ", } ;,'v For special in {o rmnrion use checklist_ J � T �� _
i i • ?4 {� /q i.+ i4 yr?u,, i , t " n . ,„ .,, „ ,i , n Qty. Ea.
Demolition Description
( 1Jew construction `
t M1; i;: ; ,F 249.2.0
0 Other: New 1 2 family dwellings (includes 100 ft. for cash utility connection)
Addition/alteration/replaceme „ I .RfK 151. a 1 ,
'E IV d "� �ra'�I ''� ra hc'n7(,r „ ';' f r SFR bath
r hr a I a L er ) — _--- � 199,00
C] Commercial /industrial
-- 1.- and 2 family dwelling SFR (3) bath 9 9 00 �^ NM _ e� D Multi- family Each additional bath/kitChcn
0 Accessory building 9 ft.) Page 2
(I � 9
Master builder Other: Fire sprinkler ( qq�� 1
' �d 7 ,77 - - ,y �r , ; � l " 1''`'�t`� 't�� iT' : r . ,,. , . ,• Sit C Utilities
r ,.
y d{ ! (, r��? ? �� • � � • .i, Catch basin or area drain - T --'- --
Job I 37i 11sL:ra- py. 16.60
s wa•e •
Sob site address: 1 7 r y w c1l, leach line, m• trench dram __
__���_ Paltc2
City/State/ZIP: - I - r .� a 7 F ooling drain (n o, linear It,: ) I Page
Slite/bidolapt no.: Project name: L �� Manufactured home utilities
16.60
Manholes 16.60
f'rnss strecUdirccHons to job site: Rain d rain connecter
—�-� Page 2
Sanitary sewer (no, linear ft,: �__)
- Page 2
Storm sewer (no, linear it ! ,„^) Page ' �p
_�,.� -.� �-- Page 2
,,2= / .S d
_ Lot no.: °� -
^`J�' — Fixture or item Water service (no" linear ft. ; - -• :=T. '
Subdivision: •— '�^ ..1-"(i .4
� ._--- AbSn8llinn valve
map /parcel ^': !i i,P r• p "e :4 „il` I 1� � .':',: ' �Y�;l �' , I' ); iI . Back lbw prevcit ter Page 2
01 5 1 fi.60 - -.
�'ilri. d'1nY a!X;xPX„ ye. ' : ” ' ' ,
n r P'` rM. Backwater valve
i..) �, ,.. � 1b.60
�q �►,a�t_ ue� v��— �^ Clothes was Dishwasher •^16.60
�� 16.60
.. - ... — ..- -� �, p r i n ki ng (1?umain —
, :' Asti i ! ° i ail r i, i S"i dr 1°'a ( ii lrr � l , I(1.60
Name: C ,w,i ., � � ,�, f ' �u ;� � • h i n Fioctorslsump
4 rl :'1' iV; �., ” r„ !'( n' 16.60
F,xpansiontattk NI
� Fixture/sewer cap
Address: �--� _.. 16,60 �^
J Floor drain/floor tin /flenr sink Rrub _
City/State/ZIP: disposal �.
__
_ _ �� Garbage disposal 16,60
10.611
Phone: ( ) „'
ol. ;,,' . r { ?4 h is , fi r �� , , ,il ,: lr(4',l`,17 {' item 16,6
maker I.:;,: I r � { ;�if1 1 >h 0 5 ,1,. I � �'1,v2;h : > ,(,„4,,.: , r,,: �.,,..� 16.60 -
j _.. i � G .w O Interceptor/grease trap . --- .
Business name: C r �.,�w r +} ...... i __ 3 - -e trap Page 2 � ^_
M edical gas (value: $ )
Contact name: �, •,, 1 •caaf+war� Primer 16.60 ^�
Address: ,� . ,rd" 16 • • r ♦ • - Roof drain (commercial) —111 16.60
City/State/ZIP: P4d'� �e 57Z6 Sink/basin/lavatory 16.60
Sink h 5in0avato
Fax: 3) 7'7/ • ,1f: Tub/shower/shower pan 11111 16.60
_ .. —,M — Urinal 16.60
�
E-mail: ::ra, ;: ( �,.,. - „ 16.60 __
1.:. if( yoil tiSt l' "ir,iir t , ^ ° - > r , ∎,',' , r I iii gn : ^�
� � r •a,u �. � ,�.- �-- ..-- ...`,..�....,., --=�- water heater 16.60
Business naroC. CROWN PLUMBING
_ O tbcr _ "
Address: `6429 SIB FRANCIS STREET 5nbtotal , --
( :ity /Stat&Z[P; PORTLAND, OR 972011 _ �' Mio ' tm pe rmit Ice: $72.50 '.f e
Phone: (603) 771 -3443 , Fax (503) 771 -9454 Residential backflow minimum perm fee: $36, _ I If
_ Plan review (25% of permit t c)
CCI3 Lie.: 42671 Plumbing Lic. no.: / • OPB
A "� State surcharge (04 a l' permit fen) ii, T�
Authorized signature: e TOTAL PERMIT FEE $ /,it0
T his permit' Application expires if a permit is not obtained within
Pr int name: Dennis Underwood o te: s _ 180 days after it hoes been accepted as complete.
" " - *Fee methodology set by Tri-County Building industry Service Board
i :•I1uiiding1PmniN \11.,01- PermitAppAOt 12/03 0140- 411(�I'(1002'C�1M;wL01
•
CITY OF aGJARD _.. :
BUILDING DWISION PERMIT #: PLM200B -00195
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/1/2008
Phone: (503) 639 -4171 m p ,10 1
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 51/3/2008 TIME: 7:02AM PAGE: 24
SITE ADDRESS: 13714 SW HILLSHIRE DR CLASS OF WORK:
SUBDIVISION: HI LLSHIRE ESTATES LOT #: 022 TYPE OF USE:
PROJECT NAME: LOOP
DESCRIPTION: Replacing 50 ft, of water service
OWNER: LOOP, CURTIS & CAROL PHONE #:
CONTRACTOR: CROWN PLUMEiING PHONE #: 503 - 711 -9449
Inspection Request Scheduled For: Date: 5113/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Watermrvice 069794-01 503-771-9449 N
=- Iva k.
Corrections /Comments /Instructions:
CA rit f 94,
X PASS _ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
I I FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: 07: 1 1(4,-.....t___- Date: ,1 13 I'O?) Phone #: (503) 718-