Permit C ITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 - 00399
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/9/2008
PARCEL: 25111 BC - 00600
SITE ADDRESS: 10085 SW INEZ ST ZONING: R - 3.5
SUBDIVISION: TIGARDVILLE HEIGHTS LOT: 019 JURISDICTION: TIG
PROJECT: PARTINGTON
Project Description: Water heater installation.
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: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
PARTINGTON, BRIGITTE AN NE
10085 SW INEZ ST Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 10/9/2008 $72.50
[TAX] 12% State Surch 10/9/2008 $8.70
Phone : Total $81.20
Contractor:
WESTERN PLUMBING
9460 SW TIGARD STREET
SUITE 101 REQUIRED ITEMS AND REPORTS
TIGARD, OR 97223
Contact # : PRI 503- 639 -5296
FAX 503- 684 -9015
Reg #: LIC 2439
PLM 34 -29PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By! Permittee Signature: i� '/c Co, \ c.—i
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
WESTERN PLUMBING 503684901S 10/09/08 09:S8am P. 001
Plumbing Permit Application .. FOR OFFICE USE ONLY
Cl of Ti 1r , 7 ✓" Received
g` d n )v Permit No.: q
Fr '1 13125 SW Hall Blvd., Tigard, OR 972 � QOv Date /Ay: to p�'_ f �� 1
O Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 j�lDate Otl lerPermit No.:
Ins Line: 503 O C� . Akio.)
T[GARD , �(tV ` - fiReadydf Saris' ® See Page 2 for
Internet: www.tigard of gov f t
k‘
II k � Supplemental Information : ° . t . ,, i .J ,," t • ' 'r 6 .Sib i _ i ia. s , ,+ y 5 . t� ¢ €. ' tea l t! , a
- s3. 1$ 4.'' 1 s
El New construction ❑ De . i ' For .special information use checklist.
Description 1 Qty. I Ea. 1 Total
Addition/alteration/replacement Ill Other:
New I- 2- family dwellings (includes 100 ft. for each utility connection)
.: ...1v o . . 01 ,, t t ,�, AN SFR 1 bath
r' ° O 249.20
Iv
11 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
IT) Accessory building 1:1 Multi-family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder 0 Other:
� i tb t,.r }fiol rt,:ruw r ^�,h, �,,� Fire sprinkler
', n i �� {� ,, , - N ,1 10:I '� 1 ( sq.ft.? Page
C' A�, a,.' ` l s, r. .Stn ro -.14.. � . ` -W,:,, '. Site utilities
Job site address: J6O ) l t4 Catch basin or area drain 16.60
City /State /ZIP: 4. Drywell, leach line, or trench drain 16.60 -
Suite /bldg. /apt. no.; ; Pro't ct name: i f / Footing drain (no. linear ft.:
3 A. 0 - lf 1L. lJ,.; -) Page 2
Cross street /directions to job ste Manufactured home utilities 110.00
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 ft.: -) Page 2
Tax map /parcel no.: Fixture or item
n „, t ,�w e �; a t w),., Absorption valve 16.60
° t t M ° t't Backflow preventer Page t
_ Backwater valve 16.60
r }MII i A/' 1 . it Clothes washer 16,60
Dishwasher 16.60
"', ° 4+ ;' t � ,,, r .o.r�x l f, , r t ∎'. t t w "; , t l eh a Drinking fountain 16.60
Sets ,0. . �,,�-
Ejectors /sump 16.60
Name:
Expansion tank 16.60
Address: Fixture /sewer cap 16,60
City /State /ZIP: Floor drain /floor sink/hub 16.60
Phone: ( ) F ax: ( ) Garbage disposal 16,60
;Tilt ii {' P c y a st4 , of s t" x r �' s y ,. I k , , ,f
� ss's I 2. • I ., `� `. w.i a 1 = "., v Hose bib 16.60
i
Business name:
ce maker 16.60
Interceptor /grease trap 16.60
Contact name: Medical gas (value: $ ) Page 2
g
Address: Primer
16.60
City /State /ZIP: Roof drain (commercial) 16.60
Phone: ( ) F ax: , ( ) Sink/basin /lavatory [6.60
-- Tub /shower /shower pan 16.60
E -mail:
j ;` 1 ra1 ' t1 d rr �" �' i., a l t 4 - "r i M 3 � 1 b r Urinal _.._.
F r t= ;9 rkplvi y r.Jt;�', 1 6.60
'�
v �. h O �1 .{ ac; d 16.60
f �5 ' � , _` . � r ^� ,•. x+h#",�.5 ; � i 'r >.� -"� as�ea °i� ��, Water closet
Business name; Western Plumbing, Inc. Water heatei I. 16.60 i 1p ta0
Address: 9460 SW Tigard Avenue, Suite 101 Other:
City/State/ZIP: Tigard, Oregon 97223 Subtotal IiGt CUO
Minimum permit fee: $72.50
. Phone: (503) 639 -5296 Fax: (503) 684 - 9015 `
Residential backtiow minimum permit fee: $36.25
CCB Lic.: 2439 Plumbing Lie. no.: 3429PB Plan review (25% of permit fee)
Authorized signature � r / t j 1 State surcharge (I 2% of permit fee) - • 'J A • "M. _' j� -' `- TOTAL PERMIT FEE �a�
Print name: Dana Jensen Date: H)..g_e This permit application expires if a permit is not obtained within
- 180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
1:\ Building \Porm its \PLM -Porte it App. doe 96/26 /06 440-46 Ira( I 0 /02 /COM/WER)
.: .
CITY OF TIGARD
,...
BUILDING DIVISION ' PERMIT #: m47008-00399
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/912008
Phone: (503) 639-4171 /o/o, •
Inspection'Requests (24 Hrs.) (503) 639-4175
INSPECTION WORKSHEET FOR DATE 10/17/2008 TIME: 7:02AM PAGE: 30
SITE ADDRESS: 10085 SW INEZ St
CLASS OF WORK:
SUBDIVISION: TIGARDVILLE HEIGHTS LOT #: 019 TYPE OF USE:
PROJECT NAME: PARTINGTON
DESCRIPTION: water heater installation.
OWNER: PARTINGTON, BRIGITTE AN NE, PHONE #:
CONTRACTOR: WESTERN PLUMBING PHONE #: r,03.,639_5296
Inspection Request Scheduled For: Date 10117/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plurnbinglinal 076842-01 603-639-5296 N
Corrections/Comments/Instructions:
6 PASS n PARTIAL APPROVAL EI CANCEL . El NO ACCESS
rj FAIL E CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector:(311U1,„..1\...g. Date: f to \ \ \o Phone #: (503) 718-