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Permit ; CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00431 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/20/2007 PARCEL: 1 S134CD -00300 SITE ADDRESS: 11995 SW KATHERINE ST ZONING: R -4.5 SUBDIVISION: LERON HEIGHTS NO.3 LOT: 073 JURISDICTION: TIG PROJECT: SCOTT/YOUNCE Project Description: Replace 35' of sanitary sewer service. CLASS OF WORK: OTR 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: 35 ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES BRIAN SCOTT & LU YOUNCE 11995 SW KATHERINE Description Date Amount TIGARD, OR 97223 [PLUMB] Permit Fee 9/20/2007 $72.50 [TAX] 8% State Surcha 9/20/2007 $5.80 Phone : 503 -579 -6687 Total $78.30 Contractor: ARS RESCUE ROOTER 28655 SW BOONES FERRY RD WILSONVILLE, OR 97070 REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 685 -9050 FAX 503- 685 -9381 Reg #: LIC 127325 PLM 34 -168PB 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 rul :uestio• to OUNC by calling 503.246.6699 or 1.800.332.2344. Issu By: LLIQ Permittee Signature: ` 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. ..:.: ;. Plumbing Permit Application FOR OFFICE USE ONLY • City of Tigard Received 7 Permit No.: �(�/ /�io 5/ n 13125 SW Hall Blvd., Tigard, OR 97223 Date/By: g Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Date /By: Other Permit No.: TIGARD Inspection Line: 503.639.4175 Date Ready /By: Iur El See Page 2 for Internet: www.tigard - or.gov Notifed/Method: Supplemental Information „ „. , _....., .. .. rt _ -oaf <' :.ate ;� ;a »R .*; �•h,;:. ' ��, >. �c: < <..,, "�.... ,�. ..- tea; -: .. s *ti � , �iE CH E DU LE-- ; , , � . . .. , , ,,,� .... , . , , �,. T.YP,E :O F �i.ORK . h� _.. . P , ., �,�; ti %„ •,....• „-;, '''':',',';-;,/,4.,::: ° ' , . -'0:‘, : , .. v ,. .. -._• ,,, s ,< For special information use checklist. ❑ New construction ID Demolition Description Qty. Ea. I Addition/alteration/replacement [1] Other: New I- 2- family dwellings (includes 100 ft. for each utility connection) , F �s,a ;.,, . '," "'� '' i � ' - :" C TEGORX. OF °C©NSTRUTION- ; SFR (1) bath 249.20 1- 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 ,.. yam,; OR .,,, MATIO > c , w ......, ,,,, TION`.,;,.;:; � - e:JOB" SITE"' =INFN= AND' LOCA ,;: ; "•.,,.. "'� ?. ` - tee �.. - ..: ,:• , , .... Site utilities Job site address: // 9'42 _ G 0) Y7�i.Y�IIM� � � Catch basin or area drain 16.60 City /State /ZIP: -n j o red ", o 9` 4z Drywell, leach line, or trench drain 16.60 Suite/bldg./apt. no.: Project name: Q Footing drain (no. linear ft.: _) Page 2 �" ' om ( ' �1n � Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 S 12.1 p sr AV Rain drain connector . 16.60 Sanitary sewer (no. linear ft.:.i S) J Page 2 5 O Storm sewer (no. linear ft.: _) Page 2 Subdivision: I Lot no.: Water service (no. linear ft.: _) Page 2 Fixture or item Tax map /parcel no.: Absorption valve 16.60 . DESCRIPTION „ .OF.WORK , , , ,, , `` � _�" venter Page 2 . ;.; o `" Back fl w pre d gitf 3 3 oh � t r'O' pJM - ost i Backwater valve 16.60 j -w. ( f t� tJ � .a W "� Clothes washer 16.60 f ► KO Dishwasher 16.60 a � ..., ,�,;,; -�A ( Drinking fountain 16.60 D ki PROPERTY':OWNE , - - ` ' T <' ;,, .;,,-,•:,. - ., ...:. .... '::lY i ., Ejectors/sump 16.60 Name: Sri f Lo Ml 2 . ,. Va(d /^ice Expansion tank 16.60 Address: / I q9S 'C ' in.A - Sr Fixture /sewer cap 16.60 City /State /ZIP: !l ayd rt 677 Floor drain /floor sink/hub 16.60 Phone: (5 �. .�. b W � l ,7 ' Fax: ( ) Garbage disposal 16.60 «,mss• PLICAN :_ T ".., . . ,.,,,: Hose bib 16.60 P RS : N : E x - v • AP, -:` A,;CO Ice k 16.60 Business name: A S R G gcx) i--vie LLL, Interceptor /grease trap 16.60 Contact name: c f )I r -. 503-7-0 -4-16 0 Medical gas (value: $ ) Page 2 Address: 2s ` t [? Primer 16.60 City/State /ZIP: /, /f � ClfilL 0k ' ct 707-a Roof drain (commercial) 16.60 ( SV.,3 ) (Q Pt5-- os� f Fax: : ( 3) 66›s--....1 l p Sink/basin/lavatory 16.60 Phone: Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 �:f?: ' COIVTRAGTOIi' 16.60 _... . „,,,,.. .� ...... �. . Water closet Business name: S p it2/36U&L- IZZ i Water heater 16.60 Address: Z�S-S YiA ta ct ,c f' M Other: Subtotal City /State /ZIP: IA 1 A1'/ ; /�D T1. �3 Minimum permit fee: $72.50 q �� Phone: i5!(3 ) ._ q 8 � (s�; ) 6� c 9, g Residential backflow minimum permit fee: $36.25 ( ,/i _ CCB Lic.:_ _Plumbing Lie. no.: Plan review (25% of permit fee) State surcharge permit fee) J • g�- Authorized signature: fi j . r., .� TOTAL PERMIT FEE 7 cc • 3 D Print name: ( Date: This permit application expires if a permit is not obtained within ��r�il �"" r 9 � / 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. I: \Building \Permits \PLM- PermitApp.doc 06/26/06 440 -46 16T( I 0 /02 /COM /WEB) • CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2007-00431 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 912012007 Phone: (503) 639-4171 ropp JA Inspection Requests (24 Hrs.): (503) 639-4175 „I- IL INSPECTION WORKSHEET FOR DATE: 9/21/2007 TIME: 7:00AM PAGE: SITE ADDRESS: 11995 SW KATHERINE ST CLASS OF WORK: SUBDIVISION: LERON HEIGHTS NO.3 LOT #: 073 TYPE OF USE: PROJECT NAME: SCOTTNOUNCE • DESCRIPTION: Replace 35' of sanitary sewer service. OWNER: SCOTT & LU YOUNCE, BRIAN PHONE #: 503-579-6687 CONTRACTOR: ARS RESCUE ROOTER PHONE #: 503-685-9050 Inspection Request Scheduled For: Date: 9/21/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 505 Sanitary sewer 056107-01 503-209-7190 i•-/e& Corrections/Comments/Instructions: ( - 7 are ci •va tc...„,k PASS PARTIAL APPROVAL El CANCEL fl NO ACCESS I I FAIL CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED Inspector: (r6V1\'V—a— Date: .9 12,1)(0 Phone #: (503) 718-