Permit CITY OF TIGARD
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PLUMBING PERMIT
A COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00086
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/2/2007
PARCEL: 2 S 114 BA -05100
SITE ADDRESS: 09850 SW KENT CT ZONING: R -4.5
SUBDIVISION: PICKS LANDING NO.2 LOT: 089 JURISDICTION: TIG
PROJECT: CUMMINS
Project Description: Backflow preventer for irrigation.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
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: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
CUMMINS, EUGENE A AND Description Date Amount
JEAN H
9850 SW KENT COURT [PLUMB] Permit Fee 3/2/2007 $36.25
TIGARD, OR 97224
[TAX] 8% State Surcha 3/2/2007 $2.90
Phone : 503- 620 -0237 Total $39.15
Contractor: •
DETEMPLE CO INC
1951 NW OVERTON ST
PORTLAND, OR 97209 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 227 -2641
FAX 503- 274 -7686
Reg #: LIC 2510
PLM 26 -25PB
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 -B • - — -� . -�` P_ermittee_Signature:_ (1T ■%
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.
. °h ,k. /O1 /2007/THU 03:10 PM DETEMPLE PLUMBING CO FAX No, 503 274 7686 P. 001
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(,),,„-, Plumbing Permit Application .. 1:()R OFFICE USE ()\1,1
City of Tigard . e .r b Wilt 7 ■ / I Permit 7_007 - 000 ?(�
II
■ 13125 SW Hall Blvd., igarcOR197223j Plan Rev'.
m Phones: 503.639.4171 gu0-, 1503.598 ;1960 Other Permit No.:
DateB :
Inspection Line: 503.639.41k75jr• ' j '101 Daze Ready/By: hurls; Et See Page 2 for
T' 6 A 1:D Internet: www.tigard- or.gov 6 1, L Notified/Method: Sobgkmet tal lnfonnadon
❑ New construction ,. ! sJ, e tn 0 l i tio n - 01 l For special XnlormaAton use checklist
t Description Qty, Ea. l Total
• ® Addition /altcration/replaoement '1/4. ❑.Qtr: New 1- 2-family dwellings (includes 100 ft. for each utility connection)
ti :; �.:,,:r,:
:'c.:% �' 124Gti r as Q Nt;,?TIJr:. ;4 "s; -` SFR (1) bath 249.20
® 1- and 2- family dwelling El Commercial/industrial SFR (2) bath 350.00
❑ Accesses building ❑ Multi- family SF?. (3) bath 399.00
Each additional bath/lcitchen 45.00
❑ Master builder ❑ Other:
�,, „ �, _ y �;_,. _ } _. ,. Fire sprinkler ( sq. ft.) Page 2
.. ..': ,..,..., , ... ..:.._:_.._......:.,4....,,.... „, . ........::...... .... ....... , Site utilities
Job site address: 9850 SW Xent Cl. Catch basin or area drain 16.60
City/State/ZIP: Tigard, OR 97224 Drywall, leach line, or trench drain 16.60
Suite/bldg. /apt..no.: I Project name: Cummins, Eugene Footing drain (no. linear ft.: ) Page 2
-- . Manufactured home utilities 110.00
Cross street/directions to job site: 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
Fixture or item
Tax map /parcel an.: Absorption val •
. . ' §G ..1 . ,,. .,. ,!,!:'..1.!':;;• ..... Backflow preventer 1 Page 2 27.55
Install backflow device Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
• :3 : . ; Drinking fountain 16.60
; r. ..4 w ` ,, ... 1 _ NAN ,. ; Pjeetor8 /sump 16.60
Name: Eugene Cummins
Expansion tank 16.60
Address: 9850 SW Kent Ct. Fixture /sewer cap 16.60
City /State/ZIP: Tigard, OR 97224 Floor drain/floor sink/hub 16.60
Phone: ( D / 0 ... 1 Fa?C: ( ) Garbage disposal 16.60 .-
c, :' Tlose bib 16.60
- - Ice maker 16,60
Business name: Interceptor /grease trap 16.60
Contact name: Medical gas (value: $ ) Page 2
Address: Primer 16.60 '
City /State /ZIP: Roof drain (commercial) 16.60
Phone: ( ) I ,F.. ( ) Sink/basin/lavatory 16.60
Tub/shower /shower pan 16.60
E-mail: . Urinal 16.60
„ ...
r.i -: ..£ ,1, '" '' ;: �' 1660
r .>; ::�Q�' � ...•�:. - Water closet -
Business name: DeTemple Co., Inc. Water heater 16.60
Address: 1951 NW Overton Other:
City /State/ZIP: Portland, OR 97209 Subtotal 27.55
INanimum permit fee: $72.50 36.25
Phone: (503) 227.2641 Fax: (503) 274.7686 Residential backdow minimum permit fee; $36.25
CCB Lic_: 2510 Plumbing Lie, no.: 26-25 1,43 Plan review (25% of permit fco)
"fie l - -- - ' - - - State surcharge (8% of permit fee) 2.90
•
Authorized signs r TOTAL PERMIT FEE _ _ - 39 = 15
Print name: Shelynn Garcia ' Date: 03.01.07 This permit application expires if a permit is not obtained within
/,.r _ � ®,��dB! .� od days after It has been lildi accepted as complete.
P II �� D Fee metlnorinlnvV ccY hV Tri- C'quoty t4nitrlinv Inducfiv Service R��ard
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CITY OF �*wu m ��m mnn�o�mnm��
BUILDING DIVISION ^ ~ PERMIT #: pLk820O7O0088
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/2/2007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639'4175 4ml « ��-
INSPECTION WORKSHEET FOR DATE: 3/512007 TIME: 7:00AM PAGE: 43
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SITE ADDRESS: 09850 SW KENT CT CLASS OF WORK:
SUBDIVISION: PICKS LANDING NO.2 LOT #: 089 TYPE OF USE:
PROJECT NAME: CUMMINS
DESCRIPTION: BackDmw preventer for irrigation.
OWNER: CUMMINS, EUGENE A AND, PHONE #: 503'620-0237
CONTRACTOR: DETEMPLE CO INC PHONE #: 503-727'2641
Inspection Request Scheduled For: Date: 302007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 044310-01 503-227-2641 N
Corrections/Comments/Instructions:
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' iii PASS_ - a ARTIAL APPRO\AAL ��
CANCEL NO .
FAIL | 'AL FOR INSPECTION El ADDITIO AL FE S ASSESSED
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napeotoc Oede�� � ~� �/ Phone #: (583)718'
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