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Permit
7 1, 1 d ( ;. z CITY OF TIGARD • PLUMBING PERMIT COMMUNITY DEVELOPMENT PERMIT #: PLM2007 - 00286 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/5/2007 PARCEL: 2 S 110 D D -90592 SITE ADDRESS: 10840 SW MEADOWBROOK DR 59 ZONING: R -7 SUBDIVISION: SUMMERFIELD BROOKSIDE CONDO LOT: 059 JURISDICTION: TIG PROJECT: CHILDS Project Description: Relocate drain (other fixtrures) for tub to shower conversion. 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: 1 TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES CHILDS, ALTON B + JUDY F 10840 SW MEADOWBROOK #59 Description Date Amount TIGARD, OR 97224 [PLUMB] Permit Fee 7/5/2007 $72.50 [TAX] 8% State Surcha 7/5/2007 $5.80 Phone : Total $78.30 Contractor: MRP SERVICES PO BOX 33585 PORTLAND, OR 97292 REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 652 -2626 FAX 503- 241 -6565 Reg #: LIC 106824 PLM 3 -265PB 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. C—eci .. Issued B d§.�UVI0..,„ Permittee Signature: 004Y\ — U , 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 Ate- WE'D FOR eal'1'l(UE 1.1,k, ONL1 City of Tigard e/ By: 3 (57 Pe No.: al J�'� 2,069 �D Z� 13125 SW Hall Blvd., Tigard, OR 97223 �UL Q 3 2007 Plan Review other Permit No.; Phone: 503.639.4171 Pax 503.598.1% ` ..= = ; k . 1� `<• Date/By: . 24- Hour Inspection Line: 503.639.4175 G , 1 ©f, i IGR`� ! I j, . I L Date Ready /By: Internee www,ct tigard.ur us . a 1 1l Notitind/Method: 1 1.ur El See Page 2 for i s Supplemental tafor enatioa .� ,ia a='4 }SR{Y�T3 .r'1�v>;n�,ra } nf1.f .3 i r° .i�lY �^yry�.'c�7�i.'- u• -`ar�V ° ''�<. a,a.Yi '„ ,r I i -7--;; �' '! y s, y 7i ' :h t4'f i �I'l of ..r al >' y: > ~ y ! °{': • .,..f�wr. ii,' 7;. i .. ; :ik,) i I j .1 Y f,:S.. i j 4E 4 : R4 . 4.ty ...34 :+,[;, �TaSt��'i1�6" [a ..w :..I j�°' YI ,tti .r�s( rt'.•V''^ ... _.- . . r _ ❑ New construction ❑Demolition Far special i(arma1L n use checklist - -- - - _Description I Qtr• I Ea. Total ! ■ ∎ Addition /alteration replacement . ❑ Other. New I- 2- ramily (includes 100 ft. for each utility connection) ql � i!I. - 7 r,. a y 1 �, h.. 4 , r 7, - .44,0 - 1.;';'21;•:: ` Y �' i .'_ ' SFR(1)bel 24920 0 >= - 1- and 2- tinnily 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 ( ne ft z-• �• 17 - c sF� lr✓ qP SQ• ) P e 2 fi�.rtiyf � f i� h1. L� F >Y 1.f )� r ^ I U L 6. I , U y : }t 9i�'�y� „ ° , . , _i„'_ M ;sa.,c , . a .:-.g4 •1 ts4 1,.-; . _ ;d. , , :, SIM utilities Job site address: 01i' i ml m r ` l .i' /] . i j raVin Catch basin or area drain 16.60 City/State/ZIP' f t Drywell, leach fine, or tench drain 16.60 eJbld a no.: Project name:: ' r Footing drain (no. linear ft - Page 2 Suit - P .m ;Ive , "Mir ri Manufactured homcutilities 110.00 Cross street/directions to job site Manholes 16.60 Rain drain connector _ 16.60 Sanitary sewer (no. linear IL: ) Page 2 Storm sewer (no. linear it.: J Page 2 Subdivision: I Lot no.: Water service (no. linear ft.: ) Ma 2 Fixture or Item Tax map /parcel no.: 1.6.60 /�,, � L _ �.�-s, Absorption valve 'argil f' r, s� G ' UIV 1 U L '' •'�1�,`:�> YQ'.+1Ji 6T'�' 4 ,i ?. r y YYs, ,.�£ -f a !' J.,l F$cafav 1. G �"i� {{ �0 �' k _ S v�xe 3 : u BaC1�10W prCVG7lter Page Z Backwater valve 16.60 E 11 . r� m!l '� `�i. �1 . 1 I :_IY m _ lam'! m % t . ti . Clothes washer 16.60 f e 1 , ` I ,� ,. 1 Dishwasher 16.60 � g b , [� j n i i: > ;F/� ', Drinking fountain 16.60 � i' I•� y..� 11 � Y ) \ M1' j � } � "'C Y �;f�,.'�� J Y. � G � } �,� �. _ a„y J 4 , I n : / I . :, ... r ),.. S. ' b'l a 04-i• l IAj�. J P,•�: 7 f43GV+ 1 /: to r -�vx 16.60 t„ •;,� ,,� �. °j� r � --= --- � - i..: `�S��: �' Ej ectors / - �l t I�p f � �� Expansion tank 16.60 Address: l I A l� ! .s; 6�1 141'ry1 Fixture/sewer cap 16.60 City/State/ZIP: r WM E r Floor drain/floor sink/hub 16.60 Phone: iallaTIVISI MEI Fax: ) Garbage disposal • 5 ram a\ l;ux i�T': ' x - ssri'` 'x••� l:: 1 Hose bib 16.60 •• _ ]ce maker 16.60 Business name: I " g r - s -' E _ Interceptor /grease trap 16.60 Contact name: A-B R-1 Ai 14.. T f A1 9)/v Medical gas (value: S ) Page 2 Address: 1 • . r . ttio Primer 16.60 / p ) a Roof drain (commercial) 16.60 I� { "�•' ��` � Sink/basin/lavatory 16.60 rtl t Phone: , / j) , .,_ - Fax:: O r Q � a ' Tub/shower /shower pen r 16.60 I (p., 66 E -mail / 1.I s t I v r ' / � Urinal 16.60 ��tY -7 ,i� t ' I� 1 Y y I,-21';';,', u y - V } r , c }, + }I �i ,, , : 3� i ( .4 ; , i .. / ' y o t k.X'= ry. 7 , ,,,, .- i ,,A.,, i N r .a i >LkrMG v ., S . C Water C 16.60 i�'z`>'t+r< `• ��tc_ _ ,� _�Smw.. .+:�T �.. .... � �'�al'xi " n A� �# 71a 16.60 l�iir,iili � I ■ t.� � �. a 1 • _ taut heater Address: 0 I I Other. ( I City/State/ZIP t 11 : �� fit ' r Minimum permit tee: $72.50 / ) Phone: a3) , a ^ ,` , �i • I , ciim Residential backfl Subtotal ow minimum permit fee: $36.25 7a .56 t 13 Plumbing 3 j r c / Q Plan review (25% of permit fee) CC13 Lie.: Pleunbi Lic no.: 3 O to y i .. State surcharge (8% of permit fee) , Authorized signature: `: s - SO4) r7. TOTAL PERMIT FEE 92 0 Print name: Sodomy A. #yt1 ) I Date: . - o9 This permit application expires if a permit is not obtained within 180 days after it lens been accepted as complete. "Fee methodology set by Tri -County Building Industry Service Board. is l0uildinaWmmitiWLM- PamitApp.doc ONOS 440.4611111ot 21cQMlWta) Z0 /Z0 39Vd delta 5959It'ZE09 ZO :VT L00Z /E0 /L0 CITY OF TIGARD -. BUILDING DIVISION - PERMIT #: PLM2007 -00286 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/5/2007 Phone: (503) 639 -4171 tlj�l� Inspection Requests (24 Hrs.): (503) 639 -4175 ' " �:_— INSPECTION WORKSHEET FOR DATE: 7/17/2007 TIME: 7:03AM PAGE: 84 SITE ADDRESS: 10840 SW MEADOWBROOK DR 59 CLASS OF WORK: SUBDIVISION: SUMMERFIELD BROOKSIDE CONDO LOT #: 059 TYPE OF USE: PROJECT NAME: CHILDS DESCRIPTION: Relocate drain (other fixtrures) for tub to shower conversion. OWNER: CHIILDS, ALTON B + JUDY F, PHONE #: CONTRACTOR: MRP SERVICES PHONE #: 503 - 6512626 Inspection Request Scheduled For: Date: 7/17/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough -in 052021 -01 503-652 -2626 Y Corrections /Comments /Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 0 li Date: 7) � I D —7 Phone #: (503) 718-